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Biomedical subjects

Heather Becker

Publications and source records attributed to Heather Becker.

At least 19 recordsLinked to original sources

Older adults in the SeniorWISE study at risk for mild cognitive impairment.

As part of a larger clinical trial, SeniorWISE (Wisdom Is Simply Exploration), this study provides baseline affective, cognitive, and functional ability data and reports on the likely incidence of mild cognitive impairment (MCI) in a tri-ethnic community sample of older adults (N = 265). Seventy-eight individuals had memory complaints, whereas 105 had none. Of the complainants, 32 had normal memory function and 46 had poor memory performance. Among those without memory complaints, 42 had no memory impairment and 63 had poor memory performance. Forty-six individuals (17%) met the criteria of poor everyday memory functioning and memory complaints whereas 81 (31%) would be considered to be at risk based on other MCI criteria. This pattern of results suggests that those with declining memory are less aware of their deficits in activities of daily living that their actual performance would suggest are occurring.

Activities of Daily Living↗

Older males, cognitive function, and alcohol consumption.

We investigated the question, how do older men who drink alcohol differ from those who do not drink on measures of cognitive function, memory, affect, and health? Of the nonprobability sample of male participants (N = 60), 35 (58%) of the males reported some degree of alcohol consumption. Eleven men had one or more drinks per day, 14 had one or more drinks per week, and 9 were occasional drinkers. The drinkers reported significantly less depression, had higher self-reported general health and vitality, and had higher cognitive performance, cognitive flexibility, and verbal memory, and greater knowledge of memory processes.

Activities of Daily Living↗

Casting light on the concept of patient satisfaction by studying the construct validity and the sensitivity of a questionnaire.

PURPOSE: This study aims to explore the construct validity and the sensitivity of a patient satisfaction questionnaire for the purpose of gaining a better understanding of the concept, and of issues surrounding its measurements. DESIGN/METHODOLOGY/APPROACH: Several statistical analyses were used to study the reliability, construct validity, and the sensitivity of a patient satisfaction questionnaire. FINDINGS: The study supported the construct validity, high internal consistency, and homogeneity of the instrument. Two factors were found; one consisted of negatively worded items and the other of positively worded items. The negatively worded items contributed more than the positively worded items to the sensitivity of the instrument. Items were identified that contribute little or nothing to the construct validity and/or the sensitivity of the questionnaire. RESEARCH LIMITATIONS/IMPLICATIONS: The effect of wording on the variability and sensitivity of the instrument can be explained both as a consequence of response set bias and with regard to the theories against which two phenomena were being measured - patient satisfaction and patient dissatisfaction. The development of two kinds of instruments is proposed: those that measure patient dissatisfaction and are sensitive to minute changes in nursing care and those that measure both concepts and capture what patients find important in their care. ORIGINALITY/VALUE: The paper demonstrates how an analysis of the construct validity and the sensitivity of patient satisfaction instrument, can enhance understanding of the concept. It contributes to the debate about whether patient satisfaction and dissatisfaction are opposite ends of the same continuum or two different phenomena that require two different definitions.

Data Interpretation, Statistical↗

Factors associated with use of hormone therapy among women with mobility impairments.

The purpose of the study was to examine the factors associated with hormone therapy (HT) use among women with mobility impairments. A non-probability sample of 188 menopausal women (average age = 53 years) from 38 states was recruited in 2004 for the study. Twenty-two percent of participants were currently taking HT; 33% were past users. Using multinomial logistic regression, this study found that those most likely to be taking HT now or in the past were older women, knowledgeable about HT, had had a hysterectomy, had bone loss, and had their provider's encouragement. Implications for health care providers are discussed.

Adult↗

Older women's cognitive and affective response to moderate drinking.

OBJECTIVE: In this paper we investigated the question, how do older women who drink moderate amounts of alcohol differ from those who do not drink on measurements of cognitive function, memory, affect and health? METHODS: The nonprobability sample of female participants (n=182) averaged 75 years of age and had a Mini Mental State Examination scores of 28. The participants were asked to indicate whether they drank alcohol or abstained (yes/no) and if they indicated that they did drink, to describe how many drinks they consumed in a given period of time (day/week/month). RESULTS: None of the participants acknowledged drinking more than 2 drinks a day. Caucasian women had the largest number of moderate drinkers (53% vs 47%), while the majority of African-American and Hispanic women reported not drinking. The moderate drinkers reported less depression, had higher self-reported health, performed better on instrumental everyday tasks, had stronger memory self-efficacy, and used more strategies to improve memory performance. In addition, these women had higher performance on tests of executive function: attention, concentration, psychomotor skills, verbal-associative capacities, and oral fluency. CONCLUSIONS: The circumstances under which people drink are complex and were not evaluated in this study. Therefore, rather than endorsing drinking behavior, these findings suggest that future research might examine why elders make the decision to drink, the circumstances that predispose women to drink (alone/with others), and other qualities that characterize female drinkers over the age of 65.

