Margaret Heitkemper - Academia.edu (original) (raw)

Papers by Margaret Heitkemper

Research paper thumbnail of Autonomic Nervous System Function In Women With Irritable Bowel Syndrome

Digestive diseases and …, 2001

Autonomic nervous system (ANS) balance was assessed in women with and without irritable bowel syn... more Autonomic nervous system (ANS) balance was assessed in women with and without irritable bowel syndrome (IBS) using laboratory tests of function (ie, expiratory/inspiratory ratio, Valsalva, posture changes, and cold pressor) and spectral and nonspectral measures of heart rate variability (HRV). Women with (N ϭ 103) and without IBS (N ϭ 49) were recruited, interviewed, then completed a laboratory assessment and wore a 24-hr Holter monitor Analysis using the entire sample showed little difference between IBS and control women and between subgroups with IBS on either laboratory measures or 24-hr HRV measures. However, analysis restricted to those women with severe IBS symptoms showed quite pronounced differences between two IBS subgroups on 24-hr HRV measures. Parasympathetic tone was significantly lower and ANS balance was significantly higher in the constipation-predominant compared to the diarrhea-predominant group. Subgroups of women with IBS do differ in ANS function as measured by 24-hr HRV; however, these differences are only apparent among women with severe symptoms. These findings point out the importance of considering symptom severity when interpreting studies of IBS.

Research paper thumbnail of Interstitial Cystitis/Painful Bladder Syndrome: Prevalence Estimates, Quality of Life and Depression among Older Adult Korean Women

Korean Journal of Women Health Nursing, 2009

Research paper thumbnail of Overlapping conditions in women with irritable bowel syndrome

Urologic nursing, 2005

Irritable bowel syndrome is a common and often unpredictable disorder with an increased incidence... more Irritable bowel syndrome is a common and often unpredictable disorder with an increased incidence among women. It is characterized by abdominal pain associated with constipation-diarrhea. Recent research, current theories about etiology and pathophysiology, diagnosis, management, and overlapping conditions such as interstitial cystitis and chronic pelvic pain are discussed.

Research paper thumbnail of Symptoms across the menstrual cycle in women with irritable bowel syndrome

The American journal of gastroenterology, 2003

The purpose of this study was to describe the patterns of GI, somatic, and psychological symptoms... more The purpose of this study was to describe the patterns of GI, somatic, and psychological symptoms across the menstrual cycle in women with irritable bowel syndrome, and to determine whether symptoms differed by oral contraceptive use or predominant bowel pattern. A daily diary was used to assess symptoms across one menstrual cycle. Repeated-measures analysis of covariance, controlling for age and body mass index, was used to compare patterns of symptoms across the menstrual cycle by oral contraceptive use and predominant bowel pattern (diarrhea, constipation, alternating). Data from control women are presented for comparison. For somatic and psychological as well as GI symptoms, women with irritable bowel syndrome had higher symptom severity than did controls. Women with irritable bowel syndrome using oral contraceptives had lower cognitive, anxiety, and depression symptoms (p < 0.05, but not significant after multiple comparison adjustment), but no differences were seen for most...

Research paper thumbnail of Irritable bowel syndrome in women: a common health problem

Nursing Clinics of North America, 2004

There are many chronic health conditions that disproportionately affect women as compared with me... more There are many chronic health conditions that disproportionately affect women as compared with men. These include migraine with aura, chronic fatigue syndrome, fibromyalgia, temporomandibular pain, interstitial cystitis, and irritable bowel syndrome. In addition to being more prevalent in women, these conditions share other commonalities, including an episodic course of exacerbation and remission, reduced quality of life, and suspected triggers of symptom onset. These conditions often coexist in the same woman, making their treatment more challenging. Inpatient and ambulatory care nurses are frequently involved in the counseling and symptom management of women with these chronic health problems. This article focuses on one of these conditions, irritable bowel syndrome (IBS), and what is currently known about its pathophysiology, diagnosis, and treatment. Information related to the gender differences is also presented.

