• Perspectives in Nursing Science
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• v.2 no.1
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• pp.37-47
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• 2005

Biobehavioral nursing research is focused on generating knowledge that examines relations among biological, behavioral, and social dimensions of health to improve outcomes. In this paper we review the findings of a biobehavioral nursing study of individuals with fibromyalgia (FM) that was framed from the perspective of an individual human response model, the FM literature, and our previous studies in midlife women. We were particularly interested in the studying the role of 'arousal' secondary to pain or to dysregulated hypothalamic-pituitary-adrenal (HPA) axis hormones during sleep and the impact on symptom expression. Unexpectedly, we did not find evidence of, arousal' or abnormal amounts of HPA axis hormones but we did find reduced amounts of growth hormone (GH) and prolactin (PRL) and of sleep spindle activity, a biomarker of sleep maintenance. We discuss these new findings and how our thinking was re-shaped to better understand the role that disturbed sleep plays in symptom expression in FM. It is argued that disturbed sleep maintenance mechanisms coupled with dysregulated somatotrophic-growth hormone axis and sleep-related PRL render individuals vulnerable to the development of or exacerbations of FM symptoms.

• Safety and Health at Work
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• v.5 no.3
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• pp.161-164
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• 2014

Obesity is a significant problem affecting United States (US) firefighters. While body mass index (BMI) is widely used to diagnose obesity, its use for this occupational group has raised concerns about validity. We examined rates and types of misclassification of BMI-based obesity status compared to body fat percentage (BF%) and waist circumference (WC). Male career firefighters (N = 994) from 20 US departments completed all three body composition assessments. Mean BMI, BF%, and WC were $29kg/m^2$, 23%, and 97 cm, respectively. Approximately 33% and 15% of BF%- and WC-defined obese participants were misclassified as non-obese (false negatives) using BMI, while 8% and 9% of non-obese participants defined by BF% and WC standards were identified as obese (false positives) using BMI. When stratified by race/ethnicity, Pacific Islanders showed high rates of false positive misclassification. Precision in obesity classification would be improved by using WC along with BMI to determine firefighters' weight status.

• Safety and Health at Work
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• v.6 no.1
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• pp.71-74
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• 2015

Obesity and fitness have been identified as key health concerns among USA firefighters yet little is known about the current habits related to exercise and diet. In particular, high-intensity training (HIT) has gained increasing popularity among this population but limited quantitative data are available about how often it is used and the relationship between HIT and other outcomes. Using survey methodology, the current study evaluated self-reported HIT and diet practice among 625 male firefighters. Almost one-third (32.3%) of participants reported engaging in HIT. Body composition, as measured by waist circumference and percentage body fat, was significantly related to HIT training, with HIT participants being approximately half as likely to be classified as obese using body fat [odds ratio (OR) = 0.52, 95% confidence interval (CI) = 0.34-0.78] or waist circumference (OR = 0.61, 95% CI = 0.37-0.98). Those who engaged in HIT were more than twice as likely as those who did not (OR = 2.24, 95% CI = 1.42-3.55) to meet fitness recommendations. Findings highlight directions for future prevention and intervention efforts.

• Perspectives in Nursing Science
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• v.2 no.1
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• pp.1-18
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• 2005

Health care providers working with IBS patients are challenged in that the underlying pathophysiology remains poorly defined and treatments are not universally effective (American College of Gastroenterology Functional Gastrointestinal Disorders Task Force, 2002). Nurses often work with patients to identify factors provoking or alleviating symptoms and based on these observations hone strategies to manage symptoms. Understanding stress induced alterations in sleep and ANS function may provide important clues as to additional self-management strategies to test.

• Proceedings of the KAN Conference
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• 2005.10a
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• pp.22-24
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• 2005

• Journal of Korean Academy of Nursing
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• v.43 no.5
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• pp.579-586
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• 2013

