Donna Zucker

Hepatitis C Screening and testing: A call for a national response

Donna M. Zucker — Fri, 13 Jul 2012 08:24:37 PDT

Mobile Outreach Strategies for Screening Hepatitis and HIV in High Risk Populations

Donna M. Zucker — Wed, 29 Feb 2012 11:59:44 PST

Objectives: To screen, counsel and offer hepatitis A and B vaccination for subjects at high risk for hepatitis C virus (HCV) and HIV, and determine any relationship between risk factors and HCV positivity. Design and Sample Q1 : A descriptive correlational design. We correlated risk factors and HCV positivity and measured vaccination completion rates. Two hundred and two unduplicated subjects in 4 locations in Western Massachusetts: a walk in substance abuse clinic, a homeless shelter, a county jail, and a community corrections facility. Measures: Demographic data and a standard HCV risk- screening survey were used. Results: Significantly higher rates of HCV were found in subjects who were currently using injection drugs (83.3% HCV positive, x2(1)520.85, po.001), who had a history of sharing needles for drug use (75% HCV positive x2(1)583.20, po.001), or a history of receiving treatment for drug abuse/alcoholism (38.4% HCV positive x2(1)512.14, po.001). Vaccination completion ranged by setting between 18% and 38%. Conclusions: Targeted outreach to hard to reach groups is effective in providing access for those at high risk for HIV and HCV infection. A mobile outreach strategy can focus needed resources for a variety of groups in a community.

Labyrinth Walking in Corrections

Donna M. Zucker — Wed, 29 Feb 2012 11:52:02 PST

A 6 week labyrinth walking program was pilot tested in a correctional setting and goals were to: 1) determine the feasibility of a labyrinth walking curriculum; 2) pilot test measures of health related quality of life (QOL) (pre and post-surveys) and blood pressure; and 3) examine the influence of relationship-centered teaching on subject satisfaction. Relational communication was used as a framework for this study, emphasizing concepts of trust, competency and similarly in the teacher. A pretest/posttest descriptive design was used. The sample was 14 offenders at a Massachusetts county jail. The intervention included six 90 minute sessions, composed of a lecture, a labyrinth walk, and journal writing. Measures included a demographic survey; pre and post session walk blood pressures; pre and post program QOL measures; and a post program measure of satisfaction. The sample was 57% Caucasian, 36% Hispanic, and 7% African American, with an average age of 34, mostly high school educated and single. Drug of choice was alcohol with age of use at 12 and 1/2 years. Seventy-nine percent were previously incarcerated more than twice. QOL data were not changed pre to post. BP data trended in a healthy direction from weeks 1 to 6. Satisfaction with the teacher and the program was high. The labyrinth walking pilot program was proven feasible, low cost and satisfying for the participants. Recommendations for future studies are discussed.

Mobile Outreach for Hepatitis C and HIV in Western Massachusetts

Donna M. Zucker et al. — Sun, 12 Dec 2010 11:05:49 PST

Poster Presentation

Labyrinth Walking & Quality of Life in High Risk Substance Abusers: A Mixed Methods Study

Donna M. Zucker et al. — Sun, 12 Dec 2010 10:51:56 PST

An Intervention to Prevent Symptoms Associated with Hepatitis C: A Pilot Study

Donna M. Zucker — Mon, 21 Dec 2009 09:20:22 PST

The objectives of this study were to (a) pilot test instruments measuring fatigue and quality of life (QOL); (b) pilot test an exercise intervention; and (c) estimate the effect size of this intervention relative to completion of combination therapy, fatigue, QOL, and walking distance in 20 patients with chronic hepatitis C about to begin interferon alpha and ribavirin treatment. Alpha reliabilities for both the Schwartz Cancer Fatigue Scale and Hepatitis Quality of Life Questionnaire were moderately high. Power analyses of all outcome measures indicated a small effect size and sample size estimate of 30–40 per group to achieve power of N.80. © 2009 Published by Elsevier Inc.

Peer education for Hepatitis C prevention

Donna M. Zucker — Mon, 21 Dec 2009 09:07:30 PST

The purpose of this article is to describe a model of education about hepatitis C virus prevention tested in a county correctional facility. The Teach One Method and Relational Communication models inform this work. Using a one-group pretest–posttest prospective design our aims were to (1) convey education about prevention, protection, and safety; (2) provide this information through relationship-centered communication; (3) test the reliability and validity of the instruments; and (4) measure changes in behavior, knowledge, and relationship in the learner. A convenience sample of 25 men was recruited at a Massachusetts county jail. Subscale reliability was 0.78 and 0.79 for the relationship and behavior subscales, respectively. Knowledge questions were evaluated using face and content validity by teachers before and during this study. All subscale mean scores improved in the posttest condition. The level of significance of the calculated t value for the behavior subscale was 0.16. The level of significance for the relationship t value was nonsignificant at 0.65. Knowledge, behavior, and relationship scores improved after the intervention. Recommendations include retesting study instruments on a larger sample and using a control group.

