Martha Driessnack

University of Iowa, Iowa City, Iowa, United States

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Publications (39)36.5 Total impact

  • Genetic Testing and Molecular Biomarkers 08/2013; · 1.44 Impact Factor
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    ABSTRACT: The purpose of this study was to explore the feasibility, utility, and validity of using the Newest Vital Sign (NVS) tool to assess health literacy in children. Forty-seven parent-child dyads individually completed the NVS and a Home Literacy Environment single-item screening question (No. of children's books in the home). The majority (72%; n = 34) of parent-child dyads had adequate health literacy (NVS scores ≥4), with no significant differences (p = .95) between children's NVS scores (M = 4.8, SD = 1.5) and parents (M = 4.8, SD = 1.6). A moderate, positive correlation was found between children's and parents' NVS scores (rs = .35, p = .017). Of note was that all of the parents (n = 4) and children (n = 6) who reported having only 10 or fewer children's books in their homes had NVS scores less than 4, indicating inadequate health literacy. The NVS is a quick screening mechanism for identifying households that have adequate health literacy levels. Asking children the Home Literacy Environment single-question screening item (No. of children's books) provided additional insight that confirmed and extended findings from the NVS.
    Journal of Pediatric Health Care 07/2013; · 1.76 Impact Factor
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    ABSTRACT: BACKGROUND: The potential for genomic incidental findings is increasing with the use of genome-based testing. At the same time approaches to clinical decision making are shifting to shared decision-making models involving both the healthcare community and the public. The public's voice has been nearly absent in discussions on managing incidental findings. METHODS: We conducted 9 focus groups and 9 interviews (N=63) with a broad cross-section of lay public groups to elucidate public viewpoints on incidental findings that could occur as a result of genome-based testing in clinical and research situations. Data were analyzed using qualitative content analysis. RESULTS: Participants wanted incidental findings disclosed to them whether or not these were clinical or research findings. Participants used different terms to define and describe incidental findings; they wanted to know that incidental findings are possible and be given a choice to learn about them. Personal utility was an important reason for disclosure, and participants believed that managing information is a shared responsibility between professionals and themselves. CONCLUSION: Broad public input is needed in order to understand and incorporate the public's perspective on management of incidental findings as disclosure guidelines and policies are developed in clinical and research settings.
    Clinical Genetics 04/2013; · 4.25 Impact Factor
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    ABSTRACT: The implementation of new competencies is often challenging in nursing education. Particularly challenging are the basic genetic/genomic nursing competencies that have been established for all nurses, and the additional competencies advocated for the advanced practice nurse (APN). For current and new DNP programs, the attainment of the DNP Essentials outcomes assumes the prior attainment of BSN Essentials outcomes, which include these recent genetic/genomic core competencies. Accordingly, APN programs need to build on those recommended core genetic/genomic competencies that should have be achieved in prelicensure programs. The purpose of this presentation is to identify existing genetic/genomic knowledge gaps/specific learning needs of incoming graduate-level APN students and the available resources to enhance genetic/genomic competency. A focused review of the literature and synthesis of findings from studies of pre-licensure students, faculty, and programs was conducted related to: 1) genetic/genomic competencies being taught, 2) perceived importance of faculty toward genetic/genomic competencies, and 3) evaluation of student genetic literacy levels. Very few research studies examined the delivery of genetic/genomic content, attitudes of responsible faculty, and/or the assessment of genetic literacy levels either upon entry or exit from advanced practice nursing programs. We will present an overview of existing genetic/genomic faculty resources, genetic literacy assessment tools, and insights and implications for both incoming and graduating advanced practice nursing students. Through research inquiry, we found variation within and across faculty regarding perceived importance of genetic/genomic competencies and in the competencies actually being taught. Few competencies were viewed overwhelmingly as both important and also taught in nursing curriculum. For example, in one study, out of 27 genetic/genomic competencies, only two were identified both as moderately/very important to teach and also as being taught by 80% or more of the responding schools of nursing. In addition, we identified genetic/genomic concepts and competencies at greatest risk of not being reached. Use of genetic literacy tools early in the graduate nursing education curriculum can assist APN faculty in tailoring course assignments which address learner gaps and facilitate achievement of graduate genetic/genomic competency achievement.
