Rebecca Winsett - Academia.edu (original) (raw)
Papers by Rebecca Winsett
Progress in Transplantation
Progress in Transplantation
Progress in Transplantation
Progress in Transplantation
Nephrology Nursing Journal, Apr 1, 2001
Http Dx Doi Org 10 1080 15323269 2012 719188, Oct 1, 2012
Nephrology Nursing Journal Journal of the American Nephrology Nurses Association, 2007
This chapter on research in nursing was included in ANNA's Career Fulfillment in Nephrology Nursi... more This chapter on research in nursing was included in ANNA's Career Fulfillment in Nephrology Nursing: Your Guide to Professional Development (2 nd edition), which was published in September 2007. This chapter encourages nurses to participate in the research process by providing an overview of the nursing research process, including the steps to designing a research project, and answers to frequently asked questions. The objectives of the chapter are to: (a) define the nursing research process, including the systematic and universal knowledge concepts along with overviews of process improvement and evidence-based practice; (b) identify the steps to designing a research project, including identifying a clinical problem and formulating a research questions, conducting a review of the literature, and providing an overview of the research design; (c) provide an overview of the study methodology, including data analysis and protecting human subjects; (d) discuss available funding opportunities and the professional obligations that go with these opportunities; and (e) provide answers to frequently asked questions regarding nursing research to help demystify the process.
Air medical journal
The long spinal board is the immobilization standard during prehospital transport. The flat surfa... more The long spinal board is the immobilization standard during prehospital transport. The flat surface of the board increases the pressure placed on both the thoracic kyphosis and the sacrum and increases the risk for pressure ulcers. This study compared patient stability and comfort between a padded litter system used in air medical transport and the long spine board. The study was completed at a large 350-bed Magnet Recognized nonteaching hospital. The hospital owns and operates an air medical transport service. Subjects were secured to a padded litter and a long spinal board with a cervical collar and head blocks and 3 straps. Laser pointers were used to mark neutral at points on the subject's head, sternum, and pelvis. The subject was tilted 45 degrees left and right with movement measured in inches. Comfort level was measured before and after. Paired t-tests were used to detect differences in movement. No statistical difference in movement was found between devices for the hea...
ANNA journal / American Nephrology Nurses' Association
Air Medical Journal, 2015
The long spinal board is the immobilization standard during prehospital transport. The flat surfa... more The long spinal board is the immobilization standard during prehospital transport. The flat surface of the board increases the pressure placed on both the thoracic kyphosis and the sacrum and increases the risk for pressure ulcers. This study compared patient stability and comfort between a padded litter system used in air medical transport and the long spine board. The study was completed at a large 350-bed Magnet Recognized nonteaching hospital. The hospital owns and operates an air medical transport service. Subjects were secured to a padded litter and a long spinal board with a cervical collar and head blocks and 3 straps. Laser pointers were used to mark neutral at points on the subject's head, sternum, and pelvis. The subject was tilted 45 degrees left and right with movement measured in inches. Comfort level was measured before and after. Paired t-tests were used to detect differences in movement. No statistical difference in movement was found between devices for the head; however, there was statistically significant greater movement on the padded litter for the sternum and pelvis. The padded litter did not immobilize as tightly as the long board although the effect of the differences was small.
Progress in transplantation (Aliso Viejo, Calif.), 2001
A self-assessment instrument for use at home by transplant recipients was developed to help foste... more A self-assessment instrument for use at home by transplant recipients was developed to help foster partnership between patients and their healthcare provider. Self-monitoring at home has not replaced the need for close follow-up but does allow patients to provide concrete data to their healthcare provider in order to promote earlier detection of and response to adverse events. Patients are taught the essentials of self-monitoring while they are in the hospital for their transplant. Patients who perform routine self-assessment would be able to detect and provide information about problems early in the course of events. Thus, early intervention could potentially decrease the severity of the problem and prevent repeated hospitalizations. The concern that patients would not be able to perform a reliable self-assessment was unfounded; patients exceeded expectations and embraced the opportunity to communicate physical signs and symptoms effectively.
Medsurg nursing : official journal of the Academy of Medical-Surgical Nurses
An intervention study evaluating the impact of journaling on nurse happiness was conducted with 9... more An intervention study evaluating the impact of journaling on nurse happiness was conducted with 91 medical-surgical nurses. No differences in general happiness, percentage of time happy, and gratitude were detected among groups although journaling was qualitatively described as meaningful.
