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Biomedical subjects

Steven V Owen

Publications and source records attributed to Steven V Owen.

13 recordsLinked to original sources
PubMed2006

Spirituality and clinical care: exploring developmental changes in nursing and medical students.

OBJECTIVE: This study identifies and assesses changes in spiritual experiences and the perceived importance of spiritual issues in nursing and medical students participating in a Spirituality and Clinical Care course. Students participated in the study by completing two survey instruments: the Spiritual Experience Index-Revised (SEI-R) and the Spiritual Importance (SI) scales. Differences from pretest to posttest by sex and by discipline (medicine vs nursing) and changes in spiritual maturity are assessed and analyzed. RESULTS: Data analyses explored discipline differences, sex differences, and changes in levels of spiritual maturity one year after the two-week course. Students (N = 416) participating in the course reflected a significant increase in perceived importance of spirituality in practice, with females of both disciplines showing greater increases than males, and students in nursing showing greater increases than students in medicine. Female students were more trusting than male students in spiritual measures for support. An interesting finding revealed that both male and female students evidenced reduced dogmatic perceptions over time, with medical students declining more sharply than nursing students. Finally, changes in the levels of spiritual maturity of the students were measured. Students in contrasting developmental groups (n = 127) regressed over time to more dogmatic and underdeveloped levels of spiritual maturity. CONCLUSIONS: Maintenance or advancement of spiritual development was the expected outcome as students began to develop the art of their practice. It was unexpected that students would regress to a more dogmatic or underdeveloped spiritual level. Several explanations for these findings are explored.

Adult↗
PubMed2006

Field testing, refinement, and psychometric evaluation of a new measure of nursing home care quality.

The primary aim of this NINR-NIH-funded field test in 407 nursing homes in 3 states was to complete the development of and conduct psychometric testing for the Observable Indicators of Nursing Home Care Quality Instrument (Observable Indicators, OIQ). The development of the OIQ was based on extensive qualitative and iterative quantitative work that described nursing home care quality and did initial validity and reliability field testing of the instrument in 123 nursing homes in 1 state. The scale is meant for researchers, consumers, and regulators interested in directly observing and quickly evaluating (within 30 minutes of observation) the multiple dimensions of care quality in nursing homes. After extensive testing in this study, the Observable Indicators instrument has been reduced to 30 reliable and discriminating items that have a conceptually coherent hierarchical factor structure that describes nursing home care quality. Seven first-order factors group together into two second-order factors of Structure (includes Environment: Basics and Odors) and Process (includes Care Delivery, Grooming, Interpersonal Communication, Environment: Access, and Environment: Homelike) that are classic constructs of Quality, which was the third-order factor. Internal consistency reliability for the 7 first-order factors ranged from .77 to .93. Construct validity analyses revealed an association between survey citations and every subscale as well as the total score of the OIQ instrument. Known groups analysis revealed expected trends in the OIQ scores. The Observable Indicators instrument as a whole shows acceptable interrater and test-retest reliabilities, and strong internal consistency. Scale subscales show acceptable reliability as well. Generalizability Theory analyses revealed that dependability of scores can be improved by including a second site observer, or by revisiting a site. There is a small additional benefit from increasing observers or visits beyond two.

Communication↗
PubMed2005

Randomized study of stability and change in patients' advance directives.

Little is known about ethnic differences in understanding or using advance directives (ADs). Although health practitioners may presume AD intentions are durable over time, there is no supporting evidence. This randomized study intended to (a) examine differences between hospitalized Hispanic and non-Hispanic patients' AD preferences, (b) assess AD stability, and (c) discover if the Life Support Preferences Questionnaire (LSPQ) influences AD preferences. Hispanics and non-Hispanics showed no difference in AD preferences. However, non-Hispanics were more likely to change AD preferences. The LSPQ itself prompted change in AD preferences, delivering an educational effect with no specific educational intent. Change seen in patients' ADs, even over a brief interval, suggests revisiting AD preferences with patients and their families after hospitalization.

Advance Directives↗
PubMed2005

Why carve up your continuous data?

Continuous data are commonplace in social, biophysical, and health research. For various reasons, researchers often carve up data into ordered chunks. Such data carving results in less information being carried by the data, a reduction or spurious increase in statistical power, and resultant Type I or Type II errors. We give examples of data carving in selected nursing literature, and illustrate how unnecessary categorization can produce erroneous statistical results. Finally, we propose credible alternatives to data carving.

