Aurelia OCOnnell | Azusa Pacific University (original) (raw)

Uploads

Papers by Aurelia OCOnnell

Research paper thumbnail of Quality of Life Is Improved in Uninsured Heart Failure Patients in Disease Management Programs in Public Hospitals

Journal of Cardiac Failure, 2010

Research paper thumbnail of Heart failure disease management in an indigent population

This is a critical abstract of an economic evaluation that meets the criteria for inclusion on NH... more This is a critical abstract of an economic evaluation that meets the criteria for inclusion on NHS EED. Each abstract contains a brief summary of the methods, the results and conclusions followed by a detailed critical assessment on the reliability of the study and the conclusions drawn. Health technology The use of a heart failure multidisciplinary disease management programme (MDMP) for nontransplant indigent patients with heart failure problems. The team consisted of a collaborative practice team of cardiologists, a nurse practitioner who specialised in the care of cardiac patients, a social worker, a cardiovascular pharmacist, a registered dietician and the cardiac rehabilitation team. The intervention consisted of the management of patients with heart failure problems, providing them and their families with a standardised heart failure book, and a comprehensive one-onone education about symptoms, diet and exercise. In addition, information about medication was reinforced at each visit. Type of intervention Secondary prevention. Economic study type Cost-effectiveness analysis. Study population The study population comprised indigent patients with heart failure who were not transplant candidates. Two different groups of patients were considered at analysis. Group A comprised indigent patients with heart failure who had at least two readmissions per year and an ejection fraction of 45% or less. Group B comprised indigent patients with heart failure referred to the hospital because of their potential for frequent admissions as a result of financial, social or noncompliance issues, who may or may not have had a prior admission. Patients were excluded if they were discharged to a long-term care facility, had severe dementia or other serious psychiatric illness, or had an anticipated survival of less than 3 months. Setting The setting was secondary care. The economic study was performed in Albuquerque (NM), USA.

Research paper thumbnail of Abstract 2094: B-type Natriuretic Peptide Is Useful In Detecting Asymptomatic Left Ventricular Dysfunction in Low-Income, Uninsured Hispanic Patients

Circulation, Oct 28, 2008

BACKGROUND: Heart failure (HF) is a significant public health problem, particularly in low income... more BACKGROUND: Heart failure (HF) is a significant public health problem, particularly in low income Hispanics with multiple cardiovascular risk factors (CRFs). The effectiveness of B-type natriuretic...

Research paper thumbnail of Abstract 5634: Outcomes of Early Referral for Depression in Low-Income, Minority Patients with Chronic Heart Failure

Circulation, Oct 28, 2008

Research paper thumbnail of Success of a multidisciplinary heart failure disease management program in an indigent population

Research paper thumbnail of Prevalence of Depression Is High among Low-Income, Uninsured Hispanic Patients with Chronic Heart Failure

ADHF and it is associated with longer length of stay and increased mortality and HF hospitalizati... more ADHF and it is associated with longer length of stay and increased mortality and HF hospitalization. Clinical characteristics present at the time of admission help identify patients at increased risk for WRF.

Research paper thumbnail of Teach to Goal”: Theory and Design Principles of an Intervention to Improve Heart Failure Self-Management Skills of Patients with Low Health Literacy

Journal of Health Communication, 2011

Self-management is vital for achieving optimal health outcomes for patients with heart failure (H... more Self-management is vital for achieving optimal health outcomes for patients with heart failure (HF). We sought to develop an intervention to improve self-management skills and behaviors for patients with HF, especially those with low health literacy. Individuals with low health literacy have difficulty reading and understanding written information and comprehending numerical information and performing calculations, and they tend to have worse baseline knowledge, short-term memory, and working memory compared with individuals with higher health literacy. This paper describes theoretical models that suggest methods to improve the design of educational curricula and programs for low literate audiences, including cognitive load theory and learning mastery theory. We also outline the practical guiding principles for designing our intervention, which includes a multisession educational strategy that teaches patients self-care skills until they reach behavioral goals (“Teach to Goal”). Our intervention strategy is being tested in a randomized controlled trial to determine if it is superior to a single-session brief educational intervention for reducing hospitalization and death. If this trial shows that the “Teach to Goal” approach is superior, it would support the value of incorporating these design principles into educational interventions for other diseases.

Research paper thumbnail of Knowledge and Perceptions of Health Literacy Among Nursing Professionals

Journal of Health Communication, 2011

Low health literacy affects nearly half of the U.S. population. Health care professionals may not... more Low health literacy affects nearly half of the U.S. population. Health care professionals may not recognize low health literacy in their patients nor understand its impact on health outcomes. The purpose of this pilot study was to describe nurses' knowledge and perceptions of low health literacy on patients, their practice, and the health system. This cross-sectional, descriptive study used a web-based survey to assess the knowledge and perceptions of health literacy among nursing professionals. Registered nurses licensed by the State of California were randomly selected and invited to participate in the study. Data analysis included descriptive statistics to describe nursing professionals' general knowledge and perceptions. Qualitative textual analysis was done on participant responses to a survey question that asks participants to define health literacy using their own words. Results of this study revealed that nursing professionals' knowledge of health literacy and their understanding on the role health literacy plays on patient health outcomes is limited. Health literacy was also reported to be a low priority among providers and organizations. Nursing plays an important role in direct patient care and in the delivery of health services. Educating nurses on health literacy and improving patient communication and understanding can improve health outcomes.

