1
|
Mathew A, Akpotu IC, Lockwood MB, Tirkey AJ, Patil CL, Doorenbos AZ. Critical Realism in Symptom Science - A Scoping Review. ANS Adv Nurs Sci 2024:00012272-990000000-00091. [PMID: 38864677 DOI: 10.1097/ans.0000000000000534] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/13/2024]
Abstract
There has been an increasing interest in research positioned within critical realism (CR). This analysis aimed to determine how CR has been applied in symptom science through a scoping review of the literature. Fifty-two articles were identified through searches in seven databases and search engines, and grey literature. Quantitative and qualitative analyses were performed using Excel and ATLAS.ti 8.0. Review findings indicate that CR has been used to examine two key aspects of symptoms - symptom experiences and symptom interventions. The details of how CR was operationalized are presented. This first scoping review highlights how a critical realist lens would help examine individual and contextual factors that influence symptom experiences, response to interventions, and outcomes.
Collapse
Affiliation(s)
- Asha Mathew
- Author Affiliations: Department of Surgical Nursing, College of Nursing, Christian Medical College Vellore, The Tamil Nadu Dr M.G.R. Medical University, Chennai, India (Dr. Mathew); Head and Neck Surgery Unit II, Christian Medical College Vellore, India (Dr. Tirkey); Department of Biobehavioral Sciences, College of Nursing, University of Illinois, Chicago, USA (Ms Akpotu and Drs. Lockwood and Doorenbos); Department of Health Behavior and Biological Sciences, School of Nursing, University of Michigan (Dr. Patil); and University of Illinois Cancer Center, Chicago, USA (Dr. Doorenbos)
| | | | | | | | | | | |
Collapse
|
2
|
Solbakken LE, Bergvik S, Wynn R. Breaking down barriers to mental healthcare access in prison: a qualitative interview study with incarcerated males in Norway. BMC Psychiatry 2024; 24:292. [PMID: 38632543 PMCID: PMC11025238 DOI: 10.1186/s12888-024-05736-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/01/2024] [Accepted: 04/03/2024] [Indexed: 04/19/2024] Open
Abstract
BACKGROUND Mental health problems are highly prevalent in prison populations. Incarcerated persons generally come from disadvantaged backgrounds and are living under extraordinary conditions while in prison. Their healthcare needs are complex compared to the general population. Studies have found that incarcerated individuals are reluctant to seek help and that they experience challenges in accessing mental healthcare services. To some extent, seeking treatment depends on the degree of fit between potential users and health services, and actual use might be a better indication of accessibility than the fact that services are available. This study aimed to explore individual and systemic facilitators and barriers to accessing mental healthcare in a prison context. METHODS An analytical approach drawing on elements of constructivist Grounded theory was the methodological basis of this study. Fifteen male participants were recruited from three prisons in Northern Norway. Data was collected through in-depth interviews on topics such as help-seeking experiences, perceived access to services and availability of health information. RESULTS We found that distrust in the system, challenges with the referral routines, worries about negative consequences, and perceived limited access to mental healthcare were barriers to help-seeking among incarcerated individuals. How prison officers, and healthcare personnel respond to incarcerated persons reporting mental distress could also be critical for their future willingness to seek help. Providing information about mental health and available services, initiating outreaching mental health services, and integrating mental health interventions into treatment programs are examples of efforts that might reduce barriers to accessing services. CONCLUSIONS Facilitating access to mental health services is crucial to accommodate the mental health needs of those incarcerated. This study provides insights into the complex interplay of individual, social and systemic factors that may contribute to the utilization of mental health care among incarcerated persons. We suggest that correctional and healthcare systems review their practices to facilitate access to healthcare for people in prison.
Collapse
Affiliation(s)
- Line Elisabeth Solbakken
- Department of Clinical Medicine, UiT The Arctic University of Norway, Tromsø, N-9038, Norway
- Division of Mental Health and Substance Use, University Hospital of North, Tromsø, Norway
| | - Svein Bergvik
- Department of Psychology, UiT The Arctic University of Norway, Tromsø, Norway
| | - Rolf Wynn
- Department of Clinical Medicine, UiT The Arctic University of Norway, Tromsø, N-9038, Norway.
