PubMed Health⌕ Search

Biomedical subjects

Patricia C Clark

Publications and source records attributed to Patricia C Clark.

14 recordsLinked to original sources
PubMed2006

Factor analysis of the Revised Piper Fatigue Scale in a caregiver sample.

The Revised Piper Fatigue Scale (R-PFS) is an instrument designed to measure subjective fatigue that was developed in samples with physical illness. Its psychometric properties in nonclinical samples are unknown. The purpose of this study was to examine the psychometric properties of the R-PFS in a sample of caregivers of stroke survivors. The convenience sample of 132 caregivers was primarily women (74%), White (71%), college-educated (73%), and employed (52%), with a mean age of 56.7 years (SD = 13.71). Internal consistency reliabilities for the four R-PFS subscales and the total scale were excellent, ranging from .90 to .97. Principal axis factor analysis with oblique rotation was conducted to examine construct validity of the R-PFS. A three-factor solution explained 75.9% of the common variance. Two factors totally replicated the behavioral/severity and affective meaning subscales of the R-PFS. The third factor incorporated a combination of Piper's sensory and cognitive/mood subscales and appeared to summarize how fatigue makes the caregiver feel. The R-PFS demonstrated strong internal consistency reliability and construct validity in this sample. However, data suggest that caregivers may perceive certain feelings associated with fatigue as conceptually similar when these feelings are conceptually distinct in Piper's breast cancer sample. The study supports the need for psychometric evaluation of instruments developed in clinical populations prior to their use in nonclinical populations.

Adult↗
PubMed2006

Pain, fatigue, and intensity of practice in people with stroke who are receiving constraint-induced movement therapy.

BACKGROUND AND PURPOSE: There is little available information about changes in pain and fatigue status among people receiving constraint-induced movement therapy (CI therapy). This study examined such changes. SUBJECTS: All participants were a subset of individuals with stroke enrolled in the Extremity Constraint-Induced Therapy Evaluation (EXCITE) trial and received 2 weeks of CI therapy either 3 to 9 months after stroke (subacute therapy group, n=18) or 1 year later (chronic therapy group, n=14). METHODS: Pain, fatigue, and intensity of therapy were evaluated. The Wolf Motor Function Test (WMFT) and the pain scale of the Fugl-Meyer Assessment for the upper extremity were administered before and after training. Single-item measures for pain and fatigue were administered twice daily during therapy. RESULTS: All participants reported low mean pain (X=2.0, SD=0.93) and fatigue (X=2.7, SD=1.23) scores. Generally, differences between the subacute and the chronic therapy groups for pain, fatigue, intensity, and WMFT change scores were nonsignificant. DISCUSSION AND CONCLUSION: For selected patients with stroke, the intensive practice associated with CI therapy may be administered without exacerbation of pain or fatigue, even early during the recovery process.

Aged↗
PubMed2005

Impediments to timely diagnosis of Alzheimer's disease in African Americans.

The purpose of this study was to identify early patterns of care for Alzheimer's disease (AD) in a cohort of African-American patients and their caregivers presenting at an inner city clinic and a suburban memory assessment clinic. Caregivers (N=79) of patients diagnosed with probable AD were interviewed. Data were collected about the delay from noticing first AD signs until recognition that a problem existed and delay from problem recognition until first physician consultation. Patients and caregivers had lower educational status, and patients had been diagnosed more recently at the inner city clinic than at the suburban clinic, although MMSE scores of patients at the two clinics did not differ; median delays in caregivers' recognizing a problem and in consulting a physician were also similar across clinics. Delay was as long as 7 years between noticing symptoms and problem recognition and between problem recognition and physician consultation. Although patients attending the suburban clinic were more likely to have previously seen a physician than those attending the inner city clinic, they were no more likely to have received a prior diagnosis of AD. Lack of physician contact is likely to be widespread in families caring for African Americans with AD. Physician consultation is more characteristic of more highly educated families but may not yield a correct diagnosis for the patient. Intensive efforts are needed to connect African-American families with physicians and to achieve more timely diagnosis of AD to enable families to understand the illness, plan for patient safety, and make long-term plans.

Activities of Daily Living↗
PubMed2005

Symptom interactions as mechanisms underlying symptom pairs and clusters.

