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This study examined the association of experienced personal control and quality of life for late-stage cancer patients within the context of Rotter's Social Learning Theory and Seligman's Theory of Learned Helplessness. It... more
This study examined the association of experienced personal control and quality of life for late-stage cancer patients within the context of Rotter's Social Learning Theory and Seligman's Theory of Learned Helplessness. It was hypothesized that in late-stage cancer patients greater control would be associated with a higher quality of life as measured by self-esteem, anxiety, and perceived self-esteem, anxiety, and perceived meaningfulness. The longer the history of the disease, the lower would be the individual's level of experienced personal control and quality of life. Fifty-seven late-stage cancer patients completed four standardized instruments: the Rosenberg Self-Esteem Scale; the Health Locus of Control Scale (HLC); the Lewis, Firsich, and Parsell Attorney Scale; and the Crumbaugh Purpose-in-Life Test. As predicted, the measure of experienced personal control over life significantly correlated with scores on the self-esteem scale (tau = -.33; p = .001), and the anxiety scale (tau = -.30; p = .001). Contrary to prediction, scores on the Health Locus of Control Scale were only significantly associated with scores on the Purpose-In-Life Test (tau = -.18; p = .05). Length of history of disease was significantly related to scores on the HLC Scale (tau = .27; p = .007) and to scores on the anxiety scale (tau = .20; p = .03) but was not significantly associated with scores on the self-esteem scale or the Purpose-In-Life Test.
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Abstract : The purpose of the current study is to elaborate the beliefs and culturally embedded meanings that a population of low income, uninsured African American women held toward breast cancer and breast cancer screening. During Year... more
Abstract : The purpose of the current study is to elaborate the beliefs and culturally embedded meanings that a population of low income, uninsured African American women held toward breast cancer and breast cancer screening. During Year 02, we conducted technical analyses of completed Phase 1 interviews that were obtained from African American women who were eligible to receive, but who chose to decline, free screening mammograms. Results obtained to date suggest that screening mammograms are physically and emotionally difficult experiences for the women, not neutral procedures for detecting early disease. Women equate mammograms with disease, not with merely early detection. For some, mammograms cause disease and put them at higher risk because of radiation exposure. Early diagnosis and treatment for many do not equate with cure, but with inevitable disease progression. Risk factors for breast cancer were not well understood and some women generated a unique set of risk factors that have no prior evidence in research literature, e.g., having large breasts. Having breast cancer means losses, deformity, remaining single, altered sexual behavior with a partner, and burdening one's family. There is little evidence of hope for cure in the interview data nor for surviving the diagnosis of breast cancer, even when detected early. Results to date have substantial implication for developing new outreach and educational messages.
Research Interests: Radiation, Behavior, Sex, Breast Cancer, Risk, and 9 moreQualitative Research, Health, Medicine, Interviewing, Population, Insurance, Data Bases, Income, and Low Income
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Although smoking prevalence in the United States has declined markedly in recent years, prevalence among blue-collar workers remains high and few successful methods of reaching this group have been identified. The present study was... more
Although smoking prevalence in the United States has declined markedly in recent years, prevalence among blue-collar workers remains high and few successful methods of reaching this group have been identified. The present study was designed to test the relative efficacy of two different approaches to telephone smoking-cessation counseling for blue-collar workers. Our study built on the experience of the National Cancer Institute's Cancer Information Service (CIS) and compared the past CIS smoking-cessation counseling procedure and a modified version of the present procedure. In our trial, callers to a special telephone hotline who asked for information on smoking cessation were randomly assigned to