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Biomedical subjects

K M Nokes

Publications and source records attributed to K M Nokes.

34 records · Page 2Linked to original sources
PubMed1990

Loneliness in veterans with AIDS and its relationship to the development of infections.

The purposes of this study were to examine loneliness in men with AIDS over a 6-month period and relate the extent of loneliness to the development of infections. Psychoneuroimmunology theory suggests that emotional distress alters immune response. It was believed that loneliness would increase vulnerability to infection. A convenience sample of 31 veterans participated in the study. Although there were no significant changes in loneliness over the 6-month period for the total sample, gay men had a significant increase (P greater than .03) in loneliness related to romantic sexual attachment. Despite an average of 3.4 infections over the 6-month period, there was no relationship between development of infection and loneliness. Factor analysis was performed for the demographic and study variables. The three factors identified from the study variables were loneliness, social support, and vitality.

Acquired Immunodeficiency Syndrome↗
PubMed1990

An examination of demographic variables, nurturance, and empathy among homosexual and heterosexual big brother/big sister volunteers.

Potential volunteers are often screened for sexual orientation and, in most circumstances, excluded if they are gay men or lesbians. This is especially true if the volunteer's work involves children. Big Brothers/Big Sisters of San Francisco deviates from this practice and screens volunteers based on other attributes. This study investigates differences in demographic variables, nurturance, and empathy among homosexual and heterosexual Big Brothers/Big Sisters of San Francisco. Two hundred nineteen questionnaires were returned and results indicated that there were no significant differences in demographic factors, nurturance, or empathy based on sexual orientation. Gender differences for the study variables were found and these are consistent with the results of earlier studies. Three significant factors were identified: stability, social support and personality attributes. Sexual orientation was not a significant factor.

Adult↗
PubMed1989

Rethinking moral reasoning theory.

Many nursing studies on moral reasoning and ethics have used Kohlberg's theory of moral development. The body of knowledge that resulted from these studies indicated that nurses and nursing students had consistently lower than expected levels of moral reasoning. Educational offerings were developed to assist nurses to improve their moral reasoning. This article explores the cognitive-developmental theory of moral development as one way of determining the moral development of nurses. Since this theory of moral reasoning focuses on the rational thought of the individual and does not consider the impact of the environment, it is of limited applicability in nursing. A new theory of morality needs to be developed--a more holistic one that will include both universal principles and contextual tissues.

Cognition↗
PubMed1989

Exploring the institutional review board process.

This article presents both the content required in preparing a proposal for review by an institutional review board (IRB) and the process involved in gaining approval. The six categories of a research proposal related to protection of human subjects are described, i.e., characteristics of the groups involved; special groups; type of consent; confidentiality of data; possible risks involved; and non-beneficial research. Federal requirements for ensuring informed consent are presented. The politics involved in winning approval for a nurse principal investigator are identified.

Clinical Nursing Research↗
PubMedDate not supplied

Experiences of nurse-researchers in gaining access to subjects for clinical nursing research.

This study investigated the experiences of nurse researchers in gaining access to potential research subjects within health care agencies. Responders were nurse researchers who were primary authors of clinical nursing research studies that had been published in nursing research journals between the years 1985 and 1989. A survey was mailed to 211 responders and returned by 99 (47 per cent). Eighty-six were employed primarily by educational institutions. Responses to the survey indicated that these nurse researchers experienced political and procedural obstacles in gaining access to potential research subjects within health care agencies.

Anecdotes as Topic↗
PubMedDate not supplied

Exploring the complexity of sleep disturbances in persons with HIV/AIDS.

