Browsing by Author "Buelow, Janice M."
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Item Chronic Disease Self-Management: A Hybrid Concept Analysis(Elsevier, 2015-03) Miller, Wendy R.; Lasiter, Sue; Bartlett Ellis, Rebecca J.; Buelow, Janice M.; School of NursingBACKGROUND: Chronic diseases require chronic disease self-management (CDSM). Existing CDSM interventions, while improving outcomes, often do not lead to long-lasting effects. To render existing and new CDSM interventions more effective, an exploration of the concept of CDSM from both the literature and patient perspectives is needed. The purpose of this study was to describe the current conceptualization of CDSM in the literature, identify potential inadequacies in this conceptualization based on a comparison of literature- and patient-based CDSM descriptions, and to offer a more comprehensive definition of CDSM. METHODS: A hybrid concept analysis was completed. DISCUSSION: In the literature, CDSM is defined as behaviors influenced by individual characteristics. Patients in the fieldwork phase discussed aspects of CDSM not well represented in the literature. CONCLUSIONS: CDSM is a complex process involving behaviors at multiple levels of a person's environment. Pilot work to develop and test CDSM interventions based on both individual and external characteristics is needed.Item Discussing Sudden Unexpected Death in Epilepsy (SUDEP) with Patients: Practices of Health-Care Providers(Elsevier, 2014-03) Miller, Wendy R.; Young, Neicole; Friedman, Daniel; Buelow, Janice M.; Devinsky, Orin; IU School of NursingItem Epilepsy self-management during a pandemic: Experiences of people with epilepsy(Elsevier, 2020-06-25) Miller, Wendy R.; Von Gaudecker, Jane; Tanner, Andrea; Buelow, Janice M.; IU School of NursingThe purpose of this descriptive study was to, from the perspective of adult people with epilepsy (PWE) and caregivers of PWE, explore the effects of the current pandemic and resulting societal changes on epilepsy self-management. Ninety-four respondents completed a mixed-methods quantitative and qualitative survey focused on their epilepsy self-management experiences during the coronavirus disease-19 (COVID-19) pandemic. Respondents noted significant disruption in epilepsy self-management. Lack of ability to obtain medications or see epilepsy providers, as well as increased stress, social isolation, and changes in routine were all reported as troublesome, and more than one-third of the sample reported an increase in seizure frequency since the onset of the pandemic. Suggestions are given regarding how to support PWE during future COVID-19 outbreaks and to better prepare PWE and their caregivers for any life-altering events, such as a pandemic, with robust self-management skills that will allow them to maintain the highest level of function possible.Item Goal Development in Parents of Children with Epilepsy and Learning Disorders(Office of the Vice Chancellor for Research, 2014-04-11) Keener, Lindsey; Miller, Wendy; Buelow, Janice M.Epilepsy is the most common, chronic neurological condition in children, impacting 2.4 children per 1,000. Caregivers of children with epilepsy and learning disorders are affected by many confounding factors including complex drug regimens, navigating a complex healthcare system, the uncertainty of their child’s future and the challenge of creating an effective educational program in conjunction with their child’s school. Parents of children with epilepsy and learning disorders participated in the Creating Avenues for Parent Partnerships (CAPP) program. The original study was an experimental design in which parents were randomly placed in an intervention group or a wait list control group. Each group consisted of 25 parents, with a total of 50 parents participating in the pilot test of CAPP. One of the instruments that the parents completed throughout the duration of this interventional program was the Goal Attainment Scale (GAS). In the GAS, parents described their goals related to their child’s condition and care. Using a qualitative and systematic coding system the parent’s goals were categorized based on content and outcomes related to their child. The goals created by parents in this population subset fell into eight distinct categories. The categories discerned during analysis were future oriented, internal/perspective adjustment, interpersonal, maintaining normalcy, education/coordination with schools, interaction with health care professionals, physical fitness, and acknowledgement/fostering independence.. Based on analysis of the goals that parents created within the GAS, parents of children with epilepsy are particularly concerned with the security of their child’s future (both residentially and vocationally), educational advancement in partnership with schools, and improving health status through interaction with health care professionals. For the nurse interacting with patients and their caregiver in this specialized population it is critical to understand the goals that caregivers create in relation to the problems that they perceive as the most significant in their lives. Then the nurse will be able to enable caregivers to meet their goals and improve the health outcomes and overall quality of life in children