Susan Heidrich - Academia.edu (original) (raw)

Papers by Susan Heidrich

Oncology Nursing Forum, Apr 28, 2009

Purpose/Objectives-To test the feasibility and acceptability of an individualized representationa... more Purpose/Objectives-To test the feasibility and acceptability of an individualized representational intervention to improve symptom management (IRIS) in older breast cancer survivors and test the short-term effects of an IRIS on symptom distress. Design-Two small randomized clinical trials and one pre-experimental study. Setting-Oncology clinic and community. Sample-41 women with breast cancer (aged 65 years and older) in pilot study 1, 20 in pilot study 2, and 21 in pilot study 3. Methods-In pilot study 1, women were randomized to the IRIS or usual care control. In pilot study 2, women were randomized to the IRIS or delayed IRIS (wait list) control. In pilot study 3, all women received the IRIS by telephone. Measures were collected at baseline, postintervention, and followup (up to four months). Main Research Variables-Feasibility, acceptability, symptom distress, symptom management behaviors, symptom management barriers, and quality of life. Findings-Across three pilot studies, 76% of eligible women participated, 95% completed the study, 88% reported the study was helpful, and 91% were satisfied with the study. Some measures of symptom distress decreased significantly after the IRIS, but quality of life was stable. Women in the IRIS group changed their symptom management behaviors more than controls. Conclusions-Preliminary evidence supports the need for and feasibility of an IRIS. Implications for Nursing-Nurses may help older breast cancer survivors manage their numerous chronic symptoms more effectively by assessing women's beliefs about their symptoms and their current symptom management strategies. More than a decade ago, the Oncology Nursing Society (ONS) recognized that oncology nurses will be caring for a growing number of older (aged 65 years or older) adults with cancer and that nursing care must meet the unique cancer-specific needs of this population (Boyle, 1992). The sentiment was revisited in 2007 in ONS's joint position with the Geriatric Oncology Consortium on cancer care for older adults. For older breast cancer survivors, the impact of a cancer diagnosis and cancer treatment combined with the physical and health changes commonly associated with aging result in unique survivorship issues (Deimling, Bowman,

Heart & Lung, Mar 1, 2001

The goal of this study was to describe the influence of physical health on social role perception... more The goal of this study was to describe the influence of physical health on social role perceptions, role performance, and role balance in women after heart surgery and coronary angioplasty. DESIGN: A cross-sectional descriptive survey was used. SETTING: The study was undertaken at a Midwestern community hospital. SAMPLE: The study considered 58 midlife and older women who had received heart surgery or coronary angioplasty. OUTCOME MEASURES: The following measures were used: Inventory of Adult Role Behavior, Role Discrepancy Measure, Role Balance Measure, and Salient Social Roles Measure. RESULTS: Women in poorer health had lower role performance and more negative role perceptions. In general, the balance of rewards and concerns in roles rated most important were not affected by health status. CONCLUSION: Dimensions of women's social roles are related to physical health after heart surgery and angioplasty. Knowledge about the effect of physical health on women's social role experiences is important information for clinicians who care for women with heart disease. If a woman can be helped to achieve better functional health to perform role and daily living tasks, she may feel more positive about her current and future health states.

Journal of the Association of Nurses in AIDS Care, Mar 1, 2006

The purpose of this report is to share results from a pilot study about the social role experienc... more The purpose of this report is to share results from a pilot study about the social role experiences and health of women living with HIV/AIDS. This pilot was designed as part of a larger study undertaken to ensure cultural competence of measures and methods proposed for testing a model of role quality and health in culturally diverse low-income women. Thirteen women participated in the study (69% African American; 77% less than $10,000 annual income; range of years since HIV diagnosis, 3-21). Measures of physical health, role quality, and psychological well-being previously used to test relationships among the variables in women with chronic illness were administered using a face-to-face interview format. Results indicated that the women experienced a number of HIV symptoms and coexisting health problems, moderate physical limitations, positive perceptions of their roles, moderate levels of well-being, and high depression scores. The pilot study represents the first step in the development of a theorybased approach to understanding linkages among health and role quality in women with HIV.

