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Factors Influencing Nurse Practitioners' Weight Management Practices in Primary Care
Title
Factors Influencing Nurse Practitioners' Weight Management Practices in Primary Care.
Creator
Hyer, Suzanne, Edwards, Joellen, Quelly, Susan, Upvall, Michele, Pasarica, Magdalena, University of Central Florida
Abstract / Description
More American adults are overweight or obese than ever before. Nurse practitioners (NPs) play a critical and expanding role in primary care, which is an ideal setting for the assessment and management of weight loss. NPs can make a significant contribution to tackling the obesity crisis. The study presented here seeks to close the gap in data related to how NPs approach weight management with their primary care patients. This study focused on a comprehensive examination of the current...
Show moreMore American adults are overweight or obese than ever before. Nurse practitioners (NPs) play a critical and expanding role in primary care, which is an ideal setting for the assessment and management of weight loss. NPs can make a significant contribution to tackling the obesity crisis. The study presented here seeks to close the gap in data related to how NPs approach weight management with their primary care patients. This study focused on a comprehensive examination of the current practice patterns of NPs related to weight management, a theoretical concept analysis of weight bias among healthcare providers, along with the results of a cross-sectional survey that investigated primary care NPs' weight management practice patterns and the relationship among attitudes, perceived barriers, self-efficacy, perceived skill, and demographic characteristics. The results from this study may be applied to provider training and education for obesity and weight management that ultimately improves patients' health outcomes.
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Date Issued
2019
Identifier
CFE0007658, ucf:52498
Format
Document (PDF)
PURL
http://purl.flvc.org/ucf/fd/CFE0007658
Subjective-Objective Discrepancies Among Patients with Sleep Complaints in the Patient-Centered Medical Home
Title
Subjective-Objective Discrepancies Among Patients with Sleep Complaints in the Patient-Centered Medical Home.
Creator
Dotson, Keri, Dunn, Michael, Cassisi, Jeffrey, Bowers, Clint, University of Central Florida
Abstract / Description
Sleep misperception (-) the discrepancy between objective and subjective measures of sleep (-) has been shown to be prevalent among patients with insomnia and may be a promising target for sleep intervention. This study examined sleep misperception in a diverse outpatient medical sample using consumer-grade wearable actigraphs (i.e., Fitbit Charge HR(TM)). Forty-four self-identified problem sleepers aged 20 to 79 participated in the study. Participants completed sleep diaries for one week...
Show moreSleep misperception (-) the discrepancy between objective and subjective measures of sleep (-) has been shown to be prevalent among patients with insomnia and may be a promising target for sleep intervention. This study examined sleep misperception in a diverse outpatient medical sample using consumer-grade wearable actigraphs (i.e., Fitbit Charge HR(TM)). Forty-four self-identified problem sleepers aged 20 to 79 participated in the study. Participants completed sleep diaries for one week while also tracking their sleep using the Fitbit Charge HR(TM). After receiving a personalized sleep report based on these data, participants repeated another week of sleep assessment. Sleep misperception was observed for both total sleep time and sleep onset latency during the first week, such that participants underestimated their total amount of sleep per night and overestimated the amount of time it took them to fall asleep. Pre-post changes in self-reported sleep, mood, and health were examined as a secondary aim in this study. Objectively measured sleep remained relatively unchanged from baseline to follow-up. Despite this lack of change in actual sleep, participants perceived themselves to be sleeping more hours per night, falling asleep more quickly, and sleeping better overall at one-week follow-up. Statistically significant improvements in depression, anxiety, mental health functioning, and insomnia symptom severity were also observed at follow-up. Overall, findings showed that sleep misperception is prevalent among problem sleepers and that sleep discrepancy can be reduced through the use of corrective sleep feedback.
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Date Issued
2018
Identifier
CFE0006976, ucf:51645
Format
Document (PDF)
PURL
http://purl.flvc.org/ucf/fd/CFE0006976
THE EFFICACY OF A 6-WEEK EVIDENCE-BASED SUPPORT GROUP FOR CAREGIVERS OF DEMENTIA IN A PRIMARY CARE SETTING
Title
THE EFFICACY OF A 6-WEEK EVIDENCE-BASED SUPPORT GROUP FOR CAREGIVERS OF DEMENTIA IN A PRIMARY CARE SETTING.
Creator
Shah, Mona, Paulson, Daniel, Cassisi, Jeffrey, Sims, Valerie, University of Central Florida
Abstract / Description
More than 16 million Americans provide unpaid care for those with Alzheimer's disease and other dementias. Extant literature has well documented the increased risk for physical, emotional, social and financial burden associated with caregiving. While intensive support groups may be well-suited to caregiver needs, they are often difficult to implement given financial, personnel and resource constraints. Thus, the purpose of this study is to examine the efficacy of a theoretically-based, 6-week...