Analysis of Variance↗
PubMed2005

Development and validation of a performance-based measure of upper extremity functional limitation.

BACKGROUND AND AIMS: While the standardized lower extremity physical performance battery (LEPPB) is widely used to measure lower body functional limitation, no corresponding measure has been developed for upper body functional limitation. We combined three standard measures (William's Hand Test, Hand Signature, Functional Reach) to develop an upper extremity physical performance battery (UEPPB) analogous to the LEPPB, and examined its validity. METHODS: We used baseline data from a community-dwelling cohort of 749 Mexican American and European American elders and combined times to complete the William's Hand Board, Hand Signature, and distance on Functional Reach into a single composite measure, using scoring methods analogous to those for the LEPPB. We summarize concurrent, discriminant, and construct validity evidence for the UEPPB, based on observed associations with established measures of physical functional limitation, disability, and dependence. RESULTS: All correlations were in the expected direction. Shared variance with self-reported upper and lower extremity functional limitation was 10 and 5%, respectively, and with self-reported ADL disability, ADL dependency, and IADL dependency it was 32, 26, and 31%, respectively. In multivariate models of self-reported and performance-based disability and dependency, the UEPPB and LEPPB made significant, independent contributions and, net of contextual variables (age, sex, ethnic group, education, income) explained 4 to 10% of the variance in disability and dependency. CONCLUSIONS: The UEPPB is a valid performance-based measure of upper extremity functional limitation and makes an independent contribution beyond LEPPB in explaining disability and dependence.

Activities of Daily Living↗
PubMed2005

Screening for cognitive impairment in older adults attending an eye clinic.

PURPOSE: We conducted a cross-sectional study examining potentially modifiable factors associated with cognitive impairments (mild or severe) in older whites, African Americans and Hispanics attending an outpatient eye clinic. METHODS: In-clinic interviews and physical examinations assessed social, demographic and health information from 100 consecutive Hispanic, African-American and white adults aged > or = 55. Our primary outcome was presence of any cognitive impairment (mild or severe) using the St. Louis University Mental Status Examination (SLUMS) scale. RESULTS: Of the 100 subjects, 65 screened positive for cognitive impairments on the SLUMS cognitive instrument: 46 with mild cognitive impairment and 19 with severe impairment (possible dementia). African-American and Hispanic adults (nonwhites) were significantly more likely to have cognitive impairment compared to white adults (OR 2.80: 95% CI = 1.05-7.44), independent of age, years of education and systolic blood pressure. Subjects with diabetes also had increased odds of cognitive impairments (OR 3.28, 95% CI = 1.21-8.90) even after adjusting for relevant confounders. There was a nonsignificant trend between visual acuity impairment and cognitive impairment (p = 0.059). CONCLUSIONS: Sixty-five percent of adults aged > or = 55 attending the eye clinic screened positive for cognitive impairments, with higher rates among nonwhites and adults living with diabetes.

Black or African American↗
PubMed2004

Quality of life of men treated with brachytherapies for prostate cancer.

BACKGROUND: Most studies of men undergoing treatment for prostate cancer examine physical symptoms as predictors of Quality of Life (QOL). However, symptoms vary by treatment modality in this population, and psychosocial variables, shown to be important to QOL, have rarely been examined. Litwin noted a need for analysis of QOL data in men treated for prostate cancer with different modes of therapy, as studies focusing on specific treatments will increase the homogeneity of research findings. METHODS: This cross-sectional study explored physical and psychosocial predictors of QOL in men receiving one of two types of radiation treatment for prostate cancer: Intensity Modulated Radiation Therapy (IMRT) + High Dose Rate (HDR) Brachytherapy or IMRT + seed implantation. Subjects completed a biographic questionnaire; quality of life measures, which were the eight subscales of the Medical Outcome Study Short Form Health Survey (SF-36); measures of physical symptoms including the Radiation Therapy Oncology Group and the European Organization for Research and Treatment of Cancer (RTOG/EORTC) and the Prostate Symptom Self-Report (PSSR); and measures of psychological factors, the Ways of Coping Scale (WOC), Perceived Stress Scale, the Anxiety Subscale of the SCL-90, and Strategies Used by Patients to Promote Health (SUPPH). Eight regression models including both physical and psychosocial variables were used to predict quality of life. RESULTS: Sixty-three subjects with complete data on all variables were studied. Treatment effect sizes were medium to large in predicting each of the quality of life subscales of the SF-36. Psychosocial variables were related to physical function, role function, bodily pain, general health, social function, emotional role, and mental health. Physical symptoms were related to subjects' perceived general health and mental health. DISCUSSION: The number of significant relationships among psychosocial variables and indicators of QOL exceeded the number of relationships among symptoms and QOL suggesting that psychosocial variables associate strongly with prostate cancer patients' reports of quality of life. Findings of the study may provide patients and families with knowledge that contributes to their understanding of quality of life outcomes of IMRT+ HDR and IMRT + seed implantation and their ability to make more informed treatment choices.

