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  1. Article ; Online: A middle range theory of self- and family management of chronic illness.

    Schulman-Green, Dena / Feder, Shelli L / David, Daniel / Rada, Lynda / Tesfai, Danait / Grey, Margaret

    Nursing outlook

    2023  Volume 71, Issue 3, Page(s) 101985

    Abstract: Background: The Self- and Family Management Framework was created in 2006 to help structure self- and family management science. Based on a series of reviews and syntheses of emerging research and critical evaluation, we developed the Framework into a ... ...

    Abstract Background: The Self- and Family Management Framework was created in 2006 to help structure self- and family management science. Based on a series of reviews and syntheses of emerging research and critical evaluation, we developed the Framework into a robust nursing theory.
    Purpose: In this article, we reintroduce the Self- and Family Management Framework as the Middle Range Theory of Self- and Family Management of Chronic Illness.
    Methods: We review steps in the development and updating of the Framework, share rationale for advancement to a middle range theory, explicate components of the newly designed model, and propose future directions.
    Discussion and conclusion: It is our hope that this middle range theory will guide researchers and clinicians more comprehensively in supporting patients and families managing chronic illness, which will in turn inform continued theory development.
    MeSH term(s) Humans ; Chronic Disease ; Nursing Theory ; Family
    Language English
    Publishing date 2023-05-06
    Publishing country United States
    Document type Review ; Journal Article
    ZDB-ID 300568-9
    ISSN 1528-3968 ; 0029-6554
    ISSN (online) 1528-3968
    ISSN 0029-6554
    DOI 10.1016/j.outlook.2023.101985
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  2. Article ; Online: "I Have a Lotta Sad Feelin'" - Unaddressed Mental Health Needs and Self-Support Strategies in Medicaid-Funded Assisted Living.

    David, Daniel / Lassell, Rebecca K F / Mazor, Melissa / Brody, Abraham A / Schulman-Green, Dena

    Journal of the American Medical Directors Association

    2023  Volume 24, Issue 6, Page(s) 833–840

    Abstract: Objective: To investigate mental health needs and barriers to seeking mental health support in Medicaid-funded Assisted Living Facility (M-ALF).: Design: A multimethod, qualitative-dominant descriptive design using questionnaires and semistructured ... ...

    Abstract Objective: To investigate mental health needs and barriers to seeking mental health support in Medicaid-funded Assisted Living Facility (M-ALF).
    Design: A multimethod, qualitative-dominant descriptive design using questionnaires and semistructured interviews.
    Setting and participants: The study occurred at a M-ALF in the Bronx, New York. A researcher in residence recruited 13 residents (11 Black or African American, 2 Asian) using purposive sampling.
    Methods: Demographic data and mental health indicators (depression, anxiety, stress, hopelessness) were measured with questionnaires (Center for Epidemiological Studies Depression Scale, Edmonton Symptom Assessment System, Perceived Stress Scale, Beck Hopelessness Survey) and analyzed with descriptive statistics. Interviews were conducted between June and November 2021, transcribed, and analyzed using conventional content analysis.
    Results: Thirteen residents (mean age: 73.4 years, mean length of stay: 3.5 years; range: 1.0-7.5) completed data collection. Quantitatively indicators of unmet mental health were common. Qualitatively, residents reported barriers to mental health access to address depression, anxiety, and substance use. This was accompanied by concerns surrounding loss of autonomy, mistrust for M-ALF organizational support, isolation and uncertainty about how to receive mental health support. Perspectives were shaped by past experiences with institutional living, serious illness, and being unhoused. Themes and subthemes were (1) mental health need (unmet mental health need, depression, and anxiety and seeking support through non-mental health resources) and (2) barriers to mental health support (dissatisfaction with M-ALF care, perceived threats to autonomy, desire for autonomy that leads to diminished care seeking).
    Conclusion and implications: Residents of M-ALF have mental health needs for which care is stymied by loss of autonomy, lack of resources, and the M-ALF environment. Residents use unconventional resources to address needs that may be neither efficient nor effective. Novel mental health interventions and processes are needed to improve mental health access and should prioritize residents' desire for autonomy and the unique circumstances of living in M-ALF.
    MeSH term(s) United States ; Humans ; Aged ; Medicaid ; Mental Health ; Patient Acceptance of Health Care ; Surveys and Questionnaires ; New York
    Language English
    Publishing date 2023-05-08
    Publishing country United States
    Document type Journal Article ; Research Support, Non-U.S. Gov't
    ZDB-ID 2171030-2
    ISSN 1538-9375 ; 1525-8610
    ISSN (online) 1538-9375
    ISSN 1525-8610
    DOI 10.1016/j.jamda.2023.04.002
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  3. Article ; Online: Integrating Family Caregivers into Palliative Oncology Care Using the Self- and Family Management Approach.