- Department of Education, ICT and Learning, Østfold University College, Tromsø, Norway.
| |
Collapse
|
3
|
Scroggins JK, Yang Q, Tully KP, Reuter-Rice K, Brandon D. Examination of Social Determinants of Health Characteristics Influencing Maternal Postpartum Symptom Experiences. J Racial Ethn Health Disparities 2024:10.1007/s40615-023-01901-1. [PMID: 38180636 DOI: 10.1007/s40615-023-01901-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2023] [Revised: 12/05/2023] [Accepted: 12/20/2023] [Indexed: 01/06/2024]
Abstract
Postpartum women experience multiple, co-occurring postpartum symptoms. It is unknown if social determinants of health (SDOH) influence postpartum symptom typologies. This secondary analysis used the Community and Child Health Network study data. Participants included for analysis varied depending on the availability of the SDOH data (N = 851 to 1784). Bivariate and multiple regression analyses were conducted to examine the association between SDOH and previously identified postpartum symptom typologies. Area under the receiver operating characteristics curve (AUROC) was calculated to examine if adding SDOH variables contributes to predicting postpartum symptom typologies. The adjusted odds (aOR) of being in high symptom severity or occurrence typologies were greater for participants who had less than high school education (aOR = 2.29), experienced healthcare discrimination (aOR = 2.21), used governmental aid (aOR = 2.11), or were food insecure (aOR = 2.04). AUROC improved after adding SDOH. Considering experiences of different social-economic hardships influence postpartum symptom typologies, future practice and research should address SDOH to improve postpartum symptom experiences.
Collapse
Affiliation(s)
- Jihye Kim Scroggins
- School of Nursing, Columbia University, 560 W 168thStreet, New York, NY, 10032, USA.
- School of Nursing, Duke University, Durham, NC, USA.
| | - Qing Yang
- School of Nursing, Duke University, Durham, NC, USA
| | - Kristin P Tully
- Department of Obstetrics and Gynecology, School of Medicine, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Karin Reuter-Rice
- School of Nursing, Duke University, Durham, NC, USA
- School of Medicine, Duke University, Durham, NC, USA
| | - Debra Brandon
- School of Nursing, Duke University, Durham, NC, USA
- School of Medicine, Duke University, Durham, NC, USA
| |
Collapse
|
4
|
Abujaradeh H, O'Brien J, Mazanec SR, Bender CM, Schlemmer IM, Brufsky AM, Nasrollahi E, Rosenzweig M. The Effect of Race and Area Deprivation on Symptom Profiles over the Course of Early-Stage Breast Cancer. RESEARCH SQUARE 2023:rs.3.rs-3649299. [PMID: 38076798 PMCID: PMC10705700 DOI: 10.21203/rs.3.rs-3649299/v1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/23/2023]
Abstract
Purpose This study compared common symptoms (fatigue, pain), overall physical functioning and changes over time between Black and White women receiving early-stage breast cancer (ESBC) chemotherapy. Methods A longitudinal, repeated measures comparative design was employed. Time points of symptom measurement (PROMIS domains) at baseline, mid and end point were adjusted as per patient chemotherapy schedule. Analyses Linear mixed models were applied. Results There were 147 patients, 36% Black 64% White (54±12 years) recommended to receive early-stage breast cancer chemotherapy with adequate data for symptom analysis. Pain Main effect of race was significant (F(1, 390) = 29.43, p<.001) for pain with Black patients experiencing significantly higher pain scores compared to White patients at pretherapy (Mean Difference; MD=3.7, p=.034), midpoint (MD=5.8, p=.002), and endpoint (MD=7.8, p<.001). Fatigue Fatigue significantly increased (deteriorated) at endpoint (MDT1-T3= 8.7, p<.001) for Black patients. Among White patients, fatigue significantly increased at midpoint (MDT1-T2= 5.7) and at endpoint (MDT1-T3=10.1, p<.001; MDT2-T3=4.3, p= .017). Physical function: Black patients had significantly lower physical function scores compared to White patients at midpoint (MD=4.0, p=.027). Physical function decreased by endpoint in Black (MDT1-T3=7.8, p<.001), and White patients (MDT1-T3=7.7, p<.001). Conclusion Symptom burden significantly increased over the course of chemotherapy for all patients. Scores for pain and physical function were higher overall for Black patients and deteriorated at a greater rate for Black vs. White women over the course of chemotherapy. This assessment holds implication for proactive assessment and mitigation strategies.
