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Biomedical subjects

Janet Deatrick

Publications and source records attributed to Janet Deatrick.

7 recordsLinked to original sources
PubMed2004

Cancer-related parental beliefs: the Family Illness Beliefs Inventory (FIBI).

OBJECTIVE: The goal of this study was to develop a reliable and valid method for assessing the cancer-related beliefs of parents with a child in treatment for cancer. METHOD: One hundred twenty-five families (119 mothers, 56 fathers) completed a measure of cancer-related beliefs written to reflect common themes associated with the diagnosis and treatment of childhood cancer. Participants also completed self-report questionnaires used for validation of the Family Illness Beliefs Inventory (FIBI). RESULTS: Principal-components analysis was used to derive a 41-item five-factor solution from the maternal data--Factor 1: Treatment-Related Suffering; Factor 2: Death and Devastation; Factor 3: Caregiver Competence; Factor 4: Connection; and Factor 5: Finding Meaning. Correlations with validation measures supported the factor structure. Paternal data showed similar patterns. CONCLUSIONS: The FIBI is a psychometrically sound method for identifying parental cancer-related beliefs. This measure may be helpful in developing and evaluating interventions to reduce parental distress related to childhood cancer and promote adaptive family functioning.

Adult↗
PubMed2003

Patient problems, advanced practice nurse (APN) interventions, time and contacts among five patient groups.

PURPOSE: To describe patient problems and APN interventions in each of five clinical trials and to establish links among patient problems, APN interventions, APN time and number of contacts, patient outcomes, and health care costs. DESIGN AND METHODS: Analysis of 333 interaction logs created by APNs during five randomized controlled trials: (a) very low birthweight infants (n = 39); (b) women with unplanned cesarean birth (n = 61), (c) high-risk pregnancy (n = 44), and (d) hysterectomy (n = 53); and (e) elders with cardiac medical and surgical diagnoses (n = 139). Logs containing recordings of all APN interactions with participants, APN time and type of patient contact were content analyzed with the smallest phrase or sentence representing a "unit." These units were then classified using the Omaha Classification System to determine patient problems and APN interventions. Groups were compared concerning total amount of APN time, number of contacts per patient, and mean length of time per APN contact. All studies were conducted in the United States. FINDINGS: Groups with greater mean APN time and contacts per patient had greater improvements in patients' outcomes and greater health care cost savings. Of the 150,131 APN interventions, surveillance was the predominant APN function in all five patient groups. Health teaching, guidance, and counseling was the second most frequent category of APN intervention in four of the five groups. In all five groups, treatments and procedures accounted for < 1% of total APN interventions. Distribution of patient problems (N = 150,131) differed across groups reflecting the health care problems common to the group. CONCLUSIONS: Dose of APN time and contacts makes a difference in improving patient outcomes and reducing health care costs. Skills needed by APNs in providing transitional care include well-developed skills in assessing, teaching, counseling, communicating, collaborating, knowing health behaviors, negotiating systems, and having condition-specific knowledge about different patient problems.

Aged↗
PubMed2002

Lessons learned from testing the quality cost model of Advanced Practice Nursing (APN) transitional care.

PURPOSE: To describe the development, testing, modification, and results of the Quality Cost Model of Advanced Practice Nurses (APNs) Transitional Care on patient outcomes and health care costs in the United States over 22 years, and to delineate what has been learned for nursing education, practice, and further research. ORGANIZING CONSTRUCT: The Quality Cost Model of APN Transitional Care. METHODS: Review of published results of seven randomized clinical trials with very low birth-weight (VLBW) infants; women with unplanned cesarean births, high risk pregnancies, and hysterectomy surgery; elders with cardiac medical and surgical diagnoses and common diagnostic related groups (DRGs); and women with high risk pregnancies in which half of physician prenatal care was substituted with APN care. Ongoing work with the model is linking the process of APN care with the outcomes and costs of care. FINDINGS: APN intervention has consistently resulted in improved patient outcomes and reduced health care costs across groups. Groups with APN providers were rehospitalized for less time at less cost, reflecting early detection and intervention. Optimal number and timing of postdischarge home visits and telephone contacts by the APNs and patterns of rehospitalizations and acute care visits varied by group. CONCLUSIONS: To keep people well over time, APNs must have depth of knowledge and excellent clinical and interpersonal skills that are the hallmark of specialist practice, an in-depth understanding of systems and how to work within them, and sufficient patient contact to effect positive outcomes at low cost.

Clinical Competence↗
PubMedDate not supplied

Maternal management behaviors for young children with type 1 diabetes.

PURPOSE: To describe the process that mothers raising young (0-4 years old) children who are newly diagnosed with type 1 diabetes move through to attain the necessary skills to care for their children. STUDY DESIGN AND METHODS: A mixed methods design was used, including qualitative interviews with 28 mothers of young children with type 1 diabetes. Principles of naturalistic inquiry were used to guide the data collection process, management, and analysis of the qualitative findings. RESULTS: The process paralleled two of three management approaches and associated behaviors previously described by Gallo and Knafl. Strict adherence behaviors included rigidly following the team recommendations and avoiding strange environments outside the home. Flexible adherence behaviors strove to bring spontaneity back into family life. Selective adherence was not used by this population. CLINICAL IMPLICATIONS: Nurses working with these mothers can provide information and support to help them transition from using strict adherence to the more user-friendly flexible adherence, while avoiding the pitfalls of the possibly harmful third approach of selective adherence. Nurses need to remember to praise the parents' efforts at managing their children's diabetes, for our acknowledgment of their work is empowering and affirming.

Adaptation, Psychological↗
PubMedDate not supplied

Mothers' experiences raising young children with type 1 diabetes.

ISSUES AND PURPOSE: To examine the day-to-day experiences of mothers raising children 4 years of age and younger with type 1 diabetes. DESIGN AND METHODS: The descriptive design compared mothers of children with (n = 25) and without diabetes (n = 25). Mother-child observations were completed for children with diabetes. RESULTS: Mothers of children with diabetes are very skilled in reading their children's behavioral cues. Mothers' concerns included the fear of hypoglycemia and seizure activity, access to daycare centers, and babysitting services capable of caring for their children's condition. These responses significantly differed from the control group mothers. PRACTICE IMPLICATIONS: Nurses can affirm that hypoglycemia-related fears are normal and help mothers identify community resources that might ease the burden of care required, especially during the early postdiagnosis period.

Activities of Daily Living↗
PubMedDate not supplied

Helping other mothers effectively work at raising young children with type 1 diabetes.

PURPOSE: This study examined the feasibility of a postdiagnosis parent mentoring intervention for mothers of young children (1-10 years old) newly diagnosed with type 1 diabetes. METHODS: A mixed-method, prospective, randomized, controlled clinical trial design was used. Parent mentors (experienced mothers who have successfully raised young children with type 1 diabetes) and mother participants with young children newly diagnosed with type 1 diabetes were recruited from 2 regional pediatric diabetes centers. The mentors were trained to provide informational, affirmational, and emotional support using Ireys' modified parent mentor curriculum. During a 6-month trial, mentors provided home visits and phone call support to the mothers who were randomized to the experimental group. The control group had the option of receiving the intervention after the 6-month trial. RESULTS: Mothers in the experimental group had fewer concerns, more confidence, identified more resources, and perceived diabetes having less of a negative impact on their family compared with mothers in the control group. Parent mentors provided important, practical day-to-day management information, reassurance, and emotional support during times of crises. CONCLUSIONS: A postdiagnosis parent mentoring intervention for mothers of children with diabetes appears to be feasible and potentially effective.

Child↗