Allostatic load: a useful concept for advancing nursing research

Peer Reviewedhttps://deepblue.lib.umich.edu/bitstream/2027.42/145197/1/jocn13753.pdfhttps://deepblue.lib.umich.edu/bitstream/2027.42/145197/2/jocn13753_am.pd

Connecting Gender, Race, Class, and Immigration Status to Disease Management

Objective: Chronic diseases are the leading causes of death in the United States. Chronic disease management occurs within all aspects of an individual’s life, including the workplace. Though the social constructs of gender, race, class, and immigration status within the workplace have been considered, their connection to disease management among workers has been less explicitly explored. Using a sample of immigrant hotel housekeepers, we explored the connections between these four social constructs and hypertension management. Methods: This qualitative research study was guided by critical ethnography methodology. Twenty-seven hotel room cleaners and four housemen were recruited (N = 31) and invited to discuss their experiences with hypertension and hypertension management within the context of their work environments. Results: Being a woman worker within the hotel industry was perceived to negatively influence participants’ experience with hypertension and hypertension management. In contrast, being a woman played a protective role outside the workplace. Being an immigrant played both a positive and a negative role in hypertension and its management. Being black and from a low socioeconomic class had only adverse influences on participants’ experience with hypertension and its management. Conclusion: Being a woman, black, lower class, and an immigrant simultaneously contribute to immigrant hotel housekeepers’ health and their ability to effectively manage their hypertension. The connection between these four constructs (gender, race, class, and immigration status) and disease management must be considered during care provision. Hotel employers and policy stakeholders need to consider those constructs and how they impact workers’ well-being. More studies are needed to identify what mitigates the associations between the intersectionality of these constructs and immigrant workers’ health and disease management within their work environment. Keywords: Gender, Race, Class, Immigration, Disease Management, Hospitalit

Exploring the optimal allostatic load scoring method in women of reproductive age

AimsThe aim of this study was to determine the optimal allostatic load scoring method.DesignThis is a secondary analysis of data on women of reproductive age from the 2001-2006 National Health and Nutrition Examination Survey.MethodsWe created allostatic load summary scores using five scoring methods including the count-based, Z-Score, logistic regression, factor analysis and grade of membership methods. Then, we examined the predictive performance of each allostatic load summary measure in relation to three outcomes: general health status, diabetes and hypertension.ResultsWe found that the allostatic load summary measure by the logistic regression method had the highest predictive validity with respect to the three outcomes. The logistic regression method performed significantly better than the count-based and grade of membership methods for predicting diabetes as well as performed significantly better for predicting hypertension than all of the other methods. But the five scoring methods performed similarly for predicting poor health status.ConclusionWe recommended the logistic regression method when the outcome information is available, otherwise the frequently used simpler count-based method may be a good alternative.ImpactThe study compared different scoring methods and made recommendations for the optimal scoring approach. We found that allostatic load summary measure by the logistic regression method had the strongest predictive validity with respect to general health status, diabetes and hypertension. The study may provide empirical evidence for future research to use the recommended scoring approach to score allostatic load. The allostatic load index may serve as an -early warning- indicator for health risk.ç ®ç è¿ é¡¹ç  ç©¶ç ç ®ç å ¨äº ,ç¡®å® æ ä½³é åº è´ è ·è¯ å æ ¹æ³ ã è®¾è®¡è¿ æ ¯å¯¹2001å¹´è ³2006æ é ´å ¨å ½å ¥åº·å è ¥å »æ£ æ ¥è° æ ¥ä¸­è ²é¾ å¦ å¥³æ °æ ®ç äº æ¬¡å æ ã æ ¹æ³ æ ä»¬ä½¿ç ¨äº äº ç§ è¯ å æ ¹æ³ (å æ ¬å ºäº è®¡æ °æ³ ã Z计å æ³ ã é »è¾ å å½ æ³ ã å  å­ å æ æ³ å é ¶å± åº¦æ ¹æ³ )æ ¥å å»ºäº é åº è´ è ·æ± æ »å æ °ã ç ¶å ,æ ä»¬æ£ æ ¥äº ä¸ ä¸ ä¸ªç» æ ç ¸å ³ç å ç§ é åº è´ è ·æ± æ »æ °å ¼ç é¢ æµ æ §è ½:æ ´ä½ å ¥åº·ç ¶æ ã ç³ å°¿ç å é« è¡ å ã ç» æ æ 们å ç °,é »è¾ å å½ æ³ ç é åº è´ è ·æ± æ »å æ °å¯¹è¿ ä¸ ä¸ªç» æ å ·æ æ é« ç é¢ æµ æ 度ã é »è¾ å å½ æ³ å ¨é¢ æµ ç³ å°¿ç æ ¹é ¢ç è¡¨ç °æ æ ¾ä¼ äº å ºäº è®¡æ °æ³ å é ¶å± åº¦æ ¹æ³ ,å ¨é¢ æµ é« è¡ å æ ¹é ¢ç è¡¨ç °ä¹ æ æ ¾ä¼ äº æ æ å ¶ä» æ ¹æ³ ã ä½ è¿ äº ç§ è¯ å æ ¹æ³ å ¨é¢ æµ ä¸ è ¯å ¥åº·ç ¶æ æ ¹é ¢ç è¡¨ç °ç ¸ä¼¼ã ç» è®ºå½ ç» æ èµ æ å ¯ç ¨æ ¶,æ ä»¬æ ¨è é »è¾ å å½ æ³ ,å ¨å ¶ä» æ ¹é ¢,å¸¸ç ¨ä¸ æ ´ç® å ç å ºäº è®¡æ °æ³ å ¯è ½ä¹ æ ¯ä¸ ä¸ªä¸ é ç é æ ©ã å½±å è¯¥ç  ç©¶æ¯ è¾ äº ä¸ å ç è¯ å æ ¹æ³ ,并æ å ºäº æ ä½³è¯ å æ ¹æ³ ç 建议ã æ 们å ç °ç ¨é »è¾ å å½ æ³ è¿ è¡ ç é åº è´ è ·æ± æ »å æ °å¯¹æ ´ä½ å ¥åº·ç ¶æ ã ç³ å°¿ç å é« è¡ å å ·æ æ 强ç é¢ æµ æ æ æ §ã è¯¥ç  ç©¶å ¯ä»¥ä¸ºä» å ä½¿ç ¨æ ¨è ç è¯ å æ ¹æ³ å¯¹æ æ é åº è´ è ·è¯ å æ ä¾ å® éª æ §è¯ æ ®ã é åº è´ è ·æ æ °å ¯ä»¥ä½ ä¸ºå ¥åº·é£ é ©ç -é¢ è­¦-æ æ  ãPeer Reviewedhttps://deepblue.lib.umich.edu/bitstream/2027.42/151983/1/jan14014_am.pdfhttps://deepblue.lib.umich.edu/bitstream/2027.42/151983/2/jan14014.pd