receive counseling under one of two protocols: 1) the past CIS procedure, in which general information was given and cessation materials were sent to the callers, and 2) a version of the present CIS stage-model procedure, adapted by us for use with blue-collar workers, in which callers were given counseling specific to their stage in the smoking-cessation process. The general-information group contained 185 subjects; the stage-model group contained 197. Despite extensive efforts in the present study, it was not possible to recruit the number of blue-collar workers planned for our statistical analysis. Consequently, of a total of 382 subjects recruited, 93 (24.3%) were blue-collar workers, 181 (47.4%) were white-collar workers, and 108 (28.3%) were retired persons who worked part time, student workers, or the unemployed. Our results show no statistically significant differences in either short-term or long-term nonsmoking rates between the general-information group and the stage-model group.(ABSTRACT TRUNCATED AT 250 WORDS)
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ancer affects not just those who have the disease but also their caregivers and families. Very few studies have examined the effects of long-term cancer survivorship on the family. Most studies that have addressed this topic have focused... more
ancer affects not just those who have the disease but also their caregivers and families. Very few studies have examined the effects of long-term cancer survivorship on the family. Most studies that have addressed this topic have focused on breast cancer survivors and are limited to three years after diagnosis. This article will examine the strengths and limitations of the current literature on families and cancer survivorship and suggest directions for future research that is needed in this field. Family is defined broadly, to include biological or blended families and oppositeand same-sex partnerships with or without children. Studies of children diagnosed with cancer are excluded because this topic constitutes a separate body of literature and deserves its own analysis.
Research Interests: Nursing, Cancer, Family, Quality of life, Social Support, and 15 moreCancer Survivorship, Medicine, Nursing Research, Humans, Survivors, Cancer Nursing, Oncology Nursing, Caregivers, Family Relations, Family Health, Public health systems and services research, Neoplasms, Nursing Assessment, Cost of Illness, and attitude to health
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Brain electrical activity as a tool for studying drugs of abuse, Scott E.Lukas multiple drug abuse patterns - recent trends and associated medical consequences, Mary Jeanne Kreek marijuana and other drug effects on reproductive hormones... more
Brain electrical activity as a tool for studying drugs of abuse, Scott E.Lukas multiple drug abuse patterns - recent trends and associated medical consequences, Mary Jeanne Kreek marijuana and other drug effects on reproductive hormones in the primate, Carol Grace Smith discriminative stimulus profiles of psycho-active drugs, Alice M.Young second-order schedules of drug injection - implications for understanding reinforcing effects of abused drugs, Jonathan L.Katz and Stephen R.Goldberg applications of causal models to the study of antecedents and consequences of adolescent and adult drug use, G.J.Huba and P.M.Bentler.
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PURPOSE/OBJECTIVES To describe mothers' reported methods of interacting with the mothers' school-age children about their breast cancer. DESIGN Qualitative. SETTING/SAMPLE 19 mothers newly diagnosed with breast cancer. Mothers... more
PURPOSE/OBJECTIVES To describe mothers' reported methods of interacting with the mothers' school-age children about their breast cancer. DESIGN Qualitative. SETTING/SAMPLE 19 mothers newly diagnosed with breast cancer. Mothers received treatment for their illness in the Pacific Northwest. Mothers had at least one child between 7 and 12 years old at the time of diagnosis. METHODS Case-intensive, in-home, semistructured interviews were audiotaped, transcribed, and inductively coded into four conceptual domains and 16 categories of behavioral strategies used by the mothers to interact with their children about the breast cancer. MAIN RESEARCH VARIABLES Behavioral strategies used by mothers when interacting with the children about the breast cancer and when providing children with support. FINDINGS Mothers used a number of methods to bring children into the mothers' breast cancer experience. The conceptual domains included talking about the breast cancer, explaining treatmen...