Show moreMore than 16 million Americans provide unpaid care for those with Alzheimer's disease and other dementias. Extant literature has well documented the increased risk for physical, emotional, social and financial burden associated with caregiving. While intensive support groups may be well-suited to caregiver needs, they are often difficult to implement given financial, personnel and resource constraints. Thus, the purpose of this study is to examine the efficacy of a theoretically-based, 6-week caregiver support group in a community primary care setting. The group focuses on self-care, behavior management techniques and interdisciplinary caregiver resources. A total of 22 participants completed the active caregiver support group and they were compared to 19 control participants who participated in community caregiver support groups. Participants on average were in their mid-60s, mostly female and Caucasian, and identified as either the care recipient's child or spouse. All participants completed self-report measures related to demographic information, caregiver preparedness (Caregiver Preparedness Scale), caregiver strain (Caregiver Strain Index), caregiver depressive symptoms (CESD-10), and care recipient's neuropsychiatric symptoms (NPI-Q), at baseline and at 6-weeks. Participants in the active caregiver support group also completed a satisfaction survey. Results from two-way mixed ANCOVA analyses revealed a time by group interaction effect for caregiver preparedness, such that caregivers in the active group demonstrated a significant increase in mean caregiver preparedness scores while scores remained invariant for the control group. No significant main effects nor group by time interaction effects were found for caregiver strain, caregiver depressive symptoms and caregiver distress related to neuropsychiatric symptoms. Participants in the active caregiver support group rated being largely satisfied with the group. Results suggest that this 6-week caregiver support group may be a promising caregiver intervention that can be readily implemented and accessible in primary care clinics. Further research with larger sample sizes is recommended.
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Date Issued
2018
Identifier
CFE0007370, ucf:52098
Format
Document (PDF)
PURL
http://purl.flvc.org/ucf/fd/CFE0007370
IDENTIFYING PATIENTS AT RISK FOR OBSTRUCTIVE SLEEP APNEA IN PRIMARY HEALTH CARE: CAN OBESITY IN COMBINATION WITH OTHER HIGH-RISK DIAGNOSES BE USED FOR SCREENING PURPOSES?
Title
IDENTIFYING PATIENTS AT RISK FOR OBSTRUCTIVE SLEEP APNEA IN PRIMARY HEALTH CARE: CAN OBESITY IN COMBINATION WITH OTHER HIGH-RISK DIAGNOSES BE USED FOR SCREENING PURPOSES?.
Creator
Lima, Clelia, Norris, Anne, University of Central Florida
Abstract / Description
Obstructive sleep apnea (OSA) affects about 15 million adults in the United States, and is an independent risk factor for all-cause mortality. The under-diagnosing of OSA has been linked to the inadequate screening by primary care practitioners (PCPs). Existing screening tools are not widely used by PCPs possibly due to time constraints they experience as providers. This study demonstrates how common high-risk diagnoses (obesity, hypertension, diabetes mellitus type 2, dyslipidemia,...
Show moreObstructive sleep apnea (OSA) affects about 15 million adults in the United States, and is an independent risk factor for all-cause mortality. The under-diagnosing of OSA has been linked to the inadequate screening by primary care practitioners (PCPs). Existing screening tools are not widely used by PCPs possibly due to time constraints they experience as providers. This study demonstrates how common high-risk diagnoses (obesity, hypertension, diabetes mellitus type 2, dyslipidemia, arrhythmia, and coronary artery disease) can be used to help PCPs identify adult patients at risk for OSA. Unlike other screening tools, these diagnoses are easy to identify in a routine visit. This study was a retrospective chart review that used a random sample of 220 electronic health records. Seventy percent of the sample was positive for OSA, 69% had obesity, and 33% had two or more high-risk diagnoses. The setting of this study was six sleep centers located in five cities in Central Florida. Logistic regression was used to analyze the data to determine interaction among variables and odds ratios. The variables "obesity" and "two or more high-risk diagnoses" had significant effects on the likelihood of being diagnosed with OSA independently of each other (odds ratio of 4.2 and 4.3 respectively; p<.001). However, there was no significant interaction between these two variables (p=.56). The predictive value for an OSA diagnosis using "obesity" was 83%, and it was 88% using "two or more high-risk diagnoses." These findings argue for the use of high-risk diagnoses to identify patients at risk for OSA. PCPs are in an ideal position to increase the number of patients screened and treated for OSA because they routinely see patients with these diagnoses in their practices. Proper diagnosis and treatment of OSA has the potential to improve patients' outcomes and their quality of life.