PURPOSE: To present a summary of the potential shared or interactive mechanisms underlying an exemplar symptom pair: sleep disturbances and pain. ORGANIZING CONSTRUCT: Understanding of the multidimensional shared and interactive mechanisms underlying symptoms pairs and clusters has the potential to enhance symptom management. METHODS: Reviews of the literature were conducted to search for information on shared or interactive mechanisms underlying sleep disturbances and pain; minimal data were available. Relevant information about individual symptoms was outlined and categorized in areas often used to describe the multidimensional nature of symptoms, including the physiological, psychological, behavioral, and sociocultural domains. This information was examined for relationships and commonalities. CONCLUSIONS: Many potential shared and interactive mechanisms underlying the symptom pair of sleep disturbances and pain were identified. These results indicate the need for further work and theory development in this area. The symptom interactional framework is a beginning conceptual perspective designed to facilitate this work. Implications for interdisciplinary translational research designed to optimize symptom management are discussed.

Cluster Analysis↗
PubMed2005

Use of a content analysis procedure for the development of a Falls Management Audit Tool.

The Falls Management Audit Tool (FMAT) was developed to assess the documentation of the falls management process in nursing homes. The multistep content analysis procedure was used to guide tool development and obtain reliability and validity of the FMAT. Established fall guidelines and national experts were used for item development. Trained gerontological nurse practitioners conducted chart audits in nursing home residents with a fall history. Adequate content validity (content validity index > .88) and interrater and intrarater reliability were established (kappas > .78) in the final version of the 57-item FMAT and pilot testing demonstrated feasibility. This study provided evidence that the FMAT is a reliable and valid tool, which can be used to assess the documentation of the falls management process and for measuring the effect of research or quality improvement interventions.

Accidental Falls↗
PubMed2003

Identifying possible depression in clinical research: ethical and outcome considerations for the investigator/clinician.

Most nurse researchers are aware of the ethical implications of research including the need to ensure confidentiality for research participants, as well as to provide full disclosure of the risks and benefits of the study. However, another consideration that can impact methodology from the perspective of the protection of human subjects from research risks includes the measurement of certain psychosocial variables such as depression and appropriate disclosure of such information to research participants. This issue has received little attention in the nursing literature. The intent of this article is to provide an overview of (1) the importance of informing participants about possible depression, (2) issues of identifying potential depression in clinical research including those related to depression measures, (3) strategies for the investigator/clinician to ensure protection of research participants and potential impact of those strategies, and (4) considerations in addressing depression in study design and analysis.

Data Interpretation, Statistical↗
PubMed2003

Family partnership intervention: a guide for a family approach to care of patients with heart failure.

While family focused care is recommended in standards of care for heart failure (HF), little data exist to guide the structure, content, and delivery of family care. The purpose of this article is to describe what is known about the impact of HF, and to examine a family based approach to improve self-management and adherence in HF. A scientific and theoretical background was used to formulate a family based approach to HF care, the Family Partnership Intervention (FPI), and to determine the feasibility and acceptability of the intervention to family members and HF patients. The components of the intervention are described as well as examples of how it was used. Lessons learned in implementing the intervention during a pilot study are addressed.

Caregivers↗
PubMed2003

Comparison of family caregivers. Stroke survivors vs. person with Alzheimer's disease.

The purpose of this study was to compare family caregivers of person with dementia and caregivers of stroke survivors with similar levels of caregiving responsibilities. The design was descriptive and included characteristics of care recipients, caregivers, and care situations. Caregivers of individuals with dementia reported care recipients were more impaired with independent activities of daily living and memory and behavior problems. There were no differences in caregiver depression and fatigue. Even with the benefit of respite care, a substantial number of caregivers had depression scores above the level indicating possible clinical depression. Consultation by advanced practice psychiatric nurses for caregivers and care recipients may be beneficial in detecting depression and making recommendations for appropriate treatment.

Activities of Daily Living↗
PubMed2003

Preliminary reliability and validity of a family caregiver conflict scale for stroke.

Recovery from stroke is a challenging process for stroke survivors and their families. Assessing family conflict may be useful in guiding interventions to reduce caregiver distress. The purpose of this study was to assess preliminary reliability and validity data for a 15-item family caregiver conflict scale [FCCS] for stroke. Construct validity was assessed using subscales from the family assessment device: communication, problem solving, general family functioning, and a perceived criticism scale. Data were pooled from three studies of caregivers of stroke survivors (total N=93). Internal consistency for the FCCS was adequate (>0.70). Higher family conflict was related to more ineffective family communication, general family functioning, and higher perceived criticism (p > or =0.05). Nonspouse caregivers reported more family conflict than spouse caregivers. The FCCS appears to have adequate internal consistency and construct validity and may provide information about family conflicts around stroke recovery and direction for family-focused interventions.

Adult↗
PubMed2002

Effects of individual and family hardiness on caregiver depression and fatigue.