Cancer Nursing, Jul 1, 2009

Negative attitudes about aging of both older adults and health care providers can be barriers to ... more Negative attitudes about aging of both older adults and health care providers can be barriers to self care in old age. The aims of this study were 1) to examine the extent to which older breast cancer survivors experience barriers to symptom management, and 2) to explore whether barriers influence quality of life. Three possible barriers to symptom management were examined: negative beliefs about managing symptoms, perceived negative attitudes of health care providers, and difficulties in communicating about symptoms. This study was a secondary analysis of pooled baseline data from 61 older (age > 64) women who participated in two pilot studies that tested a symptom management intervention for older breast cancer survivors. The most frequent barrier reported was difficulties in communicating about symptoms with health care providers. Each of the barriers affected psychosocial, but not physical, quality of life. Barriers to symptom management may lead to poorer self care of symptoms that can result in lower levels of psychosocial quality of life. Health care providers need to encourage older cancer survivors to report symptoms and worries related to their cancer diagnosis and should be cautious in expressing attitudes that could reinforce older adults' negative perceptions about aging.

International Journal of Behavioral Development, Feb 1, 1997

The guiding question was how past life experiences are linked with adults’ assessments of their p... more The guiding question was how past life experiences are linked with adults’ assessments of their present and future well-being. Typical events and transitions (normative experiences) were contrasted with atypical stresses (non-normative experiences). A sample of 308 men and women, divided between young, midlife, and older adults, completed past life event inventories and rated themselves on multiple dimensions of well-being (concurrently and prospectively). Hierarchical regression analyses revealed that normative events were significant predictors of multiple aspects of present and future wellness, but there were marked age differences in which domains were key influences: For young adults, life activities were primary; for midlife adults, greatest variance was explained by the family and friends domain; in late life, prior work and educational experiences were strongest predictors of well-being. Non-normative events were significant positive predictors of only personal growth in young adults.

Research in Nursing & Health, Jun 1, 2002

Women's social role quality may be an important factor in their adaptation after heart surgery. R... more Women's social role quality may be an important factor in their adaptation after heart surgery. Relationships among different dimensions of role quality, physical health, and psychological well-being were examined in 157 midlife and older women who had undergone heart surgery. Overall, older women (n ¼ 89) were similar to younger women (n ¼ 68) in physical recovery from heart surgery. Poorer health outcomes were associated with number of health problems, not age. Women with more health problems and lower subjective health perceptions had lower role quality. Multiple regression analyses indicated that, in general, role quality mediated the effects of physical health on psychological well-being. Regardless of the extent of physical health problems, women with higher role quality had higher levels of psychological well-being.

Research in Nursing & Health, May 12, 2003

The purpose of this study was to examine the mediating and moderating effects of women's social r... more The purpose of this study was to examine the mediating and moderating effects of women's social role quality on the psychological wellbeing of women with rheumatoid arthritis (RA). One hundred and fifty-six women with a diagnosis of RA (M age ¼ 59, SD ¼ 11) completed self-report measures of arthritis history, physical health, psychological well-being, and role quality. Hierarchical multiple regression analyses indicated that role quality mediated the effects of physical health on depression and purpose in life, moderated the effects of health on depression, and moderated the effects of pain on purpose in life. Women in poor health with high role quality were significantly less depressed than women in poor health with poor role quality. Women with high levels of pain and high role quality had more purpose in life than women with high levels of pain and low role quality. Despite difficulties with their physical health, women who had high role quality had higher levels of psychological well-being. Findings from this study may aid in the development of meaningful interventions to help women with RA manage their daily lives to optimize well-being.

