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The Resourceful-U Family Caregiving Strengths-Building Education and Support Group: A Florida Library and Aging Network Partnership Project
Get PDFProject Objective: Two Research Questions What are the information and support needs of family caregivers participating in a newly formed library-aging network educational support group? How can libraries and aging network agencies effectively partner to promote positive outcomes for the health and well-being of informal family caregivers and their care recipients with long-term medical conditions? Methods: Research Steps The following research steps are underway as of January 2018-- (1) A comprehensive and ongoing literature review of family caregiver strengths-building (i.e., resourcefulness), social support, and older adult care recipients’ wellness and quality of life including a JBI systematic review (Lauritzen, Pedersen, and Bjerrum, 2013) that points to social support as beneficial for family caregivers and their care recipients. (2) A Family Caregiver Interest Survey and assessment completed by family caregivers attending monthly support group meetings. (3) Field Notes compiled and analyzed from all meetings and training sessions for the Resourceful-U family caregivers. (4) An optional “Your Family Caregiving Story” with a follow-up telephone or in-person interview to assess caregiver strengths, health, and wellness. Results: Reporting Research Outcomes The Powerful Tools for Caregivers (2013) project curriculum will be offered in conjunction with the Resourceful-U support group as an enrichment opportunity. This evidence-based training program will serve 12 family caregivers beginning in September 2018. A training team of librarians and social workers will conduct the evidence-based family caregiver training curriculum over a six-week period at the local regional public library. The implications of this action learning intervention project for policy and program development will be explored in relationship to a June 2018 community needs report-- The Silver Tsunami: Is Broward County Ready?-- for partnerships between medical libraries, public libraries, and key aging network agencies serving family caregivers and older adults
The Importance of Clinical Documentation Improvement
Get PDFThe world of technology in the twenty first century is forever expanding. In the healthcare field, patient data has transformed from paper charts into electronic health records. Electronic health records allow for organized patient information however, an enormous amount of information becomes available. Sometimes the massive amount of information is not always needed but important detail the medical chart is looked for by insurance companies for reimbursement. There is a special department in hospitals called the Clinical Documentation Improvement specialists who are made up of experienced medical coders, registered nurses, mid-level practitioners such as nurse practitioner’s s or physician’s assistants and physicians. This team focus on the pertinent clinician documentation while the patient is hospitalized looking for accurate information depending on the patients diagnose/s and reducing low quality clinical records. The importance of precise patient information leads to the point of this project to demonstrate the value of clinical documentation improvement
Building a Framework to Guide Residents through Scholarly Activities
Get PDFObjective: The objective of this project was to build an online resource that will help guide residents through their Accreditation Council for Graduate Medical Education (ACGME) scholarly activity requirement by providing guidelines, advice, and resources on publishing, presenting, and research. Methods: The Clinical Services Librarian first met with the Graduate Medical Education (GME) office to determine the needs of the residencies and clarify current ACGME requirements. Meetings were then set with representatives from the largest residencies to discuss how the scholarly activity requirement was currently being met and to collect resources. After these meetings the librarian began building an online resource in the LibGuides software for both residents and junior faculty. The Research and Scholarly Activity Guide combines practical advice with tips and tricks for completing projects. Sections include information on how to set up and where to print a poster, how to write an abstract, and how to submit articles to journals. Research resources help guide residents through the institutional review board process, finding a mentor, and identifying statistical expertise. Results: The Research and Scholarly Activity Guide was completed over the summer and introduced to new interns and returning residents during noon conferences and orientations. The guide was also presented at both the residency directors’ and residency coordinators’ monthly meetings. The guide was well received and comments and suggestions were incorporated were appropriate. Conclusions: The Research and Scholarly Activity Guide was available starting July 2018. The guide brings a number of disparate resources together easing residents’ road to completion of their scholarly activity requirement as well as assisting junior faculty with research endeavors. Residency directors and coordinators have expressed how much this guide will help their programs
Hospital Library Here Not Closing, Not Downsizing, but Flourishing: Hospital Library Here to Stay, and NewlyRenovated
Get PDFHealth-Related Quality of Life in Female Children with Congenital Adrenal Hyperplasia: A Mixed Methods Study
Get PDFIntroduction. Health-related quality of life (HRQOL) has become a meaningful area in research, medical management, and in the evaluation of health outcomes. However, in children with congenital adrenal hyperplasia (CAH), HRQOL is a long-neglected subject. Previous research in individuals with CAH typically focused on medical treatment and outcomes, which suggested that HRQOL is influenced by personal factors such as genital ambiguity, impaired growth, higher incidence of obesity, metabolic syndrome, hypertension, acute adrenal crisis, as well as losses in psychosexual milestones and psychological functioning. Social contexts, such as family, were identified as factors that contribute to an individual’s perceived HRQOL. Today, there is some agreement that non-disclosure, shame, secrecy, and stigma affect psychological well-being. Despite research efforts, there is limited information about which factors influence HRQOL and which factors are most relevant to female children with CAH. This indicates the need to go beyond identifying single factors, and address the complex relationship of factors that impact HRQOL, and individuals’ perception of these factors. Therefore, the bioecological model of human development was used to understand the different factors that impact HRQOL in female children with CAH.
