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Kathryn M King

Publications and source records attributed to Kathryn M King.

18 recordsLinked to original sources
PubMed2006

The telephone interview is an effective method of data collection in clinical nursing research: a discussion paper.

There are varying points of view regarding the advisability and utility of using the telephone to conduct research interviews. When undertaking the Women's Recovery from Sternotomy Study, we found the telephone was an effective mechanism for data collection. Our aim is to identify the advantages and challenges of using the telephone as a mechanism for data collection in clinical nursing research. The potential benefits associated with using telephone interviews as a mechanism of data collection include (a) using economic and human resources efficiently, (b) minimizing disadvantages associated with in-person interviewing, (c) developing positive relationships between researchers and participants, and (d) improving quality of data collection. The potential challenges to telephone interviewing include (a) maintaining participant involvement, (b) maintaining clear communication, (c) communicating with participants who offer extraneous information, (d) encountering participants with health concerns, and (e) communicating with a third party. Telephone interviewing can be an effective method of data collection when interviewers understand the potential benefits as well as challenges. We offer solutions to the identified challenges and make pragmatic recommendations to enhance researcher success based on the current literature and our research practice. Supportive training for interviewers, effective communication between interviewers and with research participants, and standardized telephone follow-up procedures are needed to ensure successful telephone data collection. We have found our 'Manual of Operations' to be an effective tool that assists research assistants to meet the requirements for successful telephone interviewing.

Canada↗
PubMed2006

A randomized controlled trial of women's early use of a novel undergarment following sternotomy: the Women's Recovery from Sternotomy Trial (WREST).

BACKGROUND: Despite a lack of randomized trial evidence, clinicians often suggest that women use a brassiere to reduce poststernotomy pain and discomfort. We tested the effect of women's use of a special (compression) undergarment after sternotomy on pain, discomfort, and functional status. METHODS: Women (n = 481) having first-time sternotomy in 1 of 10 Canadian centers were randomized to receive the intervention or usual care. Pain and discomfort data (using numeric rating scales) were collected in person while participants were hospitalized. Thereafter, pain, discomfort, and functional status data (using Health Assessment Questionnaire) were collected by standardized telephone interview until 12 postoperative weeks. RESULTS: Overall, and until at least 6 weeks postoperatively, fewer women in the intervention than usual care group reported having incision and breast pain and discomfort. Breast pain scores were lower in the intervention than the usual care group at 2 weeks postoperatively (P = .04), and over time (OR 0.65 [95% CI 0.45-0.94], P = .02). For women discharged within 14 postoperative days, post hoc analyses revealed intervention group patients had a significantly reduced likelihood of breast pain (OR 0.46 [95% CI 0.32-0.66], P < .001) and breast discomfort (OR 0.62 [95% CI 0.44-0.86], P = .01) but not incision pain (OR 0.99 [95% CI 0.72-1.37], P = .95) or discomfort (OR 0.77 [95% CI 0.55-1.02], P = .06). There was no difference between groups in functional status. The effects were not influenced by age or brassiere size. CONCLUSIONS: Using a supportive undergarment during the early postoperative reduces breast pain. This finding is amplified and extends to include a reduction in breast discomfort, when women are discharged within 14 postoperative days.

Aged↗
PubMed2006

Gender-based challenges faced by older Sikh women as immigrants: recognizing and acting on the risk of coronary artery disease.

Gender and ethnocultural affiliation can influence people's health beliefs and their ability to make behavioural changes associated with risk reduction. The authors undertook a series of grounded theory studies aimed at describing and explaining how gender and ethnocultural affiliation influence the process that people undergo when faced with the need to make behavioural changes to reduce the risk of coronary artery disease (CAD). Here, they describe the gender-based influences associated with managing CAD risk in a small sample of older Sikh immigrants to Canada. Data were collected through semi-structured interviews, using an interpreter when necessary. Interviews were audiotaped to enable verification of interpretation and transcription. Data were analyzed using constant comparative methods. The core variable that emerged in the series of studies was "meeting the challenge." The process of managing CAD risk included pre-diagnosis or event, liminal or changing self, and living with CAD. Intra-, inter-, and extrapersonal factors as well as sociodemographic characteristics influenced the participants' ability to meet the challenge of managing CAD risk. Health-care providers and policy-makers have a responsibility to work with ethnocultural communities in order to (1) enhance the ability of health-care providers to provide ethnoculturally sensitive care, and (2) develop ethnoculturally relevant resources to enable health promotion and disease prevention. The ultimate aim is to improve health outcomes for Sikh immigrants as vulnerable members of society.

