Student, Preceptor, and Faculty Perceptions of Three Clinical Learning Models.

Background: Nursing faculty members strive to use optimal clinical learning environments that educate students for clinical competence and sense of salience. The purpose of this study was to offer insight into the perceptions of students, preceptors, and faculty in three clinical models: traditional, precepted, and a hybrid blend.

Method: One hundred fifty students, seven preceptors, and 12 faculty members responded to open-ended survey questions about their experience in one of the models.

PATTERNS OF HEALTHCARE ENCOUNTERS EXPERIENCED BY PATIENTS WITH CHRONIC KIDNEY DISEASE.

Background: Patterns of healthcare encounters by patients in each stage of chronic kidney disease (CKD) have not been fully described.

Objective: This study describes patterns of healthcare resource use by patients with CKD.

Design: A retrospective descriptive design was used.

Knowledge and Awareness Among Patients with Chronic Kidney Disease Stage 3.

Knowledge is a prerequisite for changing behavior, and is useful for improving outcomes and reducing mortality rates in patients diagnosed with chronic kidney disease (CKD). The purpose of this article is to describe baseline CKD knowledge and awareness obtained as part of a larger study testing the feasibility of a self-management intervention. Thirty patients were recruited who had CKD Stage 3 with coexisting diabetes and hypertension.

Patient activation with knowledge, self-management and confidence in chronic kidney disease.

Background: Chronic kidney disease is a growing health problem on a global scale. The increasing prevalence of chronic kidney disease presents an urgent need to better understand the knowledge, confidence and engagement in self-managing the disease.

Objectives: This study examined group differences in patient activation and health-related quality of life, knowledge, self-management and confidence with managing chronic disease across all five stages of chronic kidney disease.

Self-management interventions in stages 1 to 4 chronic kidney disease: an integrative review.

The prevalence, effect on health outcomes, and economic impact of chronic kidney disease (CKD) have created interest in self-management interventions to help slow disease progression to kidney failure. Seven studies were reviewed to identify knowledge gaps and future directions for research. All studies were published between 2010 and 2013; no investigations were conducted in the United States.

Development and testing of the feasibility and acceptability of a tailored dietary intervention in patients with heart failure.

Purpose: The aim of this study was to describe how to develop a theory-based tailored dietary intervention (TADI) and test its feasibility and acceptability in patients with heart failure (HF).

Methods: The development team consisted of experts in HF, nutrition, and clinical trials. Four patients with HF and 3 additional experts reviewed intervention materials and provided feedback.

Formative evaluation of a mobile liquid portion size estimation interface for people with varying literacy skills.

Chronically ill people, especially those with low literacy skills, often have difficulty estimating portion sizes of liquids to help them stay within their recommended fluid limits. There is a plethora of mobile applications that can help people monitor their nutritional intake but unfortunately these applications require the user to have high literacy and numeracy skills for portion size recording. In this paper, we present two studies in which the low- and the high-fidelity versions of a portion size estimation interface, designed using the cognitive strategies adults employ for portion size estimation during diet recall studies, was evaluated by a chronically ill population with varying literacy skills.

Non-pharmaceutical fatigue interventions in adults receiving hemodialysis: a systematic review.

Fatigue is common for individuals receiving hemodialysis and can lead to decreased physical function, quality of life, and survival. Because fatigue is frequently reported as bothersome, nurses must discover effective ways to assist patients to manage this symptom. The purpose of this systematic review was to examine the effectiveness of non-pharmacologic interventions used to minimize fatigue.

Needs, concerns, strategies, and advice of daily home hemodialysis caregivers.

Improved patient outcomes have led to increased international interest in daily home hemodialysis as a kidney replacement therapy. Daily home hemodialysis often requires the assistance of a caregiver during and between treatments. Understanding the needs and concerns of caregivers of persons on daily home hemodialysis will inform the design of supportive interventions to improve caregiver retention and maintain their health and well-being.

Using a mobile application to self-monitor diet and fluid intake among adults receiving hemodialysis.

Hemodialysis patients have difficulty self-managing a complex dietary and fluid regimen. The purpose of this feasibility study was to pilot test an electronic self-monitoring intervention based on social cognitive theory. During a 6-week intervention, 24 participants self-monitored diet and fluid intake using the Dietary Intake Monitoring Application (DIMA), and 20 participants served as controls by monitoring their activity using the Daily Activity Monitor Application (DAMA).

Systematic review of health-related quality of life models.

Background: A systematic literature review was conducted to (a) identify the most frequently used health-related quality of life (HRQOL) models and (b) critique those models.

Methods: Online search engines were queried using pre-determined inclusion and exclusion criteria. We reviewed titles, abstracts, and then full-text articles for their relevance to this review.

An offline mobile nutrition monitoring intervention for varying-literacy patients receiving hemodialysis: a pilot study examining usage and usability.

Objective: Design and evaluation of the dietary intake monitoring application (DIMA) to assist varying-literacy patients receiving hemodialysis to adhere to their prescribed dietary regimen.

Methods: An iterative, user-centered design process informed by Bandura's social cognitive theory was employed to design DIMA--a mobile application that utilizes touch-screen, visual interfaces; barcode scanning; and voice recording to assist varying-literacy patients receiving hemodialysis to self-monitor their diet. A pilot field study was conducted where 18 patients receiving hemodialysis were recruited face-to-face from two dialysis facilities to use DIMA for 6 weeks.

Development and psychometric testing of the colonoscopy embarrassment scale.

