Biomedical subjects

Colleen DiIorio

Publications and source records attributed to Colleen DiIorio.

16 recordsLinked to original sources

PubMed2006

Behavioral, social, and affective factors associated with self-efficacy for self-management among people with epilepsy.

The purpose of the study described in this article was to evaluate the extent to which selected behavioral, social, and affective factors contribute to self-reported epilepsy self-efficacy. Participants completed three assessments 3 months apart, with only those completing both the first and second assessments included in this analysis. Self-efficacy scores at the second assessment were regressed on the behavioral, social, and affective characteristics ascertained at the first assessment. The analysis revealed that self-management, depressive symptoms, and seizure severity explain the most variance in self-efficacy; patient satisfaction and stigma are less important predictors; and social support and regimen-specific support are not significant predictors. The results provide direction for identifying people with low levels of self-efficacy and highlighting areas that might help enhance self-efficacy in persons with epilepsy.

Adult↗

PubMed2006

Motivating HIV positive women to adhere to antiretroviral therapy and risk reduction behavior: the KHARMA Project.

Women comprise the fastest growing group of persons with AIDS. They are often diagnosed later in the disease, when antiretroviral therapy (ART) is strongly indicated. Antiretroviral therapy has transformed the course of HIV/AIDS to a treatable, chronic illness. This article provides a profile of women with HIV/AIDS and describes ART. Selected research related to adherence and motivation is summarized. Psychosocial and economic concerns specific to women, ART, adherence, and motivation are presented. The article reviews challenges for risk reduction behaviors for HIV+ women, such as sexual activity and substance abuse. The authors discuss the Keeping Health and Active with Risk reduction and Medication Adherence (KHARMA) Project, a research project in progress that was designed to promote adherence to both ART and risk reduction behaviors in HIV+ women. The study includes two groups: a motivational group intervention based on motivational interviewing and a health promotion program control group tailored to the needs of HIV+ women. A description of the tailored intervention and project update is included.

Adult↗

PubMed2004

An evaluation of neuroscience nursing research published during the Decade of the Brain.

The purpose of this study was to extend a previous evaluation of neuroscience nursing research to an assessment of the research published during the 1990s--the Decade of the Brain. The evaluation was conducted to assess the focus of neuroscience nursing research and to identify research strategies and scientific methods. The Journal of Neuroscience Nursing, Nursing Research, Research in Nursing & Health, and Western Journal of Nursing Research were canvassed. An assessment form developed by the authors was used to evaluate selected articles published between January 1989 and December 2000. The number of neuroscience research studies published in nursing journals increased substantially during the 1990s. The studies focused more on individuals with neurological disorders and less on neurological trauma. The findings demonstrated major changes in subspecialty area, care orientation, and nature of study variables from that observed in the previous evaluation in which acute care and physiological variables were most representative of the pre-1989 studies. As noted in the previous evaluation, the trend toward theory-then-research studies continued and the scientific methods grew more complex.

Humans↗

PubMed2003

Epilepsy self-management: a comparison of self-efficacy and outcome expectancy for medication adherence and lifestyle behaviors among people with epilepsy.

The purpose of this study was to describe self-efficacy beliefs and outcome expectancies toward medication, seizure, and lifestyle management behaviors among 108 adults with epilepsy. Participants responded to an adapted version of the Epilepsy Self-Efficacy and Epilepsy Outcome Expectancy scales. Modifiable behavioral risk factors such as confidence for following medication dosing schedule, planning for medication refills, coping with adverse effects of medication, getting sufficient sleep, avoiding alcohol, and obtaining social support were identified. A larger proportion of persons reported higher self-efficacy for medication management behaviors than for healthful lifestyle behaviors. Findings from this study extend previous research on chronic disease that showed that individuals may be adherent with medication therapy, but not with healthful lifestyle behaviors necessary for the prevention and treatment of chronic disease. Individuals with low self-efficacy would benefit from interventions that increase efficacy beliefs to enhance their ability to adopt and maintain good self-management practices.

Adult↗

PubMed2003

The association of stigma with self-management and perceptions of health care among adults with epilepsy.