Oncology Nursing Forum, Oct 29, 2011

Objective-To identify symptom clusters in older breast cancer survivors and examine whether sympt... more Objective-To identify symptom clusters in older breast cancer survivors and examine whether symptom clusters are related to demographic, health, and quality of life variables. Design-Symptom bother measures were analyzed using factor analysis to identify possible symptom clusters and the resulting clusters were then correlated with quality of life measures. Setting-The randomized clinical trail from which the data used for these analyses were drawn took place over the phone between the participant and a trained research nurse. Sample-Data from 192 older breast cancer survivors (mean age = 70) who had participated in a randomized clinical trial testing a symptom management intervention were used for this study. Methods-This was a secondary data analysis of the baseline measures of demographics, health history, symptom bother, and physical, mental, and existential dimensions of quality of life. Exploratory and confirmatory factor analyses were conducted as well as MIMIC modeling and partial correlation analyses to assess the relationships amongst clusters and demographic, health history, and quality of life measures. Main research variables-The main research variables were self-reported symptom bother, demographics such as age and education level, health history and quality of life. Findings-Seven clinically distinct symptom clusters tapping 36 different symptoms in older breast cancer survivors were found, and these symptom clusters were significantly related to multiple dimensions of quality of life. Conclusions-Older breast cancer survivors experience multiple, concurrent symptoms that appear to cluster. Identifying symptom clusters helps to elucidate possible inter-symptom relationships, which may lead to the design of more effective symptom management interventions for older breast cancer survivors. Implications for Nursing-Older breast cancer survivors should be assessed for a wide variety of symptoms if clinicians hope to identify and understand inter-symptom relationships. Such an assessment would enable more comprehensive symptom management.

Research in Nursing & Health, Apr 1, 1993

Little is known about the physical health and psychological well-being of very old women, althoug... more Little is known about the physical health and psychological well-being of very old women, although they are one of the fastest growing segments of the population. The relationships among physical health, psychological well-being, and age were investigated using a developmental perspective and a multidimensional approach to the assessment of psychological wellbeing. Two hundred and forty-three elderly women completed multiple self-report measures of physical health status and psychological well-being. Multiple regression analyses indicated that older age was related to lower levels of purpose in life, personal growth, and positive relationships. Poor health, regardless of age, was associated with more depression and anxiety and lower levels of positive relationships and autonomy. Implications for the nursing care of elderly women are discussed.

Rehabilitation Nursing, Mar 1, 2015

Purpose: The purpose of this article is to describe the care of a "super bariatric" patient. Desi... more Purpose: The purpose of this article is to describe the care of a "super bariatric" patient. Design and Methods: We used a case study approach to describe the complex interdisciplinary care challenges posed in the care of a super bariatric patient at a Veterans Administration Hospital in the Midwest. Findings: Nurses and other healthcare providers discovered ways to provide high-quality patient-centered care under challenging conditions and also ensure the safety and well-being of nursing staff and other providers. Conclusions/Clinical Relevance: An interdisciplinary, patient-centered approach with advance planning and coordination is necessary to ensure the delivery of safe, high-quality nursing care to veterans with complex health problems who are "super bariatric."

Journal of Psychosomatic Research, May 1, 2012

This article appeared in a journal published by Elsevier. The attached copy is furnished to the a... more This article appeared in a journal published by Elsevier. The attached copy is furnished to the author for internal non-commercial research and education use, including for instruction at the authors institution and sharing with colleagues. Other uses, including reproduction and distribution, or selling or licensing copies, or posting to personal, institutional or third party websites are prohibited. In most cases authors are permitted to post their version of the article (e.g. in Word or Tex form) to their personal website or institutional repository. Authors requiring further information regarding Elsevier's archiving and manuscript policies are encouraged to visit: http://www.elsevier.com/copyright

Research in Gerontological Nursing, Jul 1, 2012

Little is known about patients' understanding of a diagnosis of Mild Cognitive Impairment (MCI). ... more Little is known about patients' understanding of a diagnosis of Mild Cognitive Impairment (MCI). The purpose of this cross-sectional descriptive study was to describe beliefs about MCI in persons diagnosed with MCI and examine correlates (demographic and health) of those beliefs. Thirty persons diagnosed with MCI completed the Illness Perception Questionnaire-MCI (IPQ-MCI), measuring eight domains of beliefs about MCI, and one scale of emotional distress. Five of them also participated in a 15-minute cognitive interview to explore responses to the IPQ-MCI. Participants correctly identified symptoms related to MCI; generally attributed MCI to aging, heredity, and abnormal brain changes; and believed MCI to be chronic, predictable, and controllable, causing little emotional distress. However, there were no consistent beliefs regarding the negative consequences of MCI or whether MCI was understandable. There were few significant correlates of beliefs. Persons with MCI are able to report their beliefs about their illness suggesting that misconceptions and gaps in knowledge can be identified and addressed with nursing interventions.

