Patterns of telephone use among nursing home residents.

There is convincing evidence that nursing home residents who have more visitors fare better than those who have fewer visitors. However, as many as one third of all individuals living in nursing homes have virtually no visitors. The purpose of this study was to address this concern by examining telephone use in older adults living in nursing homes, and evaluating the potential of telephone communications as a means of social support for this at-risk group. Using a recording device activated each time the receiver was picked up, the research team "listened in" on the telephone conversations of three nursing home residents (aged 76, 79, and 92) for a period of 1 week. The transcripts revealed 56 minutes of actual conversation during the week (10, 21, and 25 minutes, respectively), most often with family or longtime friends living out of town. Each resident laughed aloud more than once per minute. The telephone conversations provided the residents with vivid glimpses of life outside the walls of their facility and appeared to help them stay connected with their family and friends. The findings support further study of the telephone as a way to sustain authentic social support in long-term care populations.

Racial differences in health status and health behaviors of older adults.

BACKGROUND: Little is known about racial differences in health status and health behaviors of older adults, especially among the oldest old. OBJECTIVES: To investigate racial differences in health status and health behaviors of African American and Caucasian older adults and to identify factors that influence health behaviors of older adults. METHOD: A descriptive comparative study using data from the Georgia Centenarian Study was conducted. The subjects were 248 older adults (181 Caucasians and 67 African Americans) ranging in age from 60 to 107 years. Demographic characteristics, health status, and four health behaviors were assessed. RESULTS: African Americans had significantly lower mental health (p < .001) and poorer self-perceived health (p < .01) than did their Caucasian counterparts; however, when covaried with education and income, racial differences in self-perceived health were eliminated, and differences in mental health decreased but remained significant (p < .05). Using univariate analyses, only two health behaviors, physical activity and eating breakfast regularly, showed significant racial differences. Relatively few older adults participated in leisure-time physical activity. Logistic regression analyses indicated that race was not significantly related to any health behaviors. Age, gender, and physical health status were most frequently related to health behaviors. CONCLUSION: The findings indicated no robust racial differences in health status and health behaviors, especially when education and income were controlled. More research is recommended to clarify the factors that explain health behaviors of older adults.

Long-term exercise patterns and immune function in healthy older women. A report of preliminary findings.

The purpose of this study was to examine the relationship between active versus inactive lifestyle and immunocompetence in older women. A sample of 46 independently dwelling, ambulatory and mentally alert women 60-98 years was examined, 25 who rated themselves as 'active' and 21 who rated themselves as 'inactive'. Lymphocyte subpopulations were analyzed by flow cytometry using selected monoclonal antibodies. The self-reported active subjects (also validated by their current unsolicited participation in a formal exercise class) demonstrated significantly higher percent change in CD25 mitogen stimulated lymphocytes (P = 0.0335) than those who reported themselves to be sedentary.

The undergraduate student as research assistant: promoting scientific inquiry.

As nurse scientists, we must find a way to excite our undergraduate students about research so that they will value it and include it as an integral part of their practice. The ambience surrounding scientific inquiry cannot be captured from readings and classroom activities alone, but must be modelled by enthusiastic faculty who are actively involved in research. Two exemplary cases involving the use of undergraduate students as integral members of faculty-directed research teams are described.

Pilot study of the relationship between heart rate and ectopy and unrestricted vs restricted visiting hours in the coronary care unit.

OBJECTIVE: To determine the relationship between cardiac performance (as measured by heart rate and ectopy) and unrestricted vs restricted visiting hours in the coronary care unit. DESIGN: Patients were from two coronary care units. Group A had unrestricted visiting hours, and group B had restricted visiting hours. Heart rate and ectopy were measured three times both in patients with unrestricted visiting hours and in those with restricted visiting hours: (1) before visitors arrived, (2) 5 minutes after visitors arrived and (3) 1 to 5 minutes after the visitors left. A total of 25 visits were analyzed. FINDINGS: There were no significant differences in rates of premature ventricular contractions and premature atrial contractions between the two groups. Patients with unrestricted visiting hours had a significantly lower heart rate after visits than patients with restricted visits. CONCLUSION: Consideration should be given to development of unrestricted visiting policies that promote the continuing presence and natural support of the family and significant others for patients in coronary care units.

Reminiscence: a viable option to enhance power in elders.

The purpose of this study was to investigate the usefulness of reminiscent storytelling as a therapeutic modality to enhance the sense of power in well elders (ages 60-86). The study was conceptualized within Rogers' (1986) Science of Unitary Human Beings and focused on Barrett's theory of power. A pre- and posttest design with experimental and control groups was used with Barrett's Power as Knowing Participation in Change Test, Version II as the measure of power (personal control). Experimental group subjects were pretested and then participated in three reminiscence sessions during a 1-week period. Subjects were then posttested both at the end of the reminiscence sessions and again after a 5-week interval. Control group subjects were tested on a schedule identical to that of the experimental group, but participated in no reminiscence sessions. Although an overall significant difference (p = 0.003) in scores was found over the testing period, no differences were found between experimental and control groups. Both experimental (n = 34) and control (n = 41) groups demonstrated a small but insignificant decrease in power between the pretest and posttest 1. Both groups then experienced a significant increase in power between posttest 1 and posttest 2. It is recommended that research energies continue to be directed toward the investigation of this topic. In our contemporary high tech world which often allows minimal human contact and diminishing quality of life for the aged, novel modalities such as reminiscence offer a human to human exchange, which may hold the key to this modern-day challenge.

The lived experience of survival and bereavement following the death of a lover from AIDS.

This phenomenologic study explored the lived experience of survival and bereavement following the death of a lover from AIDS. The sample (N = 8) included individuals who had lost a lover/partner to AIDS within the 18 month period prior to interview. Respondents were asked to reply to the following question: "Please describe your experience of losing a lover to AIDS. Describe events and feelings which you experienced both prior to and after the death of your lover." Themes were identified, analyzed, sorted into theme clusters and then categorized. Categories of Isolation/Disconnectedness, Emotional Confusion, and Acceptance/Denial were identified. A statement of the essential nature of the experience of surviving the death of a lover/partner from AIDS is presented.

Consumer-centric advocacy: its connection to nursing frameworks.

The concept of advocacy is redefined here as consumer-centric advocacy and its essential attributes are identified. Theoretical linkages between advocacy and selected nursing models are described. Specifically, the construct of advocacy is considered as it is operationalized within the theoretical frameworks of King, Newman, Orem, and Rogers. The health care system in the United States is in a state of unrest and undergoing nearly continuous change and reorganization. This reorganization has been hastened by tightened resources within the health care financing system, a growing number of elderly and indigent needing care, and the advent of care intensive disease processes such as AIDS and substance addicted newborns. In addition, the general public has become better informed concerning health and is seeking new approaches to the delivery of health care services. As changes in the health care system continue to occur, the role of nurses, the largest group of health care providers also is changing. In a system in which there is both a shortage of registered nurses and a growing demand for their services, nurses must develop strategies to maximize their impact on the health care system to meet the needs of consumers as well as protect their own professional integrity. The development of such strategies within nursing frameworks may be facilitated by closer scrutiny and clarification of the nurse's traditional role as advocate.