    The National Organization of Nurse Practitioner Faculties 39th Annual Meeting; 04/2013
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    ABSTRACT: Although there are numerous position papers on the issues and challenges surrounding disclosure of incidental genomic findings involving children, there is very little research. To fill this gap, the purpose of this study was to explore the perspectives of multiple professional (N = 103) and public (N = 63) stakeholders using both interviews and focus groups. Using qualitative analysis, we identified one overarching theme, "It's hard for us; it's hard for them," and three subthemes/questions: "What to disclose?," "Who gets the information?," and "What happens later?" Perspectives differed between professional (Institutional Review Board chairs, clinicians, and researchers) and public stakeholders. While professionals focused on the complexities of what to disclose, the lay public stated that parents should have all information laid out for them. Professionals pondered multiple parent and child situations, while the public identified parents as informational gatekeepers who know their children best. Professionals described the potential requirement for follow-up over time as a logistical "nightmare," while the public believed that parents have the responsibility for managing their children's health information over time. However, the parent role as gatekeeper was seen as time limited and in need of professional support and backup. Our findings present a case for needed dialogue around what we propose as an "ethically important moment," with the goal of protecting and respecting the viewpoints of all stakeholders when policies regarding children are developed.
    Journal of community genetics 04/2013;
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    ABSTRACT: Next generation sequencing offers benefit of improved health through knowledge, but comes with challenges, such as inevitable incidental findings (IFs). The applicability of recommended criteria for disclosure of individual results when applied to disclosure of IFs is not well known. The purpose of this study was to examine how medical genetic specialists, genomic researchers, and Institutional Review Board (IRB) chairs perceive the importance of recommended criteria when applied to genetic/genomic IFs. We conducted telephone interviews with medical genetic specialists (genetic counselors, genetic nurses, medical geneticists, laboratory professionals), genomic researchers, and IRB chairs (N = 103). Respondents rated and discussed the importance of nine recommended criteria regarding disclosure of genetic/genomic IFs. Stakeholders agreed the most important criteria for disclosure were: (1) the IF points to a life-threatening condition; (2) there is a treatment; (3) individuals indicate in writing they wanted to be informed of IFs. Criteria rated less important were: analytic validity, high penetrance, association with a young age of onset and relative risk more than 2.0. Respondents indicated that some technical criteria were confusing, and in need of context. Our findings suggest that development of guidelines regarding management of IF include multiple stakeholders' perspectives and be based on a common language.
    Journal of Genetic Counseling 04/2013; · 1.45 Impact Factor
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    ABSTRACT: The purpose of this study was to identify helpfulness of strategies used by teens growing up in families with Huntington disease. Forty-four participants responded to a mailed HD Family Survey-Teens Strategies. Strategies were those with strong positive correlation between use and perceived helpfulness, and those with negative or inverse relationships. Obtaining information, thinking about or doing something else, and actions on behalf of the parent with HD were rated as highest use and perceived helpfulness. Emotional suppression had high use but low helpfulness. Participants reported using numerous helpful strategies. Social support was often unavailable to help manage teen concerns.
    Journal of pediatric nursing 03/2013; · 0.92 Impact Factor
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    Ryoko Furukawa, Martha Driessnack, Yoshiko Colclough
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    ABSTRACT: Various methods have been used to translate existing assessment tools and clinical nursing materials from one language to another. The method of choice depends on the research objectives, availability of translators, budget, and time. We highlight our experience using the Committee Approach to translation. This less commonly used approach introduces the concept of cultural consensus building early in the translation process, which is particularly appropriate when languages are culturally and linguistically distant. Our experience centers on the translation of the Primary Communication Inventory (PCI), from English to Japanese, to study first-time parents in Japan.