Pediatric nursing
Adolescents with type 1 diabetes mellitus (T1DM) often speak of the importance of attending a dia... more Adolescents with type 1 diabetes mellitus (T1DM) often speak of the importance of attending a diabetes camp. In an effort to identify the effect of a diabetes camp on participants, a descriptive comparative pilot study was undertaken. Adolescents 10 to 16 years of age with T1DM attending a residential diabetes camp (N = 81) were recruited to explore the concept of self-efficacy and resilience, two possible mediators influenced by attending camp. Overall, self-efficacy and resilience scores were moderately high. No differences were detected in outcome measures for gender or mode of insulin therapy; however, African Americans scored significantly higher for diabetes self-efficacy and resilience. Subjects living with one parent had poorer glycosylated hemoglobin (HgbA1C) but scored better in resilience. No association for years of camp attendance and study outcomes were identified. Diabetes camp is an important experience for adolescents living with T1DM, and continued exploration of t...
Progress in transplantation (Aliso Viejo, Calif.), 2008
Telehealth technology serves individuals who live in geographical areas that prohibit easy access... more Telehealth technology serves individuals who live in geographical areas that prohibit easy access to specialized health care and can provide transplant recipients with access to transplant center personnel for adjunctive follow-up care. To compare infection, rejection, and hospitalization events in subjects randomized to telehealth or to standard posttransplant care. STUDY DESIGN, STUDY PARTICIPANTS, SETTING AND RESEARCH PROCEDURE: This longitudinal prospective study compared transplant outcomes (infections, rejections, and hospitalizations) of 106 subjects who were randomized to either the telehealth (n = 53) or standard care (n = 53) group and met the 6-month study end point. Sex, race, and transplant type were evenly distributed within the 2 groups. Subjects received primary follow-up care from nurse practitioners. The telehealth visits were conducted via live interactive sessions with digitized equipment used to perform physical examinations. Infections, rejections, and hospital...
Progress in transplantation (Aliso Viejo, Calif.), 2008
The contribution of social support networks to the recovery of transplant recipients is an import... more The contribution of social support networks to the recovery of transplant recipients is an important assessment in measuring improved physical and psychosocial well-being. Social support networks are described by structure, type, and function. (1) To describe the levels of structure (size, formal and informal support), type (concrete, emotional, and informational), and function (criticalness, direction, closeness, frequency, and duration) of the social support network and (2) to examine the relationships between individual characteristics of sex, race, and social class and social support networks. This exploratory-descriptive study was done in a Mid-south transplant center. A total of 258 kidney, liver, and pancreas transplant recipients participated, 61% of whom were less than 50-years-old. Instruments included a demographic questionnaire, the social support network pie chart, and the social support network grid. Descriptive statistics and analysis of variance were used with a .05 ...
Nephrology nursing journal : journal of the American Nephrology Nurses' Association
This chapter on research in nursing was included in ANNA's Career Fulfillment in Nephrology N... more This chapter on research in nursing was included in ANNA's Career Fulfillment in Nephrology Nursing: Your Guide to Professional Development (2nd edition), which was published in September 2007. This chapter encourages nurses to participate in the research process by providing an overview of the nursing research process, including the steps to designing a research project, and answers to frequently asked questions. The objectives of the chapter are to: (a) define the nursing research process, including the systematic and universal knowledge concepts along with overviews of process improvement and evidence-based practice; (b) identify the steps to designing a research project, including identifying a clinical problem and formulating a research questions, conducting a review of the literature, and providing an overview of the research design; (c) provide an overview of the study methodology, including data analysis and protecting human subjects; (d) discuss available funding opport...
Progress in transplantation (Aliso Viejo, Calif.), 2007
During the design phase of any research, an investigator addresses internal and external threats ... more During the design phase of any research, an investigator addresses internal and external threats to validity and develops mechanisms to minimize these threats. Controlling for threats to study validity enhances the meaningfulness and generalizability of study outcomes. Representativeness of the study sample is one key design feature undertaken to ensure study validity; however, during clinical trials the investigator must stay attuned to ongoing situations that can alter sample representativeness. In the context of an ongoing nursing-led randomized control trial, threats to sample representativeness are discussed. These threats can occur in any study and may require modification of the study design to maintain validity of research outcomes. This article provides insight regarding threats to study validity encountered by one research team and the modifications undertaken to address them.
