No abstract

Purpose The purpose of this pilot study was to evaluate a culturally tailored intervention for rural African Americans. Social Cognitive Theory provided the framework for the study. Methods Twenty-two participants were recruited and randomly assigned to either Group or Individual diabetes self-management (DSME). Group DSME included storytelling, hands-on activities, and problem-solving exercises. Individual DSME sessions focused on goal-setting and problem-solving strategies. Sessions were offered in an accessible community center over a 10-week period. Results Outcomes included glycosylated hemoglobin (A1C), self-care actions, self-efficacy level, goal attainment, and satisfaction with DSME. Participants in both Group and Individual DSME improved slightly over the 3-month period in self-care activities, A1C level, and goal attainment. Although differences were not statistically significant, trends indicate improved scores on dietary actions, foot care, goal attainment, and empowerment for those experiencing Group DSME. Conclusions The culturally tailored approach was well received by all participants. Improvements among those receiving Individual DSME may indicate that brief sessions using a culturally tailored approach could enhance self-care and glycemic control. Additional testing among more participants over a longer time period is recommended.

No abstract

This paper is concerned with the phenomenon of human suffering and is an attempt to justify and begin theoretical development of this phenomenon for nursing science. The paper is divided into three sections. The first section describes the interest of nursing science in the phenomenon and critically examines relevant literature in order to further conceptualize development and clarification. This section concludes with a theoretical definition of suffering derived from this critique. Suffering is defined as an individual's experience of threat to self and is a meaning given to events such as pain or loss. The second section elaborates on this definition and examines how it can inform theoretical discussion in two areas with import for nursing--the patient's experience of suffering and the nurse's experience of patient suffering. The final section briefly considers some implications for clinical research.

No abstract

The findings cannot be generalized to long-term care facilities across the US or to other countries, but they enhance understanding about some of the ways transfer decisions occur and the role of nurses in those transfers, especially when conflict arises.

Prostate cancer affects African Americans at a higher rate than any other ethnic group in the United States. Prostate cancer does not only affect the man with the disease but also affects those individuals who are closest to him, such as his family and friends. Open communication is valuable in coping with stressors that are affiliated with chronic illnesses. This article focuses on family and friend social support of men with prostate cancer. Data analysis revealed that support from family members and friends plays an important role in how men cope with their treatment and recovery from prostate cancer. KeywordsAfrican American men; family support; prostate cancer; survivorship Prostate Cancer is the most commonly diagnosed cancer in men and is the second leading cause of cancer deaths among men in the United States, following lung cancer. The American Cancer Society 1 estimated that in 2007, there would be approximately 219,000 newly diagnosed cases of prostate cancer and nearly 28,000 men would die from prostate cancer.Prostate cancer disproportionately affects African American (AA) men. They have the highest incidence of prostate cancer, at 255.5 cases per 100,000 in comparison with 161.4 cases per 100,000 Caucasian men and 140.8 cases per 100,000 Hispanic men. 2 The incidence rate peaked in AA men in 1993 and has been declining, but the reasons for the higher incidence rate among AA men in comparison with Caucasian and Hispanic males is unclear. Prostate cancer affects not only the man with the disease but also his entire family. Family relationships play an important part in how men with prostate cancer cope with the disease and decide on treatment issues. Mellon and Northouse 4 found a 63% decline in overall family quality of life after a family member had been given a cancer diagnosis. Cancer diagnosis and treatment-related issues such as fatigue, pain, hopelessness, financial concerns, and grief affect the family unit. Several studies 5,6 have reported correlations between the psychosocial adjustment of patients with cancer and that of their spouse or close family member. Boehmer and Clark 7 found among married men with metastatic prostate cancer that although the wives of these men were very concerned about their husbands' disease, there was little communication about the cancer, treatment options, and the emotions associated with having a diagnosis of cancer. This lack of communication may weaken coping mechanisms and decrease the resources available to men. Enhanced support, communication, and guidance from family and friends about difficult issues, such as sexual activity and fatigue, may play an important part in the lives of AA men with prostate cancer.Family support and function have been found to be critical in how the patient and his family members are affected by chronic disease. Kiley et al 8 found that among individuals who had kidney transplants, those individuals who had reduced family support had a higher risk for nonadherence to therapy, which might lead to a poorer prognosis tha...

Prostate cancer is the most commonly diagnosed cancer in men in the U.S. and affects African Americans disproportionately when compared to other ethnic groups. There are unclear reasons for this disparity, but several factors may include race, nutrition, family history of cancer, and screening. With early detection of prostate cancer, survival is much better; thus screening may be helpful, especially for high-risk individuals. Prostate cancer screening continues to be controversial. A paucity of data exist on what prostate cancer screening means to African Americans, particularly in rural areas, and how they make the decision to undergo prostate cancer screening or not. This study interviewed 17 African American men to explore how and when they decided about prostate cancer screening.The majority of the men (n = 9) said that they had prostate cancer screening. Three themes emerged from the data: 1) these men had information on prostate cancer; 2) family and friends played an important role in the men's decision-making process; and 3) for screening, it was necessary for the men to have a trusting relationship with their healthcare provider.These findings confirm that the decision-making process is not a simple process. The study's results can help healthcare providers understand some of the important decision-making factors in prostate cancer screening for African American men.