Career Cartography: From Stories to Science and Scholarship

PurposeTo present four case scenarios reflecting the process of research career development using career cartography.Organizing ConstructsCareer cartography is a novel approach that enables nurses, from all clinical and academic settings, to actively engage in a process that maximizes their clinical, teaching, research, and policy contributions that can improve patient outcomes and the health of the public.MethodsFour earlyâ career nurse researchers applied the career cartography framework to describe their iterative process of research career development. They report the development process of each of the components of career cartography, including destination statement, career map, and policy statement.ConclusionsDespite diverse research interests and career mapping approaches, common experiences emerged from the four nurse researchers. Common lessons learned throughout the career cartography process include: (a) have a supportive mentorship team, (b) start early and reflect regularly, (c) be brief and to the point, (d) keep it simple and avoid jargon, (e) be open to change, (f) make time, and (g) focus on the overall career destination.Clinical RelevanceThese four case scenarios support the need for nurse researchers to develop their individual career cartography. Regardless of their background, career cartography can help nurse researchers articulate their meaningful contributions to science, policy, and health of the public.Peer Reviewedhttps://deepblue.lib.umich.edu/bitstream/2027.42/136693/1/jnu12289.pdfhttps://deepblue.lib.umich.edu/bitstream/2027.42/136693/2/jnu12289_am.pd

Blood Pressure and Job Domains Among Hotel Housekeepers

Hotel housekeepers have challenging working conditions, putting them at risk for poor health such as hypertension. Despite their risks, few studies have measured their blood pressure (BP). The purpose of this study was to explore hotel housekeepers’ blood pressure and the associations between work and BP. Methods: A community engagement approach was used to recruit study participants. Data sources included questionnaires, and BP measurement. Results: Over 25% of the 39 hotel housekeepers reported hypertension diagnosis and/or antihypertensive medication used. Across the job domains, job satisfaction was correlated with diastolic BP, and workload was correlated with systolic BP. There were difference in blood pressure reading, diagnosis and job domains between workers affiliated with union and those with no union affiliation. Discussion: Hypertension is a major concern among this worker group and warrants further investigation. Studies targeting union and non-union workers are needed, given their differences. Researchers will likely benefit from a community engagement approach with hotel housekeepers