Western Journal of Nursing Research, Oct 1, 1994

A short-term, longitudinal, survey study was conducted to examine relationships among actual and ... more A short-term, longitudinal, survey study was conducted to examine relationships among actual and ideal self conceptions, physical health, and depression in 149 community-dwelling elderly women. Two theoretical perspectives regarding the self were compared, women's self-development and lifespan developmental theory. As predicted by theories of women's development, relationships with others emerged as a salient aspect of the self in elderly women. Regression analyses indicated that actual and ideal self-conceptions were predicted by depression, but not generally by physical health status. Thus, physical health problems were not global in their effects on the various dimensions of the self in elderly women, but depression was.

Psychology and Aging, 1990

Previous training studies of fluid intellectual abilities have involved training on either figura... more Previous training studies of fluid intellectual abilities have involved training on either figural relations or induction tasks. In the present study, young, middle-aged, and elderly adults were given training on another measure of fluid ability-Raven's Progressive Matrices. The training involved a strategy-modeling technique that lasted no more than a few minutes. The results indicated that (a) performance on the Raven decreased with increasing age, (b) training significantly improved performance, and (c) the effect of training did not differ as a function of the age or sex of the subjects. Thus, the results indicate that performance on the Raven can be significantly improved in a single, brief training session.

Annual review of nursing research, 1998

The empirical literature on health promotion in old age was reviewed. A developmental perspective... more The empirical literature on health promotion in old age was reviewed. A developmental perspective was used to examine 42 studies: studies relating health behaviors to health outcomes, descriptive studies of health promotion in old age, studies of the outcomes of health promotion programs in old age, and studies of factors related to older adults' participation in health promotion activities. In general, elderly adults perceived health promotion activities as beneficial, engaged in health behaviors more frequently than younger adults, and participated in community-based and other health promotion programs. There is little definitive evidence that health promotion activities result in better health outcomes for older adults, however. Identifying appropriate outcomes related to health promotion in old age is a critical need.

Journal of Nursing Scholarship, Mar 5, 2013

The purpose of this study was to describe infertile women&amp... more The purpose of this study was to describe infertile women's psychosocial health problems and their infertility-related beliefs and examine the relationships between their beliefs about infertility and psychosocial health problems. The study was a descriptive correlational cross-sectional survey. Women (N = 203) who were receiving treatment for fertility problems in two public hospitals in Ghana were recruited. Participants completed a Fertility Belief Questionnaire; measures of infertility-related stress, anxiety, social isolation, perceived stigma, and depressive symptoms; and sociodemographic and infertility-related health questions. Descriptive statistics, Pearson's correlations, and hierarchical regression analyses were performed. The women reported high levels of infertility-related stress, low levels of anxiety, some social isolation, low levels of perceived stigma, and high levels of depressive symptoms. Beliefs that infertility has negative consequences and that one has a poor understanding of infertility were significantly related to infertility-related stress, social isolation, and depressive symptoms. Belief that infertility could be managed by personal control was significantly related to lower levels of anxiety and perceived stigma. Beliefs about consequences, illness coherence, and personal control explained significant proportions of the variances in anxiety, stress, social isolation, perceived stigma, and depressive symptoms. Infertile women in Ghana have psychosocial health problems that are associated with their beliefs about infertility. Findings have implications for nursing care of infertile women in Ghana.

Cancer Nursing, Dec 1, 1989

For women with stage I or II breast cancer, randomized trials have demonstrated no significant di... more For women with stage I or II breast cancer, randomized trials have demonstrated no significant difference in survival rates between women receiving modified radical mastectomy (MRM) and women receiving breast conserving (BC) surgery. Therefore, many women are now in a position of having a choice between these two options. Twenty-two women who met the surgical criteria for having this choice were interviewed 1 to 2 weeks postsurgery to determine factors they had considered when deciding between MRM and BC, how much they wished to participate in decision-making, and the sources of information they used. The sample was purposefully limited to women attending one clinic in order to insure control over variables such as the information to which patients are exposed. When asked why they had chosen a given surgery, two factors, concerns about radiotherapy (p = 0.003) and body integrity (p = 0.04), emerged as significantly different for women choosing BC vs. MRM. Furthermore, women reported that participation in decision-making was important to them and that they had had sufficient participation in the decision-making process. Finally, they rated "people" sources of information as more important than written or visual materials, suggesting that nurses and other care providers are important in supporting women through the decision-making process.

