Doctor of Philosophy, University of Pittsburgh (2019)
Master of Science, University of Pittsburgh (2014)
Bachelor of Science, Capital Medical University (2012)
PURPOSE: Sleeve gastrectomy (SG) is the most widely used surgical treatment for severe obesity worldwide. Individuals who have undergone SG usually need to change lifestyle behaviors as a response to the anatomical changes imposed by SG, and patients need to sustain lifestyle changes for long-term surgical success. Little is known about how patients experience and manage lifestyle changes following SG. In China, where SG comprises over 70% of bariatric surgical procedures, there have been no reports addressing this issue. This study aimed to describe individuals' experiences related to lifestyle changes after SG in China.MATERIALS AND METHODS: Semi-structured interviews were conducted at the Shanghai Huashan Hospital in China with adults who had undergone SG between 2012 and 2018. Two independent researchers used an interpretive thematic approach to analyze transcripts for themes and sub-themes.RESULTS: Interviews (N=15) revealed three major themes of participants' experiences with postoperative lifestyle changes: advantages outweigh disadvantages; developing self-management strategies (i.e., adopting new behaviors and developing habits, continuing self-monitoring, focusing on health over weight, staying determined); and experiencing culture-specific difficulties in adherence to follow-up visits and lifestyle recommendations.CONCLUSION: The data from this study provided a rich description of the postoperative experiences of patients in China. Participants reported that surgical benefits supersede the surgery-related side effects, and participants were able to develop self-management strategies in order to achieve success. However, personal and social barriers, such as the challenges of applying postoperative dietary guidelines into daily practice, may impede patients making and sustaining recommended behavioral changes.
View details for DOI 10.1007/s11695-020-04653-7
View details for PubMedID 32385666
View details for PubMedID 30853069
Older adults with memory loss often require assistance from caregivers to manage their medications. This study examined the efficacy of a problem-solving-based intervention focused on caregiver medication management, problem solving, self-efficacy, and daily hassles. Caregiver health-related quality of life (HRQoL) and patient health care utilization were secondary outcomes. Totally, 83 patients (age 79.9±8.8 years) and their informal caregivers (age 66.9±12 years, female 69.9%, White 85.5%) were randomized; data collection occurred at baseline, 8, 16, and 24 weeks. Linear mixed modeling showed significant decreases in medication deficiencies which were sustained over time. No significant changes in caregiver problem solving, daily hassles, or patient health care utilization occurred between groups or over time. In addition, caregiver self-efficacy and mental HRQoL decreased in both groups. Physical HRQoL decreased in the intervention group, yet increased in the usual care group. Future research should investigate these outcomes in larger and more diverse samples.
View details for PubMedID 30729881
Patient portals empower patients by providing access to their health information and facilitating communication with care providers. This study aimed to examine the usage patterns of a patient portal offered as part of an electronic health record and to identify predictors of portal use among patients with type 2 diabetes (T2DM).A 2-year retrospective cohort study was performed using outpatient data from the healthcare system and its patient portal. Demographic and clinical data from 38,399 T2DM patients were analyzed. Descriptive statistics were used to summarize portal usage patterns. Binary logistic regression was employed to examine predictors and two-way interactions associated with portal use.Almost one-third of patients (n=12,615; 32.9%, 95% CI:[32.38%, 33.32%]) had used the portal for a mean 2.5±1.9 years prior to the study period. Portal use was higher on weekdays than weekends (P<0.001). An increase in portal use was observed in response to email reminders. A nonlinear relationship between age and portal use was observed and depended on several other predictors (Ps<0.05). Patients living in more rural areas with low income were at lower odds to use the portal (P=0.021), and this finding also applied to non-whites with low income (P<0.001). More chronic conditions and a higher initial HbA1c value were associated with portal use (P=0.014).The patient portal usage remained relatively stable over the 2-year period. A combination of factors is associated with an individual's patient portal use. Patient engagement in portal use can be facilitated through a proactive approach by healthcare providers.