How to Do Case Study Research

Donna M. Zucker — Wed, 09 Sep 2009 04:56:29 PDT

University and Sheriff's Office Create a Model Collaboration

Donna M. Zucker et al. — Tue, 01 Jul 2008 14:59:43 PDT

Assessment of Side Effects in Patients with Chronic Hepatitis C Receiving Combination Therapy

Donna M. Zucker et al. — Wed, 05 Mar 2008 17:27:47 PST

This purpose of this descriptive study is to review the adverse effects of combination therapy, interferon alfa-2b and ribavirin, in a sample of patients with chronic hepatitis C who were part of a larger multi-center trial. The sample (n=13) was drawn from one hepatology practice in the northeastern U.S. This secondary analysis reported sums, frequencies, means and standard deviations for the sample. Patients who received 600 mg. ribavirin per day in addition to interferon alfa-2B (Arm A) showed a mean of 9.5 different types of side effects. Patients who received 1000-1200 mg of ribavirin in addition to interferon alfa-2B (Arm B) had a mean of 8.6 different types of side effects. The highest ranking side effects were fatigue, insomnia, alopecia and arthralgia. A secondary analysis of the entire data set is required before confidence can be placed in the findings.

The Suitability of Mindfulness-Based Stress Reduction for Chronic Hepatitis C

Lynn S. Koerbel et al. — Wed, 05 Mar 2008 15:54:39 PST

As incidence of chronic hepatitis C (CHC) in the United States increases, management of physical and psychological symptoms over the long term becomes crucial. Research has shown meditation to be a valuable tool in reducing such symptoms for various chronic illnesses. In particular, the Mindfulness-Based Stress Reduction (MBSR) program offers curriculum that has been show to influence both physiology and perception of disease states. Although there has been not direct research to date on the effectiveness of the MBSR program for CHC, several studies have shown significant findings affecting other chronic conditions including heart disease, fibromyalgia and HIV. The purpose of this literature review is to examine recent research, summarize findings and indicate appropriate inclusion of MBSR as a primary, secondary and tertiary treatment option in conjunction with biomedical care for those diagnosed with CHC.

Relapse in Hepatitis C: A Case Study

Donna M. Zucker — Tue, 04 Mar 2008 18:35:00 PST

The rationale for this case study was to describe the day-to-day experiences of living with chronic hepatitis C (CHC), as described by someone who relapsed after treatment. An evolving model of treatment experiences and symbolic interaction were used as conceptual underpinnings for this case study. Participant observation in community support groups and three in depth interviews with one individual held across 2 months took place in a naturalistic setting of the participant’s choice. Analysis of the participant interviews emphasized (1) the stigma of living with a reportable disease, its etiology, and the attitudes f an uninformed public, and (2) the trajectory of a relapser. Implications for practitioners must include an emphasis on the psychological and social impact of CHC. Comparison of this chronic illness trajectory to an existing model will assist in theory development.

Chronic Heart Disease: An Approach for Intevention

Donna M. Zucker — Tue, 04 Mar 2008 11:38:18 PST

Before 1985, the goal of care for patients with coronary heart disease (CHD) was to support them through their infarction. Today, the treatment goal is to minimize ischemia and eliminate avoidable risk factors. High-tech interventions and long-acting pharmacotherapies have become the gold standard of treatment. Lengths of hospital stay are 50% less than before 1985 and, as a result, teaching opportunities directed at lifestyle change have been curtailed. The two case studies reported here of men with CHD reveal the importance of the patient’s early life experiences when developing meaningful recommendations for changing their lifestyle.

Making Meaning: The Creative Component in Qualitative Research

Anita Hunter et al. — Tue, 04 Mar 2008 09:04:47 PST

Findings in qualitative research are often wondrous and exciting, expounding new knowledge and perceptions previously unknown. Qualitative research requires the researcher to ponder and reflect on the data collected so as to find the meaning within. Helping researchers learn how to perform this step is not well discussed in the qualitative literature, yet this is one of the more crucial components of this type of research. In this article, the incubation, the meaning-making phase of qualitative research, is discussed in relation to the experiences of five researchers who have used traditional processes, models, metaphors, plays, pastiche, poetry, and quilt making and design to help them make meaning.