Research paper thumbnail of B-type Natriuretic Peptide (BNP) Is Useful in Detecting Asymptomatic Left Ventricular Dysfunction in Low-Income, Uninsured Patients

Biological Research for Nursing, 2010

Low-income, uninsured individuals with multiple cardiovascular risk factors (CRFs) are at risk of... more Low-income, uninsured individuals with multiple cardiovascular risk factors (CRFs) are at risk of heart failure (HF). B-type natriuretic peptide (BNP) screening for asymptomatic left ventricular dysfunction (ALVD) has not been tested specifically in this group. The purposes of this study were to describe BNP levels in asymptomatic low-income, uninsured individuals with multiple CRFs and determine the correlation between BNP levels and echocardiography for identifying ALVD. This correlational study included 53 patients (age 55 + or - 10 years, 83% non-White, 64% female). BNP testing and echocardiogram (ECHO) were performed. Of the 30 patients (57%) diagnosed with ALVD by ECHO, 21 (40%) had diastolic and 9 (17%) systolic dysfunction. BNP levels were lower among those with normal left ventricular (LV) function (29.6 + or - 24 pg/mL) than those with diastolic (80.2 + or - 69 pg/mL, p = .01) and systolic dysfunction (337.1 + or - 374 pg/mL, p = .009). sParticipants with BNP > or = 50 pg/ mL were 5.75 times more likely to exhibit diastolic dysfunction (odds ratio [OR] = 5.75, 95% confidence interval [CI] 1.29- 25.51; p < .01) and those with BNP > or = 100 pg/mL were 7.80 times more likely to have systolic dysfunction (OR = 7.8, 95% CI 1.60-37.14; p < .005) than those with lower levels. With BNP cut point of 50 pg/mL, area under the curve (AUC) was 0.82 (95% CI 0.63-1.00) with sensitivity of 88% and specificity of 67%. BNP is a low-cost method to detect ALVD in high-risk, uninsured, low-income individuals. Elevated BNP levels should prompt initiation of further diagnostic testing and early treatment.

Research paper thumbnail of Quality of Life Is Improved in Uninsured Heart Failure Patients in Disease Management Programs in Public Hospitals

Journal of Cardiac Failure, 2010

Research paper thumbnail of Heart failure disease management in an indigent population

This is a critical abstract of an economic evaluation that meets the criteria for inclusion on NH... more This is a critical abstract of an economic evaluation that meets the criteria for inclusion on NHS EED. Each abstract contains a brief summary of the methods, the results and conclusions followed by a detailed critical assessment on the reliability of the study and the conclusions drawn. Health technology The use of a heart failure multidisciplinary disease management programme (MDMP) for nontransplant indigent patients with heart failure problems. The team consisted of a collaborative practice team of cardiologists, a nurse practitioner who specialised in the care of cardiac patients, a social worker, a cardiovascular pharmacist, a registered dietician and the cardiac rehabilitation team. The intervention consisted of the management of patients with heart failure problems, providing them and their families with a standardised heart failure book, and a comprehensive one-onone education about symptoms, diet and exercise. In addition, information about medication was reinforced at each visit. Type of intervention Secondary prevention. Economic study type Cost-effectiveness analysis. Study population The study population comprised indigent patients with heart failure who were not transplant candidates. Two different groups of patients were considered at analysis. Group A comprised indigent patients with heart failure who had at least two readmissions per year and an ejection fraction of 45% or less. Group B comprised indigent patients with heart failure referred to the hospital because of their potential for frequent admissions as a result of financial, social or noncompliance issues, who may or may not have had a prior admission. Patients were excluded if they were discharged to a long-term care facility, had severe dementia or other serious psychiatric illness, or had an anticipated survival of less than 3 months. Setting The setting was secondary care. The economic study was performed in Albuquerque (NM), USA.

Research paper thumbnail of Abstract 2094: B-type Natriuretic Peptide Is Useful In Detecting Asymptomatic Left Ventricular Dysfunction in Low-Income, Uninsured Hispanic Patients

Circulation, Oct 28, 2008

BACKGROUND: Heart failure (HF) is a significant public health problem, particularly in low income... more BACKGROUND: Heart failure (HF) is a significant public health problem, particularly in low income Hispanics with multiple cardiovascular risk factors (CRFs). The effectiveness of B-type natriuretic...

