Matching Items (3)
Description
Health-related quality of life (HR-QOL) is a significant treatment outcome for persons with end-stage renal disease (ESRD); however, little is known about the HR-QOL of Mexican patients with ESRD. This pilot study describes relationships between demographics, sleep disorders, spirituality, mood, folk practices and dialysis modality on the HR-QOL of patients with ESRD residing in Guanajuato, Mexico. Mexican patients receiving continuous ambulatory peritoneal dialysis (CAPD), automated peritoneal dialysis (APD) and hemodialysis (HD) provided information on demographics, clinical health data including body mass index (BMI), and folk health practices. Measures included the Short Form (SF)-36 HR-QOL survey, Sleep Habits Questionnaire, Latin Spirituality Perspective Scale and Hospital Anxiety and Depression Scale. Data were analyzed using SAS software (V9.1). Signifi¬cance level for this pilot study was set at p<0.10. The Quality-Adjusted Life Year method was utilized to examine cost effectiveness for each dialysis modality. Demographics and clinical data showed participants (N=121) to be 59 (SD=13) years, predominantly men (55.4%), married (66.9%), Catholic (92.6%), and not currently working (78.3%). The majority were diabetic (72%) and slightly overweight (BMI M=26.1; SD=5.1). The CAPD group (n=39) demonstrated significantly lower HR-QOL scores compared to the APD (n=42) and HD (n=40) groups. Patients on HD reported higher rates and greater numbers of sleep disorders, including insomnia symptoms, non-restorative and insufficient sleep, and daytime somnolence compared to patients on CAPD and APD. Patients on CAPD reported more anxiety and depression compared to patients on HD and APD. Overall linear regression for HR-QOL found dialysis type, sleep disorders and income to be significant predictors and the model accounted for 31% of the variance. Cost analysis indicated APD as the preferred treatment because it is less costly and results in the best HR-QOL compared to the other treatment modalities. Findings provide the first SF-36 norms for Mexicans with ESRD. Sleep disorders and dialysis type greatly impinge on the HR-QOL of these patients, particularly their mental health. APD was identified as the preferred treatment based on low cost and improved HR-QOL. Results can inform clinical care and health policy for Mexican patients with ESRD.
ContributorsReynaga-Ornelas, Luxana (Author) / Baldwin, Carol M. (Thesis advisor) / Quan, Stuart F (Committee member) / Arcoleo, Kimberly (Committee member) / Arizona State University (Publisher)
Created2011
Description
Obesity in Hispanic youth has reached alarmingly high levels, increasing the risk of type 2 diabetes, hyperlipidemia, hypertension, and cardiovascular disease. In Mexican American children ages 6-11 years, 41.7% are overweight and obese, 24.7% are obese and 19.6% have a Body Mass Index (BMI) greater than the 97th percentile. While personal, behavioral, and environmental factors contribute to these high rates, emerging literature suggests acculturation, self-efficacy and social support are key influences. The one-group, pre- and post-test, quasi-experimental design used a community-based participatory research (CBPR) method to test the feasibility, acceptability, and preliminary efficacy of the 8-week intervention. Social Cognitive Theory (SCT) was used to guide the design. Measurements included an analysis of recruitment, retention, participant satisfaction, observation of intervention sessions, paired t-tests, effect sizes, and bivariate correlations between study variables (acculturation, nutrition and physical activity [PA] knowledge, attitude and behaviors, perceived confidence and social support) and outcome variables (BMI z-score, waist circumference and BP percentile) Findings showed the SSLN program was feasible and acceptable. Participants (n = 16) reported that the curriculum was fun and they learned about nutrition and PA. The retention rate was 94%. The preliminary effects on adolescent nutrition and PA behaviors showed mixed results with small-to-medium effect sizes for nutrition knowledge and attitude, PA and sedentary behavior. Correlation analysis among acculturation and study variables was not significant. Positive associations were found between perceived confidence in eating and nutrition attitude (r = .61, p < .05) and nutrition behavior (r = .62, p < .05), perceived confidence in exercise and nutrition behavior (r = .66, p < .05), social support from family for exercise and PA behavior (r = .67, p < .01) and social support from friends for exercise and PA behavior (r = .56, p < .05). These findings suggest a culturally specific healthy eating and activity program for adolescents was feasible and acceptable and warrants further investigation, since it may fill a gap in existing obesity programs designed for Hispanic youth. The positive correlations suggest further testing of the theoretical model.
ContributorsStevens, Carol (Author) / Gance-Cleveland, Bonnie (Thesis advisor) / Komnenich, Pauline (Committee member) / Shaibi, Gabriel (Committee member) / Arcoleo, Kimberly (Committee member) / Arizona State University (Publisher)
Created2011
Description
African American students are one of the historically disadvantaged groups by the public education system. Related to this phenomenon is the overrepresentation of African American children in special education due to disability diagnoses, which has been referred to as disproportionality. It has been hypothesized that disproportionality is due to poverty or a cultural mismatch between primarily white, middle-class teachers and African American students. Using a sample of African American children in special education from Memphis, Tennessee, this secondary data analysis explored the relationship between children's behavioral and educational outcomes and their environment, efficacy beliefs, and the impact of an intervention, the Nurse-Family Partnership. This study also explored differences in children's externalizing and internalizing behaviors by self-report, children's mothers and children's teachers. Using multiple imputation and regression analyses, the results indicated the following: 1) children's self-efficacy and number of hours in special education were associated with children's academic achievement, 2) mothers' and teachers' ratings of children's behaviors differed from children's self-report of their behaviors, 3) African American boys are more likely to experience acting-out behaviors, while African American girls are more likely to experience anxiety and depression, 4) children were less likely to experience anxiety and depression if their mother believed that she had control over circumstances in her life. These findings are discussed in light of Brofenbrenner's ecological systems theory and Bandura's social cognitive theory.
ContributorsBean, Kristen (Author) / Segal, Elizabeth (Thesis advisor) / Arcoleo, Kimberly (Committee member) / Gerdes, Karen (Committee member) / Arizona State University (Publisher)
Created2012