Factors Influencing the Impact of Depressive Symptoms on Physical Functional Capacity After Cardiac Rehabilitation

Purpose This study aims to determine (1) if depressive symptoms in the year following completion of cardiac rehabilitation impact physical functional capacity and (2) if exercise, perceived benefits and barriers, self-efficacy, and social support moderate this relationship. Design This longitudinal correlational secondary data analysis included 379 cardiovascular rehabilitation patients. Methods Participants completed measures of depression and potential moderating variables at baseline, 2 months, 6 months, and 12 months and 6-minute work test at baseline and 12 months and wore heart rate monitors to measure exercise for 12 months. Findings Poorer physical functional capacity was predicted by depressed mood score. This relationship was moderated by the percentage of time exercising in target heart rate zone and family support of exercise, but not by perceived benefits and barriers or self-efficacy for exercise. Conclusions Depressive symptoms negatively impact physical functional capacity, and this relationship is moderated by family support and the percentage of time exercising in target heart rate zone

Integrating Emerging Areas of Nursing Science into PhD Programs

The Council for the Advancement of Nursing Science aims to “facilitate and recognize life-long nursing science career development” as an important part of its mission. In light of fast-paced advances in science and technology that are inspiring new questions and methods of investigation in the health sciences, the Council for the Advancement of Nursing Science convened the Idea Festival for Nursing Science Education and appointed the Idea Festival Advisory Committee to stimulate dialogue about linking PhD education with a renewed vision for preparation of the next generation of nursing scientists. Building on the 2010 American Association of Colleges of Nursing Position Statement “The Research-Focused Doctoral Program in Nursing: Pathways to Excellence,” Idea Festival Advisory Committee members focused on emerging areas of science and technology that impact the ability of research-focused doctoral programs to prepare graduates for competitive and sustained programs of nursing research using scientific advances in emerging areas of science and technology. The purpose of this article is to describe the educational and scientific contexts for the Idea Festival, which will serve as the foundation for recommendations for incorporating emerging areas of science and technology into research-focused doctoral programs in nursing

Emerging Areas of Science: Recommendations for Nursing Science Education from the Council for the Advancement of Nursing Science Idea Festival

The Council for the Advancement of Nursing Science aims to “facilitate and recognize life-long nursing science career development” as an important part of its mission. In light of fast-paced advances in science and technology that are inspiring new questions and methods of investigation in the health sciences, the Council for the Advancement of Nursing Science convened the Idea Festival for Nursing Science Education and appointed the Idea Festival Advisory Committee (IFAC) to stimulate dialogue about linking PhD education with a renewed vision for preparation of the next generation of nursing scientists. Building on the 2005 National Research Council report Advancing The Nation\u27s Health Needs and the 2010 American Association of Colleges of Nursing Position Statement on the Research-Focused Doctorate Pathways to Excellence, the IFAC specifically addressed the capacity of PhD programs to prepare nursing scientists to conduct cutting-edge research in the following key emerging and priority areas of health sciences research: omics and the microbiome; health behavior, behavior change, and biobehavioral science; patient-reported outcomes; big data, e-science, and informatics; quantitative sciences; translation science; and health economics. The purpose of this article is to (a) describe IFAC activities, (b) summarize 2014 discussions hosted as part of the Idea Festival, and (c) present IFAC recommendations for incorporating these emerging areas of science and technology into research-focused doctoral programs committed to preparing graduates for lifelong, competitive careers in nursing science. The recommendations address clearer articulation of program focus areas; inclusion of foundational knowledge in emerging areas of science in core courses on nursing science and research methods; faculty composition; prerequisite student knowledge and skills; and in-depth, interdisciplinary training in supporting area of science content and methods

Emerging Areas of Nursing Science and PhD Education for The 21\u3csup\u3est\u3c/sup\u3e Century: Response to Commentaries

We respond to commentaries from the American Academy of Nursing, the American Association of Colleges of Nursing, and the National Institute of Nursing Research on our thoughts about integrating emerging areas of science into nursing PhD programs. We identify areas of agreement and focus our response on cross-cutting issues arising from cautions about the unique focus of nursing science and how best to proceed with incorporation of emerging areas of science into nursing PhD programs

Feasibility of an emotion regulation intervention for patients in cardiac rehabilitation

Cardiac rehabilitation is important to improve physical activity and reduce cardiovascular disease risk factors among people who have experienced a major cardiac event. However, poor emotion regulation can make it difficult to change cardiovascular risk factors. The purpose of this paper was to assess the feasibility of the Regulating Emotions to improve Nutrition Exercise and reduce Stress (RENEwS) intervention, an education program aimed at improving emotion regulation strategies among patients in cardiac rehabilitation. Fourteen cardiac rehabilitation patients (mean age 61 years) enrolled in 5 weekly RENEwS sessions. Qualitative analysis of participants’ comments was used to assess eight elements of feasibility. Fifty-seven percent of participants completed the intervention. Participants thought the intervention was feasible, with strengths in the areas of acceptability, demand, adaptation, integration, and implementation. Other comments regarding practicality, expansion, and perceived efficacy provide guidance for intervention refinement.Kelly L. Wierenga was supported in this work as The Nurses Charitable Trust of Greater Miami Scholar of the American Nurses Foundation and by NINR grants T32NR015433 and P30NR015326. David M. Fresco was supported by NHLBI Grant R01HL119977, NINR Grant P30NR015326, NCCIH Grant R61AT009867, and NICHD Grant R21HD095099. Megan Alder was supported by NINR grant P30NR015326 and T32NR015433. This secondary analysis was from a P30 pilot study in the SMART Center: Brain-Behavior Connections in Self-Management Science directed by Dr. Shirley Moore at CWRU (P30NR015326). The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health

