Biomedical subjects

Nancy L Fahrenwald

Publications and source records attributed to Nancy L Fahrenwald.

8 recordsLinked to original sources

PubMed2005

Sociocultural perspective on organ and tissue donation among reservation-dwelling American Indian adults.

OBJECTIVE: To discover the sociocultural patterns that influence decisions about organ and tissue donation among American Indian (AI) adults. DESIGN: This qualitative ethnographic study used a social-ecological framework. A snowball sampling technique was used to recruit 21 Oglala Lakota Sioux participants (age >or= 19 years) living on the Pine Ridge Indian Reservation in South Dakota, USA. Face-to-face interviews were conducted using open-ended questions derived from the social-ecological perspective of Stokols (1992). Interviews were audiotaped and transcribed. Data were categorized into construct codes to identify concepts and to discover emerging themes. RESULTS: Personal and environmental themes regarding organ and tissue donation emerged. There were two personal themes: uncertain knowledge and the diabetes crisis. Participants knew very little about organ and tissue donation but there was a basic understanding of donor/recipient compatibility. The prevalence of diabetes in the community is contributing to a dire need for kidney donors. The diabetes crisis was acknowledged by every participant. There were three environmental themes: cultural transitions, healthcare system competence and outreach efforts. Traditional cultural beliefs such as entering the spirit world with an intact body were acknowledged. However, conversations reflected re-examination of traditional beliefs because of the need for kidney donors. The healthcare environmental context of organ and tissue donation emerged as a theme. Participants were not confident that the local health system was prepared to either address traditional beliefs about organ and tissue donation or implement a donation protocol. The final theme was the environmental context of outreach efforts. Participants desired relevant outreach targeted to the community and disseminated through local communication networks including the family, the media and tribal leaders. CONCLUSIONS: Sociocultural factors relevant to the personal and environmental context of the social ecological model influenced beliefs about organ and tissue donation among the Lakota people in this study. Outreach programs aimed at increasing donation need to respect traditional beliefs yet present the choice about organ and tissue donation within the cultural context. Telling the stories of community members affected by both diabetes and donation is important. Promoting family conversation is critical. Healthcare systems must approach potential donor families with an understanding of traditional beliefs and respect for the process of family communication about organ and tissue donation.

Adult↗

PubMed2005

Mediator analysis of Moms on the move.

This study examined whether improvements in physical activity discovered in a test of Moms on the Move were mediated by the behavioral constructs from which the intervention was derived. Identifying mediator variables is vital for intervention planning. The intervention was derived from the Transtheoretical Model (TTM) of behavior change and promoted moderately intense activities like walking. Sedentary mothers with children enrolled in the Women, Infants, and Children program (N = 44) were randomly assigned to the experimental intervention or attention control. Large effect sizes were reported for improvements in physical activity and changes in TTM constructs. This study examined whether the physical activity improvements were mediated by the behavioral constructs. Statistical analyses used bivariate correlation coefficients and two-stage multiple linear regression. These exploratory findings did not support the hypothesis that increased physical activity, which was associated with the experimental intervention, was mediated by the TTM constructs.

Adolescent↗

PubMed2004

A randomized pilot test of "Moms on the Move": a physical activity intervention for WIC mothers.

BACKGROUND: Sedentary mothers are important to reach with physical activity promotion. PURPOSE: This study pilot tested "Moms on the Move," a Transtheoretical Model (TTM)-derived physical activity (PA) intervention for low-income mothers enrolled in the Women, Infants, and Children (WIC) program. METHOD: Sedentary mothers (N = 44) were randomized to (a). Moms on the Move (PA intervention) or (b). counseling on self-breast examination (control). Pre- and posttest measurement (baseline and 2 weeks after the 8-week interventions) included (a). stage of PA behavior change, (b). PA behavior, (c). selected TTM constructs, and (d). social support. Pre- and postdifference scores, chi-square, and one-way analyses of variance (ANOVAs) were used. RESULTS: The experimental group progressed in stage of change more than control, chi2(1, N = 44) = 20.50, p <.001. The experimental group had greater PA behavior: weekly minutes of PA, F(1, 42) = 46.85, p <.001; daily energy expenditure (EE), F(1, 42) = 23.01, p <.001; and weekly moderate PA EE, F(1, 42) = 32.63, p <.001. Experimental subgroup (n = 11) step counts increased pre-post, t(10) = 6.16, p <.001. An ANOVA showed that the experimental group had greater improvements in all TTM constructs and social support, ps <.001. CONCLUSIONS: WIC mothers are at risk for sedentary living and have not been targeted for PA behavior change using a provider-counseled approach. Although further testing is needed, Moms on the Move appears to be efficacious.

Adult↗

PubMedDate not supplied

Teaching core nursing values.

Nursing is a caring profession. Caring encompasses empathy for and connection with people. Teaching and role-modeling caring is a nursing curriculum challenge. Caring is best demonstrated by a nurse's ability to embody the five core values of professional nursing. Core nursing values essential to baccalaureate education include human dignity, integrity, autonomy, altruism, and social justice. The caring professional nurse integrates these values in clinical practice. Strategies for integrating and teaching core values are outlined and outcomes of value-based nursing education are described. Carefully integrated values education ensures that the legacy of caring behavior embodied by nurses is strengthened for the future nursing workforce.

