This project focused on identifying the best evidence available on the use of cognitive behavior therapy (CBT) for pediatric patients and families with sickle cell disease (SCD) to improve their coping skills with pain management. This resulted from an identified gap in nursing practice regarding psychosocial support for this subset of hospitalized pediatric patients. The practice-focused question was whether there was evidence in the literature on the use of CBT techniques to improve parental coping skills with children who have chronic and life-threatening illness that could be utilized with sickle cell disease. The theory of stress and coping guided the underpinnings of the study process. The Johns Hopkins Nursing evidence-based practice model (JHNEBP) was the framework for this project. A systematic review was conducted utilizing research-based articles from the major healthcare databases. The original search resulted in over 12,000 articles. This pool was further refined based upon a link between the pediatric population with chronic or life-threatening conditions and family coping skills. This was further narrowed down based on the use of social-cognitive therapy and coping skills. This process resulted in 6 research articles on the use of CBT with the target population. An evaluation of these studies found evidence that CBT can improve parental coping skills. Nursing support for parental coping with SCD has the positive social impact of decreased parental stress and improved quality of life for both the child and the family unit.

No description available.

No description available.

No description available.

No description available.

The purpose of this descriptive correlational study was to examine the comeback phase of the Trajectory of Chronic Illness Management for Appalachian women stroke survivors. This study predicted comeback as a relationship between physical healing, biographical reengagement, and psychological coming to terms that was mediated by rehabilitation. The concepts were evaluated through investigation of function and cognitive abilities, self-assessment of recovery, health rating, ability to control life, relationship changes, physical and mental health, and limitations of activities due to poor physical or mental health. Data were collected using, the Stroke Impact Scale (3.0) (Duncan, Bode, Lia, & Perera, 2003), the Relationship Change Scale (Guerney, 1971), and the Health-Related-Quality-of-Life-4 Scale (Morarity, Zack, & Kobau, 2003). Descriptive statistics summarized patient characteristics. Continuous variables were analyzed using bivariate relationships expressed as Pearson correlation coefficients. The difference between groups (stroke severity and stroke type) and measurement variables were analyzed using independent ttest and ANOVA. Multiple linear regressions were completed to evaluate simultaneous effects of the independent variables. Forty-six English-speaking, Caucasian women ages 40-78 who had experienced stroke at least 1 year prior to enrollment and were independently living in their home environment participated. The mean age was 57 years with survivorship ranging from 1 to 36 years. Function and cognition scores were similar to the established test range for the SIS V 3.0. Women with moderate ischemic stroke scored statistically higher for recovery score (p Study findings suggest comeback can be predicted by the theoretical propositions of the Trajectory Theory of Chronic Illness Management: physical healing, biographical reengagement, and psychologically coming to terms (Corbin & Strauss, 1991). A strong relationship exists among the phases representative of comeback, while rehabilitation procedures and interpersonal relationships demonstrated only modest significance.

