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Research Profile: Ruth
McCaffrey, DNP |
In this issue, we thank Dr. Ruth McCaffrey, DNP,
Sharon B. Raddock Distinguished Professor in Holistic
Nursing at Florida Atlantic University, for sharing with
us her recent research on the
effect of garden walking on elders with depression
and her experiences as a holistic nurse researcher.
 How
have you come to study garden walking for older adults
with depression?
I have been working over the last three years on
developing an evidence-based program using reflection
during garden walking to increase life satisfaction and
reduce depression. The work began as collaboration
between the Morikami Japanese Museum and Gardens and
myself. The Morikami has had many people write letters
and tell them that the gardens had a healing quality and
helped them in a time of great sadness or in a time when
strength was needed. The garden designer has created
several gardens in the Japanese healing traditions and
uses the idea of nine healing elements in nature. We
were able to apply for and receive a grant from the
Institute for Museum and Library Services to create a
research study with three different
interventions, individual reflective walking, guided
imagery walking and a comparison group who had art
therapy. From that work we developed a book for use in
an individual reflective walking program through the
garden with a group session at the beginning of the
walks, after three weeks and again after six weeks. This
program has proved to be very successful and popular. We
have just received a grant from the Astellas
Pharmaceutical Company to pay for 30 groups to
participate in the reflective walking. These groups
would consist of caregivers, those in support groups and
professional care givers such as nurses, physicians,
teachers etc. We plan to hold an international
conference at the Morikami to share findings from our
work with other gardens around the country.
 What
is it like to be studying this topic?
Studying this topic has been a great pleasure. Not only
have I been able to work to create a beautiful and
meaningful program but also I have met so many wonderful
individuals who have completed the walks. To hear the
stories of people that feel the program changed their
lives and provided them with a new outlook on life has
been extremely gratifying.
Tell us how your work has evolved?
The current program has been on going for three years
with walking programs in the fall and spring. The
program consists of 12 themed walks that take the
participant from awareness to fulfillment. One of the
members of the board of trustees from the Morikami
participated in the walks and found that it dramatically
changed his life. He said that when he started the walks
(at age 84) he felt his life was almost over. As he
finished the walks he said he realized that there was so
much more open to him and that his life had been rich
and blessed in many ways that he could now share with
others.
What are your biggest challenges in doing
holistic nursing research?
I am very blessed to live and work in a community that
values holism and holistic care. My mentor in holistic
nursing Eleanor Schuster was one of the early Holistic
Nurses of the Year for AHNA and someone who guided not
only my growth and understanding of holistic nursing but
created a foundational acceptance of holistic nursing in
the south Florida community of nurses. Since then the
Christine E Lynn College of Nursing has had a tradition
of fostering and honoring holistic nursing in education,
practice and research. Our university has just opened a
medical school and I am honored to present a lecture to
medical students each year on holistic health as well as
complementary and alternative therapies. The biggest
challenge I have found in holistic research is to find
ways to take therapies that essentially affect the whole
person and measure the outcomes in ways that more
traditional researchers find acceptable as evidence.
What advice can you share with holistic
nurses that want to do research?
Be as creative as possible in research
design and in attempting to secure funding for large
projects. Creating partnerships for holistic research is
also very useful. There are many groups outside of
nursing who could become partners in order to show the
effects of holistic care, interventions and the
importance of outcomes of this type of research. People
are interested in ways to maintain their own health and
take charge of their well being. Many desire using
therapies and concepts based on holism and evidence
based programs that foster well being are exciting to
individuals, groups and communities.
 What
keeps you inspired to keep doing research?
The inspiration comes primarily from the wonderful
research participants and partners that come together
for the purpose of exploring and understanding holistic
therapies and becoming more enlightened about themselves
and the world in which they live.
 McCaffrey,
R. , Hanson, C., MLS, McCaffrey, W. (2010)
Garden Walking for Depression: A Research Report.
Holistic Nursing Practice, 24(5):252-259.
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Native Navigation: Tailoring Cancer Educational Modules and
Goals for Comanche Nation |
Valerie Eschiti,
PhD, RN, AHN-BC,
CHTP, CTN-A; Jana
Lauderdale, PhD, RN;
Stacey Sanford, LPN;
Leslie Weryackwe;
and Yvonne Flores
Background:
Native Americans
(NAs) in the Lawton,
Oklahoma area,
including Comanche
people, have
excessive cancer
incidence and
mortality rates.
Native Navigators
(NAs who assist
people in a NA
community by guiding
them through and
around barriers in
the complex
healthcare system)
may be an effective
intervention to
alleviate cancer
disparities. This is
a particularly
appropriate strategy
for NAs, who have a
historical mistrust
of outsiders.
Methods:
This
multidisciplinary
(nursing, public
health, and
statistics) 3-year
project, funded by
the National
Institute of Nursing
Research, employs a
community-based
participatory
approach (CBPR).
This is a
collaborative
approach to the
research process, in
which partners
equitably contribute
and share
decision-making and
ownership. CBPR is
ideal for working
with minority
populations, such as
NAs, who have
historically been
the recipients of
abuse by outside
researchers.
