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Open access publications by faculty, staff, postdocs, and graduate students in the School of Nursing.
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Item Communal Coping and Glycemic Control: Daily Patterns Among Young Adult Couples With Type 1 Diabetes(Families, Systems & Health, 2023-11-13) Yorgason, Jeremy B.; Noorda, Naomi M.; Steeger, Danielle; Saylor, Jennifer; Berg, Cynthia; Davey, Adam; Rellaford, Susannah; Kirkham, Daylee; Saunders, James; Taylor, EvangelineIntroduction: Young adulthood is a time when persons with Type 1 diabetes (T1D) become more fully responsible for diabetes management. Establishing healthy diabetes routines during this period is foundational for successful management across adulthood. Although partner support is generally considered helpful in T1D management, less is known about specific partner behaviors that could benefit glucose levels. The aim of this study was to explore associations between communal coping behaviors and T1D glucose management. Method: During 2018–2020, 23 young married opposite-sex couples (Mage = 25.7 years), wherein one spouse had T1D, completed daily measures of communal coping for 9 consecutive days. Daily average glucose and time-in-range were computed from the person with T1D’s glucose meter or continuous glucose monitor. Results: Multilevel model results suggested that higher time-in-range on a given day was predicted by reports of lower daily spousal instrumental support, lower overprotective and controlling behaviors, and by higher emotional support. Controlling spousal behavior on one day was associated with higher time-in-range the next day. At the same time, patient reports of higher average spousal controlling behavior (across all days) were associated with lower time-in-range and higher average glucose. Average glucose was also predicted by communal coping behaviors (especially within-person higher instrumental support), yet results were less robust after covariates were considered. Discussion: Some young romantic partners may engage in behaviors that are associated with higher average blood glucose and lower time-in-range for the person with T1D. Persons with T1D could communicate to their partners types of support that are helpful versus not. Public Significance Statement This study advances the role of communal coping behaviors between young adults with Type 1 diabetes (T1D) and their romantic partner related to diabetes management. Support provided to young adults with T1D from their partners was associated with average glucose levels and time-in-range, which suggests that interventions that include partners to direct support efforts toward more beneficial forms of support may facilitate diabetes management.Item School nurses: Researcher and clinician collaborations to address paediatric health inequities(Journal of Advanced Nursing, 2023-08-02) Covington, Lauren B.; Hildick, Heidi; Robinson, Anastasia; Pennington, Mandy; Mansi, Suzanne; Ji, Xiaopeng; Strang, Abigail; Rani, Seema; Robson, Shannon; Lobo, Michele A.; Cuffee, Yendelela; Selekman, Janice; Taherzadeh, Sanaz; Carroll, Jill; Covey, Ann; Murray, Kenna; Zimmerman, Chriss; Horney, Jennifer A.; Sowinski, Christine; Patterson, FredaSchool nurses are front-line paediatric public health providers who are eager and poised to address paediatric health inequities. They are tasked with remaining informed about current health issues (i.e. immunization updates, surges in emerging and reemerging illnesses, novel medications and side effects, etc.), but also the disparities that arise within different populations of students (Willgerodt et al., 2018). Further, school nurses are well-positioned to be advocates for the most vulnerable students at risk for health disparities and inequities. For example, school nurses are able to identify and advocate for students who experience food and housing insecurity, lack access to medical or dental care, and/or those who live in unstable or insecure environments (Gratz et al., 2021). School nurses bridge gaps that address lack of healthcare access for their students by making referrals to social workers, public health departments or statewide agencies. School nurses are truly community engaged—sharing with community members the top issues plaguing their students, as well as listening to and addressing priority health issues afflicting the community (Gratz et al., 2021; Willgerodt et al., 2018).Item Exploration of Sex and Age as Moderators Between Social Cumulative Risk and Sleep in a Representative Sample of Children and Adolescents Living in the United States(International Journal of Behavioral Medicine, 2023-04-25) Covington, Lauren B.; Ji, Xiaopeng; Laurenceau, Jean-Philippe; Patterson, Freda; Brownlow, Janeese A.Background Youth who face adversity are at a disproportionate risk for poor sleep health across the life course. Identifying whether the association between adversity and poor sleep varies based upon age and sex is needed. This study aims to explore sex and age as moderators between social risk and sleep in a sample of U.S. youth. Methods This study analyzed data of 32,212 U.S. youth (6–17 years) whose primary caregiver participated in the 2017–2018 National Survey of Children’s Health. A social cumulative risk index (SCRI) score was calculated from 10 parental, family, and community risk indicators. Nighttime sleep duration was the number of hours the child slept during the past week. Weeknight sleep irregularity was operationalized as whether the child sometimes/rarely/never went to bed at the same time. Generalized logistic regression models estimated associations between SCRI and sleep duration/irregularity, with age and sex as moderators. Results Age moderated the association between SCRI and short sleep (OR = 1.12, p < 