Violence Against Women, May 1, 2008

Oncology Nursing Forum, Apr 28, 2009

Purpose/Objectives-To test the feasibility and acceptability of an individualized representationa... more Purpose/Objectives-To test the feasibility and acceptability of an individualized representational intervention to improve symptom management (IRIS) in older breast cancer survivors and test the short-term effects of an IRIS on symptom distress. Design-Two small randomized clinical trials and one pre-experimental study. Setting-Oncology clinic and community. Sample-41 women with breast cancer (aged 65 years and older) in pilot study 1, 20 in pilot study 2, and 21 in pilot study 3. Methods-In pilot study 1, women were randomized to the IRIS or usual care control. In pilot study 2, women were randomized to the IRIS or delayed IRIS (wait list) control. In pilot study 3, all women received the IRIS by telephone. Measures were collected at baseline, postintervention, and followup (up to four months). Main Research Variables-Feasibility, acceptability, symptom distress, symptom management behaviors, symptom management barriers, and quality of life. Findings-Across three pilot studies, 76% of eligible women participated, 95% completed the study, 88% reported the study was helpful, and 91% were satisfied with the study. Some measures of symptom distress decreased significantly after the IRIS, but quality of life was stable. Women in the IRIS group changed their symptom management behaviors more than controls. Conclusions-Preliminary evidence supports the need for and feasibility of an IRIS. Implications for Nursing-Nurses may help older breast cancer survivors manage their numerous chronic symptoms more effectively by assessing women's beliefs about their symptoms and their current symptom management strategies. More than a decade ago, the Oncology Nursing Society (ONS) recognized that oncology nurses will be caring for a growing number of older (aged 65 years or older) adults with cancer and that nursing care must meet the unique cancer-specific needs of this population (Boyle, 1992). The sentiment was revisited in 2007 in ONS's joint position with the Geriatric Oncology Consortium on cancer care for older adults. For older breast cancer survivors, the impact of a cancer diagnosis and cancer treatment combined with the physical and health changes commonly associated with aging result in unique survivorship issues (Deimling, Bowman,

Heart & Lung, Mar 1, 2001

The goal of this study was to describe the influence of physical health on social role perception... more The goal of this study was to describe the influence of physical health on social role perceptions, role performance, and role balance in women after heart surgery and coronary angioplasty. DESIGN: A cross-sectional descriptive survey was used. SETTING: The study was undertaken at a Midwestern community hospital. SAMPLE: The study considered 58 midlife and older women who had received heart surgery or coronary angioplasty. OUTCOME MEASURES: The following measures were used: Inventory of Adult Role Behavior, Role Discrepancy Measure, Role Balance Measure, and Salient Social Roles Measure. RESULTS: Women in poorer health had lower role performance and more negative role perceptions. In general, the balance of rewards and concerns in roles rated most important were not affected by health status. CONCLUSION: Dimensions of women's social roles are related to physical health after heart surgery and angioplasty. Knowledge about the effect of physical health on women's social role experiences is important information for clinicians who care for women with heart disease. If a woman can be helped to achieve better functional health to perform role and daily living tasks, she may feel more positive about her current and future health states.

Journal of the Association of Nurses in AIDS Care, Mar 1, 2006

The purpose of this report is to share results from a pilot study about the social role experienc... more The purpose of this report is to share results from a pilot study about the social role experiences and health of women living with HIV/AIDS. This pilot was designed as part of a larger study undertaken to ensure cultural competence of measures and methods proposed for testing a model of role quality and health in culturally diverse low-income women. Thirteen women participated in the study (69% African American; 77% less than $10,000 annual income; range of years since HIV diagnosis, 3-21). Measures of physical health, role quality, and psychological well-being previously used to test relationships among the variables in women with chronic illness were administered using a face-to-face interview format. Results indicated that the women experienced a number of HIV symptoms and coexisting health problems, moderate physical limitations, positive perceptions of their roles, moderate levels of well-being, and high depression scores. The pilot study represents the first step in the development of a theorybased approach to understanding linkages among health and role quality in women with HIV.