In this abstract,
Year 1 activities
are reported, which
focused on tailoring
and goal development
related to cancer
educational modules
to Comanche Nation
via qualitative
methodology (focus
groups). An
exploratory,
descriptive,
qualitative design
was utilized. Native
Navigators assisted
with and moderated
the focus groups.
They contributed to
data analysis and
subsequent changes
in educational
materials and goals.
Analysis
incorporated content
analysis, using the
transcribed data,
field notes and
observations. Codes,
categories, and
themes were
identified. Member
checking was
included as a means
of validation.
Results:
Five major themes
were identified: 1)
Screening =
Protection,
Knowledge = Power;
2) Waiting not
acting: Fears
associated with
screenings; 3)
Living "Native
Strong": Assessing
personal risk; 4)
Nourishing our body,
mind, and spirit;
Connecting with our
past; and 5) Keeping
learners interested:
Educational
engagement.
Conclusions:
Members of the
Comanche Nation
community need
cancer educational
modules and goals
tailored to their
culture in order to
become engaged and
maintain interest in
educational sessions
so that realistic,
achievable
goal-setting is
experienced.
Years 2 and 3 will
focus on
goal-setting
measurement, based
on principles of
Goal Attainment
Scaling (GAS) to be
implemented with NA
participants in
community cancer
education workshops
presented by Native
Navigators, as a
means of assisting
NAs to make progress
towards achieving
behavior change.
Cancer-related
knowledge will be
assessed pre-and
post-workshop.
 We
asked Dr. Eschiti
some questions that
focus on her
experience of being
a holistic nurse
researcher:.
How did you
go about finding a
granting agency?
There are a number
of ways to find out
about funding
opportunities,
whether for small or
large amounts. In
the case of this
particular project,
a request for
applications was
released by the NIH
for funds available
through the stimulus
program.
What was it
like to actually
"do" the study?
We are still in the
process of
conducting the
study; we have about
1.5 years left in
the 3-year project.
As a member of AHNA
since 1989, all the
ways I learned to
relax and stay
centered have really
come in handy! I
have an assortment
of aromatherapy at
my computer, and
often listen to
relaxing music when
I am writing up
project reports and
analyzing data.
I have switched
mental gears from
"I" to "We." Because
we have a team
approach involving
Comanche tribal
members as staff, as
well as an Advisory
Board, I cannot make
decisions on my own.
I need to consult
the rest of the
team. This has been
a paradigm shift for
me. It is "our"
project, not "my"
project.
We are fortunate to
have consultants to
assist us. Jana
Lauderdale, PhD, RN,
is a Comanche tribal
member who serves as
Assistant Dean for
Cultural
Diversity at
Vanderbilt
University School of
Nursing. She has
provided assistance
with qualitative
analysis and
feedback regarding
Comanche cultural
issues. Linda
Burhansstipanov, MSPH,
DrPH, President of
Native American
Cancer Research,
Inc., has provided
informative training
regarding Native
Navigation and
cancer for the
research team.
Research is
incredibly difficult
work, especially
when there is are
added layers of
tribal permissions
and cultural
differences. I often
quote a former AHNA
member and mentor,
Roxanne Struthers,
who once emailed me
this message:
"Research is hard
work. I think that
is why we see such
few good
researchers. It is
back breaking, sweat
toiling labor."
What did
you learn
personally?
I have learned that
research involves
much more human
relations skills
than I ever
imagined! One
envisions a
researcher toiling
in a lab with
specimens and
juggling numbers.
However, in nursing
research one is
often involved in
working with others
who have different
ideas of how to
accomplish a task,
and it involves
suspending judgments
on my part to see
the beauty of how
another perceives
something to best be
done. I have found
that a lot of
letting go of
control is needed
when using a
community-based
participatory
approach, and
trusting the
process. In fact,
when I have done so,
the results have
been much better
than if I had done
it all my own way.
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Research Grant
Proposals are due February 1, 2012 |
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AHNA members
are encouraged to submit topics concerning healing through
holistic nursing. Nationally, research goals are evolving
with new foci on real life clinical situations: patient
centered outcomes and comparative effectiveness research
designs. These changes are congruent with holistic nursing
research and we enthusiastically encourage applicants
interested in these new foci to submit proposals. Grant
application instructions, submission guidelines, and the
grant review forms are available on the
AHNA Web site. Grant funding amounts vary from $1000-
$5000.
Please e-mail
grant proposals to both Jeanette Plodek (jplodek@yahoo.com)
and Jeanne Crawford (director@ahna.org).
Consultation may be available as an aspect of the grant. For
questions about the grant application process, please
contact Jeanette Plodek (jplodek@yahoo.com).
For research consultations or mentor
information, contact Ruth McCaffrey (rmccaffr@fau.edu). |
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Grant Reviewers Needed |
|
We need you
if you have a doctoral degree and are willing to volunteer
to be a reviewer for AHNA research and/or practice grant
proposals; please contact Jeanette Plodek (as soon as
possible.
jplodek@yahoo.com). In early February, Jeanette will
send you 2-3 blinded study proposals with review forms for
you to complete and return via e-mail within 3-4 weeks.