Research paper thumbnail of Autonomic Nervous System Function In Women With Irritable Bowel Syndrome

Digestive diseases and …, 2001

Autonomic nervous system (ANS) balance was assessed in women with and without irritable bowel syn... more Autonomic nervous system (ANS) balance was assessed in women with and without irritable bowel syndrome (IBS) using laboratory tests of function (ie, expiratory/inspiratory ratio, Valsalva, posture changes, and cold pressor) and spectral and nonspectral measures of heart rate variability (HRV). Women with (N ϭ 103) and without IBS (N ϭ 49) were recruited, interviewed, then completed a laboratory assessment and wore a 24-hr Holter monitor Analysis using the entire sample showed little difference between IBS and control women and between subgroups with IBS on either laboratory measures or 24-hr HRV measures. However, analysis restricted to those women with severe IBS symptoms showed quite pronounced differences between two IBS subgroups on 24-hr HRV measures. Parasympathetic tone was significantly lower and ANS balance was significantly higher in the constipation-predominant compared to the diarrhea-predominant group. Subgroups of women with IBS do differ in ANS function as measured by 24-hr HRV; however, these differences are only apparent among women with severe symptoms. These findings point out the importance of considering symptom severity when interpreting studies of IBS.

Research paper thumbnail of Sleep disturbance influences gastrointestinal symptoms in women with irritable bowel syndrome

Digestive diseases and sciences, 2000

This analysis evaluated the association between sleep disturbance and gastrointestinal symptoms i... more This analysis evaluated the association between sleep disturbance and gastrointestinal symptoms in women with and without irritable bowel syndrome (IBS), and examined the role of psychological distress in this relationship. Women with IBS (N = 82) reported considerably higher levels of sleep disturbance compared to controls (N = 35), using both retrospective seven-day recall and daily diary recall for two menstrual cycles (P < 0.05 on 8 of 10 measures). We used daily diary data to estimate the association between sleep disturbance and gastrointestinal symptoms, both across women (ie, whether women with high average sleep disturbance have higher average gastrointestinal symptoms) and within woman (ie, whether poorer than average sleep on one night is associated with higher than average gastrointestinal symptoms the following day). The regression coefficients for the across-women effect are large and highly significant in both groups (IBS, beta +/- SE = 0.46 +/- 0.08, P < 0.001;...

Research paper thumbnail of Evidence for autonomic nervous system imbalance in women with irritable bowel syndrome

Digestive diseases and sciences, 1998

Autonomic nervous system function was assessed in women with and without irritable bowel syndrome... more Autonomic nervous system function was assessed in women with and without irritable bowel syndrome using frequency domain measures of heart rate variability. Women were interviewed and placed into the irritable bowel syndrome (N = 25) group based on history of diagnosis and self-report of current gastrointestinal symptoms. Women in the control group denied a history of chronic gastrointestinal symptoms (N = 15). Women were followed for one menstrual cycle with a symptom diary, and during mid-luteal phase they wore a Holter 24-hr electrocardiograph monitor. Women with irritable bowel syndrome demonstrated significantly lower vagal tone as measured by the high frequency spectrum relative to control women. In addition, women with irritable bowel syndrome had a flattened 24-hr pattern of heart rate variability, with significantly lower levels of vagal tone during sleep. These results suggest that systemic sympathovagal balance may be shifted in a subset of women with irritable bowel synd...

Research paper thumbnail of Symptoms across the menstrual cycle in women with irritable bowel syndrome

The American Journal of Gastroenterology, 2003

The purpose of this study was to describe the patterns of GI, somatic, and psychological symptoms... more The purpose of this study was to describe the patterns of GI, somatic, and psychological symptoms across the menstrual cycle in women with irritable bowel syndrome, and to determine whether symptoms differed by oral contraceptive use or predominant bowel pattern.

Research paper thumbnail of National Institute of Nursing Research Centers of Excellence: A logic model for sustainability, leveraging resources, and collaboration to accelerate cross-disciplinary science

Nursing Outlook, 2014

The National Institute of Nursing Research (NINR) Centers of Excellence program is a catalyst ena... more The National Institute of Nursing Research (NINR) Centers of Excellence program is a catalyst enabling institutions to develop infrastructure and administrative support for creating cross-disciplinary teams that bring multiple strategies and expertise to bear on common areas of science. Centers are increasingly collaborative with campus partners and reflect an integrated team approach to advance science and promote the development of scientists in these areas. The purpose of this paper is to present the NINR Logic Model for Center Sustainability. The components of the logic model were derived from the presentations and robust discussions at the 2013 NINR center directors&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;#39; meeting focused on best practices for leveraging resources and collaboration as methods to promote center sustainability. Collaboration through development and implementation of cross-disciplinary research teams is critical to accelerate the generation of new knowledge for solving fundamental health problems. Sustainability of centers as a long-term outcome beyond the initial funding can be enhanced by thoughtful planning of inputs, activities, and leveraging resources across multiple levels.