Cancer Nursing, Jul 1, 2009

Negative attitudes about aging of both older adults and health care providers can be barriers to ... more Negative attitudes about aging of both older adults and health care providers can be barriers to self care in old age. The aims of this study were 1) to examine the extent to which older breast cancer survivors experience barriers to symptom management, and 2) to explore whether barriers influence quality of life. Three possible barriers to symptom management were examined: negative beliefs about managing symptoms, perceived negative attitudes of health care providers, and difficulties in communicating about symptoms. This study was a secondary analysis of pooled baseline data from 61 older (age > 64) women who participated in two pilot studies that tested a symptom management intervention for older breast cancer survivors. The most frequent barrier reported was difficulties in communicating about symptoms with health care providers. Each of the barriers affected psychosocial, but not physical, quality of life. Barriers to symptom management may lead to poorer self care of symptoms that can result in lower levels of psychosocial quality of life. Health care providers need to encourage older cancer survivors to report symptoms and worries related to their cancer diagnosis and should be cautious in expressing attitudes that could reinforce older adults' negative perceptions about aging.

International Journal of Behavioral Development, Feb 1, 1997

The guiding question was how past life experiences are linked with adults’ assessments of their p... more The guiding question was how past life experiences are linked with adults’ assessments of their present and future well-being. Typical events and transitions (normative experiences) were contrasted with atypical stresses (non-normative experiences). A sample of 308 men and women, divided between young, midlife, and older adults, completed past life event inventories and rated themselves on multiple dimensions of well-being (concurrently and prospectively). Hierarchical regression analyses revealed that normative events were significant predictors of multiple aspects of present and future wellness, but there were marked age differences in which domains were key influences: For young adults, life activities were primary; for midlife adults, greatest variance was explained by the family and friends domain; in late life, prior work and educational experiences were strongest predictors of well-being. Non-normative events were significant positive predictors of only personal growth in young adults.

Research in Nursing & Health, Jun 1, 2002

Women's social role quality may be an important factor in their adaptation after heart surgery. R... more Women's social role quality may be an important factor in their adaptation after heart surgery. Relationships among different dimensions of role quality, physical health, and psychological well-being were examined in 157 midlife and older women who had undergone heart surgery. Overall, older women (n ¼ 89) were similar to younger women (n ¼ 68) in physical recovery from heart surgery. Poorer health outcomes were associated with number of health problems, not age. Women with more health problems and lower subjective health perceptions had lower role quality. Multiple regression analyses indicated that, in general, role quality mediated the effects of physical health on psychological well-being. Regardless of the extent of physical health problems, women with higher role quality had higher levels of psychological well-being.

Research in Nursing & Health, May 12, 2003

The purpose of this study was to examine the mediating and moderating effects of women's social r... more The purpose of this study was to examine the mediating and moderating effects of women's social role quality on the psychological wellbeing of women with rheumatoid arthritis (RA). One hundred and fifty-six women with a diagnosis of RA (M age ¼ 59, SD ¼ 11) completed self-report measures of arthritis history, physical health, psychological well-being, and role quality. Hierarchical multiple regression analyses indicated that role quality mediated the effects of physical health on depression and purpose in life, moderated the effects of health on depression, and moderated the effects of pain on purpose in life. Women in poor health with high role quality were significantly less depressed than women in poor health with poor role quality. Women with high levels of pain and high role quality had more purpose in life than women with high levels of pain and low role quality. Despite difficulties with their physical health, women who had high role quality had higher levels of psychological well-being. Findings from this study may aid in the development of meaningful interventions to help women with RA manage their daily lives to optimize well-being.

