Search PubMed⌕ Search

Biomedical subjects

E E Gulick

Publications and source records attributed to E E Gulick.

At least 19 recordsLinked to original sources
PubMed1996

Research priorities for nurses caring for persons with multiple sclerosis. Nursing Research Speciality Group of the Consortium of Multiple Sclerosis Centers.

The Delphi technique was used by the Nursing Research Specialty Group of the Consortium of Multiple Sclerosis Centers (CMSC) to obtain consensus on research priorities related to health and nursing care needs of persons with multiple sclerosis (MS) and their families and particular nursing interventions for which effective outcomes needed to be determined. Three rounds of questionnaires were used in obtaining responses from nurses affiliated with the CMSC and nurses affiliated with National MS Affiliated Centers/Clinics and the Veterans Administration Medical Centers (nonCMSC). Round 1, identification of research items, was the basis for developing a 108 item questionnaire for Rounds 2 and 3. Sixteen of 108 research items were selected by 25% or more of the CMSC or nonCMSC nurses. Among the top research priorities identified by both groups of nurses were determining effective programs to promote quality of life and reduce fatigue, stress and emotional difficulties (anger, anxiety, isolation); promote high level of functioning; and develop strategies for effective handling of cognitive deficits. Research priorities identified in this Delphi study provide direction for conducting collaborative research among CMSC and nonCMSC nurses with the aim of improving clinical practice and health outcomes of MS patients.

Cost-Benefit Analysis↗
PubMed1995

Reliability and validity of the Smoking and Women Questionnaire among three ethnic groups.

Cigarette smoking among women continues to be a major health risk to the smoker and to those around her. Programs aimed at stopping and maintaining smoking cessation have had very limited success due in part to the failure to individualize smoking cessation programs based on specific characteristics of the smoker. This study presents reliability and validity of a 14-item questionnaire developed to determine the readiness of women from three ethnic groups (non-Hispanic white, black American, and Hispanic American) to stop smoking. The Smoking and Women Questionnaire (SWQ) consists of items representative of core elements conceptualized in the Smoking/Ex-smoking Model for Women. The core factors are: beliefs/attitudes toward smoking, sociability, stress, coping, self-efficacy, motivation, nicotine dependence, and support. The SWQ was completed by both smoking and nonsmoking non-Hispanic white (N = 233), smoking and nonsmoking black American (N = 70), and smoking and nonsmoking Hispanic American (N = 73) women. The test-retest correlation coefficient over a one- to three-week period (N = 53) was .84. Cronbach alphas for whites, blacks, Hispanics, and combined groups were .81, .85, .84 and .83, respectively. Content validity was shown by experts who agreed that the core elements were represented in the SWQ. Construct validity was shown for ethnic groups separately and combined in that smokers had significantly lower SWQ scores than nonsmokers. Items representative of the core elements were rated by smokers in a similar manner irrespective of ethnicity, suggesting similar attitudes and behaviors toward smoking. Further research is needed to determine if the SWQ can predict readiness of women to stop smoking and serve as a basis for developing individualized smoking cessation programs. Implications for smoking cessation programs are reviewed.

Adolescent↗
PubMed1994

Social support among persons with multiple sclerosis.

The source and magnitude of perceived social support functions and structure were examined in relation to illness duration, gender, and presence or absence of spouses among 200 persons with multiple sclerosis. The associations between social support variables and a health index, ADL level of functioning, also were examined. Significant gender differences were shown for perceived availability of affect, affirmation, and aid functions. A significant change in the network property, average frequency of relationships, occurred over the chronic illness trajectory. Low to moderate correlations were observed between a number of activities of daily living and both perceived social support functions and network size, particularly for women. Implications for professional staff who provide health services for persons with MS are presented. Further study regarding lower levels of perceived social support in women than men and low levels of informational support in both men and women is suggested.

Activities of Daily Living↗
PubMed1993

Comparison of patient and staff assessment of MS patients' health status.

This study compared change scores obtained on patient self-reported symptoms (MS-RS) with the neurological examination of the Kurtzke Functional Systems (FS) and change scores obtained on patient self-reported activities of daily living (ADL-MS) with the neurologist-determined Expanded Disability Status Scale (EDSS) that were obtained from two separate times separated by approximately seven months for 100 patients with multiple sclerosis. Percent agreement based on < or = 1 unit difference between patient and neurologists' change scores (Time 2-Time 1) ranged between 73% and 86% for MS-RS and FS measures and was 72% for ADL-MS and EDSS. Together, the ADL and MS-RS patient self-report scales provide health status information from the patient's perspective that can be useful in guiding the physical examination, in making comparisons from visit to visit and/or between visits, in assessing patients' quality of life, and in increasing patient satisfaction with medical care.

Activities of Daily Living↗
PubMed1992

Holistic health patterning in multiple sclerosis.