Activities of Daily Living↗

The influence of resources on perceived functional limitations among women with multiple sclerosis.

The purpose of this longitudinal investigation was to identify the effects of external resources (i.e., education, marriage, employment, social support, economic status) on the trajectory of perceived functional limitation among women with multiple sclerosis (MS). We hypothesized that these resources would have a long-term influence upon MS-related functional limitation. As part of a longitudinal study of health promotion and quality of life among persons with MS, we tested hypothesized relationships using data obtained at five time points, using repeated-measures MANOVA. We found that functional limitation scores increased over time for all participants. In general, women who were unemployed as a result of MS consistently had higher functional limitation scores, and employed women consistently had lower functional limitation scores. Women with lower social support scores consistently perceived greater functional limitation than those with higher social support scores. Women with lower perceived-economic-adequacy scores consistently had higher functional limitation scores than women with higher perceived-economic-adequacy scores. Nurses and other healthcare professionals are in an optimum position to observe and assess the resources of women with MS. They can use presence, listening, and observational skills to identify verbal and nonverbal cues of resource depletion. In addition, they can act as advocates for women with MS and speak out on policy issues and legislation at the local and national levels. Healthcare professionals can thus influence the presence of resources for those who are particularly vulnerable to resource loss, so they can participate successfully in work, recreational, and home environments.

Activities of Daily Living↗

Marriage, impairment, and acceptance in persons with multiple sclerosis.

The purpose of this study was to investigate the relationship between marital status, marital concern, perceived impairment, health-promoting behaviors, and acceptance of disability using cross-sectional and longitudinal data from a sample of persons with multiple sclerosis (MS). We hypothesized that the quality and stability of the marital relationship would influence people's ability to accept their disability and protect from accumulation of impairment over time. Furthermore, men and women would receive dissimilar benefits from marriage. These hypotheses were considered with repeated measures analysis, Pearson correlations, and independent sample t tests of data obtained from a longitudinal study of persons with MS. The findings indicate that acceptance of disability and perceived impairment increase significantly over time for men and women. For men, being married was associated with a greater acceptance of disability and less perceived impairment. Men were more concerned than the women about how MS affected their sexual relationships.

Adaptation, Psychological↗

Adaptation of a wellness intervention for women with chronic disabling conditions.

Women with chronic disabling conditions live with multiple symptoms that decrease their ability to function in society, and they may be at elevated risk for further morbidity with age. Despite research indicating that health-promoting behaviors decrease the risk for further morbidity, few interventions have been designed to help women with chronic disabling conditions promote their health. The purpose of this article is to present the results of a pilot study of a wellness intervention adapted for use with women with fibromyalgia syndrome (FMS). First, the development of the original wellness intervention for women with multiple sclerosis (MS) will be described. Next, the steps taken to adapt the intervention to the needs of women with FMS will be described. Finally, it wil be argued that commonalities in symptoms and social experiences and the universal need for health-promoting skills make this intervention adaptable to multiple groups of women with chronic disabling conditions.

Adaptation, Psychological↗

The role of emotion in mammography screening of African-American women.

Dominant theories that are used to predict health behavior ignore the role played by emotion in peoples decisions to seek preventive health care. This exploratory study describes how the fears of African-American women and their other emotions influence their response to mammography screening interventions. Thirty-seven (N = 37) African-American women in Central and North Texas completed face-to-face interviews and paper and pencil emotion scales. Findings from this study suggest that fear of breast cancer was the predominant emotional theme that emerged. Further findings from this study also suggest that women who had previously had mammograms expressed both stronger negative and positive feelings and emotions than women who had never had mammograms. In addition, women who had never had a mammogram expressed fear of radiation from the mammography equipment, and potential pain related to the procedure, as well as fear of finding out that they might have cancer. Feedback from these African-American study participants suggests that simply to hear a message promoting breast cancer screening is not sufficient to motivate African-American women to seek mammography.

Adult↗

A randomized clinical trial of a wellness intervention for women with multiple sclerosis.

OBJECTIVE: To examine the effects of a wellness intervention program for women with multiple sclerosis (MS) on health behaviors and quality of life (QOL). DESIGN: Randomized clinical trial. SETTING: Community setting in the southwestern United States. PARTICIPANTS: Convenience sample of 113 women with physician-confirmed MS (mean age, 45.79y). INTERVENTIONS: The 2-phase intervention program included lifestyle-change classes for 8 weeks, then telephone follow-up for 3 months. Participants were followed over an 8-month period. MAIN OUTCOME MEASURES: A series of self-report instruments to measure barriers, resources, self-efficacy for health behaviors, health promotion behaviors, and health-related QOL were completed at baseline, 2 months (after the classes), 5 months (after telephone follow-up), and at 8 months. Principal outcomes measures were health-promoting behaviors (scores on the Health Promoting Lifestyle Profile II) and QOL (scores on the Medical Outcomes Study 36-Item Short-Form Health Survey [SF-36] scales). RESULTS: Hierarchical linear modeling techniques revealed a statistically significant group by time effect for self-efficacy for health behaviors, health-promoting behaviors, and the mental health and pain scales of the SF-36. CONCLUSION: These data provide initial support for the positive effects of wellness interventions to improve health behaviors and selected dimensions of QOL for women with MS.