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ObjectivesThe objective of this study was to describe in the words of child-rearing parents with incurable cancer, what they had gained or thought about as a result of participating in a five-session, scripted, telephone-delivered... more
ObjectivesThe objective of this study was to describe in the words of child-rearing parents with incurable cancer, what they had gained or thought about as a result of participating in a five-session, scripted, telephone-delivered psycho-educational parenting intervention, the Enhancing Connections Program in Palliative Care.MethodsA total of 26 parents completed the program. Parents’ responses were audio-recorded and transcribed verbatim and verified for accuracy. The analysis proceeded through four steps: unitizing, coding into categories, defining categories, and formation of a core construct that explained parents’ attributed gains. Trustworthiness of study results was protected by coding to consensus, formal peer debriefing, and maintaining an audit trail.ResultsAlthough 50% reached or exceeded clinical cutoff scores on anxiety and 42% reached or exceeded clinical cutoff scores on depressed mood, parents extensively elaborated what they gained. Results revealed six categories o...
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To operationalize a professional educational counseling model for nurses that derives from the client's frame of reference and adds to the client's behavioral management of the impact of cancer, including self-care skills and... more
To operationalize a professional educational counseling model for nurses that derives from the client's frame of reference and adds to the client's behavioral management of the impact of cancer, including self-care skills and cognitive control. Published literature and four years of clinical experience with 84 couples in which coaching behavior was applied in home-based intervention sessions. Nurse coaching behavior includes six dimensions. Attending to the Story, Encircling the Experience, inviting the Work, Exploring Solutions, Anchoring the Skill, and Setting Up Success. Nurse coaching behavior is designed to facilitate the cognitive emotional processing of the cancer experience and to add to the patient and family member's repertoire of behavioral self-care and self-management skills. Future research is needed to evaluate the processes and outcomes of nurse coaching behavior when working with patients and family members experiencing cancer. Nurse coaching provides a ...
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Although there are significant numbers of single women with breast cancer who are rearing children, there is no known study of their own or their school-aged children's adjustment to the illness. The purposes of this study are: 1) to... more
Although there are significant numbers of single women with breast cancer who are rearing children, there is no known study of their own or their school-aged children's adjustment to the illness. The purposes of this study are: 1) to describe the adjustment of single women to early stage breast cancer; 2) to contrast their responses to a comparable sample of married/partnered women; 3) and to document the psychosocial functioning of school-aged children when their single mother has breast cancer. Results obtained from questionnaire data from 22 single and 101 married/partnered women revealed that single women had significantly higher rates of depression; reported significantly higher numbers of illness-related pressures on their family; had a significantly higher proportion of young children scoring in the abnormal range on measures of self-worth and social acceptance; and reported lower quality in parenting their children. Interviews with single women revealed that many were bu...
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Closing the chasm between family theory, nursing practice, and family research requires design and methods that foster the study of families as dynamic, holistic entities. This article has outlined several strategies for capturing... more
Closing the chasm between family theory, nursing practice, and family research requires design and methods that foster the study of families as dynamic, holistic entities. This article has outlined several strategies for capturing morphostasis and morphogenesis and for studying the family as a unit of analysis.
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To describe spouse caregivers’ perceived gains in their own words from participating in a fully manualized 5-session educational counseling program whose goals were to enhance their self-care and skills to interpersonally support their... more
To describe spouse caregivers’ perceived gains in their own words from participating in a fully manualized 5-session educational counseling program whose goals were to enhance their self-care and skills to interpersonally support their wife with breast cancer. Interviews from 81 spouses obtained 7 months after exiting from a fully manualized educational counseling program, Helping Her Heal, were content analyzed using inductive coding methods adapted from grounded theory. Trustworthiness of study results was protected by coding to consensus, formal peer debriefing, and maintaining an audit trail. Analysis yielded 3 conceptual domains: Giving Me Structure; Adding Skills to Help Her and Us; and Gaining Insights into Myself and My Wife, all of which reflected practical things on which spouses could take action and ways they could take care of themselves, support their wife, and from which they gained insight into their own and their wife’s response to the breast cancer. Findings suggest that short-term, fully manualized counseling programs can provide opportunities and practical ways spouse caregivers are able to gain interpersonal communication, self-care skills, and personal insights. This scripted model of counseling is a way in which to deliver educational counseling with self-reported benefits, even though the program is fully scripted and not uniquely fashioned for each caregiver’s unique experience. NCI-2013-01838.
