complete issue - School of Nursing - University of Pittsburgh

“I love you” was the mostfrequent communicationintubated patients usedto express their feelingsto others around them—particularly family.Institute of Child Health and HumanDevelopment—looks at communicationsbetween nurses and nonspeakingintensive care unit (ICU) patients. Thisstudy is testing the impact of providingnurses with (1) basic communicationskills training and (2) consultation bya language pathologist on the use ofaugmentative and alternative communicationtechniques.In a series of observations videotapedover several years, Happ is looking atthe communication between 30 nursesand three nonspeaking ICU patientseach, for a total of 90 patients. The communicationinteractions on these tapesare coded and analyzed. To establish abenchmark, Happ first looks at tapes ofthe nurse-patient interactions duringusual care before the intervention. Afternurses receive communications skillstraining developed by the research team,the patient-nurse communication willbe taped again. In the third step, nurseswill receive individual counseling from alanguage pathologist and training in theuse of an AACD.Happ’s study provides an objectivemeasurement of how the quality andnature of communication betweennurses and nonspeaking patients in theICU changes with increased levels ofinformation, skill sets, and the additionof AACDs.Obesit y is a chronic disorder with ahigh rate of recidivism. Lora E. Burke,PhD, MPH, RN, associate professorin the Departments of Epidemiologyand Health and Community Systems,is developing tools to help patients loseweight—and keep it off.Self-monitoring is the cornerstoneof behavioral treatment. Documentingand following their behavior andresponses is important for patients whoare trying to lose weight, and is a strongpredictor of their long-term weight-losssuccess. But studies show that adherenceto those positive health behaviors maywane over time.Burke’s studies on obesity and weightloss look at self-monitoring, and waysto improve self-monitoring by makingit more timely and less time-consumingas patients go through the many-timesdailyhabit of eating. In two studieswith investigators at the University ofPittsburgh, Stonybrook University inNew York, and Emory University, fundedby the National Institute of Diabetes andDigestive and Kidney Diseases, Burkeis examining a variety of approaches todetermine which ones are most effectivefor individuals tracking their own foodconsumption and physical activity.In an earlier study that looked atpatterns of self-monitoring, Burke foundthat weight loss is significantly relatedto frequency of self-monitoring andmarginally related to recording withintwo hours of eating. The study concludedthat timeliness is important and relatedto outcome.Burke has been working with acompany to develop software for apersonal digital assistant (PDA) that willtrack when recording occurs and also willmake self-monitoring easier. The PDAbeing used to track self-monitoring doesmore than keep track of when the patientrecords. The recently developed dietarysoftware program provides a databaseof more than 6,000 foods and calculatesthe calorie and fat content of foodsconsumed, and displays these values.Meanwhile, the physical activity programtracks the patient’s daily physical activityand exercise. This information makes iteasier and more convenient for people toself-monitor how they are doing in relationto their daily goals for calories andfat grams as well as their weekly goals forphysical activity.In a further refinement of herintervention study, Burke is measuringthe effect of adding messages to the PDAthat provide individuals with feedbackon how they are doing. Burke’s studieshave expanded quite a bit from thesimple paper diary enabling people to seewhat they have actually done as opposedto what they have set for target goals.Burke will be presenting a paper at theSociety of Behavioral Medicine’s annualconference in 2006 on her latest findingspertaining to self-monitoring and successin weight loss.Losing weight and keeping it off isdifficult, but Burke is finding ways tohelp individuals succeed.20 u n i v e r s i t y o f p i t t s b u r g h