Adult↗

The use of individualized goal setting to facilitate behavior change in women with multiple sclerosis.

Setting goals is a useful strategy for changing behavior. The purpose of this study was to examine the effectiveness of a wellness intervention for women with multiple sclerosis (MS) on achieving health-related goals set individually by each participant in the experimental group (N = 57) using goal attainment scaling. The two-phase intervention included lifestyle-change classes over 8 weeks, then telephone follow-up over 3 months. Participants were followed over an 8-month period. Goal achievement was assessed at baseline, 2 months (following class), 3 1/2 months (6 weeks after class), 5 months (following 3 months of telephone follow-up), and at 8 months. The majority of the women met or exceeded all their individualized goals for changing behavior at the 6-week postclass assessment. Achievement and maintenance of individual goals remained high (59%-84%) over the 5 months after class follow-ups. These data support the positive effects of wellness interventions for helping women with MS to meet their own individualized health goals. Setting goals with incremental steps helped participants to articulate their individual goals and monitor achievement over time.

Adult↗

Explanations for improvement in both experimental and control groups.

A true experimental design with random assignment to groups protects against false causal inferences that could be made when both the treatment and control groups change because of factors such as testing effects, reactivity, contamination, maturation, history, and other measurement effects. The occurrence of these phenomena, however, provides interesting information about factors affecting health care attitudes, knowledge, and behavior change, which can interfere with a nursing study's ability to demonstrate an experimental effect. In this article, we discuss these design threats, illustrate them with examples from recent health research, and suggest strategies for decreasing them in clinical nursing studies.

Bias↗

Measuring cultural awareness in nursing students.

Recognizing the need for a valid and reliable way to measure outcomes of a program to promote multicultural awareness among nursing faculty and students, the authors developed a cultural awareness scale. In the first phase of the study, a scale consisting of 37 items was generated from a literature review on cultural awareness, sensitivity, and competence in nursing. A Cronbach's alpha reliability coefficient of .91 was obtained from a sample of 72 student nurses. In the second phase, the items were presented to a panel of experts in nursing and culture to determine content validity. A content validity index of .88 was calculated, and the total number of items on the scale was reduced to 36. The scale then was administered to 118 nursing students. Data from the two samples then were combined, and factor analysis was conducted to support construct validity. Cronbach's alpha for the combined samples was .82.

Attitude of Health Personnel↗

The decision to take hormone replacement therapy among women with disabilities.

Whereas making decisions during menopause can be challenging for all women, those with physical impairments face special issues with respect to menopause in general and hormone replacement therapy (HRT) in particular. In this correlational study the authors explored the factors such women consider when making decisions about HRT One hundred sixty-seven women with physical impairments throughout the United States completed surveys concerning their attitudes and knowledge about HRT Approximately half the menopausal women were currently taking HRT The strongest predictor of HRT use was women's perceptions of their health care providers opinions about their taking HRT, combined with their motivation to comply with the provider's recommendation. Thisfinding points to the significant role that nurses and other health care providers play in assisting women to make informed health care choices during menopause.

Adult↗

Menopausal experiences and hormone replacement therapy use among women with physical impairments.

This study describes the menopausal experiences of women with physical disabilities and their knowledge and use of hormone replacement therapy (HRT). 166 women completed a mailed survey of demographic and disability characteristics, health history, menopausal information, and HRT knowledge. The typical respondent was a 52-year-old, Anglo, college-educated woman with a neuromuscular disorder. Half of the menopausal women were taking HRT, and 47% had a hysterectomy. HRT use was significantly associated with hysterectomy status, amount of HRT information received from providers, and regular gynecologic examinations. Effective interventions are needed to assist these women in making key health decisions during menopause.

Attitude to Health↗

What makes it so hard? Barriers to health promotion experienced by people with multiple sclerosis and polio.

Perceptions of barriers to health promotion were examined in three groups of individuals with disabilities: (1) those with multiple sclerosis, (2) those with postpolio syndrome, and (3) polio survivors without postpolio syndrome. While there were small statistically significant differences among the three groups, all rated fatigue and impairment as their most frequent problems. For all groups, financial and interpersonal resources contributed significantly to the prediction of barriers, after accounting for perceived impairment. The findings suggest that health professionals should explore thoroughly the nature of individuals' perceived barriers to staying healthy, so that they can target their health-promoting interventions most effectively.

Cross-Sectional Studies↗