View details for DOI 10.1089/dia.2019.0074
View details for PubMedID 31335206
Objectives We assessed the psychometric properties of the Relapse Situation Efficacy Questionnaire - Weight (RSEQ-W) including internal consistency reliability, criterion-related validity (concurrent and predictive validity) and construct validity (convergent validity and factor analysis). Methods We administered the RSEQ-W at baseline, and at 6 and 12 months in a 12-month prospective behavioral weight loss study. Spearman correlations were used to examine the convergent and concurrent validity; multivariate linear regression was used to assess the predictive validity; exploratory factor analysis was conducted using principal component analysis. Results The sample (N = 148) was 90.5% women and 81.1% white with a mean body mass index of 34.1 ± 4.6 kg/m2. The RSEQ-W showed good internal consistency (Cronbach's ? = .95) and convergent validity (r = .69). PCA results revealed that the 31 items can be factored into 6 components negative affect, positive affect, social occasions, low focus, activity andlack of energy. Conclusion These results provide preliminary support for the reliability and validity of the RSEQ-W. Future work needs to apply RSEQ-W in studies with larger and more diverse samples and also consider adding more items to the factor lack of energy.
View details for DOI 10.5993/AJHB.42.4.8
View details for Web of Science ID 000437980800008
View details for PubMedID 29973313
Online student response systems (OSRSs), driven by the Internet and cell phone technology, provide a free, easily accessible method to increase student engagement, facilitate active learning, and provide learners and teachers with instant feedback about learning progress.This article describes undergraduate nursing students' use of 2 OSRSs and their perceptions of the impact of the tools on class participation and engagement.Students used their own mobile phones or computers to access 2 types of OSRSs: a classic and a game-based OSRS.Students indicated that both systems increased participation and engagement. The game-based OSRS was favored over the classic OSRS. The potential for use of the game-based OSRS for assessing rapid-answer fact-based knowledge and the classic OSRS for assessing more complex learning tasks is discussed.Nurse educators are encouraged to consider integrating online response system technology into their classroom teaching.
View details for PubMedID 30130268
Health information technology tools (eg, patient portals) have the potential to promote engagement, improve patient-provider communication, and enhance clinical outcomes in the management of chronic disorders such as diabetes mellitus (DM).The aim of this study was to report the findings of a literature review of studies reporting patient portal use by individuals with type 1 or type 2 DM. We examined the association of the patient portal use with DM-related outcomes and identified opportunities for further improvement in DM management.Electronic literature search was conducted through PubMed and PsycINFO databases. The keywords used were "patient portal*," "web portal," "personal health record," and "diabetes." Inclusion criteria included (1) published in the past 10 years, (2) used English language, (3) restricted to age ?18 years, and (4) available in full text.This review included 6 randomized controlled trials, 16 observational, 4 qualitative, and 4 mixed-methods studies. The results of these studies revealed that 29% to 46% of patients with DM have registered for a portal account, with 27% to 76% of these patients actually using the portal at least once during the study period. Portal use was associated with the following factors: personal traits (eg, sociodemographics, clinical characteristics, health literacy), technology (eg, functionality, usability), and provider engagement. Inconsistent findings were observed regarding the association of patient portal use with DM-related clinical and psychological outcomes.Barriers to use of the patient portal were identified among patients and providers. Future investigations into strategies that engage both physicians and patients in use of a patient portal to improve patient outcomes are needed.
View details for PubMedID 30401665
View details for PubMedCentralID PMC6246970
View details for Web of Science ID 000398947202288
Patient care problems arise when health care consumers and professionals find health information on the Internet because that information is often inaccurate. To mitigate this problem, nurses can develop Web literacy and share that skill with health care consumers. This study evaluated a Web-literacy intervention for undergraduate nursing students to find reliable Web-based health information.A pre- and postsurvey queried undergraduate nursing students in an informatics course; the intervention comprised lecture, in-class practice, and assignments about health Web site evaluation tools. Data were analyzed using Wilcoxon and ANOVA signed-rank tests.Pre-intervention, 75.9% of participants reported using Web sites to obtain health information. Postintervention, 87.9% displayed confidence in using an evaluation tool. Both the ability to critique health Web sites (p = .005) and confidence in finding reliable Internet-based health information (p = .058) increased.Web-literacy education guides nursing students to find, evaluate, and use reliable Web sites, which improves their ability to deliver safer patient care. [J Nurs Educ. 2017;56(2):110-114.].
View details for DOI 10.3928/01484834-20170123-08
View details for Web of Science ID 000398044500008
View details for PubMedID 28141885
View details for Web of Science ID 000372215200288