Methods. A convergent mixed methods design was selected whereby the quantitative and qualitative results were merged to provide a comprehensive understanding of HRQOL of female children with CAH. Qualitative methods (QUAL) involved using semi-structured interviews with child-caregiver dyads (N=20) to explore HRQOL and describe factors that impact HRQOL of female children with CAH. Member checking procedures were implemented to ensure trustworthiness or credibility and rigor of the QUAL component of this study. NVivo 10 was used to analyze the QUAL data. Additionally, the full sample of 25 child-caregiver dyads completed KINDL-R questionnaires, which provided a quantitative (QUAN) measure of HRQOL of female children with CAH. QUAN data were analyzed using SPSS version 24. Individual analysis of both QUAL and QUAN data were merged to ascertain findings for a mixed methods interpretation.
Results. Children with CAH and their caregivers reported having good overall HRQOL. Children scored significantly lower on the School subscale compared to their caregivers (Mdn= 12.5, IQR= 18.75) Examination of the data revealed significant relationships between other health issues and how caregivers rated children’s HRQOL, p \u3c.05. The following themes emerged from the child and caregiver interviews: 1) living with CAH; 2) normalcy; 3) disclosure of diagnosis; 4) feelings of the child/caregiver; 5) what should we know; and 6) improvements. Merging of data showed that not all of QUAN variables are reflected in the QUAL themes. However, many of the QUAL categories and comments elucidated information about the spectrum of children’s and caregiver’s perceptions of the HRQOL of children with CAH.
Discussion. Using a comprehensive approach offered an understanding of what it is like for children to live with CAH from the perspective of the child and caregiver. By quantitatively measuring HRQOL and using qualitative interview data, the information in this study may shed light on children’s and caregivers’ needs that are not met by current guidelines. Although the overall child- and caregiver-reported HRQOL of female children was not impaired, children’s and caregiver’s lived experiences highlight the many factors that impact HRQOL including the importance of friends and family, personal characteristics (i.e., the ability to adapt and self-esteem), the environment (i.e., home, school), and the impact of time (i.e., developmental time, past vs present). Knowing this, clinicians may better support children and families by expanding the focus beyond sex development to include: 1) information about the different ways of knowing (i.e., knowing how to talk with others and with their child); 2) self-management and independence (i.e., learning how to administer medication and handling responsibility as children grown older); and 3) psychological support (i.e., coping with a new diagnosis, adapting to the disorder.
Big Idea for a Big Challenge: Influencing Reproducibility on an Institutional Scale
Get PDFTo describe and evaluate the use of a library-sponsored national conference to influence institutional culture around reproducibility through awareness building
Effective Measures of Weight Gain Five Years Post-Kidney Transplantation
Get PDFBACKGROUND: Weight gain is commonly observed post-kidney transplantation and is associated with unfavorable health outcomes, such as graft loss, new onset diabetes, and cardiovascular disease. The purpose of this study was to determine the most effective measure for assessing body composition after kidney transplantation.
DESIGN: The study was a descriptive correlational follow-up study from a single kidney transplant site.
SUBJECTS: A total of 45 eligible patients from a 2007-2011 parent study were selected, ages of 37 to 78.
MEASUREMENTS: Body composition was obtained 5–8 years posttransplant via anthropometric measures (waist circumference, body mass index, and dual energy X-ray absorptiometry) and compared with baseline (pretransplant) values. Similarly, weight and body mass index (BMI) were obtained. Blood sampling was performed to measure levels of serum glucose, hemoglobin A1C, low-density lipoprotein-cholesterol, high-density lipoprotein, triglycerides, and coronary risk ratio. Kidney function was monitored via serum creatinine. Manual blood pressure was taken with two resting blood pressures.
RESULTS: The sample size was N = 45 and included 29 (64.4%) African Americans and 16 (35.6%) Whites. There were 25 (55.6%) males and 20 (44.4%) females. The ages were 37 to 78, with a mean of 56 (SD =10.1). Body weight increased from 186.66 ± 42.10 at baseline to 197.89 ± 48.1 at the 5-8 year follow-up, and BMI increased from 29.03 ± 4.76 to 32.14 ± 9.61. At the 5-8 year follow-up, anthropometric measure of waist circumference was found to be associated with cardiac risk ratio and weight with diastolic BP. In contrast, 7 body composition measures were associated with HDL, 4 with cardiac risk ratio, 5 with creatinine, and 2 with systolic blood pressure. Significant associations were also found with anthropometric measure BMI obtained at the time of transplant surgery and HDL and LDL 5-8 years later. There were 13 body composition measures associated with HDL, 6 with cardiac risk ratio, and 2 with triglycerides during this same time span. Lastly, one change in anthropometric measure from baseline to 5-8 year posttransplant was associated with the 5-8 year cardiac risk factors (cardiac risk ratio and BMI). There were 18 significant relationships for body compositions measures. These included 7 body composition measures associated with creatinine, 5 with LDL, 4 with diastolic blood pressure, and 2 with triglycerides.
DISCUSSION: The significant relationships found among dual-energy x-ray absorptiometry and cardiac-related outcomes suggest this method may provide a better assessment of body fat, weight gain, and potential cardiac risk factors than does the currently used method. The study continued to examine the use of dual-energy x-ray absorptiometry to better understand the emerging coronary risk that accompanies weight gain and as a basis upon which more precisely targeted interventions could be designed that would improve the health and life expectancy of kidney transplant patients