Research paper thumbnail of Effect of inactivity and undernutrition after acute ischemic stroke in a rat hindlimb muscle model

Nursing research

Stroke patients experience functional changes resulting from muscle atrophy related to disuse, la... more Stroke patients experience functional changes resulting from muscle atrophy related to disuse, lack or limited neuronal stimulation, and undernutrition. Acute ischemic stroke is assumed to induce muscle atrophy. However, there is little information regarding muscle changes after acute stroke. The purpose of this study was to examine the effect of inactivity and undernutrition after acute stroke on mass, myofibrillar protein content, and Types I and II fiber cross-sectional areas of rat hindlimb muscles. Adult male Sprague-Dawley rats (body weight, 240-270 g) were randomly assigned to one of three groups: a stroke group (n = 7) that had occlusion of the right middle cerebral artery, a control group (n = 7) that underwent a sham right middle cerebral artery procedure, and an undernourished group (n = 9) that was pair-fed to match the intake of stroke rats. Food and water intake as well as body weight were measured daily. The rats were anesthetized 7 days after occlusion or sham occlus...

Research paper thumbnail of The Effect of Hand Acupuncture Therapy and Hand Moxibustion Therapy on Premenstrual Syndrome Among Korean Women

Western Journal of Nursing Research, 2008

Premenstrual syndrome (PMS) symptoms can reduce quality of life and impair daily functioning. Thi... more Premenstrual syndrome (PMS) symptoms can reduce quality of life and impair daily functioning. This study examined the effects of Korean hand acupuncture therapy (HAT) and hand moxibustion therapy (HMT) on symptom severity in Korean women with PMS. This quasi-experimental pilot study based on the khi, yin, yang, and the five elements theory used a nonequivalent control group pretest-posttest design. Experimental groups received 10 sessions of either HAT or HMT treatment. Outcome measures included menstrual symptom severity as measured with the Menstrual Symptom Severity List and skin temperature change measured with Digital Infrared Thermographic Imaging. Both experimental groups had significantly reduced overall PMS symptom severity scores following therapy as compared to women in the control group. The HMT but not the HAT group showed improved flow of khi and balanced skin temperature in symmetric body areas. HAT and HMT may be effective strategies for women to reduce PMS symptoms.

Research paper thumbnail of Conditioned pain modulation in women with irritable bowel syndrome

Biological research for nursing, 2014

Evidence suggests that patients with irritable bowel syndrome (IBS) are more vigilant to pain-ass... more Evidence suggests that patients with irritable bowel syndrome (IBS) are more vigilant to pain-associated stimuli. The aims of this study were to compare women with IBS (n = 20) to healthy control (HC, n = 20) women on pain sensitivity, conditioned pain modulation (CPM) efficiency, and salivary cortisol levels before and after the CPM test and to examine the relationship of CPM efficiency with gastrointestinal pain, somatic pain, psychological distress symptoms, and salivary cortisol levels in each group. Women, aged 20-42 years, gave consent, completed questionnaires, and kept a symptom diary for 2 weeks. CPM efficiency was tested with a heat test stimulus and cold water condition stimulus in a laboratory between 8 and 10 a.m. on a follicular phase day. Salivary cortisol samples were collected just before and after the experimental testing. Compared to the HC group, women with IBS reported more days with gastrointestinal and somatic pain/discomfort, psychological distress, fatigue, ...

Research paper thumbnail of Irritable bowel syndrome. A survey of nurses' knowledge

Gastroenterology nursing : the official journal of the Society of Gastroenterology Nurses and Associates

Nurses in a variety of clinical settings are often involved in educating and managing patients wi... more Nurses in a variety of clinical settings are often involved in educating and managing patients with irritable bowel syndrome, though their knowledge and perceptions of irritable bowel syndrome are not well known. A national survey was undertaken as a part of a larger study of patients and healthcare providers to determine nurses' knowledge of irritable bowel syndrome, including diagnosis, etiology, disease impact, management, beliefs, and attitudes regarding irritable bowel syndrome. In addition, the nurses' perceptions of the effect of irritable bowel syndrome on the patient's lifestyle and the severity of symptoms were compared to those of irritable bowel syndrome patients. One hundred practicing registered nurses were randomly selected and then interviewed by telephone using a questionnaire. A random-digit dialing method was used to identify and recruit 1,014 women with irritable bowel syndrome. The majority of registered nurses interviewed (75%) felt that nurses play...