Collapse
|
5
|
Graves LY, Keane KF, Taylor JY, Wang TF, Saligan L, Bogie KM. Subacute and Chronic Spinal Cord Injury: A Scoping Review of Epigenetics and Secondary Health Conditions. Epigenet Insights 2023; 16:25168657231205679. [PMID: 37900668 PMCID: PMC10612389 DOI: 10.1177/25168657231205679] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2023] [Accepted: 09/11/2023] [Indexed: 10/31/2023] Open
Abstract
Background Epigenetics studies the impact of environmental and behavioral factors on stable phenotypic changes; however, the state of the science examining epigenomic mechanisms of regulation related to secondary health conditions (SHCs) and neuroepigenetics in chronic spinal cord injury (SCI) remain markedly underdeveloped. Objective This scoping review seeks to understand the state of the science in epigenetics and secondary complications following SCI. Methods A literature search was conducted, yielding 277 articles. The inclusion criteria were articles (1) investigating SCI and (2) examining epigenetic regulation as part of the study methodology. A total of 23 articles were selected for final inclusion. Results Of the 23 articles 52% focused on histone modification, while 26% focused on DNA methylation. One study had a human sample, while the majority sampled rats and mice. Primarily, studies examined regeneration, with only one study looking at clinically relevant SHC, such as neuropathic pain. Discussion The findings of this scoping review offer exciting insights into epigenetic and neuroepigenetic application in SCI research. Several key genes, proteins, and pathways emerged across studies, suggesting the critical role of epigenetic regulation in biological processes. This review reinforced the dearth of studies that leverage epigenetic methods to identify prognostic biomarkers in SHCs. Preclinical models of SCI were genotypically and phenotypically similar, which is not reflective of the heterogeneity found in the clinical population of persons with SCI. There is a need to develop better preclinical models and more studies that examine the role of genomics and epigenomics in understanding the diverse health outcomes associated with traumatic SCI.
Collapse
Affiliation(s)
- Letitia Y Graves
- School of Nursing, University of Texas Medical Branch, Galveston, TX, USA
- Louis Stokes Cleveland Veterans Affairs Medical Center, Cleveland, OH, USA
| | - Kayla F Keane
- National Institute of Nursing Research, National Institutes of Health, Bethesda, MD, USA
| | - Jacquelyn Y Taylor
- Columbia School of Nursing and Center for Research on People of Color, New York, NY, USA
| | - Tzu-fang Wang
- National Cancer Institute, National Institutes of Health, Bethesda, MD, USA
| | - Leorey Saligan
- National Institute of Nursing Research, National Institutes of Health, Bethesda, MD, USA
| | - Kath M Bogie
- Louis Stokes Cleveland Veterans Affairs Medical Center, Cleveland, OH, USA
- Case Western Reserve University, Cleveland, OH, USA
| |
Collapse
|
6
|
Jeste DV, Malaspina D, Bagot K, Barch DM, Cole S, Dickerson F, Dilmore A, Ford CL, Karcher NR, Luby J, Rajji T, Pinto-Tomas AA, Young LJ. Review of Major Social Determinants of Health in Schizophrenia-Spectrum Psychotic Disorders: III. Biology. Schizophr Bull 2023; 49:867-880. [PMID: 37023360 PMCID: PMC10318888 DOI: 10.1093/schbul/sbad031] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 04/08/2023]
Abstract
BACKGROUND Social determinants of health (SDoHs) are nonmedical factors that significantly impact health and longevity. We found no published reviews on the biology of SDoHs in schizophrenia-spectrum psychotic disorders (SSPD). STUDY DESIGN We present an overview of pathophysiological mechanisms and neurobiological processes plausibly involved in the effects of major SDoHs on clinical outcomes in SSPD. STUDY RESULTS This review of the biology of SDoHs focuses on early-life adversities, poverty, social disconnection, discrimination including racism, migration, disadvantaged neighborhoods, and food insecurity. These factors interact with psychological and biological factors to increase the risk and worsen the course and prognosis of schizophrenia. Published studies on the topic are limited by cross-sectional design, variable clinical and biomarker assessments, heterogeneous methods, and a lack of control for confounding variables. Drawing on preclinical and clinical studies, we propose a biological framework to consider the likely pathogenesis. Putative systemic pathophysiological processes include epigenetics, allostatic load, accelerated aging with inflammation (inflammaging), and the microbiome. These processes affect neural structures, brain function, neurochemistry, and neuroplasticity, impacting the development of psychosis, quality of life, cognitive impairment, physical comorbidities, and premature mortality. Our model provides a framework for research that could lead to developing specific strategies for prevention and treatment of the risk factors and biological processes, thereby improving the quality of life and increasing the longevity of people with SSPD. CONCLUSIONS Biology of SDoHs in SSPD is an exciting area of research that points to innovative multidisciplinary team science for improving the course and prognosis of these serious psychiatric disorders.