with epilepsy and learning disorders.Item An Integrative Review of School-Based Mental Health Interventions and Implications for Psychogenic Nonepileptic Seizures(Sage, 2020-02) Tanner, Andrea; Miller, Wendy R.; von Gaudecker, Jane; Buelow, Janice M.; School of NursingMillions of students with mental health concerns attend school each day. It is unknown how many of those students experience psychogenic nonepileptic seizures (PNES); however, quality of life, academic, and mental health outcomes for students experiencing PNES can be bleak. Currently, no authors have addressed potential school nurse interventions for students with PNES. Because PNES is a mental health condition and is often influenced by underlying anxiety and/or depression, an integrative review of school nurse interventions and outcomes for students with general mental health concerns was conducted. An integrative review resulted in the identification of 13 quantitative and 2 qualitative studies that met inclusion criteria. The findings from this review suggest school nurses, following principles from the Framework for 21st Century School Nursing Practice, play an active role in mental health interventions and should be involved in replicating and testing known mental health interventions to investigate their effectiveness for students with PNES.Item Living in the epilepsy treatment gap in rural South India: A focused ethnography of women and problems associated with stigma(Taylor & Francis, 2017) von Gaudecker, Jane R.; Taylor, Ann Gill; Keeling, Arlene W.; Buelow, Janice M.; Benjamin, Sailas; School of NursingIn India, women with epilepsy face unique challenges. A focused ethnography of six women within the epilepsy treatment gap was conducted in rural South India. Women were asked to describe their day-to-day lives. Data were collected through open-ended, semistructured interview questions, participant observation, and field notes. Thematic analysis was done. The disease-related stigma contributed to the women's physical, psychological, and emotional struggles; the women and their family members made every effort to conceal the disease. Educational interventions to create awareness could help women seek effective treatments for their seizures, thereby reducing the stigma and improving the quality of their lives.Item The perception of African American faith-based organizations regarding African Americans with HIV(2015-01-20) Otey, Tamara Dochelle; Buelow, Janice M.; Burke Draucker, Claire; Miller, Wendy Renee; Levy, MarianShelby County has the fastest growing rate of HIV infection in the State of Tennessee and the majority of the people with HIV/AIDS are African Americans. 2011 CDC report stated Memphis had the fifth highest proportion of new HIV infections. The African American church is a natural and potentially powerful venue to facilitate health awareness. The purpose of this qualitative study was to explore the views of African American faith-based leaders (FBLs) toward offering HIV prevention services in faith-based organizations (FBOs). The theoretical framework for this study was the Consolidated Framework for Implementation Research (CFIR). The fourth domain of CFIR, characteristics of the individuals, is concerned with organizational change which occurs on the individual level. CFIR provided a means to ensure effective implementations, data coding and analysis. Interpretative Descriptive (ID) design, which seeks to discover associations, relationships, and patterns within the described phenomenon, was used. The targeted population was African American Faith-based Leaders from areas known to have high rates of HIV and sexually transmitted infections (STIs). Purposeful sampling was employed to recruit participants. Data was generated through face-to-face, semi-structured interviews. The researchers categorized and analyzed the data to form the concepts and themes identified using a coding scheme which was applied to all data. Faith-based leaders revealed that they had a role in HIV prevention. The themes that emerged were their role to provide education on HIV, minister with compassion, teach Biblical doctrine, maintain a community focus, and partner with expert healthcare professionals. Perceived barrier concepts identified were lack of knowledge, denial, stigma, fear, keeping issues private, and the breakdown of family and community values. Findings suggest that FBLs had some knowledge of the health disparities and ongoing stigma concerning HIV remains a major barrier. The participants interviewed were open to HIV preventions on different levels to address HIV but needed more education.Item Preliminary Efficacy of a Stroke Caregiver Intervention Program for Reducing Depressive Symptoms(Office of the Vice Chancellor for Research, 2013-04-05) Bakas, Tamilyn; Austin, Joan K.; Buelow, Janice M.; Habermann, Barbara; Li, Yong; McLennon, Susan M.; Weaver, Michael T.; Williams, Linda S.Background and Purpose: Stroke caregivers who lack skills because of unmet needs are at increased risk for depressive symptoms; which can impede rehabilitation of the survivor and increase the survivor’s risk for costly, long-term institutionalization. The Telephone Assessment and Skill-Building Kit (TASK) is an 8-week follow-up program based on individualized