Biomedical subjects

Lorraine Frazier

Publications and source records attributed to Lorraine Frazier.

13 recordsLinked to original sources

PubMed2006

Adding story-centered care to standard lifestyle intervention for people with Stage 1 hypertension.

This study examined the blood pressure (BP)-lowering effect of adding story-centered care (i.e., carefully attending to another's narrative) to standard lifestyle intervention (i.e., exercise training and nutrition counseling) for people with Stage 1 hypertension. The subjects (N = 24), who were university and hospital employees, were unmedicated and received standard lifestyle intervention; half were randomly assigned to story-centered care. Their 24-hour BP was measured four times at 8-week intervals, twice before and twice after the intervention. Subjects who received story-centered care had greater decreases (p < .05) in awake systolic BP over the 6-month study period. Neither systolic nor diastolic sleep BP was significantly affected. Story-centered care showed promise for contributing to the BP-lowering effect of lifestyle intervention. Approaches for integrating story-centered care into the treatment of people with hypertension are challenging but warrant further attention.

Adult↗

PubMed2006

Understanding of genetics among older adults.

PURPOSE: To describe and compare the attitudes, knowledge, and beliefs of older adults from three ethnic groups about genetic testing and genetic research, to determine how the understanding of genetics influences informed consent, and to identify factors that are important in older adults' decisions about participation in genetic research. METHODS: Three focus groups were initially conducted with 23 African American, Caucasian, and Hispanic adults in community-based settings. Discussions were audiotaped and transcribed verbatim. Content analysis of transcripts was performed and a second session was conducted with participants from each group to confirm the analyses. FINDINGS: Four common themes related to genetics and informed consent for genetic testing were identified: (a) defining genetics, (b) justifying genetic testing, (c) family involvement, and (d) dignified agreement. CONCLUSIONS: The findings from this study indicate that although these older adults had information about genetics, the information was not always accurate. In addition, deference among this cohort to providers' opinions showed the important role of healthcare professionals in providing genetic information and obtaining consent in ways that ensure it is voluntary and informed.

Aged↗

PubMed2005

Usefulness of multidetector computed tomography for noninvasive evaluation of coronary arteries in asymptomatic patients.

This editorial addresses the capabilities, limitations, and potential of multidetector computed tomography (MDCT) for the noninvasive evaluation of coronary arteries in asymptomatic patients. The quantification of coronary calcium with MDCT correlates highly with that obtained by electron-beam computed tomography, but to date, neither has the capability of assessing the distribution of various morphologic patterns of calcium and their relation to other "soft" plaque components. Although MDCT can assess the thickness of the atherosclerotic wall and can readily identify calcific deposits, further plaque characterization (e.g., lipid pools and fibrous tissue), a prerequisite for the identification of most vulnerable lesions, is not yet a workable reality, even with the 64-slice machines in their current configuration. The noninvasive identification by MDCT of plaque components subtending vulnerable lesions will require additional improvement in the primary instrumentation, the use of hybrid constructs (e.g., with positron emission tomography and magnetic resonance imaging), the development of novel methods of post-acquisitional analysis to extract latent images of plaque components (e.g., signal analysis based on 3-dimensional wavelets), or the adaptation of molecular imaging techniques at the cell and gene levels to computed tomography. Such unique approaches may soon contribute a long list of additional parameters that could be evaluated on a noninvasive basis as predictors of acute coronary syndromes and overall patient vulnerability.

Coronary Angiography↗

PubMed2005

Genomics and cardiovascular disease.

PURPOSE: To describe genetic knowledge and discovery in the area of cardiovascular disease (CVD) and to discuss how these new advances will influence the clinical care of affected people. ORGANIZING FRAMEWORK: A selective review of the literature is presented on the disease mechanism of both the Mendelian and multifactorial genetic cardiovascular conditions. A case study approach is used to illustrate how the genetic paradigm affects the healthcare experience of a family affected with familial hypertrophic cardiomyopathy. FINDINGS: The current state of CVD treatment remains complex. An understanding of genomic concepts and a genome-based approach is necessary to determine: (a) the risk of CVD susceptibility beyond traditional risk factors; (b) early detection of illness; (c) response to treatment; and (d) molecular taxonomy of the disease. CONCLUSIONS: The results of genetic research, education, and teaching will lead to a new understanding of genes and pathways, resulting in powerful new therapeutic approaches to CVD. The challenge is to translate genetic discoveries into clinical practice that ultimately leads to preventing CVD and reducing mortality.

Adult↗

PubMed2005

Influenza and atherosclerosis: vaccination for cardiovascular disease prevention.