    Schulman-Green, Dena / Feder, Shelli

    Seminars in oncology nursing

    2018  Volume 34, Issue 3, Page(s) 252–263

    Abstract: Objective: To describe the integration of family caregivers into palliative oncology care using the Self- and Family Management Framework.: Data sources: Peer-reviewed journal articles.: Conclusion: The role of family caregivers in palliative ... ...

    Abstract Objective: To describe the integration of family caregivers into palliative oncology care using the Self- and Family Management Framework.
    Data sources: Peer-reviewed journal articles.
    Conclusion: The role of family caregivers in palliative oncology includes focusing on illness needs, activating resources, and living with cancer. Several factors may serve as facilitators of or barriers to these activities. A growing number of interventions support family caregivers' involvement in palliative oncology care.
    Implications for nursing practice: Nurses should identify who the family caregiver is, confirm ability and willingness, discuss patients' and family caregivers' goals for cancer care, activate resources, and promote ongoing communication to support changing needs.
    MeSH term(s) Caregivers ; Hospice and Palliative Care Nursing/organization & administration ; Humans ; Neoplasms/nursing ; Nurse's Role ; Nurse-Patient Relations ; Oncology Nursing/organization & administration ; Pain Management/nursing ; Palliative Care/organization & administration ; Quality of Health Care
    Language English
    Publishing date 2018-08-22
    Publishing country United States
    Document type Journal Article ; Review
    ZDB-ID 632682-1
    ISSN 1878-3449 ; 0749-2081
    ISSN (online) 1878-3449
    ISSN 0749-2081
    DOI 10.1016/j.soncn.2018.06.006
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  4. Article ; Online: Palliative care strategies offer guidance to clinicians and comfort for COVID-19 patient and families.

    Feder, Shelli L / Akgün, Kathleen M / Schulman-Green, Dena

    Heart & lung : the journal of critical care

    2020  Volume 49, Issue 3, Page(s) 227–228

    Keywords covid19
    Language English
    Publishing date 2020-04-04
    Publishing country United States
    Document type Editorial
    ZDB-ID 193129-5
    ISSN 1527-3288 ; 0147-9563
    ISSN (online) 1527-3288
    ISSN 0147-9563
    DOI 10.1016/j.hrtlng.2020.04.001
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  5. Article ; Online: Improving Breast Cancer Family Caregivers' Palliative Care Literacy: A Pilot Randomized Trial.

    Schulman-Green, Dena / Linsky, Sarah / Blatt, Leslie / Jeuland, Jane / Kapo, Jennifer / Jeon, Sangchoon

    Journal of family nursing

    2022  Volume 29, Issue 1, Page(s) 99–114

    Abstract: Self- and family management (SFM) refers to patients' and family caregivers' activities to co-manage illness. Two barriers to SFM are low palliative care literacy and lack of goals of care communication, which potentially result in SFM activities that ... ...