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Date Issued
2011
Identifier
CFE0003620, ucf:48863
Format
Document (PDF)
PURL
http://purl.flvc.org/ucf/fd/CFE0003620
The efficacy and feasibility of neuropsychological services in a primary care setting.
Title
The efficacy and feasibility of neuropsychological services in a primary care setting.
Creator
Herring, Danielle, Paulson, Daniel, Sherod, Megan, Blaney, Cerissa, Cannarozzi, Maria, University of Central Florida
Abstract / Description
Integrated primary care assimilates psychologists into the primary care setting, thus improving health outcomes and physician satisfaction. Neuropsychology has also begun to assimilate into primary care, as neurocognitive impairment is a correlate of many medical disorders. Subjective cognitive decline (SCD), a common complaint among older adults, is an increasingly recognized warning sign of non-normative cognitive aging. These patients typically present first to their primary care providers...
Show moreIntegrated primary care assimilates psychologists into the primary care setting, thus improving health outcomes and physician satisfaction. Neuropsychology has also begun to assimilate into primary care, as neurocognitive impairment is a correlate of many medical disorders. Subjective cognitive decline (SCD), a common complaint among older adults, is an increasingly recognized warning sign of non-normative cognitive aging. These patients typically present first to their primary care providers who may play a critical role in the early detection of cognitive impairment. Given the growing awareness about cognitive health and disability, the importance of neuropsychological assessment as a standard component of integrated care has been recognized by providers. Thus, the purpose of this study is to examine the efficacy and feasibility of neuropsychological services, for memory concerns, in a community primary care setting. The study also explored the relationship between SCD and performance on neurocognitive measures and satisfaction levels for both patient participants and medical providers. A total of 16 patient participants completed the study. On average, patients were in their late-60's and mostly female and Caucasian. Participants completed a brief interview, neurocognitive evaluation, self-report measures of SCD and mood, and satisfaction survey. Results did not reveal significant correlations between SCD and neurocognitive performance. Significantly more referrals were made to the onsite neurocognitive clinic, than were made for outside services in a nine-month period preceding the described program. Patients referred to the onsite clinic were also significantly more likely to have an accessible report located in their EMR than those referred offsite. Both participants and medical providers were reportedly satisfied with clinic services. Results suggest that a clinic of this nature has promising benefits and is well-liked by both patients and providers, though barriers related to full utilization of services remain a challenge. Further research with a larger, more diverse sample is recommended. ?
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Date Issued
2019
Identifier
CFE0007653, ucf:52508
Format
Document (PDF)
PURL
http://purl.flvc.org/ucf/fd/CFE0007653
A Simulation-Based Evaluation Of Efficiency Strategies For A Primary Care Clinic With Unscheduled Visits
Title
A Simulation-Based Evaluation Of Efficiency Strategies For A Primary Care Clinic With Unscheduled Visits.
Creator
Bobbie, Afrifah, Karwowski, Waldemar, Thompson, William, Elshennawy, Ahmad, Mikusinski, Piotr, University of Central Florida
Abstract / Description
In the health care industry, there are strategies to remove inefficiencies from the health delivery process called efficiency strategies. This dissertation proposed a simulation model to evaluate the impact of the efficiency strategies on a primary care clinic with unscheduled "walk-in" patient visits. The simulation model captures the complex characteristics of the Orlando Veteran's Affairs Medical Center (VAMC) primary care clinic. This clinic system includes different types of patients,...
Show moreIn the health care industry, there are strategies to remove inefficiencies from the health delivery process called efficiency strategies. This dissertation proposed a simulation model to evaluate the impact of the efficiency strategies on a primary care clinic with unscheduled "walk-in" patient visits. The simulation model captures the complex characteristics of the Orlando Veteran's Affairs Medical Center (VAMC) primary care clinic. This clinic system includes different types of patients, patient paths, and multiple resources that serve them. Added to the problem complexity is the presence of patient no-shows characteristics and unscheduled patient arrivals, a problem which has been until recently, largely neglected. The main objectives of this research were to develop a model that captures the complexities of the Orlando VAMC, evaluate alternative scenarios to work in unscheduled patient visits, and examine the impact of patient flow, appointment scheduling, and capacity management decisions on the performance of the primary care clinic system. The main results show that only a joint policy of appointment scheduling rules and patient flow decisions has a significant impact on the wait time of scheduled patients. It is recommended that in the future the clinic addresses the problem of serving additional walk-in patients from an integrated scheduling and patient flow viewpoint.
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Date Issued
2016
Identifier
CFE0006443, ucf:51462
Format
Document (PDF)
PURL
http://purl.flvc.org/ucf/fd/CFE0006443