Please volunteer! |
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Please Vote for AHNA
Research Coordinator |
|
AHNA
Leadership Council Election ballots were recently sent to
members. Help shape the future of AHNA -
Please vote online or return your paper ballot by December
16, 2011, midnight EST.
One of the
offices being voted on is Research Coordinator.
Meet the candidates here.
If your membership is current and you have not received your
ballot by mail or email, please contact Debbi at
office@ahna.org.
Voting ends
December 16, 2011! |
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Research Glossary: Power
Analysis |
|
 Power
Analysis
Melodee Harris, PhD, APN,
GNP-BC
Associate Professor, Harding
University-Carr College of Nursing
Researchers use a power
analysis to determine the sample size before conducting the
study and to determine statistical significance after the
study is completed. This is important when one is
conducting a study that has as its purpose determining the
benefit of one treatment/intervention over another. There
are a variety of computer programs that may be used to
calculate a power analysis. In holistic nursing research
this may be more of a challenge as multiple factors may be
contributing to the affect a particular
treatment/intervention has on the participant.
Power is a function of effect
size and sample size. Effect size denotes the degree of
relationship between the research variables.. A power
analysis is the combined effect size and sample size and is
used to make a more precise prediction of the study
results. A small effect size requires a larger sample
size. If the intervention has a large effect size, fewer
responses or participants are needed. Cohen sets a range to
determine a small, medium, and large effect size. Effect
size may be referred to as Cohen's d. Sometimes the ranges
are used to estimate these values and sometimes the effect
size is estimated from previous research.
A power analysis that meets
ethical standards is performed prior to conducting the study
in order to determine resources needed to carry out the
research. A sample size that is larger than necessary
wastes valuable resources and places an unnecessary burden
on participants. A sample size that is underpowered will
not determine conclusive results of a study. It is
important to remember that a power analysis is only a
calculated estimate that provides the researcher with an
objective means for guiding a scientific basis for the
statistical significance of the study.
Borestein, M.,
Rothstein, H. & Cohen, J. (2001). Power and precision.
Englewood, NJ: Biostat Inc.
Polit, D.F. &
Beck, C.T. (2011). Nursing Research: Generating and
Assessing Evidence for Nursing Practice (9th
ed.). Philadelphia, PA: Lippincott Williams & Wilkins.
View AHNA's growing research glossary. To contribute a
definition or suggest a term, please contact
research@ahna.org. |
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News Briefs |
 Mediation
Research is Blossoming
By Rorry Zahourek
A
poster at the 2011 meeting of the American
Psychiatric Association
(www.clinicalpsychiatrynews.com,
August, 2011) reported that not only did
meditation decrease depression in caregivers of
people with dementia but it also improved their
cognitive and mental functioning. The study was a
randomized controlled pilot study of 29 caregivers
comparing a specific form of meditation with
relaxation training. The caregivers had been caring
for a family member for 4-5 years, Both groups were
similar in pre-test HAM-D scores (a self-rating
depression scale). Participants in the meditation
group practiced Kirtan Kriya which involved
chanting, breathing and finger poses. Participants
in the relaxation group listened to relaxation
tapes. Each group practiced for 20 minutes a day for
8 weeks. .
Both
groups improved on the HAM-D scales but the
differences were not significant. Significance was
noted on the Global Mental Health Score as 52%of the
meditation group showed at least a 50% improvement
compared with 19% in the relaxation group. Cognition
measures on the mini mental status exam increased
significantly in the meditation group. These
preliminary data indicate other biological
differences in outcomes including increased immune
function.
Read more.
Another recent study, "Mindfulness
Meditation is Associated with Structural Changes in
the Brain" was reported on the NCAAM web site
and published.(1)
Researchers from three institutions
took brain MRI images of 16 participants 2 weeks
before and after they engaged in a weekly meditation
group with home practice. They were compared with a
control group who did not meditate over a similar
period of time. Members of both groups completed a
questionnaire that measured five aspects of
mindfulness: observing, describing, acting with
awareness, non-judging inner experience, and non
reactivity to inner experience. Brain imaging in the
mediation group revealed increased gray matter in
the left hippocampus which is involved with learning
memory and emotional control. Three of the five
aspects of mindfulness were improved in the
meditation group but not the control.
1.
Hozel, BK, Carmody, J, Vangel, M. et al. (2011) Mindfulness
practice leads to increases in regional brain gray
matter density, Psychiatry Research:
Neuroimaging. 2011; 191(1); 36-43.
More Power to the Cranberry: Study Shows the Juice
is Better than Extracts at Fighting Bacterial
Infections
Researchers from the Worcester Polytechnic Institute
have shown that cranberry juice is more effective in
preventing UTIs than an extract of what was thought
to be the active ingredient, demonstrating that the
benefits derived from a whole food is more complex
than distilling out the supposed "magic bullet"
ingredient. (Click on
title to read more)
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AHNA Researchers in Action |
AHNA members names in bold. We would
love to hear about your research. Have
you started your dissertation, had a
paper published, presented, etc. Send
your "Researcher in Action" to
research@ahna.org
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