Oncology Nursing Forum, Oct 29, 2011

Objective-To identify symptom clusters in older breast cancer survivors and examine whether sympt... more Objective-To identify symptom clusters in older breast cancer survivors and examine whether symptom clusters are related to demographic, health, and quality of life variables. Design-Symptom bother measures were analyzed using factor analysis to identify possible symptom clusters and the resulting clusters were then correlated with quality of life measures. Setting-The randomized clinical trail from which the data used for these analyses were drawn took place over the phone between the participant and a trained research nurse. Sample-Data from 192 older breast cancer survivors (mean age = 70) who had participated in a randomized clinical trial testing a symptom management intervention were used for this study. Methods-This was a secondary data analysis of the baseline measures of demographics, health history, symptom bother, and physical, mental, and existential dimensions of quality of life. Exploratory and confirmatory factor analyses were conducted as well as MIMIC modeling and partial correlation analyses to assess the relationships amongst clusters and demographic, health history, and quality of life measures. Main research variables-The main research variables were self-reported symptom bother, demographics such as age and education level, health history and quality of life. Findings-Seven clinically distinct symptom clusters tapping 36 different symptoms in older breast cancer survivors were found, and these symptom clusters were significantly related to multiple dimensions of quality of life. Conclusions-Older breast cancer survivors experience multiple, concurrent symptoms that appear to cluster. Identifying symptom clusters helps to elucidate possible inter-symptom relationships, which may lead to the design of more effective symptom management interventions for older breast cancer survivors. Implications for Nursing-Older breast cancer survivors should be assessed for a wide variety of symptoms if clinicians hope to identify and understand inter-symptom relationships. Such an assessment would enable more comprehensive symptom management.

Research in Nursing & Health, Apr 1, 1993

Little is known about the physical health and psychological well-being of very old women, althoug... more Little is known about the physical health and psychological well-being of very old women, although they are one of the fastest growing segments of the population. The relationships among physical health, psychological well-being, and age were investigated using a developmental perspective and a multidimensional approach to the assessment of psychological wellbeing. Two hundred and forty-three elderly women completed multiple self-report measures of physical health status and psychological well-being. Multiple regression analyses indicated that older age was related to lower levels of purpose in life, personal growth, and positive relationships. Poor health, regardless of age, was associated with more depression and anxiety and lower levels of positive relationships and autonomy. Implications for the nursing care of elderly women are discussed.

Rehabilitation Nursing, Mar 1, 2015

Purpose: The purpose of this article is to describe the care of a "super bariatric" patient. Desi... more Purpose: The purpose of this article is to describe the care of a "super bariatric" patient. Design and Methods: We used a case study approach to describe the complex interdisciplinary care challenges posed in the care of a super bariatric patient at a Veterans Administration Hospital in the Midwest. Findings: Nurses and other healthcare providers discovered ways to provide high-quality patient-centered care under challenging conditions and also ensure the safety and well-being of nursing staff and other providers. Conclusions/Clinical Relevance: An interdisciplinary, patient-centered approach with advance planning and coordination is necessary to ensure the delivery of safe, high-quality nursing care to veterans with complex health problems who are "super bariatric."

Journal of Psychosomatic Research, May 1, 2012

This article appeared in a journal published by Elsevier. The attached copy is furnished to the a... more This article appeared in a journal published by Elsevier. The attached copy is furnished to the author for internal non-commercial research and education use, including for instruction at the authors institution and sharing with colleagues. Other uses, including reproduction and distribution, or selling or licensing copies, or posting to personal, institutional or third party websites are prohibited. In most cases authors are permitted to post their version of the article (e.g. in Word or Tex form) to their personal website or institutional repository. Authors requiring further information regarding Elsevier's archiving and manuscript policies are encouraged to visit: http://www.elsevier.com/copyright

Research in Gerontological Nursing, Jul 1, 2012

Little is known about patients' understanding of a diagnosis of Mild Cognitive Impairment (MCI). ... more Little is known about patients' understanding of a diagnosis of Mild Cognitive Impairment (MCI). The purpose of this cross-sectional descriptive study was to describe beliefs about MCI in persons diagnosed with MCI and examine correlates (demographic and health) of those beliefs. Thirty persons diagnosed with MCI completed the Illness Perception Questionnaire-MCI (IPQ-MCI), measuring eight domains of beliefs about MCI, and one scale of emotional distress. Five of them also participated in a 15-minute cognitive interview to explore responses to the IPQ-MCI. Participants correctly identified symptoms related to MCI; generally attributed MCI to aging, heredity, and abnormal brain changes; and believed MCI to be chronic, predictable, and controllable, causing little emotional distress. However, there were no consistent beliefs regarding the negative consequences of MCI or whether MCI was understandable. There were few significant correlates of beliefs. Persons with MCI are able to report their beliefs about their illness suggesting that misconceptions and gaps in knowledge can be identified and addressed with nursing interventions.