    Abstract Self- and family management (SFM) refers to patients' and family caregivers' activities to co-manage illness. Two barriers to SFM are low palliative care literacy and lack of goals of care communication, which potentially result in SFM activities that are unsupportive of patients' goals. Managing Cancer Care: A Caregiver's Guide (MCC-CG) aims to improve palliative care literacy and communication within a SFM training program. In this pilot randomized trial, we enrolled breast cancer family caregivers and collected data at 0, 1, and 3 months on palliative care literacy, SFM engagement, communication, transitions management, uncertainty, caregiver burden, and caregiver competence/personal gain. Participants (
    MeSH term(s) Humans ; Middle Aged ; Female ; Palliative Care ; Caregivers/education ; Breast Neoplasms ; Literacy ; Pilot Projects
    Language English
    Publishing date 2022-06-07
    Publishing country United States
    Document type Randomized Controlled Trial ; Journal Article ; Research Support, Non-U.S. Gov't
    ZDB-ID 2070209-7
    ISSN 1552-549X ; 1074-8407
    ISSN (online) 1552-549X
    ISSN 1074-8407
    DOI 10.1177/10748407221099541
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  6. Article ; Online: Decision Aid Interventions for Family Caregivers of Persons With Advanced Dementia in Decision-Making About Feeding Options: A Scoping Review.

    Pei, Yaolin / Qi, Xiang / Schulman-Green, Dena / Hu, Mengyao / Wang, Kaipeng / Wu, Bei

    Journal of the American Medical Directors Association

    2022  Volume 23, Issue 12, Page(s) 1927.e1–1927.e6

    Abstract: Objectives: We provided an overview of the literature on decision aid interventions for family caregivers of older adults with advanced dementia regarding decision making about tube feeding. We synthesized (1) the use of theory during the development, ... ...

    Abstract Objectives: We provided an overview of the literature on decision aid interventions for family caregivers of older adults with advanced dementia regarding decision making about tube feeding. We synthesized (1) the use of theory during the development, implementation, and evaluation of decision aids; (2) the development, content, and delivery of decision aid interventions; (3) caregivers' experience with decision aid interventions; and (4) the effect of decision aid interventions on caregivers' quality of decision-making about feeding options.
    Design: Scoping review.
    Methods: We conducted a scoping review of peer-reviewed studies published January 1, 2000-June 30, 2022, in MEDLINE, EMBASE, The Cochrane Library, CINAHL, and Web of Science databases. The process was guided by Arksey and O'Malley's methodological framework, which includes identifying the research question, choosing related studies, charting the data, and summarizing results. Empirical articles concerning the decision aid interventions about feeding options were selected.
    Results: Six publications reporting 4 unique decision aid interventions were included. All the interventions targeted caregivers of older adults with advanced dementia. Three decision aids were culturally adapted from existing decision aids. The Ottawa Decision Support Framework and the International Patient Decision Aid Standards Framework were used in these 6 publications. Interventions aimed to improve decision making regarding tube feeding for caregivers through static delivery methods. Caregivers rated these decision aids as helpful and acceptable. Decisional conflict and knowledge of feeding options were the most common outcomes evaluated. Reduction in decisional conflict and increase in knowledge were consistently found among dementia caregivers, but no intervention effects were found on preferences for the use of tube feeding.
    Conclusions and implications: Decision aid interventions effectively improve decision-making regarding tube feeding among the target population. Cultural adaptation of an existing decision aid intervention is the main strategy. However, the lack of guidance of a cultural adaptation framework in this process may lead to difficulties explaining caregivers' behavioral changes. Moreover, merely providing information is not enough to change caregivers' preferences or behavior of use of tube feeding. A systematic approach to cultural adaptation and interactive intervention is needed in future studies.
    MeSH term(s) Humans ; Aged ; Caregivers ; Decision Support Techniques ; Dementia
    Language English
    Publishing date 2022-09-21
    Publishing country United States
    Document type Journal Article ; Review
    ZDB-ID 2171030-2
    ISSN 1538-9375 ; 1525-8610
    ISSN (online) 1538-9375
    ISSN 1525-8610
    DOI 10.1016/j.jamda.2022.08.014
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  7. Article ; Online: Exploring the Relationship Between Health-Illness Transition Experiences and Distress Among Patients With Pancreatic Cancer.

