Research With Cognitively Impaired Participants

Illnesses that cause cognitive impairment are a considerable health problem in the United States. These include Alzheimer's disease, Huntington's chorea, cerebrovascular disease, psychiatric disorders, chronic alcoholism, and AIDS dementia complex. Illness associated with cognitive impairment may cause great suffering to the affected patients and their families. Research involving individuals who may be at risk for or have cognitive impairment is necessary to improve our understanding of these illnesses. For example, this may occur during efforts to develop effective therapies to treat them. However, research with participants who have cognitive impairment presents additional ethical concerns because they may be vulnerable to coercion. Therefore, nurse researchers must not only understand the principles of informed consent (i.e., autonomy, beneficence, nonmaleficence, and justice), but also the additional safeguards provided in the common rule to protect cognitively impaired participants in research. These safeguards include advanced informed consent, legal representative, and assent. Gaps exist in federal regulations related to adhering to these safeguards such as how to assess for decision-making capacity and variations on who can be a legal representative. The nurse researchers have potential roles as educators and advocates in research involving participants with cognitive impairment

Educational QUality-improvement in APRN Learning: Reducing Health Inequities for ALL Program (EQUAL-ALL Program)

We proposed a quality improvement project focused on MSN students to ensure they are well prepared to contribute with all diverse patient populations from both the United States and beyond. Specific aims are to assess MSN students’ learning needs and develop and implement a training program to increase MSN students’ knowledge and skills for working with different others

Problems and Goals Identified by Primary Caregivers of Children with Mental Health Problems During a Problem-solving Intervention

Building Our Solutions and Connections intervention focused on enhancing problem-solving skills of 44 primary caregivers of children with mental health problems. Problems and goals were identified by individual caregivers during a nine week problem-solving intervention that included a face-to-face one-hour intervention followed by eight half-hour telephone interventions. The problem identified most often was child behavior (43 times). A summary of the problems and goals selected by these primary caregivers has been described

A review of the roles of community members and patients beyond advising in the research process

poster abstractCommunity members (i.e., community advisory boards or CABs) give researchers priceless insight about community needs, cultural norms, and health practices. Typically, CABs inform the early stages of a research project including the explication of needs and design of the intervention. However, the role of community members and patients beyond that of advising and as full members of the research team, is still unclear. This gap needs to be addressed because funding agencies are demanding that community members and patients be involved in all aspects of the research process. Hence, before we began our community intervention we reviewed the literature to explore what has been written about CAB’s role in research. We examined the: 1) researcher’s primary purpose in collaborating with a CAB, 2) tasks completed by the CAB, 3) frequency of CAB meetings, and 4) reimbursement to CABs. We searched the PsycINFO, PUBMED, and CINAHL databases using the search terms community advisory boards, intervention development, patient advisory board, and health advisory board-including and analyzing 25 articles. Content analyses revealed the following: 1 and 2) The researcher’s primary purpose and the tasks designated to CAB members were similar. Common tasks include providing education, building relationships and trust between researchers and participants, and evaluating intervention outcomes. 3) Frequency of the CAB meetings ranged from at least monthly to yearly; most common was monthly. 4) Reimbursement varied from a stipend to training/education to hourly pay. Based on our review, there appears to very limited information or clarity on the role of community members on research teams beyond simply advising. Future research needs to clearly document roles, duration of roles, and compensation for community members as co-investigators or members of research teams. We need this information to meet the national calls for research that fully involves the community members and patients that we serve

How African American Adolescents Manage Depression: Being With Others

BACKGROUND: African American (AA) adolescents with depression face serious negative outcomes. Despite racial/ethnic disparities in treatment utilization, few studies have explored how AA adolescents manage their depression. OBJECTIVE: To describe common ways AA adolescents manage depressive symptoms through relationships with people in their lives. DESIGN: Qualitative descriptive methods were used to analyze the narratives of 22 AA young adults who had been depressed as adolescents and 5 AA adolescents in treatment for depression. RESULTS: A typology describing the varied ways AA adolescents manage their depressive symptoms through interactions with other people was constructed and labeled Being With Others. The five categories in the typology are keeping others at bay, striking out at others, seeking help from others, joining in with others, and having others reach out CONCLUSIONS: Clinicians might use the Being With Others typology to guide discussions related to detecting, assessing, and treating AA adolescents with depression

Impact of Disruptive Behavior Disorder on Siblings Living with Affected Adolescents

poster abstractDisruptive behavior disorder (DBD) is a mental disorder that includes Oppositional Defiant Disorder and Conduct Disorder. DBD affects 10% of adolescents in the United States with significant stress on the entire family. Research has described the impact of chronic illness on family members but have focused mostly on primary caregivers or mothers. Even fewer studies considered DBD and how it impacts siblings. Before interventions can be developed to address the impact on siblings, we must first understand the experiences they have as a result of living with an adolescent with DBD. The aim of this report was to describe the impact on siblings who live with adolescents with DBD. The report is part of a larger qualitative descriptive study about experiences and needs of family member of adolescents with DBD. The samples for this report were 16 siblings who were 9 to 23 years, 75% male, and 75% Black. We interview siblings in their homes; audio recorded and transcribed all data. Three researchers conducted content analysis of their narratives. We grouped the data into four topics: positive impact, negative impact, interventions and/or coping mechanisms used to address impact, and what the siblings need for support. Siblings said (1) stress, blanket punishment, planned or desired activity disruption, and physical attack as negative impact; avoidance, utilization of anger management techniques, and reacting with violence as coping mechanisms; (3) the adolescents need more treatment, the family members need better communication, financial assistance, and more time together. Siblings did not describe any positive impact of DBD. Our findings reinforce the negative impact on siblings of adolescents with DBD; adds to the literature by its inclusion of a large African American sample; and supports nurses’ role in assessing the impact of DBD on siblings of the affected adolescents

A nurse-physician led multidisciplinary team improves access, treatment, and management of diabetes and high blood pressure in adult residents of a rural community in Nigeria

Developing countries have limited resources contributing to high morbidity and mortality rates from chronic diseases. The purpose of this presentation is to describe an innovative nurse-physician led international collaboration to increase access to health care and improve treatment and behavioral management of diabetes and hypertension in adult residents of a rural community in Nigeria, West Africa