Multidimensional health patterning of three groups of persons with multiple sclerosis (MS) was examined. Changing patterns over a 5-year period for each group also were examined. Serial self-assessments of the subjects' prevalence of MS-related symptoms (motor, brainstem, sensory, elimination, mental-emotional) and level of ADL functioning (fine and gross motor activities, sensory/communication, socializing/recreation, intimacy) were obtained by mail. The number of subjects grouped by years since diagnosis was: 69 (0-5), 49 (greater than 5-10), and 93 (greater than 10). Study findings indicated significantly higher levels of functioning in areas of fine and gross motor activities and intimacy among the more recently diagnosed group but no difference among the groups for sensory/communication, recreation/socializing, and symptoms. Significant increases in motor and brainstem symptoms and decline in fine and gross motor activities and intimacy occurred over the 5-year period particularly for the 0 to 5 year postdiagnosis group. Knowledge of symptom and ADL patterning is essential for nurses and other health care providers in anticipating the concerns and needed services of persons with MS and their families.

Activities of Daily Living↗
PubMed1989

Work performance by persons with multiple sclerosis: conditions that impede or enable the performance of work.

This study queried 508 persons diagnosed with multiple sclerosis (MS) regarding what conditions made performing their work or tasks 'difficult' and 'easier'. The subjects represented four groups: employed outside the home, homemakers, unemployed, and retired. Their written responses were content analysed. Conditions reported to impede the performance of work and tasks were related to three categories: physical restrictions, person-environment interaction, and MS-related symptoms. Conditions reported to enhance the performance of work and tasks were related to five categories: assistive devices, human support, personal attributes, health promotion behaviors, and person-environment adjustment. Study findings provide useful information for families, health service providers and employers of persons with MS in assisting them enhance their ability to perform work or tasks.

Activities of Daily Living↗
PubMed1989

Dietary practices and pregnancy discomforts among urban blacks.

In this prospective study, we investigated the relationship between dietary practices and pregnancy discomforts among 50 urban black American women during their first and third trimesters of pregnancy. Subjects were interviewed during their regular prenatal clinic visits for information about their previous 24-hour dietary intake, the presence and severity of pregnancy discomforts occurring in the previous month, and pertinent demographic data. Findings indicated that high intake of meat products but low or no intake of vegetables was correlated with nausea, little or no intake of milk products was correlated with heartburn, and low or no intake of citrus fruit but intake of vitamin and iron supplements was correlated with heartburn, constipation, and sleeping difficulty. Replication of the study with a larger sample is warranted so as to provide further validity to the findings.

Black or African American↗
PubMedDate not supplied

Correlates of quality of life among persons with multiple sclerosis.

The purpose of this study was to investigate the extent to which objective (demographic) and subjective (self-reported health and role) domains predicted quality of life among 153 persons with multiple sclerosis (MS). Subjects completed the Life Situation Survey, a measure of quality of life, a demographic from (sex, education, age, MS duration, employment status, marital status), the MS-Related Symptoms Scale (motor, brain stem, sensory, mental/emotions, elimination subscales), and the 15-Item Activities of Daily Living (ADL) Self-Care Scale for MS Persons (fine/gross motor, communicating, recreation/socializing, intimacy subscales). Hierarchical multiple regression was used to enter three blocks of variables (demographic, symptom, and ADL domains), and stepwise was used to enter variables within each block. The final model resulted in two health domains (mental/emotions and sensory symptoms) and two role domains (intimacy and recreation/socializing) that predicted 61% of the variance in quality of life of persons with MS.

Activities of Daily Living↗
PubMedDate not supplied

Symptom and activities of daily living trajectory in multiple sclerosis: a 10-year study.

BACKGROUND: Symptom control in chronic illness is not merely a matter of medical management as the patient and family must rely on their own judgment, wisdom, and ingenuity for controlling symptoms. The absence in the literature regarding the effects of multiple sclerosis (MS) as perceived by afflicted people and their family members led to the 10-year longitudinal study. OBJECTIVES: To study patient self-report data to determine whether particular interventions may be needed to enhance the individual's comfort and functional levels. METHODS: The chronic illness trajectory of three groups of people with MS (< or =5 years of diagnosis, n=49; >5 to 10 years, n=36; and >10 years, n=68) was examined over a 10-year period. Serial self-assessments of the subjects' prevalence of MS-related symptoms (motor, brain stem, sensory, elimination, mental/emotional) and level of activities of daily living (ADL) functioning (fine and gross motor activities, sensory/communication, socializing/recreation, intimacy) were obtained annually. Profiles illustrating the subject's symptom and ADL pattern were also returned annually to each subject. RESULTS: Using 10-year average scores, study findings indicated no group differences relative to symptoms but showed significant group differences in all ADL functions. Separate group within-year (1, 3, 5, 7, 10) comparisons reflected significant increases in motor, brain stem, and elimination symptoms together with a decline in all ADL functions for specific groups. CONCLUSIONS: Medical data suggest, on average, a continuous downward trajectory beginning in the first years of illness or at approximately 36 to 37 years of age. In contrast, in this research, patient self-reports of fine and gross motor ADL, a correlate of neurologically based disability evaluations, reflect that relatively major decline begins after 5 years post-diagnosis and after age 40 for subjects recruited primarily from nonclinical sites.

