A Review of the Concept of Impulsivity: An Evolutionary Perspective.

Impulsivity is a central concept for many psychological models and interventions. Despite extensive research, the concept of impulsivity lacks clarity due to the diversity of definitions provided. The aims of this study were to conduct a concept analysis of impulsivity to provide a clear and workable definition of impulsivity for future nursing research. This study used Rodgers' evolutionary concept analysis approach to analyze 37 articles from various disciplines. Our analysis offers promising direction in refining the concept. The findings can drive future research and enhance nurse researchers' ability to attend and explore health-related issues associated with the concept.

The impact of dementia caregiving on self-care management of caregivers and facilitators: a qualitative study.

BACKGROUND: Caregivers of patients with dementia or Alzheimer's disease (AD) face special health challenges due to the progressive nature of the disease. Self-care has crucial importance on individuals' management of life, health, and well-being. However, limited evidence is available on self-care management of dementia and AD caregivers. This study aimed to investigate the influence of caregiving on the self-care management of dementia and AD caregivers based on the caregivers' experience. In addition, the facilitators of caregivers' self-care management were assessed. METHODS: A sample of 45 caregivers of patients with dementia or AD was recruited from a local community in the south-eastern USA. Semi-structured interviews were conducted. Data were transcribed verbatim and analyzed by the method of cross-case thematic analysis of qualitative data. RESULTS: As reported by the caregivers, caregiving negatively influenced their self-care management, including physical self-care and mental and social self-care. Both internal and external facilitators were found that can assist caregivers' self-care. Caregivers differ considerably in their demographic characteristics, caregiving tasks, and self needs. CONCLUSION: Self-care management of dementia and AD caregivers can be largely affected by caregiving. Awareness, motivation, and knowledge of self-care, as well as knowledge of health-care resources, are important prerequisites for caregivers to achieve self-care management. Given the massive differences in caregiving situations, future intervention studies based on the specific needs of individual caregivers are warranted.

Impact of Mother-Daughter Relationship on Hypertension Self-management and Quality of Life: Testing Dyadic Dynamics Using the Actor-Partner Interdependence Model.

BACKGROUND: Although hypertension (HTN) treatment rates are similar across age groups of women, effective control is significantly worse among older women. Only 20% of hypertensive women aged 70 to 79 years have controlled blood pressure. OBJECTIVES: The purpose of this longitudinal study was to test the effects of the quality of mother-daughter relationship, inner strength, and control on HTN self-management and health-related quality of life (HRQOL) for both members of the dyad at 6 months. The Actor-Partner Interdependence Model was used to examine the direct ("actor") and indirect ("partner") effects of 46 dyads. RESULTS: The mothers' perceived relationship quality with daughters directly impacted their own self-management of HTN and HRQOL while also indirectly affecting their daughters' self-management. Similarly, the daughters' perceived strength of their relationship with their mothers directly influenced their self-management and HRQOL and indirectly affected their mothers' self-management and HRQOL.

Beyond social support: Self-care confidence is key for adherence in patients with heart failure.

BACKGROUND: Adherence to treatment is crucial to improve outcomes in patients with heart failure. Good social support is associated with better adherence, but the mechanism for this association has not been well-explored. AIMS: The aim of this secondary analysis was to examine whether self-care confidence mediates the relationship between social support and treatment adherence in heart failure patients hospitalized with acute exacerbation. METHODS: A total of 157 inpatients with heart failure (63.5±13 years, 73% New York Heart Association class III/IV) were recruited from two hospitals located in urban areas in the USA. Participants completed the Self-Care of Heart Failure Index, the Multidimensional Perceived Social Support Scale, and the Medical Outcomes Study Specific Adherence Scale. A series of regression models were used to determine the mediation relationship. RESULTS: Controlling for marital status and hospital site, social support was associated with adherence ( p=0.03). When self-confidence was included in the model, the effect of social support became non-significant, indicating full mediation of the relationship between social support and adherence by self-care confidence. The indirect effect (0.04) of social support on adherence through self-confidence was significant (95% confidence interval: 0.01-0.09). CONCLUSION: Heart failure self-care confidence mediated the relationship between social support and treatment adherence. Thus interventions targeting patients' self-care confidence is essential to maximize patients' treatment adherence.