Progress in transplantation (Aliso Viejo, Calif.), 2004
Quality of life and transplant age are 2 major concerns of professionals and researchers. Both va... more Quality of life and transplant age are 2 major concerns of professionals and researchers. Both variables are contemplated in transplant allocation decisions as a result of longer graft and patient survival and the likelihood of achieving a reasonably good quality of life for patients of all ages. Studies are warranted to understand if quality of life might serve as a moderating variable to balance question of age and transplant allocations. To determine if there are differences in the pretransplant and posttransplant quality of life of kidney transplant recipients with respect to age. DESIGN, PARTICIPANTS, SETTING, AND OUTCOME MEASURES: This study comparatively examined the differences in pretransplant and posttransplant quality of life of kidney transplant recipients in 5 age groups (18-29 years, 30-39, 40-49, 50-59, and older than 60). A sample of 293 patients admitted to a midsouthern US transplant center and selected on a convenience-sampling basis were included in the study. Mu...
Progress in transplantation (Aliso Viejo, Calif.), 2002
This article explores the role of ethics and regulation in human research conducted by organ proc... more This article explores the role of ethics and regulation in human research conducted by organ procurement agencies; basic ethical principles for human research are outlined. Organ procurement agencies are not required to observe federal regulations; however, voluntary adherence will ensure that procurement research is conducted according to current standards of ethical practice. Although most organ procurement research will qualify for exempt status, this determination should be made by an institutional review board. Even if studies qualify for exempt status, there is a moral presumption that informed consent should be sought, unless certain narrow conditions for waiver of consent are satisfied. Finally, when future research utilizing organ procurement records is anticipated, procurement coordinators should provide sufficiently detailed information to families about such plans to permit their advance informed consent to research activities.
Clinical transplantation
This study examined patterns, potential predictors, and outcomes of immunosuppressive medication ... more This study examined patterns, potential predictors, and outcomes of immunosuppressive medication adherence in a convenience sample of 121 kidney transplant recipients aged 21 yr or older from three kidney transplant centers using a theory-based, descriptive, correlational, longitudinal design. Electronic monitoring was conducted for 12 months using electronic monitoring. Participants were persistent in taking their immunosuppressive medications, but execution, which includes both taking and timing, was poor. Older age was the only demographic variable associated with medication adherence (r = 0.25; p = 0.005). Of the potential predictors examined, only medication self-efficacy was associated with medication non-adherence, explaining about 9% of the variance (r = 0.31, p = 0.0006). The few poor outcomes that occurred were not significantly associated with medication non-adherence, although the small number of poor outcomes may have limited our ability to detect a link. Future researc...
Progress in Transplantation
Progress in Transplantation
Progress in Transplantation
Progress in Transplantation
Nephrology Nursing Journal, Apr 1, 2001
Http Dx Doi Org 10 1080 15323269 2012 719188, Oct 1, 2012
Nephrology Nursing Journal Journal of the American Nephrology Nurses Association, 2007
This chapter on research in nursing was included in ANNA's Career Fulfillment in Nephrology Nursi... more This chapter on research in nursing was included in ANNA's Career Fulfillment in Nephrology Nursing: Your Guide to Professional Development (2 nd edition), which was published in September 2007. This chapter encourages nurses to participate in the research process by providing an overview of the nursing research process, including the steps to designing a research project, and answers to frequently asked questions. The objectives of the chapter are to: (a) define the nursing research process, including the systematic and universal knowledge concepts along with overviews of process improvement and evidence-based practice; (b) identify the steps to designing a research project, including identifying a clinical problem and formulating a research questions, conducting a review of the literature, and providing an overview of the research design; (c) provide an overview of the study methodology, including data analysis and protecting human subjects; (d) discuss available funding opportunities and the professional obligations that go with these opportunities; and (e) provide answers to frequently asked questions regarding nursing research to help demystify the process.
Air medical journal
The long spinal board is the immobilization standard during prehospital transport. The flat surfa... more The long spinal board is the immobilization standard during prehospital transport. The flat surface of the board increases the pressure placed on both the thoracic kyphosis and the sacrum and increases the risk for pressure ulcers. This study compared patient stability and comfort between a padded litter system used in air medical transport and the long spine board. The study was completed at a large 350-bed Magnet Recognized nonteaching hospital. The hospital owns and operates an air medical transport service. Subjects were secured to a padded litter and a long spinal board with a cervical collar and head blocks and 3 straps. Laser pointers were used to mark neutral at points on the subject's head, sternum, and pelvis. The subject was tilted 45 degrees left and right with movement measured in inches. Comfort level was measured before and after. Paired t-tests were used to detect differences in movement. No statistical difference in movement was found between devices for the hea...
