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Biomedical subjects

L Tulman

Publications and source records attributed to L Tulman.

At least 19 recordsLinked to original sources
PubMed1999

The impact of personal problems on accessing prenatal care in low-income urban African American women.

OBJECTIVE: The purpose of this study was to investigate the nature and contribution of personal factors related to the use of prenatal care in a sample of high-risk women residing in an urban environment where care was accessible and free. STUDY DESIGN: The sample consisted of 297 African American women with low socioeconomic status and a high school education or less who were newly delivered of neonates. The level of prenatal care was classified according to the Kessner 3 Parameter Index (adequate, intermediate, inadequate). Women who received no prenatal care made up a fourth group. Subjects responded to the "Ten-Item Checklist" of Richwald. Rhodes, and Kersey and an in-person interview that queried their reasons for obtaining different levels of prenatal care. RESULTS: Both personal and structural reasons were described by women for not obtaining care earlier in pregnancy or at all. The mean number of personal and structural problems reported per subject was inversely correlated to the level of prenatal care obtained. However, personal problems were the single most important reason cited by these women. Personal problems that were statistically significant different among the groups were drug use and desire for an abortion. The structural barriers that exhibited statistically significant differences among the groups were trouble scheduling an appointment, access totransportation, dislike of health care professionals and institutions, access to child care, and not knowing where to go. CONCLUSION: Both personal and structural problems were cited as reasons for not obtaining adequate prenatal care. Structural barriers to prenatal care have been identified and extensively studied. These barriers to care continue to persist, despite innovations in program delivery and access. This study demonstrates that the significance of personal problems has not been adequately considered as a major factor associated with insufficient prenatal care.

Adult↗
PubMed1999

A resource kit for women with breast cancer: development and evaluation.

PURPOSE/OBJECTIVES: To describe the development and evaluation of the Resource Kit for Women With Breast Cancer, designed to facilitate adaptation to diagnosis, treatment, and recovery. DATA SOURCES: Distributed to more than 200 women with newly diagnosed breast cancer. Derived from the Roy Adaptation Model of Nursing and the literature. DATA SYNTHESIS: The kit may be helpful, particularly for women who are too overwhelmed by their situations to retain the vast amount of new information to which they are exposed. CONCLUSIONS: The kit has the potential to assist women to adapt physically, emotionally, functionally, and interpersonally by concisely combining numerous relevant resources in one place, thereby facilitating the location and review of specific information. IMPLICATIONS FOR NURSING PRACTICE: The kit is a complete package that can be used independently of any professional support as a guide for women during individualized professional telephone support or as an adjunct to formal breast cancer support groups.

Adaptation, Psychological↗
PubMed1998

The Inventory of Functional Status-Dialysis: development and testing.

OBJECTIVE: Development and psychometric testing of the Inventory of Functional Status-Dialysis (IFS-Dialysis), which was designed to measure functional status in persons who are receiving chronic incenter hemodialysis treatment. DESIGN: Three-phase instrument development design: Phase 1--content validity assessment; Phase 2--examination of internal consistency reliability; Phase 3--examination of construct validity. SAMPLE/SETTING: 175 chronic hemodialysis patients recruited from an urban, free-standing, outpatient dialysis center. METHODS: Content validity was determined using Popham's average congruency proceudre. Internal consistency reliability was determined using Cronbach's alpha reliability coefficient. Construct validity was examined by bivariate correlations between the IFS-Dialysis and the Karnofsky Performance Scale (KPS), and the Medical Outcomes Study Short Form-36 Health Survey (SF-36) in a subsample of 60 patients. RESULTS: Content validity was established at 90%. The alpha reliability coefficient for the IFS-Dialysis was 0.86. Subscale alpha coefficients ranged from 0.71-0.82. Correlation between the IFS-Dialysis and the KPS was 0.55. Correlations between the IFS-Dialysis and SF-36 subscales ranged from 0.14-0.53. CONCLUSIONS: The IFS-Dialysis has acceptable content validity, internal consistency, and initial construct validity. Use of the IFS-Dialysis in clinical practice is appropriate.

Activities of Daily Living↗
PubMed1997

Effect of support groups with coaching on adaptation to early stage breast cancer.

The effects of 8-week cancer support groups (CSGs) with and without coaching on adaptation were tested in a sample of 181 women with newly diagnosed early stage breast cancer. CSG participation with coaching resulted in higher quality of relationship with significant other at CSG conclusion; this effect was not sustained 8 weeks later. CSG participation had no effect on symptom distress, emotional distress, or functional status. On average, symptom distress was low, emotional distress was moderate, and functional status was relatively high. Independent of CSGs, symptom distress decreased and functional status increased over time from entry into the study to 16 weeks later. Further research is needed to determine the optimal starting time and length for CSGs.

Adaptation, Psychological↗
PubMed1996

Development and testing of the symptom experience scale.

The Symptom Experience Scale (SES) was designed to measure women's experience of symptoms associated with treatment for breast cancer. The SES, a modification of McCorkle's Symptom Distress Scale, was developed and tested in a sample of 252 women with breast cancer. Exploratory factor analysis yielded six factors, which used all 24 SES items and accounted for 83.2% of the variance. The factors were nausea and appetite, fatigue and sleep, concentration, appearance, bowel pattern, and pain. Cronbach's alpha internal consistency reliability coefficients ranged from 0.92 to 0.96; the alpha for the total SES was 0.94. Subscale to subscale correlations ranged from 0.21 to 0.56. Additional research is recommended with samples large enough to permit confirmatory factor analysis and determine the stability of the factor structure identified in the present study. Additional research also is recommended to determine the applicability of the SES for men and women of diverse ethnic groups with various types of cancer and other chronic illnesses.