Purpose: This article provides an update and overview of a nursing research program focused on understanding the pathophysiology and management of irritable bowel syndrome (IBS). Methods: This review includes English language papers from the United States, Europe, and Asia (e.g., South Korea) from 1999 to 2013. We addressed IBS as a health problem, emerging etiologies, diagnostic and treatment approaches and the importance of a biopsychosocial model. Results: IBS is a chronic, functional gastrointestinal disorder characterized by recurrent episodes of abdominal pain and alterations in bowel habit (diarrhea, constipation, mixed). It is a condition for which adults, particularly women ages 20-45, seek health care services in both the United States and South Korea. Clinically, nurses play key roles in symptom prevention and management including designing and implementing approaches to enhance the patients' self-management strategies. Multiple mechanisms are believed to participate in the development and maintenance of IBS symptoms including autonomic nervous system dysregulation, intestinal inflammation, intestinal dysbiosis, dietary intolerances, alterations in emotion regulation, heightened visceral pain sensitivity, hypothalamic-pituitary-adrenal dysregulation, and dysmotility. Because IBS tends to occur in families, genetic factors may also contribute to the pathophysiology. Patients with IBS often report a number of co-morbid disorders and/or symptoms including poor sleep. Conclusion: The key to planning effective management strategies is to understand the heterogeneity of this disorder. Interventions for IBS include non-pharmacological strategies such as cognitive behavior therapy, relaxation strategies, and exclusion diets.

• Women's Health Nursing
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• v.15 no.4
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• pp.381-386
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• 2009

Interstitial Cystitis/Painful Bladder Syndrome: Prevalence Estimates, Quality of Life and Depression among Older Adult Korean Women. What is already known about the topic? 1) Interstitial Cystitis/Painful bladder syndrome (IC/PBS) is a chronic, painful, inflammatory condition of the bladder wall. 2) Previous studies examining the prevalence and impact were focused on middle life women and not elderly women. 3) Epidemiologic studies of IC/PBS have been predominantly conducted in Western countries and little research reported in Asian countries.

• Perspectives in Nursing Science
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• v.2 no.1
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• pp.92-104
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• 2005

Obesity rates are increasing worldwide, associated with excess acute and chronic disease risk. In most countries, obesity rates among women exceed rates in men, particularly during the post menopausal years. Many factors affect body weight and appetite, including age, metabolic rate, physical activity level, stress, cultural factors, socioeconomic status, health status and health literacy, diet composition, attitudes, and beliefs. Gender affects appetite and body weight indirectly by altering factors contributing to food choice. However, there is emerging evidence that gender affects appetite and body weight directly, altering the physiological control systems regulating appetite. The follicular menstrual cycle phase (estrogen-rich) is associated with relative suppression of appetite. Lower estrogen levels are associated with increased food intake, body weight gain, and altered body fat distribution in humans and animals. This paper reviews the linkages between estrogen and appetite regulation. While relationships among appetite, body weight, and gender-linked hormones are complex, research elucidating these interrelationships could lead to development of gender-specific treatment approaches for obesity and appetite dysregulation.

• Perspectives in Nursing Science
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• v.2 no.1
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• pp.48-60
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• 2005

The relationship of psychological stress to human health is of interest to health care providers and researchers in the field of psychoneuroimmunology. The effect of stress on wound healing is a sub-component of study within the larger context, with relevance to both wounds that are acute and chronic in nature. Data from several studies that explore the influence of stress on events early in the trajectory of wound healing suggest that activation of both the sympathetic nervous system and the hypothalamic-pituitary-adrenal axis are involved. There is consistent evidence that psychological stress is associated with dysregulation of immune and other responses to tissue injury that are required for healing and also to the final wound healing result. Current data pertinent to psychological stress and its wound healing consequences is reviewed and a biopsychosocial framework for future studies in this area is suggested and described.

• Research in Community and Public Health Nursing
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• v.33 no.4
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• pp.385-395
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• 2022

Purpose: To support implementation of comprehensive, person-centered healthcare, this study aimed to explore immigrant women's public health center (PHC) service experiences and needs while considering Photovoice's feasibility for this purpose. Methods: This qualitative study included 15 marriage-based immigrant women. Participants were recruited from churches and multicultural family support centers using purposive and snowball sampling. Data were collected through four focus group interviews and were subjected to inductive content analysis. Results: Five categories of experiences were identified: language barriers, hectic environment, affordable and practical primary healthcare, feeling ignored and discriminated against, and feeling frustrated. In addition, five categories of needs were identified: language assistance services, ease of access, healthcare across the lifespan, expansion of affordable healthcare, and being accepted as they are. This study provides preliminary evidence that the Photovoice approach can facilitate the interview process in a qualitative inquiry involving participants with limited ability to express their perspectives in the researchers' language. Conclusion: Study findings highlight the need to implement institutional policy and procedural changes within PHCs and to provide culturally competent, personcentered care for South Korea's marriage-based immigrant women and other ethnic minority populations. The findings also provide evidence-based direction for PHC service planning.