    Goldberg, Jessica I / Flynn, Jessica R / Baser, Raymond E / Nelson, Judith E / Capezuti, Elizabeth / Schulman-Green, Dena

    Oncology nursing forum

    2023  Volume 50, Issue 5, Page(s) 625–633

    Abstract: Objectives: To explore the correlation between health-illness transition (HIT) experiences and distress among patients with pancreatic cancer.: Sample & setting: 55 patients with a diagnosis of pancreatic cancer receiving chemotherapy at a tertiary ... ...

    Abstract Objectives: To explore the correlation between health-illness transition (HIT) experiences and distress among patients with pancreatic cancer.
    Sample & setting: 55 patients with a diagnosis of pancreatic cancer receiving chemotherapy at a tertiary cancer center in New York.
    Methods & variables: A prospective correlational study was performed to explore the frequency, extent, and management of HITs. HITs were evaluated using the Measurement of Transitions in Cancer Scale, and distress was measured with the National Comprehensive Cancer Network Distress Thermometer.
    Results: All patients experienced at least one HIT. The extent of HITs decreased over time. Patients reported that they managed HITs moderately well. There was a significant correlation between unmanaged HITs and distress. As distress increased, the extent of the physical and emotional HITs increased and management worsened.
    Implications for nursing: HITs are ubiquitous among patients diagnosed with pancreatic cancer. Associated distress inhibits management. Nurses are well suited to assess for potential HITs and to support self-management of HITs.
    MeSH term(s) Humans ; Prospective Studies ; Pancreatic Neoplasms ; Emotions ; New York
    Language English
    Publishing date 2023-09-07
    Publishing country United States
    Document type Journal Article ; Research Support, N.I.H., Extramural ; Research Support, Non-U.S. Gov't
    ZDB-ID 604886-9
    ISSN 1538-0688 ; 0190-535X ; 1538-0688
    ISSN (online) 1538-0688 ; 0190-535X
    ISSN 1538-0688
    DOI 10.1188/23.ONF.625-633
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  8. Article ; Online: Development of the Palliative Care Law and Policy GPS to Assess National Policies in Palliative Care.

    Feder, Shelli L / Schulman-Green, Dena / Huer, Jennifer / Hoffman, Laura / Martins, Lynette B / Sinclair, Stacie / Gluck, Abbe R / Rusyn, Eugene

    Journal of palliative medicine

    2023  Volume 26, Issue 12, Page(s) 1698–1701

    Abstract: Background: ...

    Abstract Background:
    MeSH term(s) Humans ; Child ; Palliative Care ; Clinical Competence ; Workforce ; Telemedicine ; Policy ; Health Policy
    Language English
    Publishing date 2023-08-16
    Publishing country United States
    Document type Journal Article ; Research Support, N.I.H., Extramural
    ZDB-ID 1427361-5
    ISSN 1557-7740 ; 1096-6218
    ISSN (online) 1557-7740
    ISSN 1096-6218
    DOI 10.1089/jpm.2023.0200
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  9. Article ; Online: Managing Cancer Care: a psycho-educational intervention to improve knowledge of care options and breast cancer self-management.

    Schulman-Green, Dena / Jeon, Sangchoon

    Psycho-oncology

    2017  Volume 26, Issue 2, Page(s) 173–181

    Abstract: Objective: We tested the feasibility and acceptability of a psycho-educational self-management intervention, Managing Cancer Care: A Personal Guide (MCC), to improve knowledge of care options (curative, palliative, and hospice care) among a range of ... ...

