Western Journal of Nursing Research

A wrist actigraph is a device used in sleep research studies to measure whole body movements. The purpose of this study was to evaluate the feasibility, sensitivity, and validity of wrist actigraphy during pulmonary rehabilitation (PR) upper-extremity exercise in chronic obstructive pulmonary disease (COPD) patients. In this study, 20 patients wore Octagonal Basic Motionlogger^® actigraphs during two 90-minute PR sessions while the investigator recorded details of the subject's upper-extremity movements. Concurrent validity with supervised exercise records was supported for upper-extremity endurance (UEE) intensity at baseline (r = .885, p < .001) and 1 week (r = .935, p < .001). Criterion validity was supported for UEE (r = .56, p = .01) and combined lower- and upper-extremity resistance (r = .72, p < .01) compared with rank-ordered type of exercise. Wrist actigraphy is shown to be a feasible, sensitive, and valid instrument to measure upper-extremity movement during PR in COPD patients.

The authors have undertaken a series of grounded theory studies to describe and explain how ethnocultural affiliation and gender influence the process that cardiac patients undergo when faced with making behavior changes associated with reducing their cardiovascular disease (CVD) risk. Data were collected through audiorecorded semistructured interviews (using an interpreter as necessary), and the authors analyzed the data using constant comparative methods. The core variable that emerged through the series of studies was “meeting the challenge.” Here, the authors describe the findings from a sample of Chinese immigrants (10 men, 5 women) to Canada. The process of managing CVD risk for the Chinese immigrants was characterized by their extraordinary diligence in seeking multiple sources of information to enable them to manage their health.

An exploratory study was conducted with 886 nurses at eight Korean teaching hospitals to describe nurses' perception of frequency of error reporting and patient safety culture in their hospitals and to identify relationships between the nurses' perception and work-related factors. The authors found that the majority of nurses were not comfortable reporting errors or communicating concerns about safety issues. A significant portion reported concerns about patient safety issues in their working unit. Nurses on the front line evaluated various aspects related to patient safety culture as being more of a problem than nurses who are older (p < .01) and who work in management positions (p < .05). The authors conclude that error reporting and the safety culture in Korean teaching hospitals are not emphasized enough. The authors suggest that patient safety could be improved in a nonpunitive culture where individuals can openly discuss medical errors and potential hazards.

The primary purpose of this secondary data analysis was to evaluate the efficacy and suitability of the Memorial Symptom Assessment Scale (MSAS) for use with patients with severe chronic obstructive pulmonary disease (COPD). Symptoms experienced by patients with severe COPD were assessed in the original investigation using the 32-item MSAS. The sample consisted of 72 individuals with COPD ranging in age from 36 to 79 years. To increase its efficiency for use with severely ill COPD patients, the original MSAS was shortened to include the 19 most frequently reported symptoms. Reliability of the revised tool remained high (Cronbach's alpha = .86). Content and convergent validity of the revised tool were also established. The revised MSAS appears to be an appropriate measure of the multidimensional, multisymptom experience of patients with severe COPD.

Women receiving Temporary Assistance for Needy Families (TANF) report more stress and have poorer health than women in the general population. Studies suggest chronic stress may contribute to poor health via physiological mechanisms, yet little is known about these mechanisms in this population. This study examined psychosocial stress, salivary cortisol, 24-hr ambulatory blood pressure and heart rate, and health among 40 single mothers before and after exiting TANF. As a group, perceived stress decreased after leaving TANF (p = .02), with other measures of psychosocial and physiological stress remaining unchanged. Within participants, changes in psychosocial stress predicted depression and general health over time (adjusted R ² = .30 and .22; p = .006 and .004, respectively). These findings indicate psychosocial stress is positively associated with depression and negatively associated with general health as women exit welfare. Psychosocial stress was not associated with changes in physiologic indicators of stress.

This article describes common experiences of African American women breast cancer survivors through poetic analysis. Group-as-a-whole theory and empirical and interpretive phenomenology guided analysis of transcripts from three focus groups (n = 21) of African American breast cancer survivors. Familiarity with transcripts and themes led to awareness of poetic ways in which African American women described experiences. Black feminist literature and African American historical references contextualized survivors' experiences. Poetic interpretations of African American women's breast cancer experiences, from diagnosis to survivorship, were created from transcript dialogues. Verbatim words were used to construct the poems, as often as possible. Eleven poems describe the journey from diagnosis to survivorship as experienced by African American women. The poetry may raise levels of awareness of African American women's breast cancer survivorship experiences. Attention to subtleties that underpin culture within the context of health care environments may help health care providers to improve cultural competence.