Sleep disturbances are influenced by physiological, psychological, and environmental factors. Many persons living with HIV/AIDS manifest a variety of sleep disorders. Although completion of a brief sleep assessment can be helpful to determine the presence of a sleep problem, more in-depth investigation is necessary when sleep problems are reported. This pilot work used an open-ended interview guide developed from elements of Hauri's comprehensive sleep history. A convenience sample of six HIV-positive clients was interviewed during January 1997. In addition to answering open-ended questions about sleep-wake patterns, participants completed the Pittsburgh Sleep Quality Index and a personal characteristics form. HIV-severity information was obtained from the medical record. A complete sleep evaluation includes a thorough history and physical assessment, with a special focus on underlying pathology and medication use such as over-the-counter drugs, vitamins and herbal products, and mood-altering substance use. Treatment plans can include instruction about a variety of cognitive behavioral strategies. The nurse plays a major role in assessing, evaluating, teaching, and referring, which can contribute to identification of strategies that can improve quality of life.

Adult↗
PubMedDate not supplied

Correlates of sleep quality in persons with HIV disease.

This study used the Symptom Experience dimension of the revised UCSF Symptom Management Conceptual model to examine correlates of sleep quality in HIV-infected persons. According to this model, person, health/illness, and environment categories influence perception of a symptom. The average person in the sample (N = 58) reported being HIV-infected for 8.5 years and was 46 years old, not working, and a person of color. Depending on the level of data, either chi square or Pearson correlations were computed between the person, health/illness, and environment categories and the dependent variable, sleep quality, as measured by the Pittsburgh Sleep Quality Index. Person variables significantly related to sleep quality were employment status, trait anxiety, and general well-being. Health/illness variables significantly related to sleep quality were length of time living with HIV disease and five health status measures (depressive symptoms, state anxiety, symptom severity, daytime sleepiness, and functional status). The environmental variables associated with sleep quality were sleeping alone, having a separate bedroom, and sleeping in a noisy room. Correlates of better sleep quality are positive general well-being, less anxious personality trait and emotional state, less daytime sleepiness, less depressive symptoms, and less symptom severity. Correlates of worse sleep quality are impaired functional status and longer duration of living with HIV disease.

Adult↗
PubMedDate not supplied

Predictors of perception of cognitive functioning in HIV/AIDS.

This is a descriptive, correlational study of the predictors of perceived cognitive functioning. The convenience sample of 728 nonhospitalized persons receiving health care for HIV/AIDS was recruited from seven sites in the United States. All measures were self-reported. Self-perception of cognitive functioning, the dependent variable, was composed of three items from the Medical Outcomes Study HIV scale: thinking, attention, and forgetfulness. Data related to age, gender, ethnicity, education, injection drug use, CD4 count, and length of time known to be HIV-positive were collected on a demographic questionnaire. The scale from the Sign and Symptom Checklist for Persons with HIV Disease was used to measure self-reported symptoms. Data were analyzed using hierarchical multiple regression analysis. Predictors of perception of cognitive functioning explained a total of 36.3% of the variance. Four blocks--person variables (1.5%) (age, gender, education, history of injection drug use), disease status (2.3%), symptom status (26.5%), and functional status (5.4%)--significantly contributed statistically to the total variance. Among those individuals who completed the questions related to depression (n = 450), 28% of the variance in cognitive functioning was explained by this variable. The findings in this multi-site study indicate that symptom status explained the largest amount of variance in perceived cognitive functioning. Early identification of cognitive impairment can result in appropriate clinical interventions in remediable conditions and in the improvement of quality of life.

Adult↗
PubMedDate not supplied

Two cultures, one epidemic.

HIV infection is a global epidemic, and health care providers involved in HIV/AIDS care must be aware of how communities with different cultures, values, beliefs, and resources are coping. This article describes a 3-month volunteer experience with the Shona people of Zimbabwe, Africa. Similarities and uniqueness between an urban setting in an industrial country and a rural environment in a developing country are explored.

Attitude to Health↗
PubMedDate not supplied

Alternative/complementary therapies used by persons with HIV disease.

The authors examined the kind of alternative and complementary therapies used by persons with HIV disease. A convenience sample of 145 persons with HIV disease who were receiving health care in either New York City (n = 72) or Boston (n = 73) completed the Alternative Therapies Check List. This instrument consists of 55 alternative or complementary therapies; respondents were asked to identify whether they knew the therapy and how often they used it. Frequencies were computed, demonstrating that all of the identified alternative or complementary therapies were used by at least one person with HIV disease. The different therapies were ranked according to their mean or average use. Findings showed that vitamins were the most commonly used and trigger was the least commonly used alternative/complementary therapy.