0.001), such that the magnitude of the SCRI-sleep relationship was 12% greater in school-age children. Sex was not a significant moderator. In stratified models by age group, age was positively associated with short sleep in both groups, with a greater magnitude in school-age children. Female school-age children were less likely to have short sleep than males. Conclusions Younger children with greater social cumulative risk factors may be more vulnerable to short sleep duration. Further research into the mechanisms underlying the relationships between social risk and sleep health in school-age children is needed.Item Associations between sleep and overweight/obesity in adolescents vary by race/ethnicity and socioeconomic status(Journal of Advanced Nursing, 2022-11-28) Ji, Xiaopeng; Covington, Lauren B.; Patterson, Freda; Ji, Ming; Brownlow, Janeese A.Aim To examine the interaction between sleep and social determinants of health (SDOH) [race/ethnicity and socioeconomic status (SES)] on overweight/obesity in adolescents. Design Cross-sectional. Methods We conducted a secondary analysis using the 2017–2018 National Survey of Children's Health data. We included adolescents (10–17 years old) who had sleep and body mass index (BMI) data available (n = 24,337) in analyses (samples with BMI <5th percentile excluded). Parents reported children's sleep duration and regularity. High BMI (≥85th percentile) for age defines overweight/obesity. We selected SDOH (race/ethnicity, family income, primary caregiver education and neighbourhood condition) and covariates (age, sex, smoking, exercise and depression) using a hierarchical model-building approach. Accounting for complex survey design, logistic regression estimated the interaction between sleep and SDOH. Results There were significant interactions between sleep duration and SDOH. The association between increasing sleep and decreasing odds of overweight/obesity only showed in the following subgroups: White, family income ≥400% federal poverty level (FPL) or primary caregiver' education ≥ high school. Compared with these subgroups, Hispanic adolescents and adolescents whose family income was below 100% FPL and whose caregiver education was below high school had weakened and reversed associations. Sleep regularity was not associated with overweight/obesity. Conclusions Increasing sleep duration was associated with a decreased risk of overweight/obesity, but the association was not present in adolescents from racial/ethnic minority groups (i.e. Hispanic) and those with low SES. Impact The study findings suggest that associations between sleep and overweight/obesity vary by race and SES. Identification of additional mechanisms for obesity is needed for racial/ethnic minority groups and those from families with low SES. Also, the complexity of these relationships underscores the importance of community-based needs assessment in the design of targeted and meaningful interventions to address complex health conditions such as poor sleep and obesity.Item Concordance in caregiver and child sleep health metrics among families experiencing socioeconomic disadvantage: A pilot study(Journal of Applied Research on Children, 2022-08-25) Covington, Lauren; Satti, Aditi; Brewer, Benjamin; Blair, Rachel; Duffy, Ilona; Laurenceau, Jean-Phillipe; Mayberry, Shannon; Cordova, Angeni; Hoopes, Elissa; Patterson, FredaPurpose: Child and caregiver sleep occurs in a family system, with socioeconomically disadvantaged families experiencing disproportionately worse sleep health than more advantaged families. The extent to which objectively measured sleep health metrics (i.e., sleep duration, midpoint, regularity, efficiency) are concordant within disadvantaged family systems, including caregiver-child dyads, is not clear. To address this gap, this study aimed to: (1) characterize sleep health metrics and (2) identify levels of sleep health concordance among caregiver-child dyads living in families experiencing socioeconomic disadvantage. Design and methods: We enrolled 20 caregivers and 26 children in this micro-longitudinal study. Eligible primary caregivers slept in the same house as the child ≥4 nights/week and had no sleep disorders. Eligible children were aged 6-14 years and reported no medical problems. Dyads wore an actigraphy device continuously for 14 consecutive days. Sleep duration, bedtime, midpoint, and efficiency were estimated, and concordance evaluated using linear mixed modeling (R v.3.5.2). Results: Most caregivers were female (85%), Non-Hispanic Black (80%), and aged 40.45 years (SD=11.82). On average, caregivers were not meeting national recommendations for sleep duration and efficiency. Similarly, sleep duration recommendations were not met by child participants. Bivariate results showed that bedtime 𝑟=0.19, p<.001), sleep efficiency (𝑟=0.24, p<.001), and sleep midpoint (𝑟=0.39, p<.001), were concordant between child and caregiver. Multivariable models showed that caregiver bedtime was predictive of child sleep midpoint (b=0.16, p<.05), and caregiver sleep midpoint was predictive of child bedtime (b=0.29, p<.01) and child sleep midpoint (b=0.31, p<.001). Conclusion: Objectively estimated caregiver sleep may be connected to the sleep timing of their children. Improving child sleep may require addressing caregiver sleep habits too. Practice Implications: Results highlight the importance of providers considering caregiver sleep health when assessing child sleep health during well child visits. KEY TAKE AWAY POINTS: In this sample of caregiver-child dyads living in families experiencing socioeconomic disadvantage, on average, caregivers were not meeting national recommendations for sleep duration (7-9 hours per night) and sleep efficiency (>85%), and children were not obtaining 9-11 hours of sleep per night. Bedtime, sleep efficiency, and sleep midpoint were significantly concordant in caregivers and children, with the strongest association observed with sleep midpoint. In multivariable models, caregiver bedtime predicted child sleep midpoint, and caregiver midpoint predicted child bedtime and midpoint; highlighting the necessity of addressing poor sleep health at the family versus individual level among families experiencing socioeconomic disadvantage.Item Preferences and concerns for care needs in advanced Parkinson's disease: a qualitative study of couples.