Clinical Nursing Research

Individuals with chronic renal failure generally have strict dietary guidelines. This descriptive study was designed to identify the relationship between sources of social support and dietary management by Japanese hemodialysis patients. A self-administered questionnaire was completed by a convenience sample of 325 adults receiving dialysis. Subjects 65 years and older received more support from family members, doctors, nurses, and technicians than younger subjects. Subjects who had been on dialysis for less than 3 years received more support from nurses and doctors than those who had been on dialysis for longer periods of time. Multiple regression analysis identified that support from family members and nurses were significantly related to dietary behaviors. Nurses working with dialysis patients should remember to use their influence to positively support their patients and to bear in mind that long-term dialysis patients, especially those who are young and unmarried, may benefit from ongoing nursing support and encouragement.

Nonadherence to medications is a significant reason why patients fail to control their blood pressure. Little work has been attempted to conceptualize medication-taking behaviors from the patient’s perspective. This study examined factors that influence elderly hypertensive patients’ adherence or nonadherence to prescribed medications. Using a qualitative descriptive research design, 21 hypertensive elderly people were interviewed. Two domains of adherence were identified: purposeful use of the medication for the control of patient’s blood pressure and establishing and maintaining patterns of medicationtaking. Two similar domains also emerged for nonadherence: purposeful and incidental. Adherence behaviors were dependent on the person’s decision to take hypertension medication, access to medications, and ability to initiate treatment and maintain a medication-taking pattern. The timing and location of pills were integral parts of establishing patterns of taking medications. Inadequate access to medications or interruption of a person’s pattern were associated with the incidental missing of medications.

This study examined how women’s relationship with their primary health care provider (PHP) and their perceptions about how effective their PHPs believe zidovudine (AZT) to be in decreasing perinatal transmission related to women’s AZT beliefs and intentions. It used a cross-sectional design to collect data from 59 HIV-infected African American women. Almost half the women (45%) had given birth since HIV diagnosis. Most of the babies born to HIV-infected mothers (87%) were seronegative. Data analysis with Pearson’s r indicated that the quality of the women’s relationship with their PHP was positively correlated to how important the PHP would be in decision making related to AZT therapy. Significant positive correlation was observed between women’s perceptions about how effective their PHPs believed AZT to be in decreasing perinatal HIV transmission and the women’s own beliefs about AZT, their intent to take AZT if pregnant, and intent to give AZT to a newborn.

Thirty postoperative adults were surveyed using face-to-face interviews in their homes after hospital discharge. Participants were asked to describe their pain communication during their inpatient hospitalization and pain-related problems after discharge. This study reports the content analysis of participant responses to their pain after discharge. Eighteen (60.0%) described pain-related problems after discharge. Seven (23.3%) identified pain-related fears or complications. Six (20.0%) identified analgesic management problems. Six (20.0%) described difficulty with positioning or moving. Four (13.3%) described sleep disruption from pain. The results identify several pain-related problems encountered by postoperative patients after hospital discharge. Shortened hospital stays make effective postdischarge pain management an essential aspect of care for surgical patients. Teaching patients additional pain management skills, including when and how to communicate with health care providers when pain-related issues occur at home, may lead to more effective pain relief for patients.

Tattooing and body piercing are increasing, especially among college students. A study of 766 tattooed and/or body-pierced college students in 18 universities across the United States and one in Australia was conducted to discover the demographic characteristics, motivational factors, and health concerns. The traditional college time of 18 to 22 years of age (69%) was when they obtained their tattoo (73%) and/or body piercing (63%). More frequent health problems and impulsive decision making were noted for those with body piercing when compared to those tattooed. Three cases of hepatitis were reported. Health professionals should openly discuss body art with students, convey a nonjudgmental attitude, and assist with informed decision-making information to either reduce risks or dissuade. Open communication and applicable health education will be very important.

Sleep disturbance is a complaint of childbearing women that has implications for perinatal health. A descriptive, longitudinal study examined the numbers and sources of midsleep awakenings in women prior to conception and during each trimester of pregnancy. A secondary analysis of data from a larger study of sleep during childbearing was performed for subjects (n = 25) who completed sleep diaries across the four measurement periods. There was a two-fold increase in the number of awakenings from pre-conception to the third trimester of pregnancy. Maintenance insomnia during pregnancy follows a pattern of prevalence that can be characterized by trimester. The predominant source of awakening during the first and third trimesters of pregnancy was due to the need to urinate. Parity and environmental circumstances can influence sources of awakenings. Nurses working with childbearing women can provide information and assistance with strategies to minimize or mitigate lengthy episodes of sleep disturbance.