Western Journal of Nursing Research, Oct 1, 1994

A short-term, longitudinal, survey study was conducted to examine relationships among actual and ... more A short-term, longitudinal, survey study was conducted to examine relationships among actual and ideal self conceptions, physical health, and depression in 149 community-dwelling elderly women. Two theoretical perspectives regarding the self were compared, women's self-development and lifespan developmental theory. As predicted by theories of women's development, relationships with others emerged as a salient aspect of the self in elderly women. Regression analyses indicated that actual and ideal self-conceptions were predicted by depression, but not generally by physical health status. Thus, physical health problems were not global in their effects on the various dimensions of the self in elderly women, but depression was.

Psychology and Aging, 1990

Previous training studies of fluid intellectual abilities have involved training on either figura... more Previous training studies of fluid intellectual abilities have involved training on either figural relations or induction tasks. In the present study, young, middle-aged, and elderly adults were given training on another measure of fluid ability-Raven's Progressive Matrices. The training involved a strategy-modeling technique that lasted no more than a few minutes. The results indicated that (a) performance on the Raven decreased with increasing age, (b) training significantly improved performance, and (c) the effect of training did not differ as a function of the age or sex of the subjects. Thus, the results indicate that performance on the Raven can be significantly improved in a single, brief training session.

Annual review of nursing research, 1998

The empirical literature on health promotion in old age was reviewed. A developmental perspective... more The empirical literature on health promotion in old age was reviewed. A developmental perspective was used to examine 42 studies: studies relating health behaviors to health outcomes, descriptive studies of health promotion in old age, studies of the outcomes of health promotion programs in old age, and studies of factors related to older adults' participation in health promotion activities. In general, elderly adults perceived health promotion activities as beneficial, engaged in health behaviors more frequently than younger adults, and participated in community-based and other health promotion programs. There is little definitive evidence that health promotion activities result in better health outcomes for older adults, however. Identifying appropriate outcomes related to health promotion in old age is a critical need.

Journal of Nursing Scholarship, Mar 5, 2013

The purpose of this study was to describe infertile women&amp... more The purpose of this study was to describe infertile women's psychosocial health problems and their infertility-related beliefs and examine the relationships between their beliefs about infertility and psychosocial health problems. The study was a descriptive correlational cross-sectional survey. Women (N = 203) who were receiving treatment for fertility problems in two public hospitals in Ghana were recruited. Participants completed a Fertility Belief Questionnaire; measures of infertility-related stress, anxiety, social isolation, perceived stigma, and depressive symptoms; and sociodemographic and infertility-related health questions. Descriptive statistics, Pearson's correlations, and hierarchical regression analyses were performed. The women reported high levels of infertility-related stress, low levels of anxiety, some social isolation, low levels of perceived stigma, and high levels of depressive symptoms. Beliefs that infertility has negative consequences and that one has a poor understanding of infertility were significantly related to infertility-related stress, social isolation, and depressive symptoms. Belief that infertility could be managed by personal control was significantly related to lower levels of anxiety and perceived stigma. Beliefs about consequences, illness coherence, and personal control explained significant proportions of the variances in anxiety, stress, social isolation, perceived stigma, and depressive symptoms. Infertile women in Ghana have psychosocial health problems that are associated with their beliefs about infertility. Findings have implications for nursing care of infertile women in Ghana.

Cancer Nursing, Dec 1, 1989

For women with stage I or II breast cancer, randomized trials have demonstrated no significant di... more For women with stage I or II breast cancer, randomized trials have demonstrated no significant difference in survival rates between women receiving modified radical mastectomy (MRM) and women receiving breast conserving (BC) surgery. Therefore, many women are now in a position of having a choice between these two options. Twenty-two women who met the surgical criteria for having this choice were interviewed 1 to 2 weeks postsurgery to determine factors they had considered when deciding between MRM and BC, how much they wished to participate in decision-making, and the sources of information they used. The sample was purposefully limited to women attending one clinic in order to insure control over variables such as the information to which patients are exposed. When asked why they had chosen a given surgery, two factors, concerns about radiotherapy (p = 0.003) and body integrity (p = 0.04), emerged as significantly different for women choosing BC vs. MRM. Furthermore, women reported that participation in decision-making was important to them and that they had had sufficient participation in the decision-making process. Finally, they rated "people" sources of information as more important than written or visual materials, suggesting that nurses and other care providers are important in supporting women through the decision-making process.

Violence Against Women, May 1, 2008