Western Journal of Nursing Research

This study investigated whether people with chronic obstructive pulmonary disease (COPD) can differentiate distress and anxiety associated with dyspnea from the intensity of dyspnea and the perceived effort of breathing. Fifty-two subjects with COPD rated their perception of the individual components of dyspnea on a 200 mm visual analog scale at rest, after a 6-min walk (6MD), and every 2 min during an incremental treadmill test (ET). Subjects differentiated among the four dyspnea components at the end of the 6MD (p <.0001) and during ET (at rest, p < 0.001; at 75% V02 max, p < 0.0001; and at end exercise, p < 0.0001). Intensity was significantly related to perceived effort of breathing (p < .0001), as distress was to anxiety (p < .0001), suggesting that each pair measures similar components. Subjects were able to differentiate their affective response to dyspnea from the intensity of the symptom. Measurement of a patient's affective response to dyspnea may improve the selection of specific treatments and validity of outcomes.

The role of food reactions in asthma has not been well described. The objectives of this study were to evaluate the types of self-reported reactions to foods in asthmatic patients, and to determine the association between self-reported food reactions and self-reported severity of asthma and asthma health care utilization. We characterized 914 patients, aged 3-55 years, in a large health maintenance organization. We characterized the patients according to demographic data (age, sex, occupation, SES, marital status) and their asthma according to duration, triggers, severity (symptoms, FEVJ percentage predicted) and presence of atopy, Overall, 414 (45.3%) participants, primarily women, reported adverse reactions to food, particularly milk, red wine, eggs, chocolate, and peanuts. Those with food reactions were more likely to report having ever been hospitalized for breathing problems than those without food reactions (31% vs. 22%, two-tailedp = 0.004) although theirasthma was not worse. Self-reportedfood reactions, particularly in females, may be associated with increased asthma health care utilization, and such patients may require closer health care management.

The purpose of this qualitative descriptive study was to investigate types of family support and stress among former Soviet immigrants. Forty-two immigrants (14 males and 28 females) were interviewed about their immigration experiences, including description of current relationships with family in the resettlement country. Content analysis of interview data documented that immigrant families can be a valuable source of emotional and/or instrumental support. Immigrant families, however, can also be too overwhelmed by their own immigration demands to provide support or can generate additional stress for its members. Types of family stress included conflict from differing values and opinions, increased responsibility for family members who could not manage resettlement on their own, family members 'emotional distress over immigration experiences, unmet expectationsfor family members'adjustment, and changes in household composition and living arrangements upon arrival in the United States.

The purpose of this qualitative study was to determine the process of spousal influence as it relates to health-promotion behaviors and the concept desire to change spousal health behaviors. Fifty-nine elderly couples in long-term marriages were recruited through three senior centers; participants were asked to respond tofive open-ended questions. The majority of couples said that they made health decisions jointly; wives tended to be the primary deciders in the event that a health decision had to be made. Most people, but particularly wives, desired to change something about their spouses 'health behavior; a variety of strategies were used in the attempt to change spousal behavior Aging or illness in the self or spouse were identified as precipitants of increased desire to change the spouses 'health behavior over time.

Although approximately 58% of patients in critical care units die despite resuscitation efforts, the experience of nurses who participate in unsuccessful patient resuscitation has been largely unexamined. The article is a description of a phenomenological research study designed to investigate this experience. Nine nurses employed in cardiac or intensive care units of a tertiary care hospital participated in the study by contributing paradigm narratives concerning unsuccessful patient resuscitation. The lived experience of unsuccessful resuscitation was described by the participants as one in which theyfortified themselves for the emotional consequences and sense of loss associated with this experience while establishing a connectedness with the patient and his/her significant others.