ELIZABETH CHIN | University of Massachusetts, Dartmouth (original) (raw)

Papers by ELIZABETH CHIN

Nurses, 2018

There is a debate on possible alterations of self-identity following deep brain stimulation for n... more There is a debate on possible alterations of self-identity following deep brain stimulation for neurological disorders including Parkinson's disease. Among the psychological variables likely to undergo changes throughout such a medical procedure, illness representations and coping strategies have not been the target of much research to this day. In order to remedy this, we investigated the dynamics of illness representations and coping strategies in an 18-month longitudinal study involving 45 patients undergoing deep brain stimulation for idiopathic Parkinson's disease. Two research hypotheses were formulated and investigated through repeated measures of ANOVAs and structural equation modelling with full information maximum likelihood and Bayesian estimations. Representations of Parkinson's disease as a cyclical condition and perception of control over the disease diminished after surgery. Use of instrumental coping strategies was not modified after deep brain stimulation. These changes were identified by SEM but not ANOVAs; their magnitude was nevertheless relatively small, implying general stability in representations. These findings suggest that psychological variables do not undergo major changes after deep brain stimulation for Parkinson's disease.

Applied Nursing Research, 2013

Background: Pain is a distressing and often undertreated symptom of cardiac surgery. Little is kn... more Background: Pain is a distressing and often undertreated symptom of cardiac surgery. Little is known about pain levels, interference and treatment strategies beyond the 9 week period. Aim: The purpose of this study was to describe pain intensity, interference and strategies used to manage pain in post-operative CABG patients. Methods: Baseline data were collected by interview in the hospital after CABG surgery using the Modified Brief Pain Inventory. One to 12 weeks after discharge, weekly telephone interviews were conducted to collect data. Results: Pain levels and interference with activities of daily living were greatest during hospitalization and decreased over 12 weeks. Pain interfered the most with coughing and sleep. Once opioid medications ran out, activity modification was primarily used to manage pain. Conclusions: Activity modification below recommended levels was reported as a pain management strategy. Patients reported pain lasting longer than they expected and the need for more education about activity and pain management strategies.

Journal of Addictions Nursing, 2021

Purpose Nurse practitioners (NPs) are in a unique position to address the problem of opioid use d... more Purpose Nurse practitioners (NPs) are in a unique position to address the problem of opioid use disorders (OUDs) because they provide a large percentage of primary care services (Agency for Healthcare Research and Quality, 2014). This study aimed to increase doctoral NP students' beliefs/attitudes about their ability to care for and about individuals with OUDs through a multifaceted educational approach, guided by social cognitive theory. Methods Researchers used a quasi-experimental pre/post design. Five doctoral students attended lectures and 16 hours of direct clinical exposure to individuals with OUDs at a medication-assisted treatment center. The 22-item Drug and Drug Problems Perception Questionnaire examined students' attitudes toward individuals with OUDs before and after receiving this multifaceted education. Students completed reflective writings. Descriptive statistics and effect sizes were computed, and reflective writings were reviewed. Results Changes in Drug a...

Nursing Education Perspectives

Abstract Undergraduate research, a high-impact learning practice, peaks interest and enthusiasm f... more Abstract Undergraduate research, a high-impact learning practice, peaks interest and enthusiasm for research and contributes to development of research process knowledge, skills, and competency. Fifty millennial sophomore nursing students participated in the innovative learning activity using lyrics from popular songs to complete qualitative analysis in a research course. Students analyzed, synthesized, and developed themes from music lyrics that helped them to more fully understand the processes and perspectives of qualitative research. This activity taught students about qualitative research and provided an opportunity to develop analysis, synthesis, and teamwork knowledge and skills transferable to the professional environment.