Plato's Cave and Aristotle's Collections: Dialogue across Disciplines

Donna M. Zucker et al. — Tue, 04 Mar 2008 08:56:07 PST

This paper describes a joint effort between the Department of Theatre and the School of Nursing at the University of Massachusetts, Amherst, MA. The purpose of this collaboration was to design and evaluate techniques commonly used in theatre programmes to help doctoral nursing students understand philosophical content. Various theatre workshop techniques were used in order to help them bring abstract ideas to physical life. In other words, these techniques and exercises help bridge theory and practice.

Peer-Mentoring for Tenure-Track Faculty

Cynthia S. Jacelon et al. — Tue, 04 Mar 2008 08:47:47 PST

Four tenure-track nursing faculty members at a large, research-intensive university came together to help each other learn the role of faculty scholar and to provide discipline, critique, and collegiality for each other with the goal of building research careers. Peer mentoring is usually construed more as senior faculty mentoring newer faculty. In this model, new faculty members mentor each other based on the knowledge gained in their doctoral programs and through sharing experiences with their own mentors. The value of this strategy includes building relationships among diverse faculty members, creating opportunities for collaboration on research projects, and developing camaraderie among members that might not otherwise develop. One year after implementing this innovative strategy for faculty peer mentoring, group members report success in individual and collective scholarship productivity, more research collaboration, improved mutual expertise, and stronger relationships with each other.

Depicting Death: Lessons on Writing and Professional Development in Nursing

Donna M. Zucker — Tue, 04 Mar 2008 08:41:02 PST

The aim of this article is to describe methods incorporating creative uses of classic literature about death and dying in a writing course for nurses. Selected writing activities included free-writing, responses to classic and contemporary literature on dying, and free-drawing. This course facilitated self-exploration and finding one’s own vice. Including classic literature into a nursing writing course was essential in demonstrating to students that death is a powerful life event that requires sharing to promote learning and healing

Migrating to the Web: The Transformation of a Traditional RN to BS Program

Donna M. Zucker et al. — Tue, 04 Mar 2008 08:18:55 PST

Background: Evaluation of our school's self-study data pointed to the need to offer creative distance learning options for students in the RN to BS program. Method: Selected courses in the RN to BS program curriculum were offered to students in both the traditional classroom and via an online format. Results: End-of-course evaluations and course grades showed no significant difference between the learning experiences of the traditional classroom students compared with those of the online students. Conclusion: This successful pilot encouraged our school to migrate the curriculum of a traditional RN to BS program to an online format.

The Nature of Hope in Hospitalized Chronically Ill Patients

Dale Sook Kim et al. — Mon, 03 Mar 2008 11:01:58 PST

Background: Hope as a universal human phenomenon has been studied from various perspectives often conceptualized as having a unified set of attributes. In this study however hope is viewed to be experienced by people in various patterns structured by different orientations and emphases depending upon their life circumstances. There is a paucity of studies in the literature examining patterns of hope experienced by people in chronic illness or in special life circumstances. Objectives: The aim of this study was to discover patterns of hope in hospitalized chronically ill patients and to identify the major threads that structure various patterns of hope experienced by them. Design: Q-methodology, which is an approach designed to discover patterns in various subjective experiences, was used as the method for data collection and theory generation. Q-methodology involves five steps in its approach, the first two as the first phase and the last three as the second phase. The study was carried out at a general acute-care, tertiary hospital in a New England state in the US. The study obtained data from a convenient sample of 12 chronically ill patients and 16 oncology nurses for the first phase, and a different convenient sample of 20 chronically ill patients for the second phase. Results and conclusions: Five patterns of subjective experiences of hope emerged as: (a) externalism orientation, (b) pragmatism orientation, (c) reality orientation, (d) future orientation, and (e) internalism orientation. This means that chronically ill patients experience hope in various ways by focusing on different dimensions of meaning, suggesting the conceptualization of hope as a unitary construct may not reflect people's experiences of hope accurately. The major implication of the study is to rethink ways to assess patients' hope in terms of pattern differences rather than in terms of quantity.

Using Case Study Methodology in Nursing Research

Donna M. Zucker — Mon, 03 Mar 2008 10:34:57 PST

Abstract The purpose of this paper is to illustrate a research method that may contribute a unique and valuable method of eliciting phenomena of interest to nursing. Case study method can be used as a creative alternative to traditional approaches to description, emphasizing the patient's perspective as central to the process. This manuscript will define case study method, and discuss various case study designs. Approaches and tactics from a variety of disciplines, and theoretical or philosophical perspectives are discussed with an emphasis on method and analysis. The bulk of the manuscript outlines the stages used in a case study of men with chronic coronary heart disease (CHD), as well as presenting a case study protocol. Implications for its usefulness in nursing research, practice, and theory generation are discussed.