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Nurse researchers share latest discoveries
By Deborah A. Benedetti

Dr. May Wykle
During a workshop of the Scientific Session of the Eastern Nursing Research Society, Dr. May Wykle, dean of the Frances Payne Bolton School of Nursing at Case Western Reserve University, emphasizes the importance of including older adults in research studies.
Photos by Dave Shelly—Penn State Image Resource Center





Dr. Steven Zarit
Dr. Steven Zarit, professor of human development in Penn State’s College of Health and Human Development, discusses “Research on Family Caregivers of People with Dementia: Interventions that Work” during a workshop of the Scientific Session of the Eastern Nursing Research Society.

  More than 300 nursing scholars, scientists, nursing professionals and graduate students from New England and Mid-Atlantic states met at The Penn Stater Conference Center Hotel to learn about the latest research and developments in nursing during the 14th annual Scientific Session of the Eastern Nursing Research Society.

  The theme of the 14th scientific session was “Shaping a Healthier Tomorrow through Informed Practice.” Established in 1988, the Eastern Nursing Research Society is a community of nurses interested in promoting research in the Eastern Region of the United States. There are similar nursing societies representing other regions of the country.

  Dr. Donna Havens, Elouise Ross Eberly Professor of Nursing in the School of Nursing at Penn State, and Dr. Sarah H. Gueldner, professor of nursing in the School of Nursing, co-chaired the conference. It was the first time the School of Nursing hosted the scientific session. The co-chairs enlisted the help of the school’s faculty and staff to plan the conference, with assistance from Penn State Continuing Education’s Conferences and Institutes. Other sponsors were the College of Health and Human Development, Penn State Milton S. Hershey Medical Center’s Department of Nursing and the Eastern Nursing Research Society.

  “It was an all-out effort by the School of Nursing faculty and staff,” Havens said. “The result was one of the most successful Eastern Nursing Research Society conferences in many years.”

  The conference is held at a different School of Nursing each year. Dr. Jana Pressler, assistant professor of nursing, suggested that Penn State host this year’s conference.

  “We saw hosting the conference as a wonderful opportunity to show people the Penn State School of Nursing,” Havens said. “Last year, the Rutgers University School of Nursing was the host. Yale University’s School of Nursing will host the 2003 conference. We’re in good company.”

  She added, “Good planning for a year and a half on the part of our faculty and staff paid off. We did a great job.”

  One conference event, a reception held by the president of the Eastern Nursing Research Society took place in the new Hintz Family Alumni Center. Havens said the event was well received by participants.

  The program began with preconference sessions on critical research topics involving research with older adults, electronic data collection and analysis and development of a state agenda for nursing research. The conference offered two days of scientific sessions on research methods, psychometrics, evidence-based practice, health services research and transcultural research involving infants and children, adolescents, older adults, family caregivers and people living in acute- and long-term care settings.

  Dr. Ada Sue Hinshaw, dean and professor at the University of Michigan School of Nursing and former director of the National Institute of Nursing Research, gave the keynote address.

  During a workshop on Issues in Research with Older Adults, Dr. Steven Zarit, professor of human development and assistant director of the Gerontology Center in Penn State’s College of Health and Human Development, discussed “Research on Family Caregivers of People with Dementia: Interventions that Work,” which focused on his research, as well as studies by other researchers.

  Zarit is the principal investigator for the Family Cares Study, funded by the National Institute of Mental Health. His colleagues on the project are co-principal investigators Rick Greene, New Jersey Department of Health and Senior Services, and Mary Ann Parris Stephens, Kent State University, and project manager Elia Femia.

  “This study examines the benefits and drawbacks of adult day care for people with Alzheimer’s disease and other dementing illnesses and their family caregivers,” Zarit said. “The focus is on how disruptive behavior might change as a result of involvement in structured day activity programs, and the implications of those changes for the primary family caregiver. Caregiving is one of the most uniquely stressful events. This is particularly true for caregivers of patients with dementia. Chronic caregiving can have adverse affects on the health of the caregivers.”

  Zarit said 40 to 70 percent of caregivers report they are depressed. Caregivers also suffer increased death rates.

  “There is shockingly little research on interventions to help caregivers,” he noted. “Most caregivers do not get help in a timely way. We can’t change disease, but we can change behavior and intervene and build support for the family member caring for a loved one. This will reduce stress for the caregiver.”

  Zarit noted, “The stresses of caregiving are severe and multidimensional. There are promising interventions that have gone unevaluated. Progress will depend on a partnership of researchers and providers.”

  He and his colleagues learned in an earlier study they conducted in the 1980s that there are potentially modifiable aspects of the stress process. They worked with families to help them understand patients’ behaviors, identify triggering events and learn to generate strategies to disrupt the process.

  In a recent study conducted in conjunction with the New Jersey Department of Health and Senior Services and Kent State University, the researchers have found that caregivers who use adult day care regularly (at least two days a week for five to six hours at a time) experienced decreased feelings of overload and strain. Caregivers’ depression and anger also decreased, but there was no change in their feelings of being trapped.

  In addition, the research suggested that day care helped Alzheimer’s patients, making them less agitated and easier to handle. Patients slept better at night and functioned better mentally. They looked forward to returning to day care.

  “We are following up these findings more systematically in our new study,” Zarit said.

  In a presentation about research on older adults, Dr. May Wykle, dean and professor at the Frances Payne Bolton School of Nursing at Case Western Reserve University, emphasized the importance of encouraging older adults, especially minority elders, to participate in research studies.

  “Older adults have unique and specific needs that should be investigated,” Wykle said. “We’re seeing calls for this, and nurse researchers can make a difference in the quality of life of older adults by doing these studies. It’s critical that we add new knowledge to gerontology to improve practice.”

  Why are older adults not included in research?

  Among the reasons Wykle cited are that some researchers believe older adults are too much trouble, take more time, that it is difficult to get their informed consent, and researchers are not socialized to include elders. Other reasons include: older adults do not like to sign forms, family members sometimes stop their elders from participating in research, and researchers conducting longitudinal studies fear older adults might die before the research is completed.

  She dismissed these concerns as manageable and encouraged nurse researchers to focus their research on older adults, especially minority elders, because so little research has been done on these populations.

  “We are seeing an increase in chronic illnesses in older adults because of the increase in longevity,” Wykle said. “It takes years for research findings to get from the lab to the field, so we need to be doing more research now to improve the quality of health for older adults in the future.”

  Wykle outlined the steps involved in obtaining informed consent from research participants and emphasized how critical it is to follow mandated guidelines for research, which protect human subjects from harm.

  Havens pointed to these presentations as examples of the high caliber of research shared during the conference.

  “It was a very scholarly three-day conference,” Havens said. “There were excellent research presentations by renowned researchers from throughout the northeast.”

An outreach program of the Penn State School of Nursing, College of Health and Human Development, Penn State Milton S. Hershey Medical Center Department of Nursing, Eastern Nursing Research Society and Continuing Education’s Conferences and Institutes

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