Nurse education today, Jan 31, 2017

The purpose of this review was to clarify the concept of nursing student integrity. Unlike publis... more The purpose of this review was to clarify the concept of nursing student integrity. Unlike published reviews that highlight the absence of integrity, the author sought to identify the positive defining characteristics of integrity. Concept analysis. A literature review was conducted using the Cumulative Index for Nursing and Allied Health, Social Science Index, Psyc Info and Medline. Inclusion criteria included peer reviewed articles, written in English, with no limitation on publication date. The search also revealed that a concept analysis of integrity had not been performed. Walker and Avant's (2005) eight step modification of Wilson's (1963) classic concept analysis procedure was used as the organizing framework to explore how the concept of integrity is defined in the current literature. Nursing student integrity was analyzed using Walker and Avant's method of concept analysis: concept definition, defining attribute, model, borderline, related and contrary cases, an...

Current heart failure reports, 2015

Persons with heart failure (HF) symptoms delay up to 7 days before seeking treatment. Delay can r... more Persons with heart failure (HF) symptoms delay up to 7 days before seeking treatment. Delay can result in worse symptoms and potentially impact outcomes. The purpose of this review was to describe predictors and outcomes of delay in HF patients. Demographic factors, increased symptom number, social factors, greater HF knowledge, lower anxiety, and depression predicted increased delay. HF patients had difficulty recognizing and interpreting symptoms of HF. Results are conflicting related to symptom pattern, time of care seeking, and history of HF as predictors of delay. The only outcome predicted by delay was length of stay with those delaying longer reporting longer lengths of stay. Future research related to delay should include theoretical frameworks and larger, more ethnically diverse samples from multiple sites and link delay to outcomes. Valid and reliable instruments are needed to measure delay and related factors. HF education should include supportive others.

Journal of Advanced Nursing, 2005

Modelling novice clinical reasoning for a computerized decision support system Aim. The aim of th... more Modelling novice clinical reasoning for a computerized decision support system Aim. The aim of this paper is to introduce the theoretical framework that directs the project. Background. The Novice Computer Decision Support (N-CODES) Project is developing a point-of-care system to assist novice acute care nurses while making clinical judgements. Unlike prior approaches, N-CODES is guided by a theoretical understanding of nurses' decision-making processes, including the manner by which novices develop this skill. Framework. Assumptions within information processing theory guided the clinical decision-making framework. The framework is composed of a clinical decisionmaking model and a second embedded model depicting the clinical reasoning development of novice nurses. Models. The model is developed within a pluralistic perspective synthesizing theoretical and empirical knowledge on clinical decision-making and the development of novice reasoning skills. A visual representation of experienced nurse decision-making is presented. A central element is the nurse's use of pre-encounter data and working knowledge. A second model integrates empirical data on the developing clinical reasoning of the novice. This knowledge is loosely scattered through 25 years of literature. The intersection of these models provides a novel perspective on the way novices begin to identify working knowledge patterns and develop a sense of saliency. Conclusions. Previous attempts to build comprehensive clinical decision support systems have disregarded important theoretical considerations hindering the success of these projects. Grounding a Decision Support System in a theoretical model of novice nurse decision-making will strengthen the utility and acceptance of the Decision Support System. Additionally, a conceptualization of novice nurse development is an asset to nurse educators, managers and scientists interested in improving clinical decision-making.

Journal of Advanced Nursing, 2005

Modelling novice clinical reasoning for a computerized decision support system Aim. The aim of th... more Modelling novice clinical reasoning for a computerized decision support system Aim. The aim of this paper is to introduce the theoretical framework that directs the project. Background. The Novice Computer Decision Support (N-CODES) Project is developing a point-of-care system to assist novice acute care nurses while making clinical judgements. Unlike prior approaches, N-CODES is guided by a theoretical understanding of nurses' decision-making processes, including the manner by which novices develop this skill. Framework. Assumptions within information processing theory guided the clinical decision-making framework. The framework is composed of a clinical decisionmaking model and a second embedded model depicting the clinical reasoning development of novice nurses. Models. The model is developed within a pluralistic perspective synthesizing theoretical and empirical knowledge on clinical decision-making and the development of novice reasoning skills. A visual representation of experienced nurse decision-making is presented. A central element is the nurse's use of pre-encounter data and working knowledge. A second model integrates empirical data on the developing clinical reasoning of the novice. This knowledge is loosely scattered through 25 years of literature. The intersection of these models provides a novel perspective on the way novices begin to identify working knowledge patterns and develop a sense of saliency. Conclusions. Previous attempts to build comprehensive clinical decision support systems have disregarded important theoretical considerations hindering the success of these projects. Grounding a Decision Support System in a theoretical model of novice nurse decision-making will strengthen the utility and acceptance of the Decision Support System. Additionally, a conceptualization of novice nurse development is an asset to nurse educators, managers and scientists interested in improving clinical decision-making.