ANNA journal / American Nephrology Nurses' Association
Air Medical Journal, 2015
The long spinal board is the immobilization standard during prehospital transport. The flat surfa... more The long spinal board is the immobilization standard during prehospital transport. The flat surface of the board increases the pressure placed on both the thoracic kyphosis and the sacrum and increases the risk for pressure ulcers. This study compared patient stability and comfort between a padded litter system used in air medical transport and the long spine board. The study was completed at a large 350-bed Magnet Recognized nonteaching hospital. The hospital owns and operates an air medical transport service. Subjects were secured to a padded litter and a long spinal board with a cervical collar and head blocks and 3 straps. Laser pointers were used to mark neutral at points on the subject's head, sternum, and pelvis. The subject was tilted 45 degrees left and right with movement measured in inches. Comfort level was measured before and after. Paired t-tests were used to detect differences in movement. No statistical difference in movement was found between devices for the head; however, there was statistically significant greater movement on the padded litter for the sternum and pelvis. The padded litter did not immobilize as tightly as the long board although the effect of the differences was small.
Progress in transplantation (Aliso Viejo, Calif.), 2001
A self-assessment instrument for use at home by transplant recipients was developed to help foste... more A self-assessment instrument for use at home by transplant recipients was developed to help foster partnership between patients and their healthcare provider. Self-monitoring at home has not replaced the need for close follow-up but does allow patients to provide concrete data to their healthcare provider in order to promote earlier detection of and response to adverse events. Patients are taught the essentials of self-monitoring while they are in the hospital for their transplant. Patients who perform routine self-assessment would be able to detect and provide information about problems early in the course of events. Thus, early intervention could potentially decrease the severity of the problem and prevent repeated hospitalizations. The concern that patients would not be able to perform a reliable self-assessment was unfounded; patients exceeded expectations and embraced the opportunity to communicate physical signs and symptoms effectively.
Medsurg nursing : official journal of the Academy of Medical-Surgical Nurses
An intervention study evaluating the impact of journaling on nurse happiness was conducted with 9... more An intervention study evaluating the impact of journaling on nurse happiness was conducted with 91 medical-surgical nurses. No differences in general happiness, percentage of time happy, and gratitude were detected among groups although journaling was qualitatively described as meaningful.
Pediatric nursing
Adolescents with type 1 diabetes mellitus (T1DM) often speak of the importance of attending a dia... more Adolescents with type 1 diabetes mellitus (T1DM) often speak of the importance of attending a diabetes camp. In an effort to identify the effect of a diabetes camp on participants, a descriptive comparative pilot study was undertaken. Adolescents 10 to 16 years of age with T1DM attending a residential diabetes camp (N = 81) were recruited to explore the concept of self-efficacy and resilience, two possible mediators influenced by attending camp. Overall, self-efficacy and resilience scores were moderately high. No differences were detected in outcome measures for gender or mode of insulin therapy; however, African Americans scored significantly higher for diabetes self-efficacy and resilience. Subjects living with one parent had poorer glycosylated hemoglobin (HgbA1C) but scored better in resilience. No association for years of camp attendance and study outcomes were identified. Diabetes camp is an important experience for adolescents living with T1DM, and continued exploration of t...
Progress in transplantation (Aliso Viejo, Calif.), 2008
Telehealth technology serves individuals who live in geographical areas that prohibit easy access... more Telehealth technology serves individuals who live in geographical areas that prohibit easy access to specialized health care and can provide transplant recipients with access to transplant center personnel for adjunctive follow-up care. To compare infection, rejection, and hospitalization events in subjects randomized to telehealth or to standard posttransplant care. STUDY DESIGN, STUDY PARTICIPANTS, SETTING AND RESEARCH PROCEDURE: This longitudinal prospective study compared transplant outcomes (infections, rejections, and hospitalizations) of 106 subjects who were randomized to either the telehealth (n = 53) or standard care (n = 53) group and met the 6-month study end point. Sex, race, and transplant type were evenly distributed within the 2 groups. Subjects received primary follow-up care from nurse practitioners. The telehealth visits were conducted via live interactive sessions with digitized equipment used to perform physical examinations. Infections, rejections, and hospital...
Progress in transplantation (Aliso Viejo, Calif.), 2008
The contribution of social support networks to the recovery of transplant recipients is an import... more The contribution of social support networks to the recovery of transplant recipients is an important assessment in measuring improved physical and psychosocial well-being. Social support networks are described by structure, type, and function. (1) To describe the levels of structure (size, formal and informal support), type (concrete, emotional, and informational), and function (criticalness, direction, closeness, frequency, and duration) of the social support network and (2) to examine the relationships between individual characteristics of sex, race, and social class and social support networks. This exploratory-descriptive study was done in a Mid-south transplant center. A total of 258 kidney, liver, and pancreas transplant recipients participated, 61% of whom were less than 50-years-old. Instruments included a demographic questionnaire, the social support network pie chart, and the social support network grid. Descriptive statistics and analysis of variance were used with a .05 ...