Curriculum↗

PubMedDate not supplied

Development and expert evaluation of "Moms on the Move," a physical activity intervention for WIC mothers. Women, Infants, and Children.

The purpose of this descriptive study was to develop and evaluate "Moms on the Move," a provider-counseled physical activity intervention for mothers enrolled in the Women, Infants, and Children (WIC) program. The intervention was based on the Transtheoretical Model (TTM) of behavior change. The evaluation occurred in two stages. In the first stage, physical activity behavioral experts (n=4) evaluated the: (a) rationale for intervention components; (b) linkages between behavior change constructs, intervention activities, and study outcomes; (c) literature support for the TTM behavior change constructs; and (d) the intervention brochure. The expert evaluation tool was adapted from the "Educational Materials Review Form." Each item in the expert evaluation met the <or= 3.0 mean criterion for acceptability (range, 1.33-2.67). Revisions were made based on expert comments before stage 2. In the second stage, WIC mothers (n=5) evaluated the intervention brochure. The 9-item WIC mothers' evaluation tool was adapted from a simple tool for community members. In the second stage evaluation, the mean total score for the intervention brochure evaluation was 44.0 (SD=1.22), which met the a priori criterion to retain as is. Mean item responses ranged from 4.8 to 5.0 (5.0=great). This evaluation indicates that "Moms on the Move" is a promising physical activity intervention for WIC mothers, which should be implemented for efficacy testing.

Adult↗

PubMedDate not supplied

Application of the Transtheoretical Model of behavior change to the physical activity behavior of WIC mothers.

This descriptive-correlational study examined the Transtheoretical Model (TTM) of behavior change in relationship to the physical activity behavior of mothers receiving assistance from the Women, Infants, and Children program. A purposive sample (N = 30) of six women at each of the five stages of readiness for behavior change was used. Relationships between stage of behavior change (measured using the Stage of Exercise Adoption tool) and other TTM constructs were examined. The constructs and corresponding instruments included physical activity behavior (Seven-Day Physical Activity Recall), pros, cons, decisional balance (Exercise Benefits/Barriers Scale and two open-ended questions), self-efficacy (Self-efficacy for Exercise scale), and processes of behavior change (Processes of Exercise Adoption tool and the Social Support for Exercise scale). Significant relationships were found between stage of behavior change and two physical activity energy expenditure indices (rs = 0.71-0.73, p < 0.01), daily minutes of moderate to very hard physical activity (rs = 0.81, p < 0.01), pros (rs = 0.56, p < 0.01), cons (rs = -0.52, p < 0.05), decisional balance (rs = 0.56, p < 0.01), and self-efficacy (rs = 0.56, p < 0.01). Use of the 10 processes of change differed by stage of change. Pros to physical activity included a sense of accomplishment, increased strength, stress relief, and getting in shape after pregnancy. Cons included fatigue, childcare, and cold weather. Results support the TTM as relevant to WIC mothers and suggest strategies to increase physical activity in this population.

Adaptation, Psychological↗

PubMedDate not supplied

Teaching social justice.

Social justice is a core nursing value and the foundation of public health nursing. Social justice ideology requires nursing students to uphold moral, legal, and humanistic principles related to health. As such, teaching social justice requires a basis in moral developmental theory. In addition, teaching social justice demands action beyond classroom pedagogy. The author describes how social justice is taught within a baccalaureate program. A social justice project is described and examples are provided.

Community Health Planning↗

PubMedDate not supplied

Physical activity behavior of American Indian mothers.

BACKGROUND: Mothers of young children who live in low-income households are a population at-risk for sedentary living that could experience important health benefits from improved physical activity behavior. Previous research among Caucasian mothers attending the Women, Infants and Children (WIC) program showed that the Transtheoretical Model of behavior change was an appropriate model for designing interventions for activity promotion. PURPOSE: This study examined the Transtheoretical Model of behavior change in relationship to the physical activity behavior of low-income American Indian mothers. DESIGN: A descriptive-correlational study employed a purposive sample (N = 30) of six American Indian mothers at each of five stages of behavior change. Participants were recruited from a Women, Infants and Children program located on the Pine Ridge Indian Reservation in South Dakota. Instruments included the 7-day Activity Recall, Stages of Exercise Adoption tool, Pros and Cons to Exercise tool, Self-efficacy for Exercise scale, and the Processes of Exercise Adoption tool. FINDINGS: Significant relationships were found between stage of change and energy expenditure indices (r = 0.69-0.74, p < .01), pros (r = 0.62, p < .01), cons (r = -0.58, p < .05), decisional balance (r = 0.59, p < .01), and self-efficacy (r = 0.60, p < .01). Pros and cons were different from a prior study of mothers attending the Women, Infants and Children program. CONCLUSIONS: The Transtheoretical Model is relevant to American Indian mothers and should be tested in future physical activity interventions.

Activities of Daily Living↗