OBJECTIVE: The purpose of this study was to examine the perception of stigma among adults with epilepsy including its association with epilepsy self-management and perceptions of health care. METHODS: Participants for the study were recruited from two epilepsy centers and a neurology clinic. Individuals agreeing to participate in the study were asked to complete three assessments each 3 months apart. Data were collected from 320 adult men and women with epilepsy; 314 provided responses on stigma and were included in this analysis. RESULTS: Participants ranged in age from 19 to 75 years (mean=43). Fifty percent of the sample was female, and 80% was white. The mean age of seizure onset was 22 years, and 76% of participants reported having had a seizure within the past year. Analysis suggests levels of perceived stigma are similar for men and women and across ethnic and age groups. However, participants who were not married or living with a partner, were not working for pay, and had limited income reported higher levels of stigma than did married participants, those working for pay, and those in higher income brackets. Participants reporting higher levels of stigma included those who had their first seizure before the age of 50 and a seizure in the last year. Participants whose seizures interfered more with activities, who rated their seizures as under less control, and who were not legally able to drive also reported higher levels of stigma. Tests of association between stigma and health-related variables revealed that participants reporting higher levels of perceived stigma also reported lower levels of self-efficacy to manage epilepsy; more negative outcome expectancies related to treatment and seizures; and lower levels of medication management, medication adherence, and patient satisfaction. However, they also reported greater management of information related to seizures. In regression analysis, income, age at first seizure, seizures during the past year, lower self-efficacy, negative outcome expectancies for seizures, and less patient satisfaction explained 54% of the variance in perceived stigma. CONCLUSIONS: The results of the study suggest that perceived stigma is significant for people with epilepsy and is associated with factors that are known to be important in the management of epilepsy. Understanding who is at greatest risk for feeling stigmatized could lead to the development of preventive measures.

Adolescent↗

PubMed2003

Prevalence and predictors of women's experience of psychological trauma during childbirth.

BACKGROUND: The increased acceptance of the prevalence of trauma in human experience as well as its psychological consequences has led to revisions of diagnostic criteria for the disorder. The three purposes of this study were to examine the rates at which women experienced psychological trauma in childbirth, to explore possible causal factors, and to examine possible factors in the development of the disorder. METHODS: One hundred and three women from childbirth education classes in the Atlanta metropolitan area completed a survey in late pregnancy and a follow-up interview approximately 4 weeks after the birth. RESULTS: The childbirth experience was reported as traumatic by 34 percent of participants. Two women (1.9%) developed all the symptoms needed to diagnose posttraumatic stress disorder, and 31 women (30.1%) were partially symptomatic. Regression analysis showed that antecedent factors (e.g., history of sexual trauma and social support) and event characteristics (e.g., pain in first stage of labor, feelings of powerlessness, expectations, medical intervention, and interaction with medical personnel) were significant predictors of perceptions of the childbirth as traumatic. The pain experienced during the birth, levels of social support, self-efficacy, internal locus of control, trait anxiety, and coping were significant predictors of the development of posttraumatic stress disorder symptoms after the birth. CONCLUSIONS: These findings suggest several intervention points for health care practitioners, including careful prenatal screening of past trauma history, social support, and expectations about the birth; improved communication and pain management during the birth; and opportunities to discuss the birth postpartum.

Adult↗

PubMed2003

The epilepsy medication and treatment complexity index: reliability and validity testing.

Medications are the most common treatment for epilepsy. Regimens vary from once per day dosing to several pills several times per day. More complex regimens have been associated with lower adherence rates. To date, medication complexity has been measured by the number of pills and the number of times per day the pills are taken. However, complexity also includes special instructions (e.g., take at a separate time than other medications) and the specific administration actions (e.g., take 1/2 pill). This article describes the development of an instrument designed to measure the complexity associated with epilepsy treatment regimens. The medication complexity tool (MCI) was modified to create the Epilepsy Medication and Treatment Complexity Index (EMTCI). The EMTCI comprises four sections: (a) general medication information, (b) frequency of administration, (c) special instructions, and (d) administration actions. Points are given for dosing schedules, special instructions, and administration actions. A total complexity score is calculated by adding points for each section. One form is completed for each medication prescribed for each person. The initial development of the EMTCI included revising the MCI to make it applicable to epilepsy medication. Interrater and intrarater reliability assessments were conducted. The EMTCI was administered to adults with epilepsy as part of a larger study of self-management in people with epilepsy. Data from that study were used for further assessments of the EMTCI including test-retest reliability, criterion validity, and construct validity. The EMTCI shows evidence of both reliability and validity. Information from the tool can be used to describe the medication complexity of epilepsy medication regimens in much greater detail than has been done previously for this population. This information is useful in describing the treatment and adherence issues for persons with epilepsy.

Adult↗

PubMed2002

Parenting style and adolescent's reaction to conflict: is there a relationship?