Endocrinology, 1995

In situ hybridization histochemistry was used to map cellular patterns of gene expression for the... more In situ hybridization histochemistry was used to map cellular patterns of gene expression for the insulin-like growth factor (IGF) system in developing murine skeleton from embryonic day 15 (E15) through postnatal day 25 (P25). IGF-I receptor and IGF-II receptor messenger RNAs (mRNAs) are both selectively concentrated in developing chondrocytes and osteoblasts. IGF-II and IGF-binding protein-5 and -6(IGFBP-5 and -6) mRNAs are abundant in mesenchymal condensations and chondroblasts on E15. Chondrocyte IGF-II mRNA levels remain high, but IGFBP-5 and -6 mRNAs decline significantly as cartilage matures. Low levels of IGFBP-6 mRNA are detected in postnatal chondrocytes up to at least P25, but IGFBP-5 mRNA is no longer detected in chondrocytes after E18. IGF-I and IGFBP-2, -3, and -4 mRNAs are detected in surrounding mesenchymal tissue, but are not detected in mesenchymal condensations or chondrocytes at any stage of development. IGFBP-3 mRNA is localized in sprouting capillaries invading the perichondrium and periosteum throughout development. IGF-I, IGF-II, and IGFBP-2, -4, -5, and -6 mRNAs are detected in osteoblasts localized in zones of endochondral ossification from E18 to at least P25. IGFBP-1 mRNA is not detected in cartilage or bone cells at any stage of development. These data confirm the recent report by Shinar et al. that IGF-II, but not IGF-I, mRNA is detected in rat chondrocytes in vivo and show that this pattern also applies to the mouse. The present study demonstrates, for the first time, the cell-specific patterns of IGF-I and -II receptor and IGFBP-2 to -6 gene expression during the processes of chondro- and osteogenesis in vivo. Interestingly, IGF-II, both IGF receptors, and IGFBP-5 and -6 are simultaneously coexpressed in chondrocyte precursors early in skeletal development, suggesting functional interactions between these specific factors in chondrogenesis. Both IGFs, both IGF receptors, and IGFBP-2, -4, -5, and -6 are all expressed in osteoblasts, providing evidence for potential local interactions between these IGF system components in osteogenesis. Thus, 9 of 10 known components of the IGF system demonstrate dynamic cell-specific patterns of gene expression during chondro- and osteogenesis, supporting the view that the IGF system has a complex and integral role within the developing skeleton.

CIN: Computers, Informatics, Nursing, 2006

For a technology to be implemented successfully, it must be thoroughly tested by the stakeholders... more For a technology to be implemented successfully, it must be thoroughly tested by the stakeholders who will use it in practice. This article reports on the user testing of the Nurse Computer Decision Support working prototype. Ten acute care nurses with varying levels of education and experience participated in the testing. The study's protocol consisted of a series of tasks requiring the participants to use the system while solving patient problems. Both quantitative and qualitative data on usability, ease of navigation, and nurse satisfaction were collected. The nurses ranked usability and ease of navigation highly. Nurses were excited about the system's clinical potential and felt that it would be useful to all practitioners regardless of experience. Testing the system in an actual clinical setting is the next step, but it is clear that the system has extraordinary potential to improve clinical decision making and patient outcomes.