(Wiley-Blackwell, 2016-08-29) Habermann, B.; Shin, J.; Habermann, B., & Shin, J.; Habermann, B.Aims and objectives: To explore how couples with Parkinson’s disease (PD) discuss their needs, concerns, and preferences at the advanced stages of illness. Background: The majority of care for people with PD is provided at home by family members. PD is characterized by a slow progressive decline with care needs often exceeding a decade. Design: A descriptive qualitative study with 14 couples. Methods: Data were collected on two occasions over a one month period utilizing semi‐structured interviews, with both individual and couple interviews. Data were analyzed thematically by the research team. Results: All participants discussed the strong desire to remain in their homes for as long as possible. For the people with PD, placement to long‐term facilities was not an option to be considered. For spouses, there was an acknowledgement there may come a time when they could no longer continue to provide care. Concerns regarding falls, choking, voice production, financial strain and need for prognostic information from providers were influences on what they believed the future would hold and the decisions they would need to make. Conclusions: The need for improved communication between providers and PD couples is evident. Interventions to support the couple in their discussions and decision making regarding remaining in the home or not, and options to support advanced care needs are required. Relevance to clinical practice: Nurses can help support decision making by providing tangible information regarding the advanced stages of PD including adequate prognostic information. Advanced PD 2 What does this article contribute to the wider global clinical community? >\Preferences for placement to long‐term care facilities are different among people with PD and their spouses. Beliefs about the future and decision making are influenced by concerns about physical complications including falls and choking and the need for prognostic information from health care providers. The need for improved communication between health care providers and PD couples is reported. Nursing interventions to support the couple in their discussions and decision making regarding placement and options to support advanced care needs are required.Item Fathers of Children Born with Cleft Lip and Palate: Impact of the Timing of Diagnosis(American Psychological Association, 2016-04-21) Zeytinoğlu, Senem; Davey, Maureen P.; Crerand, Canice; Fisher, Kathleen; Senem Zeytinoğlu Maureen P. Davey Canice Crerand Kathleen Fisher; Davey, Maureen P.INTRODUCTION: Cleft lip and/or palate (CL/P) affects not just the child born with the condition but also the child’s parents. Prior research has been primarily cross-sectional, quantitative, and focused on mothers’ emotional, social, and care experiences. Fathers’ experiences have been neglected despite the important role fathers have in their child’s well-being and development. The purpose of this study was to examine how the timing of a child’s diagnosis (prenatal versus postnatal) affects how fathers cope and adapt. METHOD: We conducted a descriptive qualitative study with a convenience sample of 17 fathers and used thematic content analysis to code the interviews. The sample included ten fathers who received a prenatal diagnosis and seven who received a postnatal diagnosis. RESULTS: The following four major themes emerged: (1) first hearing the diagnosis, (2) taking care of a baby with cleft, (3) future concerns, and (4) reflections. Course of treatment, feeding and social stigma were reported as major sources of stress for all fathers. DISCUSSION: All fathers should be routinely assessed by CL/P treatment teams and included in support services. Some fathers whose babies were diagnosed at birth experienced self-blame, suggesting the importance of screening this group of fathers for distress at birth. Findings underscore the importance of family-centered approaches to care that include both mothers and fathers in treatment planning, interventions, and future research.Item Experiences of Couples Caring for a Child Born with Cleft Lip and/or Palate: Impact of the Timing of Diagnosis(Wiley for American Association for Marriage and Family Therapy, 2016-07-08) Zeytinoğlu, Senem; Davey, Maureen P.; Crerand, Canice; Fisher, Kathleen; Akyil, Yudum; Senem Zeytinoğlu Maureen P. Davey Canice Crerand Kathleen Fisher Yudum Akyil; Davey, Maureen P.Raising a child born with cleft lip and/or palate (CL/P) can be challenging for parents. Few researchers have examined how having a child born with CL/P impacts couples. The purpose of this descriptive qualitative study was to examine how a child’s CL/P diagnosis affects couples’ adjustment and their relationship. We conducted interviews with 17 couples (10 prenatal and 7 postnatal) caring for children born with CL/P. After conducting thematic content analysis, six overarching themes emerged: (1) relationship growth, (2) challenges, (3) roles and responsibilities, (4) sources of support, (5) talking about cleft, and (6) lessons learned. Findings suggest couples should be routinely assessed for psychosocial issues and prevention programs should be tailored to pre-existing stressors and timing of the diagnosis.