Adaptation, Psychological↗
PubMed2004

Measuring student perceptions of clinical competence.

In a large, southwestern, Gulf coast school of nursing, the faculty sought additional information to enhance their clinical evaluations of students. To gather such information, the faculty developed a rapid and psychometrically sound evaluation tool that elicited students' self-efficacy beliefs for newly learned clinical skills, and the perceived importance of the clinical skills they were mastering. The Self-Efficacy for Clinical Evaluation Scale (SECS) is a 30-item, dual-response scale that demonstrates strong psychometric properties. Scores on the SECS help faculty identify skills or content areas that students feel little confidence in using, even when students value those skills or content as very important. These insights are assisting course leaders in tailoring the course structure and teaching strategies to better meet students' educational and practice needs.

Adult↗
PubMed2003

Preoperative teaching received and valued in a day surgery setting.

This study examined the congruence between the preoperative teaching received and valued by patients undergoing same day surgery. A convenience sample of 116 patients was interviewed using the 26-item preoperative teaching interview guide, which explores five dimensions of preoperative information, including situational/procedural information, sensation/discomfort information, patient role information, psychosocial support, and skills training. The correlation between preoperative teaching received and valued was r = 0.34, P < or = .01. Significant relationships were observed between income level and preference for situational/procedural information and between gender and preference for psychosocial support information. The findings are being used to frame a program of research in perioperative nursing and to restructure preoperative teaching in one facility.

Adult↗
PubMed2003

Becoming "at home" in assisted living residences: exploring place integration processes.

OBJECTIVES: This study explores the roles of place attachment, nonfamily social involvement, place valuation, and individual characteristics in the process of becoming at home in assisted living residences. METHODS: Purposive sampling and cross-sectional data by means of a questionnaire completed by current assisted living residents in four states (N = 297) were used to estimate a structural equation model to explain becoming at home. RESULTS: Place attachment to town and community is a necessary but not sufficient explainer of older adults' process of becoming at home. Nonfamily social involvement plays a pivotal role through which place attachment works to explain becoming at home. Both place valuation and nonfamily social involvement exhibit direct positive effects on the outcome. DISCUSSION: Findings support a transactional interpretation of assisted living as home. The relationship between place attachment to one's community and full integration into assisted living is more complex than currently acknowledged.

Activities of Daily Living↗
PubMed2003

Development and implementation of a problem-focused neurological assessment system.

A menu-driven, problem-focused neurological assessment system was constructed and implemented after concerns at a six-hospital teaching center about the quality of nursing assessments for patients with neurological diagnoses were validated. This system enables the physician to guide the nurse's assessment by ordering specific neurological tests for each patient. Extensive staff training took place to develop competence with this system. This new system has resulted in positive changes for this facility. Nurses acknowledge greater comfort with performing neurological assessment; documentation of assessment has improved; and the assessments are becoming more individualized for each patient. This system resulted in a higher quality of neurological care for patients.

Brain Neoplasms↗
PubMed2003

Validation of the Spanish Life Support Preference Questionnaire (LSPQ).

PURPOSE: To translate and validate the Life Support Preference Questionnaire (LSPQ) for use with Spanish-speaking adults, and to further validate the English version of the LSPQ. METHODS: Two samples were included: community-dwelling Hispanic and non-Hispanic adults who were monolingual or bilingual Spanish speakers, and an English-speaking sample, all living in south-central United States. Validation included calculation of internal consistency, stability, and alternate forms reliability estimates for two language versions of the LSPQ. Factorial validity was studied for both language versions and regression and t test analyses were done to explore ethnic differences in selection of the life support choices in the scale. FINDINGS: Both language versions of the LSPQ showed strongly supportive measurement properties. Differences were found between ethnic groups on four of the item choices, indicating that Hispanics in this sample preferred interventions to actively support life more than did the non-Hispanic adults. CONCLUSIONS: Both the English and Spanish versions of the LSPQ have been validated for use in research and practice. Additional validation will be necessary in other samples.

Adolescent↗