Research paper thumbnail of Gender differences in irritable bowel syndrome

Gastroenterology, 2002

In the United States and other Western cultures, a greater number of women seek health care servi... more In the United States and other Western cultures, a greater number of women seek health care services for symptoms of functional pain disorders, including irritable bowel syndrome, than men. Recent clinical trials indicate that gender differences in responsiveness to drug therapy also occur. Several lines of inquiry have focused on explaining this gender-related difference due to the higher prevalence of

Research paper thumbnail of GI Symptoms, Function, and Psychophysiological Arousal In Dysmenorrheic Women

Nursing Research, 1991

In a previous study, gastrointestinal (GI) symptoms and stool characteristics were found to be in... more In a previous study, gastrointestinal (GI) symptoms and stool characteristics were found to be influenced by menstrual cycle phase. The current study was designed to replicate initial work regarding GI symptoms and stool characteristics and to explore the relationships between GI symptoms, stool characteristics, ovarian hormone levels, and indicators of psychophysiological arousal. Fifty women (dysmenorrheic, N = 22; nondysmenorrheic, N = 28) maintained a daily dairy for recording stool characteristics, GI symptoms, and daily anxiety level. First morning void urine specimens for catecholamine assays and serum samples for ovarian hormone and cortisol determinations were obtained at menses, follicular, and luteal phases. Results showed menstrual cycle-related differences in stool characteristics and report of GI symptoms, with the greatest changes occurring at menses in the total sample. Dysmenorrheic women reported higher levels of all GI symptoms at menses as compared to nondysmenorrheic women. In addition, cycle-related differences in serum cortisol, urine catecholamines, and report of anxiety were also noted, particularly in dysmenorrheic women. However, looser stools and GI symptoms at menses were not correlated with absolute levels of ovarian hormones or indicators of psychophysiological arousal.

Research paper thumbnail of T1056 Validation of the Gastrointestinal Pain Pointer (GIPP) as a Measure of Symptom Severity in Persons With Abdominal Pain

Research paper thumbnail of Self-Report and Polysomnographic Measures of Sleep in Women with Irritable Bowel Syndrome

Nursing Research - NURS RES, 1998

Women who report chronic gastrointestinal symptoms compatible with a diagnosis of irritable bowel... more Women who report chronic gastrointestinal symptoms compatible with a diagnosis of irritable bowel syndrome (IBS) frequently report sleep disturbances. The purposes of this study were to (a) compare self-reported and polysomnographic indicators of sleep quality in women with IBS symptoms (IBS-SX, n= 16) and controls (n= 16); (b) examine the relationship between the indicators of sleep quality; and (c) determine the relationship between sleep indicators and psychological distress. The women slept in a laboratory for 2 consecutive nights. Polysomnographic measurements were recorded during sleep, and a sleep questionnaire was completed upon awakening each morning. Psychological distress was measured with the Symptom Checklist-90-R during the initial interview. Women in the IBS-SX group reported significantly greater numbers of awakenings during sleep (p = .008) and had a longer latency to REM sleep (p = .04) than did the controls. Self-reported and polysomnographic indicators were more highly correlated in the control group than in the IBS-SX group. In the IBS-SX group, the greater the psychological distress, the less alert (rs = .419) and rested (rs = .564) the women felt in the morning and the more time the women spent in stages 3 and 4 sleep (rs = .479) and less in stage 2 (rs = -.447) and REM (rs = -.414) sleep. In the control group, psychological distress was not significantly associated with self-reported measures but was significantly associated with the number of awakenings (rs = .506) and time in stages 3 and 4 sleep (rs = -.677). Although the women in the IBS-SX group reported significantly more awakenings, the weak relationship between self-reported and polysomnographic indicators suggests that clinicians must keep in mind that further assessments may be necessary.

Research paper thumbnail of Applying Physiologic Data to Nursing Therapeutics

Western Journal of Nursing Research, 1982

Research paper thumbnail of Psychophysiological response to a laboratory challenge in women with and without diagnosed irritable bowel syndrome

Research in Nursing & Health, 1997

The purpose of this study was to describe and compare physiological variables at baseline and in ... more The purpose of this study was to describe and compare physiological variables at baseline and in response to laboratory stress among women diagnosed with irritable bowel syndrome (IBS, n = 26), women with undiagnosed chronic gastrointestinal symptoms consistent with IBS (IBS-NP, n = 24), and asymptomatic women (n = 22). Urine catecholamine levels were measured in the first voided specimen on the morning of testing. Cardiovascular variables were measured at baseline and repeatedly during the Stroop Color-Word Conflict Test (Stroop). Women in the IBS group had higher baseline systolic blood pressure (SBP) than the control group and higher basal urine norepinephrine (NE) levels than the IBS-NP group. Control for activity or body mass reduced the group difference in SBP to nonsignificance but did not affect the observed difference in urine NE. There were no significant differences among the groups in other baseline values or in response to the Stroop. These results suggest that, despite higher basal urine catecholamine levels, cardiovascular reactivity to a cognitive challenge in a laboratory setting is not elevated in women with diagnosed IBS.