Nurses, 2018

There is a debate on possible alterations of self-identity following deep brain stimulation for n... more There is a debate on possible alterations of self-identity following deep brain stimulation for neurological disorders including Parkinson's disease. Among the psychological variables likely to undergo changes throughout such a medical procedure, illness representations and coping strategies have not been the target of much research to this day. In order to remedy this, we investigated the dynamics of illness representations and coping strategies in an 18-month longitudinal study involving 45 patients undergoing deep brain stimulation for idiopathic Parkinson's disease. Two research hypotheses were formulated and investigated through repeated measures of ANOVAs and structural equation modelling with full information maximum likelihood and Bayesian estimations. Representations of Parkinson's disease as a cyclical condition and perception of control over the disease diminished after surgery. Use of instrumental coping strategies was not modified after deep brain stimulation. These changes were identified by SEM but not ANOVAs; their magnitude was nevertheless relatively small, implying general stability in representations. These findings suggest that psychological variables do not undergo major changes after deep brain stimulation for Parkinson's disease.

Applied Nursing Research, 2013

Background: Pain is a distressing and often undertreated symptom of cardiac surgery. Little is kn... more Background: Pain is a distressing and often undertreated symptom of cardiac surgery. Little is known about pain levels, interference and treatment strategies beyond the 9 week period. Aim: The purpose of this study was to describe pain intensity, interference and strategies used to manage pain in post-operative CABG patients. Methods: Baseline data were collected by interview in the hospital after CABG surgery using the Modified Brief Pain Inventory. One to 12 weeks after discharge, weekly telephone interviews were conducted to collect data. Results: Pain levels and interference with activities of daily living were greatest during hospitalization and decreased over 12 weeks. Pain interfered the most with coughing and sleep. Once opioid medications ran out, activity modification was primarily used to manage pain. Conclusions: Activity modification below recommended levels was reported as a pain management strategy. Patients reported pain lasting longer than they expected and the need for more education about activity and pain management strategies.

Journal of Addictions Nursing, 2021

Purpose Nurse practitioners (NPs) are in a unique position to address the problem of opioid use d... more Purpose Nurse practitioners (NPs) are in a unique position to address the problem of opioid use disorders (OUDs) because they provide a large percentage of primary care services (Agency for Healthcare Research and Quality, 2014). This study aimed to increase doctoral NP students' beliefs/attitudes about their ability to care for and about individuals with OUDs through a multifaceted educational approach, guided by social cognitive theory. Methods Researchers used a quasi-experimental pre/post design. Five doctoral students attended lectures and 16 hours of direct clinical exposure to individuals with OUDs at a medication-assisted treatment center. The 22-item Drug and Drug Problems Perception Questionnaire examined students' attitudes toward individuals with OUDs before and after receiving this multifaceted education. Students completed reflective writings. Descriptive statistics and effect sizes were computed, and reflective writings were reviewed. Results Changes in Drug a...

Nursing Education Perspectives

Abstract Undergraduate research, a high-impact learning practice, peaks interest and enthusiasm f... more Abstract Undergraduate research, a high-impact learning practice, peaks interest and enthusiasm for research and contributes to development of research process knowledge, skills, and competency. Fifty millennial sophomore nursing students participated in the innovative learning activity using lyrics from popular songs to complete qualitative analysis in a research course. Students analyzed, synthesized, and developed themes from music lyrics that helped them to more fully understand the processes and perspectives of qualitative research. This activity taught students about qualitative research and provided an opportunity to develop analysis, synthesis, and teamwork knowledge and skills transferable to the professional environment.