PURPOSE: To determine if the reactions of adolescents toward hypothetical situations that can lead to conflict and violence varied by parenting style of their mothers. METHODS: This study was part of a larger research project involving adolescents and their mothers participating in a longitudinal HIV-prevention program. Mothers and their adolescents were recruited from a community-based organization (CBO) and interviewed separately. Data were analyzed using the responses of 439 African-American adolescents ranging from ages 11 to 14 years. The responses of adolescents to questions about parenting were used to classify mothers into one of three parenting styles: authoritative, authoritarian, or permissive. The "anticipated reactions to hypothetical situations" scale consists of 11 items with 6 response categories. The six responses were reclassified into three categories ranging from "not at all violent" to "extremely violent." Higher scores indicate more violent reactions to the hypothetical situations. The parenting scale consists of two subscales: a 13-item parental involvement scale and a 13-item parental control scale. Items were rated on a 5-point Likert scale from "strongly disagree" to "strongly agree." Analysis of variance was used to determine if the anticipated reactions of adolescents toward hypothetical situations varied by parenting style of their mothers. RESULTS: Adolescent participants who reported a more permissive parenting style expressed more intense negative reactions toward the hypothetical situations that can provoke conflict. Male adolescents also expressed more intense reactions than females to the situations. There was no difference in intensity of reaction by age after controlling for gender and parenting style. CONCLUSIONS: Parenting style is associated with adolescents' reactions to hypothetical situations that can provoke conflict. This finding highlights the importance of considering parents and their approach to child-rearing as a factor in the adolescent's ability to react to conflict.

Adolescent↗

PubMed2002

Healthy Body/Healthy Spirit: a church-based nutrition and physical activity intervention.

African-Americans (AAs) are significantly less likely to be physically active than other Americans, and, like all Americans, they consume fewer than the recommended five fruit and vegetable (F & V) servings per day. This study, titled Healthy Body/Healthy Spirit, has two primary aims: (1) to test the effectiveness of a culturally tailored self-help dietary (focusing on F & V intake) and physical activity (PA) intervention compared to standard health education materials, and (2) to test the effectiveness of using Motivational Interviewing (MI), delivered by telephone, to modify PA and dietary habits. The study is a randomized effectiveness trial with three experimental conditions. Group 1 (comparison) will receive standard (existing commercial) nutrition and PA intervention materials, Group 2 (TX1) will receive a culturally tailored self-help nutrition and PA intervention of similar intensity as Group 1, and Group 3 (TX2) will receive the same intervention as Group 2, plus four telephone counseling calls based on MI. Participants will be AA adults recruited through local black churches. Despite the extensive use of MI to modify addictive behaviors, this represents one of the first controlled field trials to employ MI to address diet and PA. Secondly, this is one of the first studies to test the effectiveness of a self-help diet and PA intervention tailored for an African-American church population.

Adult↗

PubMed2002

Keepin' it R.E.A.L.!: program description and results of baseline assessment.

In this article, the authors present the results of the analysis of the baseline data from Keepin' it R.E.A.L.!, an HIV prevention project developed for mothers and their adolescents. Six hundred twelve mostly male (60.6%) and African American (98.2%) adolescents completed baseline assessments. Eleven percent of the adolescent participants reported initiating sexual intercourse. Adolescent participants expressing higher levels of self-efficacy to resist peer pressure, more favorable outcome expectancies, less communication about sex with their mothers, higher levels of self-concept related to their behavior, lower levels of self-concept related to popularity, and less stress reported fewer types of intimate sexual behaviors. Adolescent participants who reported higher self-efficacy to resist peer pressure to have sex and lower levels of stress were less likely to have initiated sexual intercourse. Selected characteristics of mothers did not contribute to understanding factors associated with intimate sexual behaviors or initiation of sexual intercourse among adolescent participants.

Adolescent↗

PubMed2002

Childhood sexual abuse and risk behaviors among men at high risk for HIV infection.

OBJECTIVES: This study examined the association between unwanted sexual activity during childhood and risky behaviors among a sample of predominantly African American and Hispanic men. METHODS: Data were obtained from baseline interviews completed by 2676 men enrolled in a multisite HIV prevention trial. RESULTS: Approximately 25% of the men reported unwanted or uninvited sexual activity before 13 years of age, with Hispanic men more likely than African American men to report unwanted sexual activity during childhood. Men with a history of unwanted sexual activity during childhood were more likely to report unwanted sexual activity since age 13, the buying and selling of sex, problems with alcohol, and drug use. Men who reported unwanted sexual activity during childhood also reported a significantly greater frequency of unprotected sexual acts and more partners. CONCLUSIONS: Among men at high risk for HIV infection, unwanted sexual activity during childhood is more widespread than previously described and can increase the risk of participating in harmful health practices during adulthood, including risky sexual behaviors.

Adolescent↗

PubMed2002

An assessment of the HIV/AIDS knowledge, attitudes, and behaviors of adolescents living in a large metropolitan area.