Research paper thumbnail of Autonomic Nervous System Function In Women With Irritable Bowel Syndrome

Digestive diseases and …, 2001

Autonomic nervous system (ANS) balance was assessed in women with and without irritable bowel syn... more Autonomic nervous system (ANS) balance was assessed in women with and without irritable bowel syndrome (IBS) using laboratory tests of function (ie, expiratory/inspiratory ratio, Valsalva, posture changes, and cold pressor) and spectral and nonspectral measures of heart rate variability (HRV). Women with (N ϭ 103) and without IBS (N ϭ 49) were recruited, interviewed, then completed a laboratory assessment and wore a 24-hr Holter monitor Analysis using the entire sample showed little difference between IBS and control women and between subgroups with IBS on either laboratory measures or 24-hr HRV measures. However, analysis restricted to those women with severe IBS symptoms showed quite pronounced differences between two IBS subgroups on 24-hr HRV measures. Parasympathetic tone was significantly lower and ANS balance was significantly higher in the constipation-predominant compared to the diarrhea-predominant group. Subgroups of women with IBS do differ in ANS function as measured by 24-hr HRV; however, these differences are only apparent among women with severe symptoms. These findings point out the importance of considering symptom severity when interpreting studies of IBS.

Research paper thumbnail of Interstitial Cystitis/Painful Bladder Syndrome: Prevalence Estimates, Quality of Life and Depression among Older Adult Korean Women

Korean Journal of Women Health Nursing, 2009

Research paper thumbnail of Overlapping conditions in women with irritable bowel syndrome

Urologic nursing, 2005

Irritable bowel syndrome is a common and often unpredictable disorder with an increased incidence... more Irritable bowel syndrome is a common and often unpredictable disorder with an increased incidence among women. It is characterized by abdominal pain associated with constipation-diarrhea. Recent research, current theories about etiology and pathophysiology, diagnosis, management, and overlapping conditions such as interstitial cystitis and chronic pelvic pain are discussed.

Research paper thumbnail of Symptoms across the menstrual cycle in women with irritable bowel syndrome

The American journal of gastroenterology, 2003

The purpose of this study was to describe the patterns of GI, somatic, and psychological symptoms... more The purpose of this study was to describe the patterns of GI, somatic, and psychological symptoms across the menstrual cycle in women with irritable bowel syndrome, and to determine whether symptoms differed by oral contraceptive use or predominant bowel pattern. A daily diary was used to assess symptoms across one menstrual cycle. Repeated-measures analysis of covariance, controlling for age and body mass index, was used to compare patterns of symptoms across the menstrual cycle by oral contraceptive use and predominant bowel pattern (diarrhea, constipation, alternating). Data from control women are presented for comparison. For somatic and psychological as well as GI symptoms, women with irritable bowel syndrome had higher symptom severity than did controls. Women with irritable bowel syndrome using oral contraceptives had lower cognitive, anxiety, and depression symptoms (p < 0.05, but not significant after multiple comparison adjustment), but no differences were seen for most...

Research paper thumbnail of Irritable bowel syndrome in women: a common health problem

Nursing Clinics of North America, 2004

There are many chronic health conditions that disproportionately affect women as compared with me... more There are many chronic health conditions that disproportionately affect women as compared with men. These include migraine with aura, chronic fatigue syndrome, fibromyalgia, temporomandibular pain, interstitial cystitis, and irritable bowel syndrome. In addition to being more prevalent in women, these conditions share other commonalities, including an episodic course of exacerbation and remission, reduced quality of life, and suspected triggers of symptom onset. These conditions often coexist in the same woman, making their treatment more challenging. Inpatient and ambulatory care nurses are frequently involved in the counseling and symptom management of women with these chronic health problems. This article focuses on one of these conditions, irritable bowel syndrome (IBS), and what is currently known about its pathophysiology, diagnosis, and treatment. Information related to the gender differences is also presented.

Research paper thumbnail of Autonomic Nervous System Function In Women With Irritable Bowel Syndrome

Digestive diseases and …, 2001

Autonomic nervous system (ANS) balance was assessed in women with and without irritable bowel syn... more Autonomic nervous system (ANS) balance was assessed in women with and without irritable bowel syndrome (IBS) using laboratory tests of function (ie, expiratory/inspiratory ratio, Valsalva, posture changes, and cold pressor) and spectral and nonspectral measures of heart rate variability (HRV). Women with (N ϭ 103) and without IBS (N ϭ 49) were recruited, interviewed, then completed a laboratory assessment and wore a 24-hr Holter monitor Analysis using the entire sample showed little difference between IBS and control women and between subgroups with IBS on either laboratory measures or 24-hr HRV measures. However, analysis restricted to those women with severe IBS symptoms showed quite pronounced differences between two IBS subgroups on 24-hr HRV measures. Parasympathetic tone was significantly lower and ANS balance was significantly higher in the constipation-predominant compared to the diarrhea-predominant group. Subgroups of women with IBS do differ in ANS function as measured by 24-hr HRV; however, these differences are only apparent among women with severe symptoms. These findings point out the importance of considering symptom severity when interpreting studies of IBS.