Preliminary Efficacy of an Emotion Regulation Intervention on Physical Activity and Depressive and Anxious Symptoms in Individuals in Cardiac Rehabilitation

Background: For the 720 000 Americans expected to experience a new acute cardiac event this year, cardiac rehabilitation is an important part of recovery. Symptoms of depression and anxiety undermine recovery efforts, leaving recovering patients at risk for diminished functional capacity and heightened risk of mortality. Poor emotion regulation can worsen symptoms of depression and anxiety and hinder recovery efforts. Objective: The purpose of this randomized controlled trial was to evaluate the early efficacy testing of a theoretically based emotion regulation treatment (Regulating Emotions to Improve Self-management of Nutrition, Exercise, and Stress [RENEwS]) designed to assist survivors of an acute cardiac event in cardiac rehabilitation to optimize recovery. Methods: Survivors of an acute cardiac event in cardiac rehabilitation (n = 30, 83% men) were randomized to five 1-hour in-person group sessions of RENEwS or a phone-based attention-control group. Participants completed measures of depression and anxiety symptoms at 3 time points. Moderate to vigorous physical activity (MVPA) was objectively measured for 7 days at each time point using waist-worn actigraphy monitors. Between-group differences were calculated using analysis of variance with Cohen f effect sizes calculated to evaluate initial efficacy. Results: There was no statistically significant difference in depression, anxiety, or MVPA over time based on group assignment (all P > .05). Compared with attention control participants, in RENEwS participants, preliminary effects showed greater reductions in depression (Cohen f = 0.34) and anxiety (Cohen f = 0.40) symptoms but only modest improvements in MVPA from baseline to 5 months (Cohen f = 0.08). Conclusions: Findings show that RENEwS is a promising emotion regulation intervention to enhance cardiac rehabilitation and potentially decrease symptoms of depression and anxiety.Kelly L. Wierenga was supported in this work as The Nurses Charitable Trust of Greater Miami Scholar of the American Nurses Foundation and by NINR grants T32NR015433 and P30NR015326. David M. Fresco was supported by NHLBI Grant R01HL119977, NINR Grant P30NR015326, NCCIH Grant R61AT009867, NIMH Grant R01MH118218, NICHD Grant R21HD095099, and NCI Grant R01CA244185. Megan Alder was supported by NINR grant P30NR015326 and T32NR015433. This secondary analysis was from a P30 pilot study in the SMART Center: Brain-Behavior Connections in Self-Management Science directed by Dr. Shirley Moore at CWRU (P30NR015326). The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health

Deconstructing interventions: approaches to studying behavior change techniques across obesity interventions

Deconstructing interventions into the specific techniques that are used to change behavior represents a new frontier in behavioral intervention research. This paper considers opportunities and challenges in employing the Behavior Change Techniques Taxonomy (BCTTv1) developed by Michie and colleagues, to code the behavior change techniques (BCTs) across multiple interventions addressing obesity and capture dose received at the technique level. Numerous advantages were recognized for using a shared framework for intervention description. Coding interventions at levels of the social ecological framework beyond the individual level, separate coding for behavior change initiation vs. maintenance, fidelity of BCT delivery, accounting for BCTs mode of delivery, and tailoring BCTs, present both challenges and opportunities. Deconstructing interventions and identifying the dose required to positively impact health-related outcomes could enable important gains in intervention science

Differences among physical activity actigraphy algorithms in three chronic illness populations

Objectives: In three chronic illness populations and in a combined sample, we assessed differences in two algorithms to determine wear time (WT%) and four algorithms to determine: Kilocalories, light physical activity (PA), moderate-to-vigorous PA (MVPA), and metabolic equivalents (METs). Methods: Data were collected from 29 people living with HIV (PLHIV), 27 participants recovering from a cardiac event, and 15 participants with hypertension (HTN). Participants wore the ActiGraphTM wGT3X-BT for > 3 days on their hip. Analysis of variance (ANOVA) was used to assess differences among the algorithms. Results: No differences were found between the two algorithms to assess WT% or among the four algorithms to assess kilocalories in each of the chronic illness populations or in the combined sample. Significant differences were found among the four algorithms for light PA (p < .001) and METs (p < .001) in each chronic illness population and in the combined sample. MVPA was significantly different among the four algorithms in the PLHIV (p=.007) and in the combined sample (p < .001), but not in the cardiac (p=.064) or HTN samples (p=.200). Discussion: Our findings indicate that the choice of algorithm does make a difference in PA determination. Differences in algorithms should be considered when comparing PA across different chronic illness populations.This work was supported by the National Institute of Nursing Research (grant numbers P30NR015326 and T32NR015433)

Multilevel Interventions Targeting Obesity: Research Recommendations for Vulnerable Populations

The origins of obesity are complex and multifaceted. To be successful, an intervention aiming to prevent or treat obesity may need to address multiple layers of biological, social, and environmental influences