Acculturation↗
PubMed2005

Men and women managing coronary artery disease risk: urban-rural contrasts.

People's beliefs about health and making lifestyle changes associated with risk reduction and disease prevention can vary based on their gender and ethnocultural affiliation. Our objective was to describe and explain how gender and ethnocultural affiliation influence the process that people undergo when faced with making lifestyle changes related to their coronary artery disease (CAD) risk. A series of grounded theory studies were undertaken in Alberta, Canada, with men and women from five ethnocultural groups diagnosed with CAD. Here, we describe the cultural aspects associated with urban- and rural-living in 42 Euro-Celtic men and women. Data were collected through semi-structured, audio-recorded interviews and analysed using constant comparative methods. The core variable that emerged through the process was 'meeting the challenge'. There were three phases to the process of managing CAD risk: pre-diagnosis/event, liminal self, and living with CAD. Intra-personal, inter-personal, extra-personal, and socio-demographic factors influenced the participants' capacity to meet the challenge of managing their CAD risk. The influence of these factors was either direct or indirect through the intertwined elements of the participants' knowledge about CAD and perceived extent of necessary change. Each element of this process was influenced by the participants' gender and culture (urban- versus rural-living). When healthcare providers understand and work with the gender- and ethnoculturally based components that influence people's appraisal of their cardiac health and their decision-making, appropriate secondary prevention interventions and positive health outcomes are more likely to follow.

Adult↗
PubMed2005

The Women's Recovery from Sternotomy (WREST) study: design of a randomized trial of a novel undergarment for early use after sternotomy.

BACKGROUND: Clinicians who work with women poststernotomy often suggest that they wear a supportive brassiere to ameliorate pain, discomfort, and potential wound complications. There is no empirical evidence that supports this practice. METHODS: Despite methodological challenges, a clinical trial is currently underway to investigate the efficacy of early use of a novel undergarment after sternotomy. Women (N = 430) having first time sternotomy in 9 Canadian centers will be randomized to receive either the usual care of the institution or early use of a novel undergarment. Follow-up is planned over 12 postoperative weeks. Coprimary outcomes are pain, discomfort, and return to function. Wound healing is a secondary outcome. An economic evaluation substudy is also underway. CONCLUSIONS: The WREST Study is a unique ongoing trial examining the efficacy of a novel undergarment in reducing women's pain and enhancing their comfort and return to function. The findings of the trial and its economic substudy will enable health care providers to make rational evidence-based clinical decisions regarding women's early care after sternotomy.

Activities of Daily Living↗
PubMed2005

Implementing evidence-based practice: walking the talk.

Russworm and Larrabee's (1999) six-step model for evidence-based practice (EBP) was used by 10 nursing teams to seek answers to clinical questions. These teams, primarily composed of staff nurses, participated in a health region-wide EBP program over 1 year. Overall, the model served as a useful mechanism for examining practice-derived questions. However, additional strategies needed to be incorporated by the project teams. These included making decisions about change/no change at an earlier stage than was suggested by the model; seeking additional evidence including survey data to benchmark "best" practices; and ensuring colleagues' and managers' input, support, and involvement. Four project teams (three of which addressed nursing procedural questions) found insufficient empirical evidence on which to base change; the outlook for directing evidence-based practice was promising for the remaining six projects. The EBP program was judged to be highly satisfactory to participants and their managers.

Canada↗
PubMed2005

Ethnocultural affiliation, gender, and cardiovascular disease risk management.