Research paper thumbnail of Sleep disturbance influences gastrointestinal symptoms in women with irritable bowel syndrome

Digestive diseases and sciences, 2000

This analysis evaluated the association between sleep disturbance and gastrointestinal symptoms i... more This analysis evaluated the association between sleep disturbance and gastrointestinal symptoms in women with and without irritable bowel syndrome (IBS), and examined the role of psychological distress in this relationship. Women with IBS (N = 82) reported considerably higher levels of sleep disturbance compared to controls (N = 35), using both retrospective seven-day recall and daily diary recall for two menstrual cycles (P < 0.05 on 8 of 10 measures). We used daily diary data to estimate the association between sleep disturbance and gastrointestinal symptoms, both across women (ie, whether women with high average sleep disturbance have higher average gastrointestinal symptoms) and within woman (ie, whether poorer than average sleep on one night is associated with higher than average gastrointestinal symptoms the following day). The regression coefficients for the across-women effect are large and highly significant in both groups (IBS, beta +/- SE = 0.46 +/- 0.08, P < 0.001;...

Research paper thumbnail of Evidence for autonomic nervous system imbalance in women with irritable bowel syndrome

Digestive diseases and sciences, 1998

Autonomic nervous system function was assessed in women with and without irritable bowel syndrome... more Autonomic nervous system function was assessed in women with and without irritable bowel syndrome using frequency domain measures of heart rate variability. Women were interviewed and placed into the irritable bowel syndrome (N = 25) group based on history of diagnosis and self-report of current gastrointestinal symptoms. Women in the control group denied a history of chronic gastrointestinal symptoms (N = 15). Women were followed for one menstrual cycle with a symptom diary, and during mid-luteal phase they wore a Holter 24-hr electrocardiograph monitor. Women with irritable bowel syndrome demonstrated significantly lower vagal tone as measured by the high frequency spectrum relative to control women. In addition, women with irritable bowel syndrome had a flattened 24-hr pattern of heart rate variability, with significantly lower levels of vagal tone during sleep. These results suggest that systemic sympathovagal balance may be shifted in a subset of women with irritable bowel synd...

Research paper thumbnail of Symptoms across the menstrual cycle in women with irritable bowel syndrome

The American Journal of Gastroenterology, 2003

The purpose of this study was to describe the patterns of GI, somatic, and psychological symptoms... more The purpose of this study was to describe the patterns of GI, somatic, and psychological symptoms across the menstrual cycle in women with irritable bowel syndrome, and to determine whether symptoms differed by oral contraceptive use or predominant bowel pattern.

Research paper thumbnail of National Institute of Nursing Research Centers of Excellence: A logic model for sustainability, leveraging resources, and collaboration to accelerate cross-disciplinary science

Nursing Outlook, 2014

The National Institute of Nursing Research (NINR) Centers of Excellence program is a catalyst ena... more The National Institute of Nursing Research (NINR) Centers of Excellence program is a catalyst enabling institutions to develop infrastructure and administrative support for creating cross-disciplinary teams that bring multiple strategies and expertise to bear on common areas of science. Centers are increasingly collaborative with campus partners and reflect an integrated team approach to advance science and promote the development of scientists in these areas. The purpose of this paper is to present the NINR Logic Model for Center Sustainability. The components of the logic model were derived from the presentations and robust discussions at the 2013 NINR center directors&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;#39; meeting focused on best practices for leveraging resources and collaboration as methods to promote center sustainability. Collaboration through development and implementation of cross-disciplinary research teams is critical to accelerate the generation of new knowledge for solving fundamental health problems. Sustainability of centers as a long-term outcome beyond the initial funding can be enhanced by thoughtful planning of inputs, activities, and leveraging resources across multiple levels.