The lived experience of help-seeking by South African women after sexual assault.

The purpose of this study was to explore the lived experience of help-seeking by South African women following sexual assault. Hermeneutic phenomenology guided the study. Interviews were conducted with six women who had experienced sexual assault at some point in their lives. Three venues were most significant to women's help-seeking experiences: the criminal justice system, health care facilities, and/or social service agencies. Essentially, the women's help-seeking experiences in these three venues are best described as fraught justice-seeking, pragmatic help-seeking, and desperate help-seeking. The study findings have implications for the provision of services for women who experience sexual assault in South Africa.

Palliative and end-of-life care: using a standardized patient family for gerontological nurse practitioner students.

This article describes an innovative approach to educating gerontological nurse practitioner students about the needs of patients and their families related to palliative and end-of-life care. By using a standardized patient family and creatively using resources from the End-of-Life Nursing Education Consortium (ELNEC), this author maximized learning experiences for advanced practice students who will care for elderly individuals and their families. The goal of ELNEC is to strengthen nursing education to improve end-of-life care. Principles for developing and implementing a complex standardized patient scenario for graduate nursing students are offered.

Assessing and maintaining mental health in elderly individuals.

This article provides detailed information about assessing the mental health needs of older adults as well as strategies to maintain mental health. An overview of the public health needs of older adults is provided that includes examples of policies that ensure minimum physical and mental health for older adults. Multiple resources are described that will enable clinicians to access information that will increase their knowledge of assessment of mental health needs of older adults.

Standardized patients: a creative teaching strategy for psychiatric-mental health nurse practitioner students.

In this article, a learning strategy for psychiatric nurse practitioner students in a research-intensive university is described. The strategy actively involved students in experiences with standardized patients. The course content included review of the causes, manifestations, assessment, and diagnoses of psychopathology across the lifespan. The goal was for students to build diagnostic reasoning skills so they could conceptualize case formulations and examine differential diagnoses related to mental disorders. Faculty simulated complex mental health disorders in a controlled environment where students practiced assessment and diagnostic skills with feedback from faculty, peers, and the standardized patients. On completion of the course with six different standardized patient situations and a final standardized patient scenario that involved assessment, diagnosis, and creation of a formal paper about the case, the students demonstrated excellent interviewing skills, confident assessment abilities, appropriate use of screening and diagnostic tools, and accurate diagnosis of the standardized patients.

Living vigilant lives with chronic illness: stories from older low-income minority women.

Our purpose in this pilot study is to test the validity of the concepts in the Evolutionary Empowerment-Strength model, which was developed through analysis of data from a previous study that observed how older women coped with a hip fracture. Thirteen minority women aged 63 to 88 years with chronic illness participated in this pilot study. Findings indicate four themes: (1) Positive Self-Talk, (2) Strong Spiritual Faith, (3) Refusal to Dwell on Deficits, and (4) Sense of Survival. Three of the five concepts in the Evolutionary Empowerment-Strength model were supported, which demonstrates initial usefulness of the model for varied populations.

Empowerment of aging mothers and daughters in transition during a health crisis.

The purpose of this study was to develop a theoretical model illustrating aging mothers' and daughters' transitions through a health crisis. The investigator, using grounded theory, conducted 27 interviews over a 15-month period with 6 older women who had experienced a hip fracture and their adult daughters. The use of the constant comparative method guided data collection and generation of theory. The theoretical model that emerged from data illustrates five major concepts: Internalizing female lineage, Mastering maturity, Evolving matriarchs, Emerging transformation, and Becoming empowered. The basic social process integrating these five concepts is the Evolution of Female Strength. The model could be used to explicate strengths of aging mothers and their daughters while identifying health care problems that require interventions.

The empowerment of older mothers and daughters: rehabilitation strategies following a hip fracture.

Empowerment was a major concept that emerged from a grounded theory study of 6 older mother-daughter dyads when the mother experienced a hip fracture. Modeling courage and sharing ideas were key components of empowerment. Modeling courage enabled mothers and daughters to retain strength in the face of pain and difficulties. Sharing ideas involved suggestions about physical rehabilitation, ways to access medical and legal information, as well as life philosophies. In this article, the process of empowerment is described. Recommendations are made to improve the lives of older women and their daughters during and after a hip fracture.