assessment of caregiver needs. The purpose of this study was to explore preliminary efficacy of the TASK program for improving stroke caregiver depressive symptoms. Methods: A subgroup of 15 caregivers who screened positive for mild to severe depressive symptoms at baseline (PHQ-9 > 5) were randomized to the TASK program (n=8) or an attention control group (n=7). Data were analyzed using Univariate ANCOVA, controlling for baseline scores and number of minutes spent with the nurse for each timepoint (4, 8, and 12 weeks after baseline). Partial ƞ2 was used to estimate effect sizes (< .08 small, .09-.24 medium, >.25 large). Results: Although not statistically significant because of the small sample size, medium to large improvements based on effect sizes were found in depressive symptoms for the TASK group relative to the control group at 4 weeks [F(1,11) = 4.15, p=.07, ƞ2=.27], 8 weeks [F(1,11) = 1.66, p=.22, ƞ2=.13], and 12 weeks after baseline [F(1,11) = 1.47, p=.25, ƞ2 =.12]. Adjusted PHQ-9 means for the TASK group at 4, 8, and 12 weeks ranged from 4.9 to 5.9; adjusted PHQ-9 means for the control group at 4, 8, and 12 weeks ranged from 9.0 to 10.8. Conclusions: Caregivers in the TASK group reduced their depressive symptoms to the mild range, while caregivers in the control group maintained their scores primarily in the moderately depressed range. Further testing of the TASK program in a larger randomized controlled clinical trial is warranted and is currently underway.Item Shoulder Pain after Neck Dissection among Head and Neck Cancer Patients(2009-11-04T18:53:26Z) Wang, Hsiao-Lan; Keck, Juanita F.; Rawl, Susan M.; Buelow, Janice M.; Mikesky, Alan E.Shoulder pain was constantly reported as a problematic symptom causing dysfunction and quality of life interference after neck dissection in head and neck cancer patients. Due to a lack of conceptual framework and inconsistency of instrument selection, a comparison among previous studies was almost impossible, making it difficult to understand the phenomenon. The current study applied the University of California, San Francisco School of Nursing Symptom Management Model. The purposes of the study were to (a) describe the symptom experience of shoulder pain at 1 month after neck dissection, (b) describe the relationships among symptom experience of shoulder pain, functional status, and quality of life, and (c) identify the contextual variables, concurrent symptoms, and/or adherence predicting symptom experience of shoulder pain, functional status, and/or quality of life. This was a descriptive study with a convenience sample of head and neck cancer patients. The data were collected via a medical record review, a self-administered survey, and a physical examination. The data from 29 patients were entered for descriptive statistics, Pearson correlations, and multiple regressions. At 1 month after surgery, 62% of patients reported they had shoulder pain at some point within a week. Their shoulder pain was from mild to moderate. Fifty-nine percent complained that shoulder pain bothered them about the moderated level. In the final model, symptom experience, shoulder pain, was significantly correlated with one outcome, active shoulder abduction, but not the other, total quality of life, generic quality of life, and head and neck quality of life. Active shoulder abduction was significantly correlated with three quality of life measures. Adding significant predictors of symptom experience and outcomes into the final model, there is a potential that the model would be useful to guide treatment strategies. Treatment for myofascial pain of the levator scapulae could relieve shoulder pain after neck dissection and improve head and neck quality of life. Those with level V dissection were high risk populations of developing shoulder pain. Risk factors of quality of life, which were depression, loss of sensation, and radiation would describe how an intervention could change or unchange the patient’s life.Item Women’s Experiences with Epilepsy Treatment in Southern India: A Focused Ethnography(NSU, 2019) von Gaudecker, Jane R.; Taylor, Ann Gill; Buelow, Janice M.; Benjamin, Sailas; Draucker, Claire B.; School of NursingWomen with epilepsy in rural southern India often do not receive anti-epilepsy drugs (AEDs) or take these drugs regularly, but little is known about how they experience the epilepsy treatment they do receive. The purpose of this study was to provide an in-depth description of the treatment experiences of women in this region who had been diagnosed with epilepsy but who do not consistently take AEDs. Focused ethnography was conducted using participant observation and in-depth interviews with six women with epilepsy, eight of their family members, and two traditional healers. The women's treatment experiences are best described as living at the intersection of Western allopathic ("English") medicine and traditional healing practices-approaches that could be complementary or conflicting. The women revealed a variety of perceived barriers to the use of "English" medicine. Health care professionals should appreciate the dynamic interplay of the two treatment approaches and consider all cultural, social, and economic factors that influence the women's treatment experiences.