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Research Interests: Health Psychology, Education, Clinical Trial, Breast Cancer, Medicine, and 15 moreHumans, Female, Male, Psychological Intervention, Statistical Power, Aged, Middle Aged, Adult, Intervention study, Resource Availability, Outcome measure, Breast Neoplasms, Psychology and Cognitive Sciences, Medical and Health Sciences, and Spouses
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A commitment to quality assurance means offering a cycle of feedback to those being evaluated. How to meet that commitment was the question asked by the Health Education Department of a large Health Maintenance Organization whose more... more
A commitment to quality assurance means offering a cycle of feedback to those being evaluated. How to meet that commitment was the question asked by the Health Education Department of a large Health Maintenance Organization whose more than 70 facilitators annually provide instruction for over 3,000 enrollees. As part of the multi-faceted endeavor to develop a systematic quality assurance program for the department's offerings, a reliable participant-scored standardized tool had to be constructed. The staff of the department first identified two concepts as critical for quality instruction: interpersonal skills and technical competence. Based on these criteria a 49-item questionnaire was developed and tested during "pre-pilot" and pilot stages. By computer analysis, 27 items with an alpha-reliability coefficient of .94 remained to form the tool the department uses. The development of the evaluation tool and its use are described.
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Purpose:United States Hispanics are more likely to be diagnosed with advanced cancer as parents than their non-Hispanic white counterparts but little is known about Hispanic parents’ willingness to discuss a terminal cancer diagnosis with... more
Purpose:United States Hispanics are more likely to be diagnosed with advanced cancer as parents than their non-Hispanic white counterparts but little is known about Hispanic parents’ willingness to discuss a terminal cancer diagnosis with dependent children, potentially resulting in suboptimal child coping. Therefore, we investigated Hispanic mothers’ willingness to communicate with dependent children about her actual or hypothetical advanced cancer diagnosis.Methods:Two focus groups (n = 6 participants) and three, one-on-one interviews (n=3), were conducted among adult, Mexican-American mothers with a current cancer diagnosis of any stage residing in U.S.-Mexico border communities. Participants reported their perceived concerns, parenting challenges and openness to discussing an incurable cancer diagnosis with a dependent child. Audio files were transcribed into English and qualitatively coded using content analysis.Results:Participants, most with breast cancer, ranged in age from 25–47. Five had considered the possibility of their own death from advanced cancer and three had previously discussed this with their children. While many expected their children would carry on well without them, seven expressed concern for the emotional/spiritual well-being of their children. Mothers anticipated physical and time-based parenting challenges but wanted the opportunity to focus on themselves and their children in advance of death. All but one would be willing to discuss an advance cancer diagnosis with dependent children; four expressed the value of doing so or the potential harm of abdicating this responsibility.Conclusions:If faced with an advanced cancer diagnosis, Mexican-American mothers are open to communicating with dependent children.
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OBJECTIVES This exploratory study (a) examined pre-existing and peri-trauma risk factors of parental stress during a child's PICU hospitalisation using the Integrative Trajectory Model of Paediatric Medical Traumatic Stress and (b)... more
OBJECTIVES This exploratory study (a) examined pre-existing and peri-trauma risk factors of parental stress during a child's PICU hospitalisation using the Integrative Trajectory Model of Paediatric Medical Traumatic Stress and (b) identified the type of PICU-related stressors that predicted parental stress during the child's PICU hospitalisation. METHODS A cross-sectional, descriptive correlational design with 81 parents of children admitted 48 or more hours to a Paediatric Intensive Care Unit (PICU). Questionnaires measured parent's and child's demographic and clinical characteristics and parent-reported stressors using the Parental Stressors Scale (PSS:PICU). Analysis included descriptive statistics and multiple linear regression analyses with simultaneous predictor entry. RESULTS Male parents tended to be significantly more stressed than female parents. Parental stress was significantly increased when parents had one or more stressful life events one-month prior to PICU admission, when the child required ventilatory support, or the child had a cardiovascular diagnosis. Parental stress was also predicted by the child's appearance, procedures, child's behaviour, behaviour of staff, and parental role. CONCLUSION Nurses are in a prime position to identify parents at potentially high risk for psychological morbidity when they know a parent has had a stressful life event prior to admission, has a child with a cardiovascular diagnosis or requires ventilatory assistance. Nurses can diminish parental stress by interpreting the child's appearance for parents, helping parents understand the procedures being done for the child, interpreting the child's behaviour, explaining the staff's behaviour, and assisting parents to define their parental role during the child's hospitalisation.