Hardiness is defined as commitment to life, viewing change as challenge, and having control over one's life. Previous research suggests that hardiness is related to better outcomes in stressful situations. The effects of individual and family hardiness on depression and fatigue of caregivers of disabled older adults (DA) were examined using a descriptive, cross-sectional design. The sample was 67 caregivers of DA with high functional impairment. One-third of caregivers reported moderate to high fatigue, and 40% had scores indicating possible clinical depression. Memory and behavior problems of the DA were positively correlated with caregiver depression and fatigue. Family hardiness was negatively related to memory and behavior problems of the DA. Controlling for covariates, individual hardiness was negatively associated with depression and fatigue; coping strategies did not mediate the relationship. Caregivers with low individual and family hardiness had more depression than those high in both resources. Additional research is needed to determine the relevance of hardiness theory in caregiving research.

Activities of Daily Living↗
PubMedDate not supplied

Caregiver perspectives of memory and behavior changes in stroke survivors.

Post-stroke memory and behavior changes (MBC) are associated with negative outcomes for stroke survivors and caregivers. This article describes the types of MBC that occur most frequently and caregivers' responses to these behaviors. Data were obtained through in-person interviews and administration of questionnaires to 132 caregivers of first-time stroke survivors 3-9 months after stroke. MBC were measured with a modified version of a Memory and Behavior Problems checklist. On average, caregivers reported 7.7 +/- 3.6 (range 0-17) behaviors. Common stroke survivor MBC included appearing sad or depressed, interrupting the caregiver, and being restless or agitated. These MBC were distressing to caregivers. Caregivers may not recognize some MBC as potential symptoms of depression. In addition, caregiver misunderstanding of the amount of control survivors may have over some behaviors has implications for rehabilitation and caregivers' responses to these changes.

Adult↗
PubMedDate not supplied

Influence of stroke survivor characteristics and family conflict surrounding recovery on caregivers' mental and physical health.

BACKGROUND: Stroke recovery is a dynamic process for stroke survivors, and shorter lengths of stay in healthcare settings shift the care of the survivors to family caregivers. The physical and mental sequelae after stroke and the family's response to this catastrophic event may have deleterious effects on caregivers. OBJECTIVE: To examine the influence of stroke survivors' motor function, their memory and behavior changes, and the family conflict surrounding stroke recovery on the mental and physical health of caregivers during the subacute recovery period. METHODS: This cross-sectional, correlational study used baseline data from family caregivers (n = 132) and first-time stroke survivors enrolled in a larger multisite study. RESULTS: The caregivers were primarily White (71%), female (74%), college-educated (73%) spouses (80%) of survivors. Most of the caregivers (66%) reported family conflict. The caregivers from families with lower family functioning scores reported worse mental health. The caregivers reported lower mental health when they were caring for stroke survivors with a combination of high memory/behavior changes and low motor function (R =.30). Family conflict appears to exacerbate the impact of memory and behavior changes on caregiver mental health. Higher caregiver education and no major health problems were associated with better caregiver physical health (R =.36). Caregiver physical health was not associated with family functioning or stroke survivor memory and behavior changes. CONCLUSIONS: These results indicate that memory and behavior changes of stroke survivors and family conflict surrounding stroke recovery are important considerations for assessment during the poststroke recovery period.

Activities of Daily Living↗
PubMedDate not supplied

Family education and support interventions in heart failure: a pilot study.

BACKGROUND: Self-management of dietary sodium restriction by persons with heart failure (HF) is difficult and usually occurs within the home setting and within a family context. OBJECTIVE: To compare a patient and family education (EDUC) intervention with a combined education and family partnership intervention (EDUC + FPI) for effects on improving dietary sodium self-management in persons with HF. METHODS: Patients with HF and a family member (FM) were randomized to EDUC (n = 29 dyads) or EDUC + FPI (n = 32 dyads). Participants with HF were primarily White males with a mean age of 61 years (+/-12). The FMs were primarily women and spouses and had a mean age of 54 years (+/-17). Self-reported dietary sodium (Diet NA) intake and 24-hr urinary sodium (Urine NA) were measured at baseline (BL) and 3 months (3M) after intervention. Data were analyzed with descriptive statistics, generalized least squares regression, paired t test, and chi-square test. RESULTS: Groups did not differ by age, gender, or clinical variables; however, family functioning (Family APGAR) scores were slightly higher in the EDUC + FPI group at BL. Both groups decreased Diet NA and Urine NA from BL to 3M; the EDUC + FPI group showed greater decrease in Urine NA and had a greater percentage of those who decreased Urine NA by at least 15% (p = .04). Regression analysis to predict Urine NA revealed a significant Group x Time interaction (p = .03) when accounting for time-varying measures of body mass index (p = .001). DISCUSSION: A family-focused intervention may be useful in reducing dietary sodium intake in persons with HF. The Urine NA results support the importance of incorporating family-focused education and support interventions into HF care.

Depression↗