Research paper thumbnail of Effect of inactivity and undernutrition after acute ischemic stroke in a rat hindlimb muscle model

Nursing research

Stroke patients experience functional changes resulting from muscle atrophy related to disuse, la... more Stroke patients experience functional changes resulting from muscle atrophy related to disuse, lack or limited neuronal stimulation, and undernutrition. Acute ischemic stroke is assumed to induce muscle atrophy. However, there is little information regarding muscle changes after acute stroke. The purpose of this study was to examine the effect of inactivity and undernutrition after acute stroke on mass, myofibrillar protein content, and Types I and II fiber cross-sectional areas of rat hindlimb muscles. Adult male Sprague-Dawley rats (body weight, 240-270 g) were randomly assigned to one of three groups: a stroke group (n = 7) that had occlusion of the right middle cerebral artery, a control group (n = 7) that underwent a sham right middle cerebral artery procedure, and an undernourished group (n = 9) that was pair-fed to match the intake of stroke rats. Food and water intake as well as body weight were measured daily. The rats were anesthetized 7 days after occlusion or sham occlus...

Research paper thumbnail of The Effect of Hand Acupuncture Therapy and Hand Moxibustion Therapy on Premenstrual Syndrome Among Korean Women

Western Journal of Nursing Research, 2008

Premenstrual syndrome (PMS) symptoms can reduce quality of life and impair daily functioning. Thi... more Premenstrual syndrome (PMS) symptoms can reduce quality of life and impair daily functioning. This study examined the effects of Korean hand acupuncture therapy (HAT) and hand moxibustion therapy (HMT) on symptom severity in Korean women with PMS. This quasi-experimental pilot study based on the khi, yin, yang, and the five elements theory used a nonequivalent control group pretest-posttest design. Experimental groups received 10 sessions of either HAT or HMT treatment. Outcome measures included menstrual symptom severity as measured with the Menstrual Symptom Severity List and skin temperature change measured with Digital Infrared Thermographic Imaging. Both experimental groups had significantly reduced overall PMS symptom severity scores following therapy as compared to women in the control group. The HMT but not the HAT group showed improved flow of khi and balanced skin temperature in symmetric body areas. HAT and HMT may be effective strategies for women to reduce PMS symptoms.

Research paper thumbnail of Conditioned pain modulation in women with irritable bowel syndrome

Biological research for nursing, 2014

Evidence suggests that patients with irritable bowel syndrome (IBS) are more vigilant to pain-ass... more Evidence suggests that patients with irritable bowel syndrome (IBS) are more vigilant to pain-associated stimuli. The aims of this study were to compare women with IBS (n = 20) to healthy control (HC, n = 20) women on pain sensitivity, conditioned pain modulation (CPM) efficiency, and salivary cortisol levels before and after the CPM test and to examine the relationship of CPM efficiency with gastrointestinal pain, somatic pain, psychological distress symptoms, and salivary cortisol levels in each group. Women, aged 20-42 years, gave consent, completed questionnaires, and kept a symptom diary for 2 weeks. CPM efficiency was tested with a heat test stimulus and cold water condition stimulus in a laboratory between 8 and 10 a.m. on a follicular phase day. Salivary cortisol samples were collected just before and after the experimental testing. Compared to the HC group, women with IBS reported more days with gastrointestinal and somatic pain/discomfort, psychological distress, fatigue, ...

Research paper thumbnail of Irritable bowel syndrome. A survey of nurses' knowledge

Gastroenterology nursing : the official journal of the Society of Gastroenterology Nurses and Associates

Nurses in a variety of clinical settings are often involved in educating and managing patients wi... more Nurses in a variety of clinical settings are often involved in educating and managing patients with irritable bowel syndrome, though their knowledge and perceptions of irritable bowel syndrome are not well known. A national survey was undertaken as a part of a larger study of patients and healthcare providers to determine nurses' knowledge of irritable bowel syndrome, including diagnosis, etiology, disease impact, management, beliefs, and attitudes regarding irritable bowel syndrome. In addition, the nurses' perceptions of the effect of irritable bowel syndrome on the patient's lifestyle and the severity of symptoms were compared to those of irritable bowel syndrome patients. One hundred practicing registered nurses were randomly selected and then interviewed by telephone using a questionnaire. A random-digit dialing method was used to identify and recruit 1,014 women with irritable bowel syndrome. The majority of registered nurses interviewed (75%) felt that nurses play...