    Applied nursing research: ANR 01/2013; · 0.87 Impact Factor
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    ABSTRACT: OBJECTIVE: Evidence documenting management of incidental findings (IFs) from clinical genomic testing is limited. The aim of this study was to examine genetics specialists' perspectives regarding current and preferred disclosure of clinical genomic IFs. METHODS: 50 genetics specialists, including medical geneticists, laboratory professionals, genetic counselors, and nurses participated in structured telephone interviews. Data were analyzed using qualitative content analysis and descriptive statistics. RESULTS: Most specialists had encountered IFs, but definitions of IFs varied. They discussed challenges with informing patients about the prospect of IFs and disclosing IFs to patients. Causing psychological harm to patients was a concern. Participants were divided on whether IFs needed to be clinically significant and/or actionable in order to be disclosed to patients. Creating formal disclosure guidelines was considered useful, but only if they were flexible. Additional counseling, more interdisciplinary communication, maintaining contact with patients, and a centralized database to interpret IFs were also proposed. CONCLUSION: Genetics specialists offer insights into the challenges of defining IFs, knowing when and how to disclose them, and the potential need for flexible disclosure guidelines. PRACTICE IMPLICATIONS: Further discussion between practicing genetics specialists is needed to develop consensus on the development of best-practice guidelines for IF management.
    Patient Education and Counseling 10/2012; · 2.60 Impact Factor
  • Ryoko Furukawa, Martha Driessnack
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    ABSTRACT: It can be difficult to maintain family connections with geographically distant members. However, advances in computer-human interaction (CHI) systems, including video-mediated communication (VMC) are emerging. While VMC does not completely substitute for physical face-to-face communication, it appears to provide a sense of virtual copresence through the addition of visual and contextual cues to verbal communication between family members. The purpose of this study was to explore current patterns of VMC use, experiences, and family functioning among self-identified VMC users separated geographically from their families. A total of 341 participants (ages 18 to above 70) completed an online survey and Family APGAR. Ninty-six percent of the participants reported that VMC was the most common communication method used and 60% used VMC at least once/week. The most common reason cited for using VMC over other methods of communication was the addition of visual cues. A significant difference between the Family APGAR scores and the number of positive comments about VMC experience was also found. This exploratory study provides insight into the acceptance of VMC and its usefulness in maintaining connections with distant family members.
    Clinical Nursing Research 05/2012; · 0.86 Impact Factor
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    ABSTRACT: Chronic headaches are one of the top five health problems for young children in the United States, negatively affecting their quality of life and learning opportunities. A clear understanding of children's headache characteristics is crucial for delivering appropriate treatment. However, current data collection methods were designed for adults often resulting in insufficient information. In this paper we present a novel method to help children communicate with health care providers and researchers about their headaches. It augments an existing child-centric method called Draw-and-Tell Conversation, which has already been shown to provide more actionable information from children than standard data collection methods. It does so by enabling children to draw their symptoms on a zoomable drawing application, giving them the ability to provide more details and context than on paper. We present a study conducted with nineteen children aged 7 to 12 suggesting that children provided more information about their headaches when using the zoomable drawing application than when drawing on paper. This study provides a rare example of a mobile device used to enhance face-to-face interactions and contributes evidence of a specific benefit of zoomable user interfaces.
  • Martha Driessnack, Juan Pablo Hourcade, Kelsey Huebner
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    ABSTRACT: Background: While the development of point-of-care (POC) documentation has improved many aspects of patient care, including patient safety, it has unfortunately resulted in reductions in both verbal and visual interactions between providers and patients. There is a need for POC documentation mechanisms that instead sustain and/or enhance nurse/patient interactions. Nowhere is this more important than in interactions with children, where communication is often already a challenge. Purpose: Children with chronic headaches were selected as a prototype population to explore using a novel, computer-based drawing application developed to enhance POC communication of children’s pain experiences. Headache was selected as it is the most common and one of the most disabling types of chronic pain in childhood, affecting 60.5% of children. Methods: This was an exploratory pilot using a modified cooperative inquiry approach. 20 children, 7-12 years of age with chronic primary headaches (e.g. migraines, tension-type) were recruited through two pediatric neurology clinics. Each child participated in a1:1 interactive interview about their headache pain experience using a ‘zoomable’ drawing application on a Dell XT2 tablet with multi-touch display and attached digital pen. Each session was videotaped and screen recording software (Camtasia©) was used to capture the drawing process. Data were analyzed using basic descriptive statistics and content analysis. Results/Findings: Children’s drawings and accompanying narratives were clear and focused. Children described very specific patterns of headache pain, including the location, primary and secondary symptom descriptors, and actions/behaviors that accompanied their headaches (e.g. placing an ice pack, lying down). The number of descriptors ranged from 7-19, with a median of 12. The ability to ‘zoom’ in/out using their fingers, offered children with the opportunity to provide additional details as well as context. The median time for completion was 5 minutes. Discussion/Implications: Using a novel, computer-based drawing application, children to provided rich descriptions of their headache experiences, without any hesitation. The time it took would fit into a regular visit. Further, the format for these POC drawings and/or screen/voice recordings is able to be stored as electronic medical record files.
