Donald Bailey, Jr., PhD, RN, Julie Barroso, PhD, RN,. FAAN, Andrew Muir, MD, Rick Sloane, MPH,. Sharron Docherty, CPNP, PhD, and Merle Mishel, PhD,.
2009 AAN Poster Abstracts continued From the AAN Annual Meeting and Conference
Chronic Hepatitis C: Perceptions of Disease Impact on Patients Undergoing Watchful Waiting Donald Bailey, Jr., PhD, RN, Julie Barroso, PhD, RN, FAAN, Andrew Muir, MD, Rick Sloane, MPH, Sharron Docherty, CPNP, PhD, and Merle Mishel, PhD, RN, FAAN
Background: Hepatitis C Virus (HCV) is the most common blood-borne infection in the U.S., affecting at least 4 million individuals. In CHC, providers and patients monitor disease status by liver function studies. While providers rely on liver biopsy as the gold standard, patients track alanine aminotransferase levels (ALT). Unfortunately, ALT is not a useful marker of disease progression in CHC. Purpose: To examine serum ALT levels, disease stage, and illness uncertainty in participants with CHC and explore their relationships to symptoms and quality of life (QOL). Methodology: This is part of a longitudinal study of CHC-related illness uncertainty, symptoms, and QOL. 121 participants, 64 women and 57 men, with a mean age of 53.1 years, were categorized into ‘‘high’’ and ‘‘low’’ levels for ALT and illness uncertainty based on cutoffs imposed at the median for the measure, and clustered in four groups created by the 2X2 combination. Findings: Median level for ALT was 60 U/L (range 23300) and for uncertainty, it was 86, indicating a moderate level of uncertainty (scale range 33-165). Distributional differences among the four groups with the symptom and QOL outcomes were assessed in linear modeling using a 3 df omnibus test and then pairwise comparisons were made using a 1 df contrast. Significant differences were found between groups 3 (high ALT/low uncertainty) and 4 (high ALT/high uncertainty) for depressive symptoms (p¼.008) and QOL (p¼.03), with Tukey’s HSD test corrected for Type I error. As follow-up, we used Cochran-Mantel-Haenszel statistic and found that an increase in disease stage was significantly associated with membership in group 3 versus group 4 (p¼.03). Summary Concluding Statement: Findings suggest that participants may not understand their disease status or their laboratory values. Tailored educational interventions may improve patient understanding and self-management, thus enabling them to be more active participants in their care and limit the demands on public health.
Satisfaction with the Quality of Geriatric Care Beth E Barba, PhD, RN, FAAN and Jie Hu
Background: Numerous studies have explored the link between nurses’ satisfaction with care and work
environments on one hand and a variety of physical, behavioral, and psychological reactions of nurses on the other. One key to keeping nurses in the workplace is a better understanding of nurses’ satisfaction with the quality of care they provide. Purpose: This study focused on differences in nurses’ satisfaction with quality of geriatric care and organizational characteristics and work environment between acute care and long-term care settings. Methodology: 298 RNs and LPNs who provided geriatric care to minority, underserved and disadvantaged older populations in 89 long-term care and