This article assesses the HIV/AIDS knowledge, attitudes, and behaviors of a predominately African-American sample of adolescents (N=1503) attending 8th grade in a major Southeastern metropolitan area. Although their knowledge about human immunodeficiency virus (HIV) transmission was high, respondents held several misconceptions about HIV and acquired immunodeficiency syndrome (AIDS), and not all students knew which type of condom effectively blocks HIV transmission. Respondents in general felt confident that they could resist pressure to smoke marijuana or drink alcohol, but were less confident of their ability to resist pressure to have sex. Sexual activity was also more prevalent than drinking and smoking marijuana among this group of adolescents. Information from this and similar assessments can facilitate responsiveness of healthcare professions to the current educational needs of adolescents.

Acquired Immunodeficiency Syndrome↗

PubMed2002

Motivational interviewing in health promotion: it sounds like something is changing.

Motivational interviewing (MI), initially developed for addiction counseling, has increasingly been applied in public health, medical, and health promotion settings. This article provides an overview of MI, outlining its philosophic orientation and essential strategies. Major outcome studies are reviewed, nuances associated with the use of MI in health promotion and chronic disease prevention are described, and future directions are offered.

Chronic Disease↗

PubMedDate not supplied

Initial testing of the Antiretroviral Medication Complexity Index.

This article describes the initial development and testing of the Antiretroviral Medication Complexity Index (AMCI), an instrument to measure complexity of antiretroviral medications and regimens. Data were derived from a pilot study and the main study of an intervention designed to promote adherence to antiretroviral medications. Interrater reliability coefficients ranged from .74 to 1.0 for project staff and from .33 to 1.0 for nurse clinicians. Test-retest coefficients ranged from .297 to .988 for forms completed by the same interviewer and from .200 to .922 for different interviewers. Strong relationships existed between rankings of the medications by clinical judgment and rankings of the medications using the AMCI, providing support for criterion validity. Complexity as measured by the AMCI was associated with some measures of adherence, providing partial support for construct validity. Results provide evidence for the reliability and validity of the AMCI when used for research purposes.

Adult↗

PubMedDate not supplied

Keepin' it R.E.A.L.!: results of a mother-adolescent HIV prevention program.

BACKGROUND: The concern that adolescents may be placing themselves at risk for contracting HIV has led to widespread public and parental support for HIV prevention programs. Several programs on increasing communication between parents and teenagers have been tested, but the study of the impact of these programs on resulting sexual behavior is lacking. OBJECTIVE: To test the efficacy of two interventions for mothers and their adolescents in delaying initiation of sexual intercourse for youth who are not sexually active and encouraging the use of condoms among sexually active youth. METHODS: Employed were a control group and two treatment groups: one based on social cognitive theory (SCT) and the other a life skills program (LSK) based on problem behavior theory. Assessments were conducted before the intervention (baseline) and at 4, 12, and 24 months after the baseline assessment. RESULTS: Adolescents and their mothers (total N = 582) enrolled in the trial. At baseline, the adolescents ranged in age 11-14 years and were mostly male and African American. The mean age of the mothers was 37.9 years, and most were African American and single. The primary analyses showed no difference among groups in abstinence rates for adolescents. However, adolescents in the LSK group demonstrated an increase in the condom use rate, and those in the SCT and control groups scored higher on human immunodeficiency virus (HIV) knowledge than those in the LSK group. Mothers showed substantial increases over time in comfort talking about sex and self-efficacy. For HIV knowledge, mothers in the SCT group scored significantly higher than those in the LSK and control groups. CONCLUSION: The results of this study are comparable to previous studies that have included mothers in the HIV education of their adolescents. Although the program did not demonstrate a substantial effect on abstinence rates, increases were observed in condom use among adolescents and in mother's sex-based discussions and comfort in talking about sexual issues.

Adolescent↗

PubMedDate not supplied

Using motivational interviewing to promote adherence to antiretroviral medications: a pilot study.

This report describes a pilot study of a nursing intervention to increase adherence to combination therapy. The intervention was based on motivational interviewing (MI). Participants completed a baseline assessment using the computer-administered self-interview with audio (ACASI) data collection method and then were randomly assigned to the MI intervention or control condition. Nurse counselors met with participants in the MI intervention group for three adherence sessions. Two months following baseline, participants completed a follow-up assessment. Mean scores on ratings of missed medications were lower for participants in the intervention group than those in the control group. Although there were no significant differences in the number of medications missed during the past 4 days, participants in the MI group reported being more likely to follow the medication regimen as prescribed by their health care provider. The pilot study provided useful information about the acceptability of ACASI and the adequacy of intervention procedures. The results of this pilot study show promise for the use of MI as an intervention to promote adherence to antiretroviral medications.

Adolescent↗