Individuals exposed to abuse, neglect, and household dysfunction during childhood are at increased risk of developing chronic illnesses including heart disease, cancer, and chronic emphysema. A relationship between early childhood adversity and health risk factors contributing to chronic disease such as smoking, obesity, and sedentary lifestyle has also been established in prior literature. Chronic conditions carry many negative consequences at both societal and individual levels and have been associated with significant financial cost, a decline in quality of life, and functional impairment. According to research, more than half of an average community sample has experienced at least one type of adverse childhood experience, including psychological, physical, or sexual abuse or substance abuse, mental illness, domestic violence, or criminal behavior within the household, with approximately 25% experiencing two or more. However, there is evidence that higher than usual levels of trauma exist in forensic inpatient samples, which may increase the odds of chronic disease development in this population. Despite this evidence, little research exists examining the prevalence of adverse childhood experiences in forensic mental health clients, as well as the relationship between trauma and chronic health conditions and risky health behaviors in this population. Archival data were collected from a forensic psychiatric facility in the Midwestern US. Inclusion criteria included admission since 2005, residence for at least one year, and discharge prior to data collection. A list of clients (N=182) meeting inclusion criteria was randomly generated by the facility’s research coordinator. Medical, psychiatric, social services, and annual review reports as well as discharge summaries were coded by three trained research assistants. The sample was predominantly male (N=147; 80.8%) and Caucasian (N=101; 55.5%). The average admission age was 32.5 years (SD=11.6 years) and average discharge age was 40.5 years (SD=12.7). Reasons for initial admission include transfers from lower-security facilities for aggressive behavior, lack of competency to stand trial, direct admission from the state department of corrections, suicidality or self-harm behavior, and pretrial evaluation. All participants were civilly committed to the facility at the time of discharge. In this study, frequencies and descriptive statistics will illustrate the prevalence of adverse childhood experiences broadly and categorically within a forensic inpatient facility. Logistic regression will also be used to examine the relationship between adverse childhood experience and later chronic disease diagnosis. A hierarchical regression will also be used to evaluate to what extent risky health behaviors account for relationships between chronic diseases and adverse childhood exposures. Results may explain how trauma exposure may increase the likelihood of chronic illness among forensic mental health patients.

The purpose of this study was to qualitatively examine family relationships in families where one adult member was diagnosed with chronic illness resulting in chronic pain to determine why the crucible, or trial, of chronic illness triggered some families to strengthen while others weakened. The introduction of chronic illness instigates a process of change in family life, yet there is a paucity of research examining families in this situation, specifically when the chronic illness results in chronic pain. Utilizing grounded theory methodology and qualitative data analysis methods, dyadic interviews and periods of observation were conducted with six families across the United States. Questions were focused on family relationships and the impact of adult-onset chronic illness on relationships and family life. Open, axial, and selective coding were conducted during the process of data analysis, illuminating the important role family unity played in helping families remain strong. Findings detail the relationship between family strength and family unity. Adult-onset chronic illness provided a catalyst for families to establish and/or maintain family unity. Five families established or maintained family unity and reported positive changes in family strength, while one family failed to maintain or establish family unity and reported negative changes in family strength leading to separation and eventually divorce. This study has important implications for families facing adult-onset chronic illness and for practitioners serving this population.

Emerging evidence indicates self-compassion can be beneficial for medical populations and for medical adherence; yet, research to date has not fully examined the reasons for this association. This study examined the association of dispositional self-compassion to adherence across five medical samples and tested the extent to which perceived stress accounted for this association. Five medical samples (total N = 709), including fibromyalgia, chronic fatigue syndrome, and cancer patients, recruited from various sources, completed online surveys. Self-compassion was positively associated with adherence in all five samples. A meta-analysis of the associations revealed a small average effect size (average r = .22, [0.15, 0.29]) of self-compassion and adherence and non-significant heterogeneity among the effects (Q (4) = 3.15, p = .532). A meta-analysis of the kappa2 values from the indirect effects of self-compassion on adherence revealed that, on average, 11% of the variance in medical adherence that was explained by self-compassion could be attributed to lower perceived stress. Overall, findings demonstrate that dispositional self-compassion is associated with better medical adherence among people with fibromyalgia, chronic fatigue syndrome, and cancer, due in part to lower stress. This research contributes to a growing evidence base indicating the value of self-compassion for health-related behaviours in a variety of medical populations.

The purpose of this review of literature was to understand the role of mobile device applications in health related conditions and to analyze their effects on health outcomes related to the management of chronic illnesses. Implications for future use of applications in client-centered care and interpretation of the data by health care providers was also explored. Peer-reviewed, English-language research articles published from 2008 to present were included for synthesis. Study results revealed positive outcomes when health-related mobile applications were used in practice and support clinicians' use of mobile applications as a tool for monitoring symptoms and communicating with individuals. The literature indicated nurses play a significant role in providing feedback, which reinforces self-care strategies and adherence, with the potential for improving outcomes. Additional research is needed to evaluate the long-term effects of applications on patient outcomes, nurses' perspectives, and feasibility of implementation into practice.