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Research Interests: Perception, Social Perception, Medicine, Breastfeeding, Self Efficacy, and 15 moreHumans, Female, Infant, Mothers, Newborn Infant, Adult, Breast feeding, Crying, Human Milk, Guidance and Counseling Intervention Programs, Pilot Projects, postpartum period, breastfeeding promotion, discontinuation, and Medical and Health Sciences
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Semislructured interviews were conducted with 26 mothers who had one or more children(N = 36) aged 8 to 12 years when they were diagnosed with early stage breast cancer. Formal methods were used to analyze the content of the data... more
Semislructured interviews were conducted with 26 mothers who had one or more children(N = 36) aged 8 to 12 years when they were diagnosed with early stage breast cancer. Formal methods were used to analyze the content of the data inductively. Mothers identified times during their diagnosis and treatment that were most difficult for their children, behaviors they observed indicating
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Abstract This study investigated the effects of parental functioning on adolescent adjustment during the acute phase of treatment for mothers diagnosed with breast cancer. Data from self-and parent-report questionnaires were obtained in... more
Abstract This study investigated the effects of parental functioning on adolescent adjustment during the acute phase of treatment for mothers diagnosed with breast cancer. Data from self-and parent-report questionnaires were obtained in the homes of 87 adolescents and 174 parents within six months of the mother's diagnosis. Associations between adolescent adjustment (self-esteem, behavioral problems, anxiety) and parental functioning (depressed mood, parenting quality, and marital adjustment) were examined when neither, one, or both parents were functioning at compromised levels. When both parents had depressed mood, adolescents tended to show increased behavioral problems; maternal depressed mood was the main source of influence. When the quality of the parenting relationship between the adolescent and both parents was poor, adolescents showed significantly lowered self-esteem and increased anxiety. Marital adjustment did not affect adolescent functioning significantly. Maternal depressed mood and the quality of the parent-child relationship significantly influenced adolescent adjustment during the acute phase of the mother's breast cancer.
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The ICD is a common therapy for treatment of ventricular arrhythmias and prevention of sudden cardiac death. After ICD therapy, 50% of survivors are known to have significantly elevated anxiety, depression, anger, and fear in getting back... more
The ICD is a common therapy for treatment of ventricular arrhythmias and prevention of sudden cardiac death. After ICD therapy, 50% of survivors are known to have significantly elevated anxiety, depression, anger, and fear in getting back to normal physical activities. Despite these problems, few interventions to improve adjustment have been rigorously evaluated within a clinical trial format. This article reports the short-term efficacy of a structured weekly educational telephone intervention (8 weeks) delivered by expert cardiovascular nurses to recipients of an ICD. To test these effects, a two-group (n = 84/group) randomized clinical trial design was used with measures at baseline (hospital discharge), 1 month, and 3 months after ICD therapy. The study sample were first time ICD recipients for secondary prevention of sudden cardiac arrest. Primary outcomes included (1) physical functioning (Patient Concerns Assessment [PCA], Short-Form Health Survey [SF-12], ICD shocks), (2) psychological adjustment (State-Trait Anxiety Inventory [STAI]), Centers for Epidemiologic Studies-Depression (CES-D), (3) knowledge (Sudden Cardiac Arrest [SCA] knowledge assessment), and (4) health care use (emergency room visits, outpatient visits, hospitalizations). The intervention group, as compared to the control group, significantly reduced mean PCA symptoms at 1 month (11.3-8.8 vs 9.7-9.3, respectively, P < 0.02), and reduced state anxiety (36.1-31.9 vs 33.1-33.0, respectively, P < 0.08), and enhanced knowledge (21.8-22.4 vs 21.4-21.7, respectively, P < 0.02) at 3 months. The intervention did not significantly impact short-term health care use. A structured telephone intervention delivered during the first 8 weeks after ICD therapy by expert cardiovascular nurses decreased ICD related physical symptoms and anxiety, and increased SCA knowledge over 3 months.
