Clinical Nursing Research

The purpose of this study was to evaluate a strategy designed to permit early detection of anxiety disorders in adolescent asthmatics. Adolescents with asthma (N = 53) were screened for anxiety disorders using the Trait subscale of the State-Trait Anxiety Inventory for Children [STAI-C (Trait)] and the Multidimensional Anxiety Scale for Children (MASC). Adolescents and their parents were individually evaluated by a nurse trained in the administration of the Anxiety Disorders Interview Schedule-IV: Parent and Child Versions (ADIS-IV: P&C). Of the participants, 21 (40%) met the diagnostic criteria for one or more anxiety disorders. The STAI-C (Trait) was more effective than the MASC in screening adolescents for risk of coexisting anxiety disorders. Nurses trained to administer the ADIS-IV: P&C diagnosed anxiety disorders with a high degree of accuracy. These results have important implications for resolving the problem of unrecognized and untreated anxiety disorders in the adolescent asthmatic population.

The specific aims of this study were to (a) identify relationships among care-giving stress, caregivers’ functional ability, and number of self-care behavior responses to physical and psychological symptoms in caregivers of persons with dementia and (b) examine the mediating function of functional ability in the relationship between caregiving stress and self-care behavior response to symptoms. A correlational, cross-sectional design was used, and a survey was mailed to 99 caregivers. The survey questionnaire contained items about demographics, caregiving stress, functional ability, and self-care behavior. The results indicate that caregivers who reported higher levels of caregiving stress had poorer self-rated health, poorer physical function, more symptoms, high levels of depressed mood, and more self-care behaviors. Caregiving stress was indirectly related to self-care behavior response to symptoms through functional ability, which suggests a need for developing early interventions to enhance the functional ability and self-care behaviors in response to some caregivers’ symptoms.

Nurses have been advised to encourage older persons to keep their doors locked, but there is little guidance about how home care providers should best gain access to the homes of clients. During a descriptive phenomenological study of the experience of home care (N = 25), 9 frail older women explained their strategies for allowing providers access to their homes. Women who typically left their doors open for their own reasons were not uncomfortable leaving the door open when a provider was expected. However, women who left the door unlocked at the request of a provider expressed misgivings about doing so. Older women need personalized counseling about ensuring access to care providers while maximizing safety. For practical, ethical, and legal reasons, home care providers who ask older women to leave their doors open should reconsider that strategy.

Mitral valve prolapse (MVP) is a common valvular heart disease associated with a variety of frightening symptoms. Beta-adrenergic blockers along with calcium channel blockers and anxiolytics are widely used to treat symptoms associated with MVPS despite a lack of evidence that supports their efficacy. This study examined the relationship between prescribed medication use and frequency and intensity of MVPS symptoms. A descriptive cross-sectional survey design was used. Descriptive statistics and Cramèr’s V correlational analysis were used to answer the research questions. Self-completed questionnaires were mailed to 2,282 MVPS individuals older than 21 years of age throughout the United States and Canada previously diagnosed with MVPS. Of the 837 participants, 337 (40%) were taking one or more medications. Although there were significant positive correlations between anxiety and calcium channel blockers, chest pain and digoxin, and mood swings and digoxin, the correlations were very weak.

Providing safe nursing home care is both a clinical and fiscal challenge in many countries. The fiscal realities result in the addition of other workers, such as medication technicians or aides (CMT/A), to the health care team. The purpose of this study was to determine the impact of various levels of credentialing among nursing home staff who deliver medications (RN, LPN, or CMT/A) on medication error. In addition, the impact of distractions and interruptions was explored. Using naïve observation, 39 medication administrators representing various levels of credentialing were unobtrusively observed to determine the number of medication errors, distractions, and interruptions in five nursing homes. There were no differences in medication error rates by level of credential. However, RNs had more interruptions during their medication administration, and these increased interruptions were associated with increased medication error rates when wrong time errors were excluded (p = .0348).