Nephrology nursing journal : journal of the American Nephrology Nurses' Association
This chapter on research in nursing was included in ANNA's Career Fulfillment in Nephrology N... more This chapter on research in nursing was included in ANNA's Career Fulfillment in Nephrology Nursing: Your Guide to Professional Development (2nd edition), which was published in September 2007. This chapter encourages nurses to participate in the research process by providing an overview of the nursing research process, including the steps to designing a research project, and answers to frequently asked questions. The objectives of the chapter are to: (a) define the nursing research process, including the systematic and universal knowledge concepts along with overviews of process improvement and evidence-based practice; (b) identify the steps to designing a research project, including identifying a clinical problem and formulating a research questions, conducting a review of the literature, and providing an overview of the research design; (c) provide an overview of the study methodology, including data analysis and protecting human subjects; (d) discuss available funding opport...
Progress in transplantation (Aliso Viejo, Calif.), 2007
During the design phase of any research, an investigator addresses internal and external threats ... more During the design phase of any research, an investigator addresses internal and external threats to validity and develops mechanisms to minimize these threats. Controlling for threats to study validity enhances the meaningfulness and generalizability of study outcomes. Representativeness of the study sample is one key design feature undertaken to ensure study validity; however, during clinical trials the investigator must stay attuned to ongoing situations that can alter sample representativeness. In the context of an ongoing nursing-led randomized control trial, threats to sample representativeness are discussed. These threats can occur in any study and may require modification of the study design to maintain validity of research outcomes. This article provides insight regarding threats to study validity encountered by one research team and the modifications undertaken to address them.
Progress in transplantation (Aliso Viejo, Calif.), 2004
Quality of life and transplant age are 2 major concerns of professionals and researchers. Both va... more Quality of life and transplant age are 2 major concerns of professionals and researchers. Both variables are contemplated in transplant allocation decisions as a result of longer graft and patient survival and the likelihood of achieving a reasonably good quality of life for patients of all ages. Studies are warranted to understand if quality of life might serve as a moderating variable to balance question of age and transplant allocations. To determine if there are differences in the pretransplant and posttransplant quality of life of kidney transplant recipients with respect to age. DESIGN, PARTICIPANTS, SETTING, AND OUTCOME MEASURES: This study comparatively examined the differences in pretransplant and posttransplant quality of life of kidney transplant recipients in 5 age groups (18-29 years, 30-39, 40-49, 50-59, and older than 60). A sample of 293 patients admitted to a midsouthern US transplant center and selected on a convenience-sampling basis were included in the study. Mu...
Progress in transplantation (Aliso Viejo, Calif.), 2002
This article explores the role of ethics and regulation in human research conducted by organ proc... more This article explores the role of ethics and regulation in human research conducted by organ procurement agencies; basic ethical principles for human research are outlined. Organ procurement agencies are not required to observe federal regulations; however, voluntary adherence will ensure that procurement research is conducted according to current standards of ethical practice. Although most organ procurement research will qualify for exempt status, this determination should be made by an institutional review board. Even if studies qualify for exempt status, there is a moral presumption that informed consent should be sought, unless certain narrow conditions for waiver of consent are satisfied. Finally, when future research utilizing organ procurement records is anticipated, procurement coordinators should provide sufficiently detailed information to families about such plans to permit their advance informed consent to research activities.
Clinical transplantation
This study examined patterns, potential predictors, and outcomes of immunosuppressive medication ... more This study examined patterns, potential predictors, and outcomes of immunosuppressive medication adherence in a convenience sample of 121 kidney transplant recipients aged 21 yr or older from three kidney transplant centers using a theory-based, descriptive, correlational, longitudinal design. Electronic monitoring was conducted for 12 months using electronic monitoring. Participants were persistent in taking their immunosuppressive medications, but execution, which includes both taking and timing, was poor. Older age was the only demographic variable associated with medication adherence (r = 0.25; p = 0.005). Of the potential predictors examined, only medication self-efficacy was associated with medication non-adherence, explaining about 9% of the variance (r = 0.31, p = 0.0006). The few poor outcomes that occurred were not significantly associated with medication non-adherence, although the small number of poor outcomes may have limited our ability to detect a link. Future researc...