Cardiovascular disease (CVD) is a major cause of morbidity and mortality in North America. Making behavioural changes following a diagnosis of CVD can attenuate the disease risk. Canada's population is composed of a growing mosaic of persons of various ethnic backgrounds. A person's ethnocultural affiliation and gender can influence the context, process and outcome of their decision-making about health related behaviours. Though several models exist to assist clinicians working with persons facing behavioural change, these models do not include ethnocultural affiliation and gender as fundamental components. The authors contend that ethnocultural affiliation and gender need to be central constructs in new investigations related to behavioural change and that decision-modeling methodology is a useful mechanism to do so.

Canada↗
PubMed2004

Sex differences in outcomes after cardiac catheterization: effect modification by treatment strategy and time.

CONTEXT: Studies comparing outcomes of cardiac care in women vs men yield various results, with some suggesting worse outcomes for women and others suggesting equivalent outcomes. OBJECTIVE: To determine whether extent of coronary disease, treatment strategy, and follow-up time influence the risk of death in women vs men among patients who have had cardiac catheterization. DESIGN, SETTING, AND PATIENTS: We studied a large inception cohort by using detailed clinical data from a registry of 37 401 patients undergoing cardiac catheterization in Alberta, Canada, from 1995-2000, with follow-up through December 31, 2001. MAIN OUTCOME MEASURES: The risk of death for women vs men was assessed for all patients combined and then in analyses stratified by degree of coronary anatomic risk and by treatment strategy (no revascularization, percutaneous coronary intervention [PCI], coronary artery bypass graft [CABG] surgery). The latter analysis included a graphic assessment of the changing relative risk over time for women vs men. RESULTS: Women had higher 1-year mortality than men did (5.6% vs 4.6%; P<.001). However, stratified analyses demonstrated that sex differences in risk occurred only early after catheterization and were most apparent among patients undergoing revascularization. The early risk-adjusted relative risks for women vs men were elevated at 3.49 (95% confidence interval [CI], 1.95-6.24) for CABG surgery and 2.38 (95% CI, 1.48-3.83) for PCI on day 1 after catheterization, with a subsequent decrease in relative risk over time to equivalence in risk between sexes before 1 year. CONCLUSIONS: Sex-based differences in death rates after cardiac catheterization are time- and treatment-specific. This finding may at least partially explain the discrepancies in results from earlier studies on sex differences in outcomes of cardiac care.

Aged↗
PubMed2004

Peer support. An under-recognized resource in cardiac recovery.

BACKGROUND: Cardiovascular disease remains the leading cause of mortality and premature death in western societies. Thus, rates of interventions such as coronary artery bypass surgery are continuing to grow. Health care reform and initiatives to reduce health care expenditures have resulted in early patient discharge from hospital following cardiac surgery. With subsequent cutbacks in nursing support and community-based care, patients are leaving hospital less prepared and supported to deal with the changes that occur during the first weeks of recovery. AIMS: To examine the theoretical assumptions that support the contention that peer support is an under-utilized resource for patients who are recovering from cardiac surgery and the challenges to evaluating peer support interventions. METHODS: A review of current literature, which focuses on cardiac surgery recovery, transitions, social support, and peer support interventions. RESULTS: Peer support (lay assistance from individuals who possess experiential knowledge and similar characteristics), a form of social support, is a viable and potentially sustainable mechanism to put in place during transitional life events such as recovery from cardiac surgery. CONCLUSIONS: Further investigation is needed of peer support interventions for cardiac surgery patients. Specifically, investigations of the influence of peer support interventions on recovery and health outcomes are necessary in this patient population. Yet, challenges exist to undertaking well-designed investigations of social interventions such as peer support.

Aftercare↗
PubMed2004

Implementing evidence-based practice: walking the talk.

