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“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
Independence is happiness.Susan B. AnthonyThe greatest challenge as people age is to keep their independence.As they get older, adults may develop geriatric syndromesand multiple chronic disorders with complex treatment regimensto follow. Judith Matthews, assistant professor in the Departmentof Health and Community Systems, is working on two studiesto develop mobile robots capable of monitoring and guiding thedaily activities of elderly people, and enabling them to sustainindependent living.The NurseBot project is an interdisciplinary multi-universityresearch initiative focused on developing robotic technology forthe elderly. Initially funded by the National Science Foundation,this study brings together researchers from the University ofPittsburgh, Carnegie Mellon University, the University ofMichigan, and Stanford University.Specifically, the NurseBot project is developing two mobilepersonal-service robots that assist elderly people suffering fromchronic disorders in their everyday lives. In a study funded by theNational Institutes of Health, the current prototypes—Pearl, ahumanoid robot; and the IMP (Intelligent Mobility Platform), arobotic walker—are undergoing preliminary usability testing infield studies with older adults.The two robots provide research platforms to test a rangeof ideas for assisting elderly people, such as:• Intelligent reminding: Many elderly patients have to giveup independent living because they forget. The robot canremind people to visit the restroom, take medicine, drink,or see the doctor.• Tele-presence: Professional caregivers can use the robotto establish a “tele-presence” and interact directly withremote patients.• Data collection and surveillance: Systematic data collectioncan help avoid a range of emergency conditions such ascertain types of heart failures.• Mobile manipulation: Arthritis is the main reason for theelderly to give up independent living. A semi-intelligentmobile manipulator can help older adults overcome somebarriers that currently force patients to move into assistedlivingfacilities.• Social interaction: Too many elderly people are forced tolive alone, deprived of social contacts. The project is exploringwhether robots can take over certain social functions.If successful, this project could change the way we deliverhealthcare to the ever-growing contingent of elderly people,and it could significantly advance the state of the art in mobileservicerobotics and human-robot interaction.These projects all employ patient-centric technology as a toolto enhance the quality of life for people with acute or chronicillness and their families. Nurse researchers are well suited toidentify patient needs that can benefit from technology solutionsand assure that the resulting products fit seamlessly withtheir daily lives.IMP (IntelligentMobility Platform)p i t t N u r s e W i n t e r 2 0 0 6 21
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