Nurse education today, Jan 31, 2017

The purpose of this review was to clarify the concept of nursing student integrity. Unlike publis... more The purpose of this review was to clarify the concept of nursing student integrity. Unlike published reviews that highlight the absence of integrity, the author sought to identify the positive defining characteristics of integrity. Concept analysis. A literature review was conducted using the Cumulative Index for Nursing and Allied Health, Social Science Index, Psyc Info and Medline. Inclusion criteria included peer reviewed articles, written in English, with no limitation on publication date. The search also revealed that a concept analysis of integrity had not been performed. Walker and Avant's (2005) eight step modification of Wilson's (1963) classic concept analysis procedure was used as the organizing framework to explore how the concept of integrity is defined in the current literature. Nursing student integrity was analyzed using Walker and Avant's method of concept analysis: concept definition, defining attribute, model, borderline, related and contrary cases, an...

Current heart failure reports, 2015

Persons with heart failure (HF) symptoms delay up to 7 days before seeking treatment. Delay can r... more Persons with heart failure (HF) symptoms delay up to 7 days before seeking treatment. Delay can result in worse symptoms and potentially impact outcomes. The purpose of this review was to describe predictors and outcomes of delay in HF patients. Demographic factors, increased symptom number, social factors, greater HF knowledge, lower anxiety, and depression predicted increased delay. HF patients had difficulty recognizing and interpreting symptoms of HF. Results are conflicting related to symptom pattern, time of care seeking, and history of HF as predictors of delay. The only outcome predicted by delay was length of stay with those delaying longer reporting longer lengths of stay. Future research related to delay should include theoretical frameworks and larger, more ethnically diverse samples from multiple sites and link delay to outcomes. Valid and reliable instruments are needed to measure delay and related factors. HF education should include supportive others.

Journal of Advanced Nursing, 2005

Modelling novice clinical reasoning for a computerized decision support system Aim. The aim of th... more Modelling novice clinical reasoning for a computerized decision support system Aim. The aim of this paper is to introduce the theoretical framework that directs the project. Background. The Novice Computer Decision Support (N-CODES) Project is developing a point-of-care system to assist novice acute care nurses while making clinical judgements. Unlike prior approaches, N-CODES is guided by a theoretical understanding of nurses' decision-making processes, including the manner by which novices develop this skill. Framework. Assumptions within information processing theory guided the clinical decision-making framework. The framework is composed of a clinical decisionmaking model and a second embedded model depicting the clinical reasoning development of novice nurses. Models. The model is developed within a pluralistic perspective synthesizing theoretical and empirical knowledge on clinical decision-making and the development of novice reasoning skills. A visual representation of experienced nurse decision-making is presented. A central element is the nurse's use of pre-encounter data and working knowledge. A second model integrates empirical data on the developing clinical reasoning of the novice. This knowledge is loosely scattered through 25 years of literature. The intersection of these models provides a novel perspective on the way novices begin to identify working knowledge patterns and develop a sense of saliency. Conclusions. Previous attempts to build comprehensive clinical decision support systems have disregarded important theoretical considerations hindering the success of these projects. Grounding a Decision Support System in a theoretical model of novice nurse decision-making will strengthen the utility and acceptance of the Decision Support System. Additionally, a conceptualization of novice nurse development is an asset to nurse educators, managers and scientists interested in improving clinical decision-making.

Journal of Advanced Nursing, 2005

Modelling novice clinical reasoning for a computerized decision support system Aim. The aim of th... more Modelling novice clinical reasoning for a computerized decision support system Aim. The aim of this paper is to introduce the theoretical framework that directs the project. Background. The Novice Computer Decision Support (N-CODES) Project is developing a point-of-care system to assist novice acute care nurses while making clinical judgements. Unlike prior approaches, N-CODES is guided by a theoretical understanding of nurses' decision-making processes, including the manner by which novices develop this skill. Framework. Assumptions within information processing theory guided the clinical decision-making framework. The framework is composed of a clinical decisionmaking model and a second embedded model depicting the clinical reasoning development of novice nurses. Models. The model is developed within a pluralistic perspective synthesizing theoretical and empirical knowledge on clinical decision-making and the development of novice reasoning skills. A visual representation of experienced nurse decision-making is presented. A central element is the nurse's use of pre-encounter data and working knowledge. A second model integrates empirical data on the developing clinical reasoning of the novice. This knowledge is loosely scattered through 25 years of literature. The intersection of these models provides a novel perspective on the way novices begin to identify working knowledge patterns and develop a sense of saliency. Conclusions. Previous attempts to build comprehensive clinical decision support systems have disregarded important theoretical considerations hindering the success of these projects. Grounding a Decision Support System in a theoretical model of novice nurse decision-making will strengthen the utility and acceptance of the Decision Support System. Additionally, a conceptualization of novice nurse development is an asset to nurse educators, managers and scientists interested in improving clinical decision-making.