Adult↗
PubMedDate not supplied

Sleep quality in people with HIV disease.

This study examined sleep quality in HIV infected people. The research explored the incidence of the study variables (sleep quality, anxiety, well-being, and symptom severity) and found differences on the variables between subjects who reported HIV infection through male/male sex (n = 18) as compared to injecting drug use (n = 23). The instruments were the Pittsburgh Sleep Quality Index (PSQI), the HIV Assessment Tool (HAT), and the Spielberger State/Trait Anxiety Tool. The average subject (N = 56) was male, 48 years old, a person of color and reported HIV infection through injecting drug use. General well-being was significantly correlated (Pearson product moment correlations) with sleep quality (r = .46, p = .01). Significant differences on the global PSQI (t = 3.22, p = .003) and on the well-being factor of HAT (t = -2.05, p = .04) were found in that injecting drug users reported worse sleep quality and well-being. No significant differences were determined between the two groups on any of the other study variables.

Adult↗
PubMedDate not supplied

Development of an HIV educational needs assessment tool.

The learning needs of persons with HIV/AIDS continue to grow more complex as new treatments are developed and HIV disease shifts from being a terminal to a chronic illness. Clinicians could use a simple tool to help them to focus on what clients think is important to know about living with HIV/AIDS. This article describes the development of the HIV Educational Needs Assessment Tool (HENAT). HIV+ persons (N = 363) who were receiving health care in a variety of ambulatory and institutional settings participated in this research during 1990 and 1993-1994. Factor analysis was used to shorten the instrument into a form that could be used in any nurse/client interaction. Principal axis factor extraction and varimax rotation deleted 16 items. The remaining 34 items were grouped into six factors: Treatments, Entitlements, Relationships, Preventing Infections, Social Support, and Working. Cronbach's alphas were computed and results ranged from .70 to .88. Two month test-retest correlations for a subset of participants (n = 195) ranged from .54 to .67. HENAT can be used (a) to examine differences in perception of learning needs between clients with HIV disease and their health care providers, (b) to measure shifts in learning needs over time, (c) to relate HIV-specific learning needs to length of time living with HIV disease, (d) to give clients an opportunity to assess their learning needs, and (e) as part of a larger intervention study that evaluates the effectiveness of patient education.

Adult↗
PubMedDate not supplied

Addressing human immunodeficiency virus/acquired immunodeficiency syndrome in advanced practice nursing education.

Despite a number of professional meetings and policy statements recommending that advanced practice nurses be prepared to meet society's needs, relatively few graduate programs in nursing offer specific content related to the human immunodeficiency virus (HIV) pandemic. The need for advanced preparation in this area is highlighted by the fact that information about HIV infection and treatment of persons with HIV disease shifts rapidly, that more than 500,000 Americans have been diagnosed with acquired immunodeficiency syndrome (AIDS), and that the disease is the leading cause of death in the United States in persons 25 to 44 years old. Recommendations for how HIV/AIDS content can be incorporated into advanced-level education are presented.

Curriculum↗
PubMedDate not supplied

Educational learning needs of ANAC members--1991.

One of the purposes of the Education Committee of ANAC is to assess the learning needs of ANAC members. In order to achieve this purpose the Educational Needs Assessment tool was developed. It was included in the July 1991 issue of ANACDOTES and sent to the 1,116 members of ANAC. One hundred and fifty-five ANAC members responded (14%) by the cut-off date of August 15th. Demographic information about the respondents was compared to demographic data about ANAC members; the top three interest and expertise areas in the primary, secondary, tertiary prevention of HIV infection categories were identified. The Educational Needs Assessment tool can be used in other settings to plan programs and identify learning needs.

Acquired Immunodeficiency Syndrome↗