Patterns of psychological distress in mothers of preterm infants.

Mothers of preterm infants experience significant psychological distress, with elevated levels of inter-correlated depressive, stress, anxiety and post-traumatic stress symptoms. In a sample of racially and ethnically diverse mothers of preterm infants, we identified differing patterns of psychological distress during infant hospitalization and examined the effect of these psychological distress patterns on longitudinal trajectories of each psychological distress measure and on maternal perceptions of the child over the first year of the infant's life. Mothers of preterm infants (N=232) completed five questionnaires assessing depressive symptoms, anxiety, post-traumatic stress symptoms, stress due to infant appearance, and stress due to parental role alteration during enrollment during the neonatal hospitalization, discharge, and at 2, 6, and 12 months of age adjusted for prematurity.

Results of the Chronic Heart Failure Intervention to Improve MEdication Adherence study: A randomized intervention in high-risk patients.

Background: Poor adherence to evidence-based medications in heart failure (HF) is a major cause of avoidable hospitalizations, disability, and death. To test the feasibility of improving medication adherence, we performed a randomized proof-of-concept study of a self-management intervention in high-risk patients with HF.

Methods: Patients with HF who screened positively for poor adherence (<6 Morisky Medication Adherence Scale 8-item) were randomized to either the intervention or attention control group.

Maternally administered interventions for preterm infants in the NICU: effects on maternal psychological distress and mother-infant relationship.

Although studies have examined the effects of interventions focused on preterm infants, few studies have examined the effects on maternal distress (anxiety, depressive symptoms, post-traumatic stress symptoms, parenting stress) or parenting. This study examined the effects of the auditory-tactile-visual-vestibular (ATVV) intervention and kangaroo care (KC) on maternal distress and the mother-infant relationship compared to an attention control group. 240 mothers from four hospitals were randomly assigned to the three groups.

Feasibility and preliminary effects of a virtual environment for adults with type 2 diabetes: pilot study.

Background: Innovative interventions that empower patients in diabetes self-management (DSM) are needed to provide accessible, sustainable, cost-effective patient education and support that surpass current noninteractive interventions. Skills acquired in digital virtual environments (VEs) affect behaviors in the physical world. Some VEs are programmed as real-time three-dimensional representations of various settings via the Internet.

Evaluation of neonatal peripherally inserted central catheter tip movement in a consistent upper extremity position.

Objective: To compare the effect of standardized upper extremity position versus varied upper extremity positions on neonatal peripherally inserted central catheter (PICC) tip placement and movement. Secondary outcomes assessed were compliance with education, implementation, and complication rates.

Study Design: Tip movement was analyzed between 136 post-PICC insertion x-ray pairs from 72 infants in the 6 months before and after standardization of upper extremity position.

Maternal satisfaction with administering infant interventions in the neonatal intensive care unit.

Objective: To examine mothers' satisfaction with administering interventions for their preterm infants and with the helpfulness of the study nurse by comparing massage with auditory, tactile, visual, and vestibular stimulation (ATVV intervention), kangaroo care, and education about equipment needed at home and to explore whether mother and infant characteristics affected maternal satisfaction ratings.

Design: Three-group experimental design.

Setting: Four neonatal intensive care units (NICUs) (two in North Carolina, two in Illinois).

A pilot study to examine maturation of body temperature control in preterm infants.

Objective: To test instrumentation and develop analytic models to use in a larger study to examine developmental trajectories of body temperature and peripheral perfusion from birth in extremely low-birth-weight (EBLW) infants.

Design: A case study design.

Setting: The study took place in a Level 4 neonatal intensive care unit (NICU) in North Carolina.

Relationships among factual and perceived knowledge of harms of waterpipe tobacco, perceived risk, and desire to quit among college users.

Waterpipe tobacco smoking is increasing in the United States among college students. Through a web-based survey, we explored associations among factual and perceived knowledge, perceived risks and worry about harm and addiction, and desire to quit among 316 college waterpipe tobacco smoking users. Overall, factual knowledge of the harm of waterpipe tobacco smoking was poor, factual and perceived knowledge was weakly correlated, both forms of knowledge were related inconsistently to perceived risks and worry, and neither form of knowledge was associated with the desire to quit.

The promise of the state space approach to time series analysis for nursing research.

Background: Nursing research, particularly related to physiological development, often depends on the collection of time series data. The state space approach to time series analysis has great potential to answer exploratory questions relevant to physiological development but has not been used extensively in nursing.

Objectives: The aim of the study was to introduce the state space approach to time series analysis and demonstrate potential applicability to neonatal monitoring and physiology.

The effects of environmental noise and infant position on cerebral oxygenation.

Purpose: To assess how different infant positions and peak sound levels affected cerebral oxygen saturation over time.

Subjects: Twenty-four premature infants who were born less than 32 weeks' gestational age without congenital cardiac, neurologic, and gastrointestinal anomalies.

Design: Repeated-measures design with the first observation between 2 and 48 hours of life; once again between 49 and 96 hours of life; on day of life 7; and every 7 days thereafter until discharge home, transfer to another hospital, or 40 weeks postmenstrual age, whichever came first.

Advances in mediation analysis can facilitate nursing research.

Background: Two recent advances in the statistical methods for testing hypotheses about mediation effects are important for nursing science. First, bootstrap sampling distributions provide more accurate tests of hypotheses about mediated effects. Second, methods for testing statistical hypotheses about subgroup differences in mediation models (moderated mediation) are now well developed.

Impact of health portal enrollment with email reminders on adherence to clinic appointments: a pilot study.

Background: Internet portal technologies that provide access to portions of electronic health records have the potential to revolutionize patients' involvement in their care. However, relatively few descriptions of the demographic characteristics of portal enrollees or of the effects of portal technology on quality outcomes exist. This study examined data from patients who attended one of seven Duke Medicine clinics and who were offered the option of enrolling in and using the Duke Medicine HealthView portal (HVP).

Affecting perceptions of harm and addiction among college waterpipe tobacco smokers.

Introduction: The spread of waterpipe tobacco use among youth may be due in part to perceptions that waterpipe tobacco use is safer than other tobacco products, such as cigarettes. In two pilot studies, we sought to modify college waterpipe smokers' perceived risks and worry about waterpipe tobacco smoking.

Methods: We conducted two web-based studies that varied whether college waterpipe users received information on (a) spread of and use of flavored tobacco in waterpipe and (b) harms of waterpipe smoking.

Measuring addiction propensity and severity: the need for a new instrument.

Drug addiction research requires but lacks a valid and reliable way to measure both the risk (propensity) to develop addiction and the severity of manifest addiction. This paper argues for a new measurement approach and instrument to quantify propensity to and severity of addiction, based on the testable assumption that these constructs can be mapped onto the same dimension of liability to addiction. The case for this new direction becomes clear from a critical review of empirical data and the current instrumentation.

Potential Pitfalls in Collecting and Analyzing Longitudinal Data from Chronically Ill Populations.

Research on the prevention and management of chronic illnesses involves understanding changes in complex and interrelated aspects of each individual. To capture these changes or to control for them, nursing and health research needs to be longitudinal. However, there are a number of potential pitfalls in analyzing longitudinal data from a chronically ill population.