Caregiver Burdens of Family Members with Alzheimer's Disease.

Alzheimer's disease is a common form of dementia characterized by progressive deterioration of a patient's cognitive abilities and memory. Most individuals that have Alzheimer's disease live and depend on family members for assistance or total care. This descriptive, correlational study examines the relationship between perceived caregiver burden of a family member with Alzheimer's disease who attended an adult day care center and perceived caregiver burden of a family member that did not attend an adult day care center. Research data were collected using the Caregiver Burden Inventory (CBI) and a researcher-developed demographic survey. This study used a purposive sample of (N = 84) caregivers. Results of the study indicated no significant differences in the perceived caregiver burden between the groups. The findings indicate the need to refine community and professional understanding of the challenges caregivers face.

Breast cancer risk elements and nurse practitioners' knowledge, use, and perceived comfort level of breast cancer risk assessment.

PURPOSE: The purpose of this study was to describe nurse practitioners' (NPs') knowledge, use, and perceived comfort level in providing breast cancer risk assessment to women in clinical settings. DATA SOURCES: This descriptive study was part of a needs assessment to determine if education and training programs on breast cancer risk assessment are warranted for NPs. A convenience sample of 147 NPs completed surveys to assess their knowledge of breast cancer risk assessment and use of empiric breast cancer risk assessment tools, and to evaluate their perceived comfort level in assessing women's risk for developing breast cancer. CONCLUSIONS: Assessing women's risk for the development of breast cancer is important in providing primary and secondary preventive strategies such as chemoprevention, lifestyle changes, and enhanced surveillance that may reduce a woman's risk for developing the disease. Although 51.4% of NPs reported providing breast cancer risk assessment, few (37%) reported use of family history or the Gail model (6%) to determine their patients' breast cancer risk. NPs' knowledge of breast cancer risk assessment and use of empiric risk assessment models were low. The majority (71%) of NPs felt uncomfortable or a low level of comfort in conducting breast cancer risk assessment. IMPLICATIONS FOR PRACTICE: Excluding skin cancer, breast cancer is the leading cause of cancer and second leading cause of cancer death among women in the United States. Breast cancer risk assessment is important in identifying women who may be at high risk for developing the disease. At the front line in health care, NPs can play a vital role in assessing women's risk for breast cancer. These findings suggest that education and training may be warranted to enhance knowledge and use of empiric risk models to increase the comfort level of NPs in conducting breast cancer risk assessment to their patients.

Factors associated with breastfeeding intentions of African-American women at military health care facilities.

Studies have shown that 21% to 51% of African-American women (AAW) reported breastfeeding, lagging behind Caucasian (61%-71%) and Hispanic (67%-71%) women despite breastfeeding's health benefits. This study aimed to assess AAWs "intent" to breastfeed and describe the relationship among knowledge, age, education, parity, and selected factors of the theory of planned behavior with their intent. The theory of planned behavior assumes intentions are immediate antecedent of behavior. Voluntary surveys of 95 AAW who intended to breastfeed were collected at two U.S. military prenatal clinics. The results were that breastfeeding intent was related to AAW's age, education, and perceived subjective norms (social pressures) and behavioral control (success in breastfeeding); only age and perceived behavior-control best "predicted" breastfeeding intent. Healthy People 2010's objectives are to increase numbers to 75% of women who breastfeed. This study notes the importance of health care providers in promoting AAW to breastfeed by initiating culturally sensitive strategies that enhances AAW's social support and personal confidence toward breastfeeding success.

Lichen sclerosus of the vulva in women: assessment, diagnosis, and management for the nurse practitioner.

PURPOSE: To describe the etiology, clinical manifestations, assessment, and management of vulvar lichen sclerosus (LS) in women. DATA SOURCES: Selected research and clinical articles in professional journals and online websites, peer review, educational technical bulletin from professional organization and the authors' professional clinical experiences. CONCLUSIONS: Vulvar LS can manifest with varied symptoms that may mimic other common vulvar disorders such as infections. Careful assessment of the vulva and biopsy of any suspicious skin changes are needed for diagnosis and management of vulvar LS. Treatment with high-potency topical corticosteroids may alleviate uncomfortable symptoms and reduce physical changes. Follow-up management is essential to check for progressing problems such as introital stenosis and to assess for skin changes that may indicate vulvar squamous cell carcinoma. IMPLICATIONS FOR PRACTICE: Accurate diagnosis and successful management of vulvar LS requires thorough assessment of the genitalia, knowledge of the disorder and appropriate treatment and follow-up management.