Colorectal cancer, the third leading cause of cancer-related death in the United States, could largely be prevented if more people had polyps removed via colonoscopies. Embarrassment is one important barrier to colonoscopy, but little is known about embarrassment in this context, and there were no reliable and valid measures of this construct. The purpose of this study was to develop a reliable and valid instrument to measure colonoscopy-related embarrassment.

The Design of a Mobile Portion Size Estimation Interface for a Low Literacy Population.

Being aware of one's portion sizes is a key component of maintaining a healthy diet, however, it is difficult for individuals especially low literacy populations to estimate their consumption. Nutritional monitoring applications can help but most of them are designed for people with high literacy and numeracy skills. In this paper, we designed and evaluated six portion size estimation interfaces through a Wizard of Oz based experiment using low-fidelity prototypes with ten varying literacy individuals.

A new instrument to measure quality of life of heart failure family caregivers.

Background And Purpose: Family caregivers of heart failure (HF) patients experience poor physical and mental health leading to poor quality of life. Although several quality-of-life measures exist, they are often too generic to capture the unique experience of this population. The purpose of this study was to evaluate the psychometric properties of the Family Caregiver Quality of Life (FAMQOL) Scale that was designed to assess the physical, psychological, social, and spiritual dimensions of quality of life among caregivers of HF patients.

Perceived informational needs, problems, or concerns among patients with stage 4 chronic kidney disease.

The purpose of this descriptive study was to describe the informational needs, problems, or concerns of patients with Stage 4 CKD and to describe what is desired in an educational program for them. Awareness of needs can facilitate the development of quality educational programs for this complex patient population. This study found the top four informational needs, problems, or concerns since reaching Stage 4 included knowledge of kidney disease, taking medication the physician prescribed, care of an access, and financial concerns.

Merging health literacy with computer technology: self-managing diet and fluid intake among adult hemodialysis patients.

Objective: The Dietary Intake Monitoring Application (DIMA) is an electronic dietary self-monitor developed for use on a personal digital assistant (PDA). This paper describes how computer, information, numerical, and visual literacy were considered in development of DIMA.

Methods: An iterative, participatory design approach was used.

Validity and reliability of the chronic heart failure questionnaire mastery subscale in patients with defibrillators.

Reliable, valid measures are needed to assess one's sense of mastery, which has the potential for decreasing anxiety and depressive symptoms among patients with implantable cardioverter-defibrillators (ICDs). This study evaluates the reliability and validity of a measure of mastery, the Chronic Heart Failure Questionnaire (CHQ) mastery subscale. One hundred twenty-two (75% men, mean age 65 years) and 100 patients complete baseline and 12-month face-to-face interviews, respectively.

Physical function of patients with implantable cardioverter-defibrillators.

Background: Patients with implantable cardioverter-defibrillators (ICDs) face problems in physical function, but little is known about how mastery predicts physical function over time.

Purpose: The primary purpose of this study was to examine the influence of mastery (assessed at baseline) on physical function (observed distance walked and perceived function) over 12 months among ICD patients. Secondary purposes were to (1) examine the influence of aging, in interaction with mastery, on physical function and (2) determine predictors of 12-month physical function.

Patterns of interdialytic weight gain during the first year of hemodialysis.

This retrospective study describes patterns of interdialytic weight gain (IWG) over the first year of hemodialysis in 27 individuals. IWG increased over the first 12 weeks and appeared to reverse after 12 weeks, increasing again after 32 weeks. Interventions may need to occur after the individual has been receiving treatment for 12 weeks; booster interventions may be indicated after 32 weeks.

Use of electronic self-monitoring for food and fluid intake: A pilot study.

In this small pilot study, the authors examined the use of a personal digital assistant (PDA) to electronically self-monitor the dietary and fluid intake of individuals receiving hemodialysis. The purpose of this study was to describe intake patterns of fluid, sodium, potassium, phosphorus, protein, and calories over a 3-month period as recorded using a PDA. Mean weekly intake values were plotted on line graphs to examine trends of intake.

Benefits of and barriers to dietary sodium adherence.

Failure to limit dietary sodium leads to thirst, large fluid weight gain, and poor outcomes in patients receiving hemodialysis. Perceived benefits and barriers may influence adherence; however, tools measuring these relationships are not available. This study's purpose, based on the health belief model, was to evaluate the reliability and validity of the Beliefs about Dietary Compliance Scale (BDCS), describe perceived benefits and barriers over time, and identify individual benefits and barriers that may be amenable to tailored interventions.

Nutrition in chronic heart failure with coexisting chronic kidney disease.

Background And Research Objectives: Patients with heart failure (HF) may be predisposed to malnutrition. Little is known about the nutritional status of patients with HF, particularly patients who have coexisting major medical conditions such as chronic kidney disease. The purposes of this study were to (1) describe the nutritional status of 211 patients with chronic HF, (2) examine relationships between nutrition variables and health-related quality of life, and (3) evaluate the nutritional status of the subset of HF patients with coexisting chronic kidney disease.

Psycho-educational strategies to promote fluid adherence in adult hemodialysis patients: a review of intervention studies.

Background: We reviewed psycho-educational intervention studies that were designed to reduce interdialytic weight gain (IDWG) in adult hemodialysis patients. Our goals were to critique research methods, describe the effectiveness of tested interventions, and make recommendations for future research.

Methods: Medline, PsychInfo, and the Cumulative Index to Nursing and Applied Health (CINAHL) databases were searched to identify empirical work.