Activities of Daily Living↗
PubMedDate not supplied

Emotional distress and activities of daily living functioning in persons with multiple sclerosis.

BACKGROUND: Emotional distress is higher in persons with multiple sclerosis (MS) than in other chronic illnesses. Not known is whether personal attributes of the person with MS and/or the presence of social support will function as mediating and/or moderating variables between emotional distress and adaptation to the illness. OBJECTIVES: Determine if personal attributes and social support function as mediating and/or moderating variables between emotional distress and ADL functioning in persons with MS. METHODS: Secondary analyses of data obtained from 686 persons with MS through self-report measures of emotional distress, personal attributes, social support, and ADL functioning was conducted. Separate mediation and moderation models were tested using stepwise and hierarchical multiple regression. Demographic variables of education, age, and length of MS illness, were controlled in all analyses. RESULTS: Personal attributes and social support functioned as mediator variables between emotional distress and ADL functioning. Additionally, personal attributes and not social support functioned as a moderator. Significant main effects were shown for social support and emotional distress in the moderator model. CONCLUSION: Personal attributes and social support mediated the effects of emotional distress by decreasing its impact on ADL functioning. Personal attributes, as a moderator variable, demonstrated that higher levels were associated with low levels of emotional stress and moderate or lower levels of personal attributes were associated with increased emotional distress suggesting that personal attributes may intervene between emotional distress and ADL functioning by attenuating or preventing a stress appraisal response.

Activities of Daily Living↗
PubMedDate not supplied

Model for predicting work performance among persons with multiple sclerosis.

A causal model was tested on a sample of 201 MS subjects for the purpose of examining the role of selected demographic factors, work impediments, and work enhancers as predictors of activities essential for performing outside employment, home making, and for personal care. The results showed a relatively good fit of the model to the data through a number of indicators. Explained variance included: 9.0% in work impediments from the direct effect of age; 32.3% in work enhancers--A (job and environmental adjustment, social support, healthful practices) through direct effects from MS duration and work impediments; 9.8% in work enhancers--B (personal attributes) through direct effects from MS duration and work impediments; 61.1% in work performance through direct effects from the antecedent variables (age, education), stress-appraisal variable (work impediments), and coping variables (work enhancers-A, work enhancers-B).

Activities of Daily Living↗
PubMedDate not supplied

Reliability and validity of the work assessment scale for persons with multiple sclerosis.

Reliability and validity of the Work Assessment Scale (WAS) was done on a sample of 551 subjects with multiple sclerosis. Work was defined as those activities performed in employment, homemaking and/or personal care. The WAS has two parts consisting of: Work-Impeding (WAS-I) and Work Enhancing (WAS-E) situations and conditions. Varimax rotated factor analysis of the WAS-I resulted in a seven-factor solution containing 33 of the 53 scale items. Theta reliability coefficients for the factors ranged between .73 and .90 and test-retest correlation coefficients (n = 51) ranged between .76 and .91. Varimax rotated factor analysis of the WAS-E resulted in a five-factor solution containing 19 of the 27 scale items. Theta reliability coefficients for the factors ranged between .66 and .81 and test-retest correlation coefficients ranged between .68 and .82. Concurrent validity was shown between WAS and both ADL and Symptom subscales.

Activities of Daily Living↗
PubMedDate not supplied

Smoking among women: a life cycle perspective on which to base prevention/cessation interventions.

Smoking among women continues at high rates despite the severe health consequences that may result for these women and for their children. A conceptual model identifying core factors that influence the onset and development of smoking and its cessation and continued abstinence was developed and provides a framework for understanding women's smoking behavior. This model examines a number of smoking-related health consequences that occur during the woman's life cycle and proposes suggestions for assessment and nursing intervention.

Attitude to Health↗
PubMedDate not supplied

Model confirmation of the MS-Related Symptom Checklist.

Data from a 26-item self-administered MS-Related Symptom Checklist (MS-RS), designed for persons diagnosed with multiple sclerosis (MS), were factored for the purpose of (a) providing further validity for the MS-RS Checklist, (b) determining structural relationships between and within MS symptom clusters, and (c) determining conceptual similarities between symptoms contained within the MS-RS model and those associated with eight neurological functional systems. Data analyses were based on 491 MS subjects. Principal component analysis and Varimax-rotated factor analysis were used to achieve scale parsimony. The resultant 22-item scale consisting of five factors was subjected to confirmatory factor analysis to determine relationships among factors, observed variables, and residual variance within the factor model. Modification of the initial factor model resulted in the inclusion of one additional relationship between an observed variable and a second factor and six paired relations among the residual variances. The modified factor model had a satisfactory GFI of .910. Signs and symptoms contained within the five-factor solution compared favorably with signs and symptoms assigned to the neurological functional systems which are used clinically in classifying MS disease impairment.

Adult↗