Research paper thumbnail of Gender differences in irritable bowel syndrome

Gastroenterology, 2002

In the United States and other Western cultures, a greater number of women seek health care servi... more In the United States and other Western cultures, a greater number of women seek health care services for symptoms of functional pain disorders, including irritable bowel syndrome, than men. Recent clinical trials indicate that gender differences in responsiveness to drug therapy also occur. Several lines of inquiry have focused on explaining this gender-related difference due to the higher prevalence of

Research paper thumbnail of GI Symptoms, Function, and Psychophysiological Arousal In Dysmenorrheic Women

Nursing Research, 1991

In a previous study, gastrointestinal (GI) symptoms and stool characteristics were found to be in... more In a previous study, gastrointestinal (GI) symptoms and stool characteristics were found to be influenced by menstrual cycle phase. The current study was designed to replicate initial work regarding GI symptoms and stool characteristics and to explore the relationships between GI symptoms, stool characteristics, ovarian hormone levels, and indicators of psychophysiological arousal. Fifty women (dysmenorrheic, N = 22; nondysmenorrheic, N = 28) maintained a daily dairy for recording stool characteristics, GI symptoms, and daily anxiety level. First morning void urine specimens for catecholamine assays and serum samples for ovarian hormone and cortisol determinations were obtained at menses, follicular, and luteal phases. Results showed menstrual cycle-related differences in stool characteristics and report of GI symptoms, with the greatest changes occurring at menses in the total sample. Dysmenorrheic women reported higher levels of all GI symptoms at menses as compared to nondysmenorrheic women. In addition, cycle-related differences in serum cortisol, urine catecholamines, and report of anxiety were also noted, particularly in dysmenorrheic women. However, looser stools and GI symptoms at menses were not correlated with absolute levels of ovarian hormones or indicators of psychophysiological arousal.

Research paper thumbnail of T1056 Validation of the Gastrointestinal Pain Pointer (GIPP) as a Measure of Symptom Severity in Persons With Abdominal Pain

Research paper thumbnail of Self-Report and Polysomnographic Measures of Sleep in Women with Irritable Bowel Syndrome

Nursing Research - NURS RES, 1998

Women who report chronic gastrointestinal symptoms compatible with a diagnosis of irritable bowel... more Women who report chronic gastrointestinal symptoms compatible with a diagnosis of irritable bowel syndrome (IBS) frequently report sleep disturbances. The purposes of this study were to (a) compare self-reported and polysomnographic indicators of sleep quality in women with IBS symptoms (IBS-SX, n= 16) and controls (n= 16); (b) examine the relationship between the indicators of sleep quality; and (c) determine the relationship between sleep indicators and psychological distress. The women slept in a laboratory for 2 consecutive nights. Polysomnographic measurements were recorded during sleep, and a sleep questionnaire was completed upon awakening each morning. Psychological distress was measured with the Symptom Checklist-90-R during the initial interview. Women in the IBS-SX group reported significantly greater numbers of awakenings during sleep (p = .008) and had a longer latency to REM sleep (p = .04) than did the controls. Self-reported and polysomnographic indicators were more highly correlated in the control group than in the IBS-SX group. In the IBS-SX group, the greater the psychological distress, the less alert (rs = .419) and rested (rs = .564) the women felt in the morning and the more time the women spent in stages 3 and 4 sleep (rs = .479) and less in stage 2 (rs = -.447) and REM (rs = -.414) sleep. In the control group, psychological distress was not significantly associated with self-reported measures but was significantly associated with the number of awakenings (rs = .506) and time in stages 3 and 4 sleep (rs = -.677). Although the women in the IBS-SX group reported significantly more awakenings, the weak relationship between self-reported and polysomnographic indicators suggests that clinicians must keep in mind that further assessments may be necessary.

Research paper thumbnail of Applying Physiologic Data to Nursing Therapeutics

Western Journal of Nursing Research, 1982

Research paper thumbnail of Psychophysiological response to a laboratory challenge in women with and without diagnosed irritable bowel syndrome

Research in Nursing & Health, 1997

The purpose of this study was to describe and compare physiological variables at baseline and in ... more The purpose of this study was to describe and compare physiological variables at baseline and in response to laboratory stress among women diagnosed with irritable bowel syndrome (IBS, n = 26), women with undiagnosed chronic gastrointestinal symptoms consistent with IBS (IBS-NP, n = 24), and asymptomatic women (n = 22). Urine catecholamine levels were measured in the first voided specimen on the morning of testing. Cardiovascular variables were measured at baseline and repeatedly during the Stroop Color-Word Conflict Test (Stroop). Women in the IBS group had higher baseline systolic blood pressure (SBP) than the control group and higher basal urine norepinephrine (NE) levels than the IBS-NP group. Control for activity or body mass reduced the group difference in SBP to nonsignificance but did not affect the observed difference in urine NE. There were no significant differences among the groups in other baseline values or in response to the Stroop. These results suggest that, despite higher basal urine catecholamine levels, cardiovascular reactivity to a cognitive challenge in a laboratory setting is not elevated in women with diagnosed IBS.