    2013 Western Institute of Nursing Annual Communicating Nursing Research Conference; 04/2012
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    ABSTRACT: We conducted a systematic literature review to identify tools that could be used to measure faculty and undergraduate nursing students' genetic literacy, and we assessed the utility of one of those tools, the Genetic Literacy Assessment Instrument (GLAI), with faculty and students at a college of nursing in a large public university. No significant differences were noted between faculty and students in terms of their overall scores on the GLAI. On average, faculty answered 76% of the questions correctly and students answered 73% of the questions correctly. Both groups scored highest in the genetics and society domain (93% and 85% correct answers for faculty and students, respectively) and lowest in the evolution domain (52% correct for both groups). The GLAI may be used to evaluate curricula for strengths and deficiencies, as well as to identify students and faculty in need of additional instruction.
    Journal of Nursing Education 03/2012; 51(5):294-8. · 1.13 Impact Factor
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    ABSTRACT: Genomic research can produce findings unrelated to a study's aims. The purpose of this study was to examine researcher and Institutional Review Board (IRB) chair perspectives on genomic incidental findings (GIFs). Nineteen genomic researchers and 34 IRB chairs from 42 institutions participated in semi-structured telephone interviews. Researchers and chairs described GIFs within their respective roles. Few had direct experience with disclosure of GIFs. Researchers favored policies where a case by case determination regarding whether GIF disclosure would be offered after discovery, whereas IRB chairs preferred policies where procedures for disclosure would be determined prior to approval of the research. Researcher and IRB chair perspectives on management of GIFs overlap, but each group provides a unique perspective on decisions regarding disclosure of GIFs in research. Engagement of both groups is essential in efforts to provide guidance for researchers and IRBs regarding disclosure of GIFs in research.
    Genetic Testing and Molecular Biomarkers 02/2012; 16(6):508-13. · 1.44 Impact Factor
  • Martha Driessnack, Ryoko Furukawa
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    ABSTRACT: The purpose of this study was to identify the different arts-based techniques being used in health-related research with children. A systematic survey of literature was conducted. Two hundred and ten articles were initially identified and reviewed. Of these, 116 met inclusion criteria of arts-based techniques in research with children 7-12 years of age. The different categories of techniques identified included (a) drawings, (b) photographs, (c) graphics, and (d) artifacts. Only 19% of the studies were health related. Further, 79% were conducted outside the United States, revealing that arts-based techniques appear to be underused by nurses and other healthcare researchers, especially in the United States. To ensure that children actively engage in research involving them, nurses can familiarize themselves with and advocate for the use of arts-based techniques.
    Journal for Specialists in Pediatric Nursing 01/2012; 17(1):3-9. · 0.78 Impact Factor
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    ABSTRACT: It is unclear how genomic incidental finding (GIF) prospects should be addressed in informed consent processes. An exploratory study on this topic was conducted with 34 purposively sampled Chairs of institutional review boards (IRBs) at centers conducting genome-wide association studies. Most Chairs (96%) reported no knowledge of local IRB requirements regarding GIFs and informed consent. Chairs suggested consent processes should address the prospect of, and study disclosure policy on, GIFs; GIF management and follow-up; potential clinical significance of GIFs; potential risks of GIF disclosure; an opportunity for participants to opt out of GIF disclosure; and duration of the researcher's duty to disclose GIFs. Chairs were concerned about participant disclosure preferences changing over time; inherent limitations in determining the scope and accuracy of claims about GIFs; and making consent processes longer and more complex. IRB Chair and other stakeholder perspectives can help advance informed consent efforts to accommodate GIF prospects.