In both animal and human studies, strong prothrombotic and pro-inflammatory effects have been observed after influenza infection. Influenza is an important trigger for acute coronary syndromes, and it has been shown that in the US it may cause up to 90,000 deaths per year simply by triggering fatal myocardial infarctions. Multiple case-control and cohort studies have shown that the influenza vaccine has a marked protective effect against cardiovascular events, decreasing the incidence of these events by 20 - 70% in the settings of primary and secondary prevention. Although influenza vaccination is an extremely cost-effective method of cardiovascular protection and is recommended for all patients with cardiac diseases, it is largely underused in these patients. Therefore, increased efforts should be directed towards educating physicians and patients about the benefits of influenza vaccination in patients with coronary heart disease.

Atherosclerosis↗

PubMed2003

Addressing current challenges to cardiac rehabilitation care.

Cardiac rehabilitation, the structured programming of exercise and risk reduction teaching and counseling to promote healthy living with heart disease, is grounded in a strong nurse-patient relationship. This relationship provides a foundation for meeting current healthcare challenges. Three challenges are presented and addressed through specific examples. The challenge of the changing cardiac rehabilitation population is addressed through the example of the heart failure patient. The challenge to create innovative programming is addressed through the example of the Therapeutic Rehabilitative Intensive Program, developed to meet the needs of people who live in communities without cardiac rehabilitation services. The challenge to measure outcomes is addressed through the example of choosing a blood pressure measurement method. In addressing each challenge, the role of the advanced practice nurse is described.

Blood Pressure↗

PubMed2003

Novel predictors of acute coronary syndrome outcomes.

Morbidity and mortality rates among patients with acute coronary syndrome (ACS) remain high, and it is difficult to determine which patients will progress satisfactorily and which patients will have poor outcomes. Research has indicated that the inflammatory process is involved in coronary disease. There is great interest within the research community in determining if inflammatory markers could be used to determine the severity of the disease process and therefore serve as a prognostic tool for clinicians. This article describes the inflammatory process in ACS and provides a review of the current diagnostic studies of endothelial inflammatory markers (EIMs) in heart disease. Although research results of EIMs have not all been significant in determining outcomes, there is some evidence that they may be more specific than other generalized inflammatory markers, such as C-reactive protein. Future research of EIMs in patients with ACS might provide evidence of easy-to-measure and economically feasible markers that are sound prognosticators.

Biomarkers↗

PubMed2003

Genetic content in Japanese language nursing textbooks.

The purpose of this study was to assess the amount of genetic content included in Japanese language nursing textbooks. A total of 222 Japanese nursing textbooks for registered nurses, public health nurses, and nurse midwives published by five publishers in 2001 were evaluated for genetic content. The textbooks were reviewed for content in fundamental knowledge of genetics, genetic diseases, genetic counseling, and nursing care for patients with genetic problems. Results from the review indicated that although information about genetics was found in more than half of the textbooks, descriptions of the roles of nurses in genetic counseling and nursing interventions related mostly to single gene disorders. These findings suggest that not all Japanese nursing textbooks contain genetic content and that they do not include the latest knowledge concerning common diseases and genetic nursing interventions. Although the study did not review other educational methods, based on these findings, nursing educators in Japan should introduce textbooks with genetic information that will prepare registered nurses, public health nurses, and nurse midwives to remain current in genetic concepts and to apply these concepts to their nursing roles through genetic counseling and patient care.

Curriculum↗

PubMed2002

Expressing health experience through embodied language.

PURPOSE: To describe embodied language for Japanese elders who suffered a stroke or cardiac disease within the previous year. Embodied language is the overlap of feeling and temporal word use with blood pressure during descriptions of health experience. DESIGN: Exploratory. METHODS: Blood pressure and word use were recorded simultaneously when 17 cardiac and 20 stroke participants described their health experiences for 4 minutes. Blood pressure was measured using a tonometric monitor and word use was measured using linguistic analysis software. Descriptive and nonparametric statistics were used. FINDINGS: Participants with strokes retained higher blood pressure after talking than did cardiac participants. The two groups showed contrasting relationships between word use and blood pressure, particularly for temporal words. CONCLUSIONS: This collaborative research between Japanese and American colleagues was a step toward deciphering shared values, which are important to understanding health for people who have lived through life-changing illness events.

Aged↗

PubMed2002

A review of nursing research on blood pressure.