Adult↗
PubMed1995

Enhancing function in life transitions and serious illness.

Function, which encompasses functional ability and functional status, is discussed within the context of three conceptual models of nursing. Functional ability is the person's capacity to perform biological, psychological, and social activities, whereas functional status is the actual performance of those activities. Comprehensive assessment of function encompasses instrumental and expressive elements of functional ability and functional status, with attention given to the internal, external, and cultural factors that influence function. The goal of nursing interventions is to help the individual attain the highest possible and most desirable level of function.

Activities of Daily Living↗
PubMed1993

The effects of coaching in breast cancer support groups: a pilot study.

A pilot study was conducted to determine the feasibility of a large-scale study testing how cancer support groups (CSGs) with coaching affect adaptation to newly diagnosed, early-stage breast cancer. The investigators randomly assigned subjects (n = 64) to one of three treatment groups: a CSG with coaching, a CSG without coaching, or no CSG. Results of the pilot study indicated that the study intervention and methods of sample accrual and instrumentation were appropriate. Currently, a large-scale, randomized, controlled clinical trial is being conducted.

Activities of Daily Living↗
PubMed1991

Development of the inventory of functional status-cancer.

The purpose of this article is to report the development and psychometric testing of the Inventory of Functional Status-Cancer (IFS-CA). The IFS-CA was developed to measure functional status in women with cancer. The questionnaire includes four subscales measuring the extent to which the woman continues her usual household and family, social and community, personal care, and occupational activities. Content validity was established at 98.5%. Internal consistency reliability testing used a sample of 100 women receiving treatment for cancer. Internal consistency reliability using average correlations for the subscale item to subscale total scores ranged from 0.56 to 0.82. Subscale to total IFS-CA score correlations ranged from 0.73 to 0.92. Test-retest reliability used a sample of 17 women who had completed treatment for cancer. The coefficients ranged from 0.43 to 0.96 for the four subscales. Initial construct validity testing was accomplished by examination of subscale correlations and by comparing the functional status of women in active treatment for cancer with those who had completed treatment. The study's findings reveal content validity, internal consistency, test-retest reliability, and beginning construct validity; thus, they demonstrate strong evidence for further development and testing of the IFS-CA's construct validity.

Activities of Daily Living↗
PubMed1990

Maternal employment following childbirth.

This longitudinal study was an investigation of differences in demographic, health, psychosocial, and family variables, and in functional status for nonoccupational activities, between employed and nonemployed mothers for 6 months following childbirth. Variables associated with employed mothers' functional status in occupational activities also were examined. Fifty-three (58%) of the 92 women in the sample were employed by 6 months postpartum. Although employed mothers performed more roles than nonemployed mothers, the two groups appeared more similar than different on the variables studied. In addition, functional status for occupational activities was positively related to parity and level of physical energy.

Adaptation, Psychological↗
PubMed1990

Building a programme of research from the Roy Adaptation Model of Nursing.

This paper describes a series of methodological and substantive studies derived from the Roy Adaptation Model of Nursing. The research encompassed development of an instrument to measure functional status after childbirth and retrospective and longitudinal studies of variables associated with functional status during the postpartum period. The conceptual model proved to be a useful guide for the design and conduct of these studies as well as ongoing investigations of functional status during pregnancy and following diagnosis of breast cancer. Findings from completed studies support the credibility of Roy's conceptual model.

Adaptation, Physiological↗
PubMed1990

A framework for studying functional status after diagnosis of breast cancer.

This article presents a framework for studying changes in and variables associated with functional status after diagnosis of breast cancer. Functional status is defined as the woman's performance of activities related to her possible multiple roles of spouse, parent, homemaker, community member, and worker. Roy's Adaptation Model of Nursing serves as the overall conceptual model. A review of the research literature provides support for relationships linking psychological state, interpersonal relationships, immune status, treatment regimen, severity of disease, and demographic factors with functional status.

Adaptation, Physiological↗
PubMedDate not supplied

The inventory of functional status-antepartum period. Development and testing.

The Inventory of Functional Status-Antepartum Period (IFSAP) includes six subscales measuring the extent to which a pregnant woman continues her usual household, social and community, childcare, personal care, occupational, and educational activities. Content validity was established at 94.4%. Reliability testing used a sample of 192 pregnant women. Internal consistency reliability using average correlations for the subscale item to subscale total scores ranged from .57 to .87. Subscale to total IFSAP score correlations ranged from .53 to .90. Test-retest reliability used a subsample of 21 pregnant women. The coefficients ranged from .27 to .93. Initial construct validity testing was accomplished by examination of subscale correlations, by comparing IFSAP scores for pregnant women who had no children with those who had children, and by comparing women who had complications and/or restrictions with women who experienced no complications or restrictions. The IFSAP may be used in research and clinical practice to assess functional status during pregnancy.

Activities of Daily Living↗
PubMedDate not supplied

The Inventory of Functional Status-Fathers. Development and psychometric testing.

The Inventory of Functional Status-Fathers (IFS-F) was developed to measure the extent to which men continue or increase their usual household, social and community, childcare, personal care, occupational, and educational activities, and assume infant care responsibilities during their partners' pregnancies and the postpartum period. Content validity was established at 86%. Reliability testing used a sample of 125 expectant fathers and 57 new fathers. Internal consistency reliability using average correlations for the subscale item to subscale total scores ranged from .54 to .75. Subscale to total IFS-F score correlations ranged from .31 to .61. Initial construct validity testing was accomplished by examination of subscale correlations, which ranged from -.02 to .69. The IFS-F may be used to assess the functional status of men during the childbearing period for clinical and research purposes.

Child Care↗