Research paper thumbnail of Abstract 5634: Outcomes of Early Referral for Depression in Low-Income, Minority Patients with Chronic Heart Failure

Circulation, Oct 28, 2008

Research paper thumbnail of Success of a multidisciplinary heart failure disease management program in an indigent population

Research paper thumbnail of Prevalence of Depression Is High among Low-Income, Uninsured Hispanic Patients with Chronic Heart Failure

ADHF and it is associated with longer length of stay and increased mortality and HF hospitalizati... more ADHF and it is associated with longer length of stay and increased mortality and HF hospitalization. Clinical characteristics present at the time of admission help identify patients at increased risk for WRF.

Research paper thumbnail of Teach to Goal”: Theory and Design Principles of an Intervention to Improve Heart Failure Self-Management Skills of Patients with Low Health Literacy

Journal of Health Communication, 2011

Self-management is vital for achieving optimal health outcomes for patients with heart failure (H... more Self-management is vital for achieving optimal health outcomes for patients with heart failure (HF). We sought to develop an intervention to improve self-management skills and behaviors for patients with HF, especially those with low health literacy. Individuals with low health literacy have difficulty reading and understanding written information and comprehending numerical information and performing calculations, and they tend to have worse baseline knowledge, short-term memory, and working memory compared with individuals with higher health literacy. This paper describes theoretical models that suggest methods to improve the design of educational curricula and programs for low literate audiences, including cognitive load theory and learning mastery theory. We also outline the practical guiding principles for designing our intervention, which includes a multisession educational strategy that teaches patients self-care skills until they reach behavioral goals (“Teach to Goal”). Our intervention strategy is being tested in a randomized controlled trial to determine if it is superior to a single-session brief educational intervention for reducing hospitalization and death. If this trial shows that the “Teach to Goal” approach is superior, it would support the value of incorporating these design principles into educational interventions for other diseases.

Research paper thumbnail of Knowledge and Perceptions of Health Literacy Among Nursing Professionals

Journal of Health Communication, 2011

Low health literacy affects nearly half of the U.S. population. Health care professionals may not... more Low health literacy affects nearly half of the U.S. population. Health care professionals may not recognize low health literacy in their patients nor understand its impact on health outcomes. The purpose of this pilot study was to describe nurses' knowledge and perceptions of low health literacy on patients, their practice, and the health system. This cross-sectional, descriptive study used a web-based survey to assess the knowledge and perceptions of health literacy among nursing professionals. Registered nurses licensed by the State of California were randomly selected and invited to participate in the study. Data analysis included descriptive statistics to describe nursing professionals' general knowledge and perceptions. Qualitative textual analysis was done on participant responses to a survey question that asks participants to define health literacy using their own words. Results of this study revealed that nursing professionals' knowledge of health literacy and their understanding on the role health literacy plays on patient health outcomes is limited. Health literacy was also reported to be a low priority among providers and organizations. Nursing plays an important role in direct patient care and in the delivery of health services. Educating nurses on health literacy and improving patient communication and understanding can improve health outcomes.

Research paper thumbnail of B-type Natriuretic Peptide (BNP) Is Useful in Detecting Asymptomatic Left Ventricular Dysfunction in Low-Income, Uninsured Patients

Biological Research for Nursing, 2010

Low-income, uninsured individuals with multiple cardiovascular risk factors (CRFs) are at risk of... more Low-income, uninsured individuals with multiple cardiovascular risk factors (CRFs) are at risk of heart failure (HF). B-type natriuretic peptide (BNP) screening for asymptomatic left ventricular dysfunction (ALVD) has not been tested specifically in this group. The purposes of this study were to describe BNP levels in asymptomatic low-income, uninsured individuals with multiple CRFs and determine the correlation between BNP levels and echocardiography for identifying ALVD. This correlational study included 53 patients (age 55 + or - 10 years, 83% non-White, 64% female). BNP testing and echocardiogram (ECHO) were performed. Of the 30 patients (57%) diagnosed with ALVD by ECHO, 21 (40%) had diastolic and 9 (17%) systolic dysfunction. BNP levels were lower among those with normal left ventricular (LV) function (29.6 + or - 24 pg/mL) than those with diastolic (80.2 + or - 69 pg/mL, p = .01) and systolic dysfunction (337.1 + or - 374 pg/mL, p = .009). sParticipants with BNP > or = 50 pg/ mL were 5.75 times more likely to exhibit diastolic dysfunction (odds ratio [OR] = 5.75, 95% confidence interval [CI] 1.29- 25.51; p < .01) and those with BNP > or = 100 pg/mL were 7.80 times more likely to have systolic dysfunction (OR = 7.8, 95% CI 1.60-37.14; p < .005) than those with lower levels. With BNP cut point of 50 pg/mL, area under the curve (AUC) was 0.82 (95% CI 0.63-1.00) with sensitivity of 88% and specificity of 67%. BNP is a low-cost method to detect ALVD in high-risk, uninsured, low-income individuals. Elevated BNP levels should prompt initiation of further diagnostic testing and early treatment.