Endocrinology, 1995

In situ hybridization histochemistry was used to map cellular patterns of gene expression for the... more In situ hybridization histochemistry was used to map cellular patterns of gene expression for the insulin-like growth factor (IGF) system in developing murine skeleton from embryonic day 15 (E15) through postnatal day 25 (P25). IGF-I receptor and IGF-II receptor messenger RNAs (mRNAs) are both selectively concentrated in developing chondrocytes and osteoblasts. IGF-II and IGF-binding protein-5 and -6(IGFBP-5 and -6) mRNAs are abundant in mesenchymal condensations and chondroblasts on E15. Chondrocyte IGF-II mRNA levels remain high, but IGFBP-5 and -6 mRNAs decline significantly as cartilage matures. Low levels of IGFBP-6 mRNA are detected in postnatal chondrocytes up to at least P25, but IGFBP-5 mRNA is no longer detected in chondrocytes after E18. IGF-I and IGFBP-2, -3, and -4 mRNAs are detected in surrounding mesenchymal tissue, but are not detected in mesenchymal condensations or chondrocytes at any stage of development. IGFBP-3 mRNA is localized in sprouting capillaries invading the perichondrium and periosteum throughout development. IGF-I, IGF-II, and IGFBP-2, -4, -5, and -6 mRNAs are detected in osteoblasts localized in zones of endochondral ossification from E18 to at least P25. IGFBP-1 mRNA is not detected in cartilage or bone cells at any stage of development. These data confirm the recent report by Shinar et al. that IGF-II, but not IGF-I, mRNA is detected in rat chondrocytes in vivo and show that this pattern also applies to the mouse. The present study demonstrates, for the first time, the cell-specific patterns of IGF-I and -II receptor and IGFBP-2 to -6 gene expression during the processes of chondro- and osteogenesis in vivo. Interestingly, IGF-II, both IGF receptors, and IGFBP-5 and -6 are simultaneously coexpressed in chondrocyte precursors early in skeletal development, suggesting functional interactions between these specific factors in chondrogenesis. Both IGFs, both IGF receptors, and IGFBP-2, -4, -5, and -6 are all expressed in osteoblasts, providing evidence for potential local interactions between these IGF system components in osteogenesis. Thus, 9 of 10 known components of the IGF system demonstrate dynamic cell-specific patterns of gene expression during chondro- and osteogenesis, supporting the view that the IGF system has a complex and integral role within the developing skeleton.

CIN: Computers, Informatics, Nursing, 2006

For a technology to be implemented successfully, it must be thoroughly tested by the stakeholders... more For a technology to be implemented successfully, it must be thoroughly tested by the stakeholders who will use it in practice. This article reports on the user testing of the Nurse Computer Decision Support working prototype. Ten acute care nurses with varying levels of education and experience participated in the testing. The study's protocol consisted of a series of tasks requiring the participants to use the system while solving patient problems. Both quantitative and qualitative data on usability, ease of navigation, and nurse satisfaction were collected. The nurses ranked usability and ease of navigation highly. Nurses were excited about the system's clinical potential and felt that it would be useful to all practitioners regardless of experience. Testing the system in an actual clinical setting is the next step, but it is clear that the system has extraordinary potential to improve clinical decision making and patient outcomes.