PURPOSE: To provide this second 10-year review of nursing research on blood pressure (BP) and to focus attention on incorporating biopsychosocial factors affecting BP in nursing research. ORGANIZING CONSTRUCT: Blood pressure is a dynamic, multidimensional, cardiovascular indicator of a person's state rather than a one-dimensional static measurement. METHODS: This 10-year literature review 1990-1999 included 54 nursing research articles with BP as an outcome measure. Four nursing research journals were reviewed to identify all nurse-authored articles investigating BP as an outcome variable in adult populations. Inclusion of individual characteristics, environmental factors, dynamic nature of blood pressure, and interpersonal aspects of blood pressure were assessed for each article. FINDINGS: Age, gender, and health status were mentioned consistently in both decades. Reporting of socioeconomic, occupational, educational, activity, and martial status remained low. Descriptions of environments increased, and automated devices were the most common method for BP assessment. Less than half of the articles included a description of the person measuring the BP. Measurements of BP under multiple conditions increased, but measurement within conditions did not. CONCLUSIONS: Advances in technology and data analysis have increased knowledge of the dynamic nature of BP, but recognition of the complex nature of BP has not progressed rapidly over the last 2 decades.

Adult↗

PubMed2002

Resting and reactive blood pressure. Predictors of ambulatory blood pressure in older adults with hypertension.

The study examined whether reactive change scores from a short blood pressure (BP) reactivity protocol, resting BP, or resting pulse pressure (PP) would be predictors of 24-hour ambulatory BP and BP load in cardiac patients. The study used a single-group design, with both an experimental clinical component and an observational field component. Both components used repeated measurement methods. The study population consisted of 45 adult patients with a mean age of 64.6 +/- 8.5 years who were diagnosed with cardiac disease in a cardiac rehabilitation program and who were taking anti-hypertensive medication. Blood pressure reactivity was operationalized with a speech protocol. During the speech protocol, BP was measured with an automatic device (Dinamap) while patients talked about their health and about their usual day. Twenty-four-hour ambulatory BP measurement followed the speech protocol. Resting systolic BP and resting PP were significant predictors of 24-hour ambulatory systolic BP, and resting systolic BP was a significant predictor of systolic BP load. No predictors were significant of 24-hour diastolic BP or diastolic BP load. Initial resting BP and PP may be used in clinical settings to assess hypertension management. Future studies are necessary to confirm the ability of resting BP to predict ambulatory BP and BP load in older adults who are medicated and hypertensive.

Age Factors↗

PubMed2002

Genetics and gerontological nursing: a need to stimulate research.

The purpose of this chapter is to discuss how genetics will affect gerontological nursing. The chapter will answer two questions: (1) Which aspects of genetics will be most relevant to future gerontological nursing practice? and (2) What will be the impact of genetics on the future of gerontological nursing education and research? MEDLINE was searched for relevant articles from 1995 to 2001 using the key words aging, genetics, geriatrics, nursing education, research, and gerontology. CRISP was searched using the thesaurus terms education/planning, genetics, health education, model design/development, psychological model, pubic health curriculum, behavioral/social science research, and research nursing/genetics. A total of 101 nursing and nonnursing articles were reviewed. Research reports were selected if they focused on issues related to gerontological nursing. Articles were reviewed that had application to genetic nursing, complex diseases, and genetics. The evolution of the science of genetics will revolutionize gerontological nursing and affect future nursing education and research as the concepts of genetic science and the technology they generate are translated into everyday clinical practice. Genetic discoveries in common complex diseases will affect care provided by gerontological nurses in the 21st century. Gerontological nurses must move quickly to recognize this genetic paradigm shift and to incorporate genetics issues into their nursing practice.

Aged↗

PubMedDate not supplied

Genetic discoveries and nursing implications for complex disease prevention and management.

The purpose of this article is to examine the management of patients with complex diseases, in light of recent genetic discoveries, and to explore how these genetic discoveries will impact nursing practice and nursing research. The nursing science processes discussed are not comprehensive of all nursing practice but, instead, are concentrated in areas where genetics will have the greatest influence. Advances in genetic science will revolutionize our approach to patients and to health care in the prevention, diagnosis, and treatment of disease, raising many issues for nursing research and practice. As the scope of genetics expands to encompass multifactorial disease processes, a continuing reexamination of the knowledge base is required for nursing practice, with incorporation of genetic knowledge into the repertoire of every nurse, and with advanced knowledge for nurses who select specialty roles in the genetics area. This article explores the impact of this revolution on nursing science and practice as well as the opportunities for nursing science and practice to participate fully in this revolution. Because of the high proportion of the population at risk for complex diseases and because nurses are occupied every day in the prevention, assessment, treatment, and therapeutic intervention of patients with such diseases in practice and research, there is great opportunity for nurses to improve health care through the application (nursing practice) and discovery (nursing research) of genetic knowledge.

Ecology↗