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... concept of design and description measured data of patients Fear of patient dying Lewis, Demands of ... was the most frequently cited problem for both the patient and her mate in both ... Over 52 of themates experiencing both early... more
... concept of design and description measured data of patients Fear of patient dying Lewis, Demands of ... was the most frequently cited problem for both the patient and her mate in both ... Over 52 of themates experiencing both early and advanced cancer in their spouse were fearful ...
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While previous research has studied the impact of chronic illness on the patient or spouse, the impact on the marriage, the child, the parent-child relationship, and the family's functioning have been relatively ignored. To date... more
While previous research has studied the impact of chronic illness on the patient or spouse, the impact on the marriage, the child, the parent-child relationship, and the family's functioning have been relatively ignored. To date ther is no known study of the impact of a mother's chronic illness on the family. The purpose of the current exploratory study was to test a set of interrelated hypotheses about family functioning with the mother's chronic illness from the spouse's perspective based on a family systems perspective. Data were obtained from standardized questionnaires from 48 fathers with young school-age children whose wife had either breast cancer, diabetes, or fibrocystic breast disease. Results of a path analysis revealed that the number of illness demands the father experienced was a significant predictor of his level of depression. More demands resulted in higher depression scores. Marital adjustment was significantly affected by both the father's level of depression as well as by his wife's type of disease. Spouses of women with breast cancer had significantly higher levels of marital adjustment than did partners of the other women. More depressed spouses had lower levels of marital adjustment. Both illness demands and level of marital adjustment significantly predicted the type of coping behavior the family used. More frequent illness demands and higher levels of marital adjustment were associated with familial introspection, that is, coping behavior characterized by frequent feedback, reflection, and discussion in the family. The quality of the father-child relationship was significantly affected by this type of coping behavior. Families characterized as introspective had fathers who reported more frequent interchange with their children.(ABSTRACT TRUNCATED AT 250 WORDS)
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Cancer survivorship research has largely focused on non-Latino white participants, with fewer studies exploring survivorship in multi-ethnic groups. The goal of this study was to explore the experiences of Latina mothers living with... more
Cancer survivorship research has largely focused on non-Latino white participants, with fewer studies exploring survivorship in multi-ethnic groups. The goal of this study was to explore the experiences of Latina mothers living with cancer in the southwest U.S.-Mexico border region. Diagnosed mothers were asked to describe their (i) challenges to coping with cancer, (ii) facilitators to coping with cancer, and (iii) types and sources of social support for coping with their cancer. Nine Latina mothers, most of whom reported non-localized cancer diagnoses, participated in focus groups or individual interviews in a pilot study. We conducted a secondary analysis of the verbatim transcripts using inductive content analysis adapted from a grounded theory framework. Coding to consensus, systematic peer debriefing, and maintaining an audit trail protected trustworthiness of study results. The core construct Not letting the cancer take any more than it had from me, is grounded in three domains reflecting their challenging position as Latina mothers under the age of 50 living with various types and stages of cancer in a resource-challenged border region. The first domain, Having the most difficult time of my life, was composed of three categories that covered their struggles with cancer treatment (i.e. feeling like treatment is worse than the disease, being scared to look in the mirror, and feeling very alone). The second domain, Figuring out how to live day-by-day, was composed of two categories that captured the impact of cancer on their homes and their need for instrumental support (i.e. being especially challenging on my family and home life and needing other things). The last domain, Giving me the strength to fight and carry on, was composed of the remaining six categories that revealed how the mothers garnered all the resources available to them to physically and mentally overcome the stress of cancer and its treatment (getting support and compassion from medical staff, friends, family, their children, and other cancer patients; trusting God; and not letting the cancer stop them). Latina mothers under the age of 50 living with diverse cancer types and stages on the U.S.