Ethics in Photovoice: A Response to Teti

Much has been written about the Photovoice method. With the pervasive uptake of this method, debates about its use and ethical considerations will continue to permeate qualitative researchers’ work. Thus, the timeliness of Teti’s 2019 paper about ethical considerations for Photovoice methods. We concur with Teti’s take on the method. We also further had the discussion on Photovoice ethics by emphasizing that (1) as Photovoice methods evolve, so too should ethical considerations, (2) though processes may vary, there are standard ethical considerations that must be adhered to in Photovoice research, and (3) researcher intentionality is important in considering the digital image as a driver of social change. The potential for Photovoice to contribute to social change remains appealing, especially given the current disparaging economic, political, social, and environmental climate

“You get three different hats on and try to figure it out:” home based care provision during a disaster

Abstract Background Home based care is a vital, and growing, part of the health care system that allows individuals to remain in their homes while still receiving health care. During a disaster, when normal health care systems are disrupted, home based care remains a vital source of support for older adults. The purpose of this paper is to qualitatively understand the barriers and facilitators of both patients and providers that influence the provision of home based care activities in two hurricane affected communities. Methods Using qualitative inquiry informed by the social ecological model, five focus groups were conducted with home based care providers (n = 25) in two settings affected by Hurricane Irma and Hurricane Harvey. An open-source database of home health agencies participating in Centers for Medicare and Medicaid Services programs was used to identify participants. Data were manually coded and larger themes were generated from recurring ideas and concepts using an abductive analysis approach. Results Twenty five participants were included in one of five focus groups. Of the 22 who responded to the demographic survey, 65 % were registered nurses, 20 % were Licensed Vocational Nurses (LVN), and 15 % were other types of health care providers. 12 % of the sample was male and 88 % was female. Five themes were identified in the analysis: barriers to implementing preparedness plans, adaptability of home based care providers, disasters exacerbate inequalities, perceived unreliability of government and corporations, and the balance between caring for self and family and caring for patients. Conclusions This study provides qualitative evidence on the factors that influence home based care provision in disaster-affected communities, including the barriers and facilitators faced by both patients and providers in preparing for, responding to and recovering from a disaster. While home based care providers faced multiple challenges to providing care during and after a disaster, the importance of community supports and holistic models of care in the immediate period after the disaster were emphasized. We recommend greater inclusion of home health agencies in the community planning process. This study informs the growing body of evidence on the value of home based care in promoting safety and well-being for older adults during a disaster.http://deepblue.lib.umich.edu/bitstream/2027.42/173523/1/12912_2021_Article_676.pd

Immigration-related stressors and health outcomes among low-wage immigrant hotel workers: A pilot study

BackgroundImmigrants comprise over 40% of the low-wage workforce. They are more likely to be employed in service industries, paid less, and experience more illness and injuries than their native counterparts.Design/ObjectiveThe aim of this cross-sectional pilot study was to explore the relationship between immigrant workers’ stressors and health.SampleTwenty-five female Mexican immigrant hotel workers.MeasurementsSurveys and blood samples were analyzed and compared to national data. Descriptive statistics and linear regression were used for analysis.ResultsLonger length of stay, older age at migration, and higher Demands of Immigration (DI) were significantly associated with more chronic conditions. Higher DI were significantly associated with more depressive symptoms. This is comparable to national data (n = 468) which shows a significant relationship between length of stay, Allostatic Load (AL), and chronic conditions (β = 0.14, p = .043; β = 0.13, p = .025).ConclusionsImmigrant-specific factors affect individuals’ health. More studies are needed to further explore the relationship between DI and health among foreign-born workers.Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/174936/1/phn13086.pdfhttp://deepblue.lib.umich.edu/bitstream/2027.42/174936/2/phn13086_am.pd

Creating Emancipatory Dialogues About Identity and Health by Modernizing Interviews

Emancipatory insights about health as constituted by demographic identity codifiers remain hidden using current interview methods and analytic techniques. The purpose of this article is to demonstrate how the Identity, Research, and Health Dialogic Open-Ended (I-ReH-DO) Interview was used across 3 separate research topics to enhance emancipatory knowledge development. Three featured research topics focus on health issues relevant to populations worldwide, including asthma management, hypertension management, and preconception care. The use of the I-ReH-DO Interview across multiple studies supports the power of participants to define identity and its health significance, contextualizes research analysis, and advances emancipatory understandings