Collapse
Affiliation(s)
- Dilip V Jeste
- Department of Psychiatry, University of California, San Diego (Retired), CA, USA
| | - Dolores Malaspina
- Departments of Psychiatry, Neuroscience and Genetics, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Kara Bagot
- Department of Psychiatry, Addiction Institute, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Deanna M Barch
- Departments of Psychological and Brain Sciences, Psychiatry, and Radiology, Washington University in St. Louis, St. Louis, MO, USA
| | - Steve Cole
- Departments of Psychiatry and Biobehavioral Sciences, and Medicine, University of California, Los Angeles, CA, USA
| | - Faith Dickerson
- Department of Psychology, Sheppard Pratt, Baltimore, MD, USA
| | - Amanda Dilmore
- Department of Pediatrics, University of California, San Diego, CA, USA
| | - Charles L Ford
- Center for Translational Social Neuroscience, Department of Psychiatry, Emory University, Atlanta, GA, USA
| | - Nicole R Karcher
- Department of Psychiatry, Washington University in St. Louis, St. Louis, MO, USA
| | - Joan Luby
- Department of Psychiatry (Child), Washington University in St. Louis, St. Louis, MO, USA
| | - Tarek Rajji
- Adult Neurodevelopment and Geriatric Psychiatry Division, Centre for Addiction and Mental Health, Toronto, ON, Canada
| | - Adrián A Pinto-Tomas
- Biochemistry Department, School of Medicine, Universidad de Costa Rica, San José, Costa Rica
| | - Larry J Young
- Center for Translational Social Neuroscience, Department of Psychiatry, Emory University, Atlanta, GA, USA
| |
Collapse
|
7
|
Harris CS, Pozzar RA, Conley Y, Eicher M, Hammer MJ, Kober KM, Miaskowski C, Colomer-Lahiguera S. Big Data in Oncology Nursing Research: State of the Science. Semin Oncol Nurs 2023; 39:151428. [PMID: 37085404 DOI: 10.1016/j.soncn.2023.151428] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2023] [Accepted: 03/21/2023] [Indexed: 04/23/2023]
Abstract
OBJECTIVE To review the state of oncology nursing science as it pertains to big data. The authors aim to define and characterize big data, describe key considerations for accessing and analyzing big data, provide examples of analyses of big data in oncology nursing science, and highlight ethical considerations related to the collection and analysis of big data. DATA SOURCES Peer-reviewed articles published by investigators specializing in oncology, nursing, and related disciplines. CONCLUSION Big data is defined as data that are high in volume, velocity, and variety. To date, oncology nurse scientists have used big data to predict patient outcomes from clinician notes, identify distinct symptom phenotypes, and identify predictors of chemotherapy toxicity, among other applications. Although the emergence of big data and advances in computational methods provide new and exciting opportunities to advance oncology nursing science, several challenges are associated with accessing and using big data. Data security, research participant privacy, and the underrepresentation of minoritized individuals in big data are important concerns. IMPLICATIONS FOR NURSING PRACTICE With their unique focus on the interplay between the whole person, the environment, and health, nurses bring an indispensable perspective to the interpretation and application of big data research findings. Given the increasing ubiquity of passive data collection, all nurses should be taught the definition, characteristics, applications, and limitations of big data. Nurses who are trained in big data and advanced computational methods will be poised to contribute to guidelines and policies that preserve the rights of human research participants.
Collapse
Affiliation(s)
- Carolyn S Harris
- Postdoctoral Scholar, School of Nursing, University of Pittsburgh, Pittsburgh, Pennsylvania, USA
| | - Rachel A Pozzar
- Nurse Scientist at Phyllis F. Cantor Center for Research in Nursing and Patient Care Services, Dana-Farber Cancer Institute, Boston, Massachusetts, USA and Instructor at Harvard Medical School, Boston, Massachusetts, USA
| | - Yvette Conley
- Professor, School of Nursing, University of Pittsburgh, Pittsburgh, Pennsylvania, USA
| | - Manuela Eicher
- Associate Professor and Director of the Institute of Higher Education and Research in Healthcare (IUFRS), Faculty of Biology and Medicine, University of Lausanne, and Lausanne University Hospital, Lausanne, Switzerland
| | - Marilyn J Hammer
- Director, The Phyllis F. Cantor Center for Research in Nursing and Patient Care Services, Dana-Farber Cancer Institute, Boston, Massachusetts, USA and Lecturer at Harvard Medical School, Boston, Massachusetts, USA
| | - Kord M Kober
- Associate Professor, School of Nursing, University of California, San Francisco, California, USA
| | - Christine Miaskowski
- Professor, Schools of Medicine and Nursing, University of California, San Francisco, California, USA
| | - Sara Colomer-Lahiguera
- Senior Nurse Scientist and Junior Lecturer, Institute of Higher Education and Research in Healthcare (IUFRS), Faculty of Biology and Medicine, University of Lausanne, and Lausanne University Hospital, Lausanne, Switzerland.
| |
Collapse
|