-Mexico border described the complexity of factors influencing their survivorship experience and the strategies they used to move forward. Results highlighted the importance of assessing cancer survivorship experiences across cancer types, age groups, regions, and diverse racial/ethnic groups. These findings can be used to develop targeted approaches to improve the quality of survivorship among Latinas. Citation Format: Clara Reyes, Rebecca Palacios, Karoline Sondgeroth, Frances Lewis. Not letting the cancer take any more than it had from me: Latina mothers surviving cancer in the Paso del Norte border region [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2019; 2019 Mar 29-Apr 3; Atlanta, GA. Philadelphia (PA): AACR; Cancer Res 2019;79(13 Suppl):Abstract nr 3350.
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Military personnel, first responders and health professionals on the front line of service are at risk of being exposed to non-mutable traumatic events. However, their professional education and training do not typically include ways to... more
Military personnel, first responders and health professionals on the front line of service are at risk of being exposed to non-mutable traumatic events. However, their professional education and training do not typically include ways to minimise their distress caused by witnessing a future trauma. The purpose of this scoping systematic review is to analyse the impact of intervention studies on measures of psychobehavioural adjustment to exposure to a future traumatic event. A systematic search was conducted using PubMed, CINAHL, PsycINFO and the Cochrane Library plus a hand search of five journals, including Military Medicine and Journal of Trauma. A total of 100 articles from an initial pool of 15 306 were assessed for inclusion on criteria and 10 manuscripts meeting the inclusion criteria were evaluated. Interventions focused on combating stress, relaxation techniques, resilience training, psychological skills training, preventing psychological morbidity or post-traumatic stress disorder, and stress management skills. Only 50% of the interventions significantly changed any outcomes. Studies had multiple methodological limitations including a limited number of training hours, trial bias, statistically underpowered designs, short follow-up periods and using inconsistent methods and measures to assessed impact. The paucity of preparatory intervention studies shows there is an urgent need for future research.
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OBJECTIVES The concept analysis of environmental enrichment aims to clarify the meaning of the term contributing to a shared understanding of its use in healthcare and future research studies. Environmental enrichment has implications in... more
OBJECTIVES The concept analysis of environmental enrichment aims to clarify the meaning of the term contributing to a shared understanding of its use in healthcare and future research studies. Environmental enrichment has implications in health promotion in children's development and healthy aging in the general population. METHODS A literature search using PubMed and CINAHL databases on environmental enrichment was conducted to identify the uses of the term from various disciplines. The keywords are "environmental enrichment", "socialization", "physical activity", "cognitive stimulation", and "experience-dependent". Human studies from 2000 to 2020 were included in the search. RESULTS Availability of green spaces, neighborhood safety, walkability to community centers, and accessibility of community resources are antecedents of environmental enrichment. Defining attributes are positive stimulation, interpersonal interaction, and physical engagement. The consequences of environmental enrichment are improved cognitive functioning in children, decline in memory impairment, and reduced risk of developing dementia in the elderly. CONCLUSION Engaging and counseling patients, family members, and the community in adverse effects of a deprived environment and the benefits of an enriched environment is a vital tenet of the nursing discipline. Understanding the optimum amount of positive stimulation, interpersonal interaction duration, and frequency are needed in future research.