Russworm and Larrabee's (1999) six-step model for evidence-based practice (EBP) was used by 10 nursing teams to seek answers to clinical questions. These teams, primarily composed of staff nurses, participated in a health region-wide EBP program over 1 year. Overall, the model served as a useful mechanism for examining practice-derived questions. However, additional strategies needed to be incorporated by the project teams. These included making decisions about change/no change at an earlier stage than was suggested by the model; seeking additional evidence including survey data to benchmark "best" practices; and ensuring colleagues' and managers' input, support, and involvement. Four project teams (three of which addressed nursing procedural questions) found insufficient empirical evidence on which to base change; the outlook for directing evidence-based practice was promising for the remaining six projects. The EBP program was judged to be highly satisfactory to participants and their managers.

Alberta↗
PubMed2003

Publishing your findings.

The road to publication often seems complicated for newer authors. Therefore, in this column, the authors will clarify the publication process. Topics including why publication is important, choosing a journal, preparing the manuscript-as well as some tips for writing and understanding and responding to peer review-are addressed.

Humans↗
PubMedDate not supplied

Coronary heart disease prevention: views on women's gender-based perceptions and meanings.

The construct of gender is typically differentiated from that of sex on the basis that it is socioculturally created rather than biophysically endowed. There has been some investigation regarding the relationship of gender to coronary heart disease prevention and risk factor management. However, mechanisms underlying the influence of gender on these important outcomes have not yet been fully examined or explained. There is a complex interplay among and between the sociocultural environments in which women live and the biophysical outcomes they experience. Funding agencies need to advance a research agenda aimed at prospectively examining the issues surrounding gender and development of coronary heart disease, as well as developing and testing practical and sustainable gender-specific interventions.

Coronary Disease↗
PubMedDate not supplied

A history of diabetes: from antiquity to discovering insulin.

This article, the first of a three-part series, gives a historical account of events for diabetes, dating from antiquity and its first recording in the Ebers Papyrus--an Egyptian document circa 1500 BC. This article describes initial thoughts that diabetes was linked to an alimentary complaint, and concludes with the discovery of it being a chronic systemic disease. It highlights the discoveries and also includes details of the failed attempts to locate the cause and identify a solution to the ancient mysterious disease which became known to all as diabetes mellitus. Early remedies and treatments are included. The article tells how for many centuries individuals suffered from the debilitating complaint with very little offered in terms of treatment or relief. Eventually the pancreas was identified as the causative organ and, some time later, animal experimentation resulted in the abstraction of the substance insulin. The article concludes with Frederick Banting and John Macleod being awarded the Nobel Prize in 1923 for their revolutionary discovery of insulin.

Diabetes Mellitus↗
PubMedDate not supplied

A history of insulin: from discovery to modern alternatives.

Following on from the first article in this series (Vol 12(18): 1091-5), which described the history of diabetes, this article, the second of three literature reviews, explores the early production and development of insulin, from its initial production in a university laboratory to becoming a major pharmaceutical product. Also discussed are the various forms of insulin developed over the last 80 years and their means of delivery to the patient. The future is considered and the development of insulin analogues (substances that mimic the effect of human insulin) is described. The article also looks at the introduction of DAFNE (dose adjustment for normal eating) - an intensive programme of education aimed at teaching individuals the necessary skills to adjust their own insulin injection dosage to reflect their individual eating patterns.

Critical Care↗
PubMedDate not supplied

Diabetes: classification and strategies for integrated care.

This article is the third in a series of three in-depth literature reviews on diabetes. The first article (Vol 12(18): 1091-5) detailed the history of diabetes from the first recorded mention of the disease in the Ebers papyrus through to the discovery of insulin. The second (Vol 12(19): 1137-41) dealt with the history of insulin over the past 80 years and the development of possible alternatives. This final article in the series details the new classifications for diabetes and addresses the aetiology, pathophysiology and complications of the disease. While discussing both type 1 and type 2 diabetes, the article concentrates on the newly defined type 1 diabetes mellitus. An examination of the recently released National Service Framework for Diabetes: Delivery Strategy (DoH, 2003) is included, healthcare provision is discussed, as is the role of the diabetes specialist nurse. An insight is given into the challenges and opportunities available for healthcare practitioners to work in partnership to reform the way in which diabetes services are managed.

Delivery of Health Care, Integrated↗