    Abstract Objective: We tested the feasibility and acceptability of a psycho-educational self-management intervention, Managing Cancer Care: A Personal Guide (MCC), to improve knowledge of care options (curative, palliative, and hospice care) among a range of breast cancer self-management skills.
    Methods: We conducted a one-group, pre-post-test study among women with non-metastatic breast cancer (n = 105). We gave participants the printed, self-guided, seven-module intervention following enrollment. At baseline and 2  months, we measured knowledge of care options, desired and actual role in self-management, medical communication skills, experience and management of transitions, anxiety, depression, uncertainty, and self-efficacy. We conducted interviews to obtain module ratings and qualitative data on strengths and limitations of MCC.
    Results: Knowledge of care options (δ = 0.40 (1.11), p = 0.0005) and desired role in self-management (δ = -0.28 (1.08), p = 0.0177) significantly improved. Less skilled medical communicators significantly improved their communication (δ = 3.47, standard deviation = 6.58, p = 0.0449). Multivariate modeling showed that changes in our primary outcomes of medical communication and management of transitions seemed to drive positive changes in our secondary outcomes of anxiety, depression, uncertainty, and self-efficacy. Participants highly rated MCC and reported the importance of understanding care options despite non-metastatic disease.
    Conclusions: MCC is a feasible and acceptable means of improving knowledge of care options and other aspects of breast cancer self-management. The combination of modules offered in MCC appears to have beneficial interactive effects. We are currently testing MCC more rigorously in a randomized controlled trial to explore mediating and moderating relationships. Copyright © 2015 John Wiley & Sons, Ltd.
    Language English
    Publishing date 2017-02
    Publishing country England
    Document type Journal Article
    ZDB-ID 1118536-3
    ISSN 1099-1611 ; 1057-9249
    ISSN (online) 1099-1611
    ISSN 1057-9249
    DOI 10.1002/pon.4013
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  10. Article ; Online: Clinicians' Perceptions of a Modified Hospital Elder Life Program for Delirium Prevention During COVID-19.

    Schulman-Green, Dena J / Inouye, Sharon K / Tabloski, Patricia / Schmitt, Eva M / Shanes, Hannah / Fong, Tamara G

    Journal of the American Medical Directors Association

    2023  Volume 24, Issue 8, Page(s) 1133–1142

    Abstract: The Hospital Elder Life Program (HELP) is a multicomponent delirium prevention program targeting delirium risk factors of cognitive impairment, vision and hearing impairment, malnutrition and dehydration, immobility, sleep deprivation, and medications. ... ...

    Abstract The Hospital Elder Life Program (HELP) is a multicomponent delirium prevention program targeting delirium risk factors of cognitive impairment, vision and hearing impairment, malnutrition and dehydration, immobility, sleep deprivation, and medications. We created a modified and extended version of the program, HELP-ME, deployable under COVID-19 conditions, for example, patient isolation and restricted staff and volunteer roles. We explored perceptions of interdisciplinary clinicians who implemented HELP-ME to inform its development and testing. This was a qualitative descriptive study of HELP-ME among older adults on medical and surgical services during the COVID-19 pandemic. Participants included HELP-ME staff at 4 pilot sites across the United States who implemented HELP-ME.We held five 1-hour video focus groups (5-16 participants/group) to review specific intervention protocols and the overall program. We asked participants open-endedly about positive and challenging aspects of protocol implementation. Groups were recorded and transcribed. We used directed content analysis to analyze data. Participants identified general, technology-related, and protocol-specific positive and challenging aspects of the program. Overarching themes included the need for enhanced customization and standardization of protocols, need for increased volunteer staffing, digital access to family members, patient technological literacy and comfort, variation in the feasibility of remote delivery among intervention protocols, and preference for a hybrid program model. Participants offered related recommendations. Participants felt that HELP-ME was successfully implemented, with some modifications needed to address limitations of remote implementation. A hybrid model combining remote and in-person aspects was recommended as the preferred option.
    MeSH term(s) Humans ; Aged ; Delirium/prevention & control ; Delirium/epidemiology ; Pandemics ; COVID-19 ; Hospitals
    Language English
    Publishing date 2023-06-12
    Publishing country United States
    Document type Journal Article ; Research Support, N.I.H., Extramural ; Research Support, Non-U.S. Gov't
    ZDB-ID 2171030-2
    ISSN 1538-9375 ; 1525-8610
    ISSN (online) 1538-9375
    ISSN 1525-8610
    DOI 10.1016/j.jamda.2023.05.032
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