    Journal of Empirical Research on Human Research Ethics 12/2011; 6(4):53-67. · 1.49 Impact Factor
  • Martha Driessnack, Agatha M Gallo
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    ABSTRACT: The intersection of the genomic era and information age has created novel ethical, legal, and social issues that may be beyond the reach of existing guidelines for children and adolescents in research. By taking the opportunity to stop, to look, and to listen, nurses are in an ideal situation to help children, adolescents, and families understand these emerging and important issues. This chapter thus reviews and highlights the issues and challenges that arise when children and adolescents are involved in genomic research. First, we stop and review existing guidelines for the protection of individual children and adolescents in research and existing gaps and inconsistencies in their implementation. Then we take a closer look at the unique features of genetic and genomic research that create particular ethical challenges for completing the informed consent process when the research participant is a child or adolescent. Finally, we challenge nurses to listen more intently to what children and their families need to know before they are included in genetic and genomic research. We emphasize the changing context of children's lives today and the emergence of their decision-making skills.
    Annual review of nursing research 12/2011; 29:133-49.
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    ABSTRACT: Adolescents, who have a parent with Huntington Disease (HD), not only are at genetic risk for HD but also are witness to its onset and devastating clinical progression as their parent declines. To date, no mechanism has been developed to direct health care providers to the atypical adolescent experiences of these teens. The purpose of this report is to describe the process of developing the HD-Teen Inventory clinical assessment tool. Forty-eight teens and young adults from 19 U.S. states participated in the evaluation of the HD-Teen Inventory tool. Following item analysis, the number of items was reduced and item frequency and reaction scales were combined, based on the strong correlation (r = .94). The resultant tool contains 15 inventory and 2 open-ended response items. The HD-Teen Inventory emerged as a more compact and efficient tool for identifying the most salient concerns of at-risk teens in HD families in research and/or clinical practice.
    Clinical Nursing Research 06/2011; 21(2):213-23. · 0.86 Impact Factor
  • Martha Driessnack
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    ABSTRACT: Background: Self report remains the gold standard in pain research. Yet, the majority of pediatric self-report tools used in pain research and clinical practice were originally developed with and for adults, not children. Adding child-friendly pictures and/or language does not eliminate the adult-centered and –biased origins or nature of the tools. To improve the accuracy of research with children there is a critical need to develop child-sensitive tools that match children’s processing capabilities. One child-sensitive approach to self-report is the Draw-and-Tell Conversation (DTC). Purpose: The purpose of this study was to explore transitioning the DTC to a computer platform. Methods: Using a cooperative inquiry approach, 16 children completed a DTC using both paper/pencil and multi-touch tablet PC applications. Each DTC was video-taped. To focus the study, only children between 7-12 years of age with primary headache were recruited. These children were purposefully selected because headaches are common, intrusive, interfere with learning, and the tools used to assess these children were developed with and for adults first and only later adapted for use with children. Findings: While the children advocated for both approaches, the narratives that accompanied the drawings using a multi-touch PC provided new insights into headache pain and the ability of children to communicate these insights in detail. Using the multi-touch PC, children created personalized pain communication tools, inserting their own self-portraits or photos. Of particular interest was the dichotomous, rather than scaled, nature of their self-report of headache pain. Implications: Headaches are one of the top five health problems for young children and there are indications that existing rates are on the rise. Headaches currently account for over a million lost school days each year. Further, 70% of children with chronic headaches continue to experience headaches into adulthood, leaving to question whether or not existing measures and intervention efforts are adequate. The development of child-sensitive approaches to self-report may provide insight into personalized assessment and/or tailoring of interventions, not only for children with headache pain, but also for other health-related phenomena. The ability to transition the DTC to a computer platform may also be helpful for children with limited mobility. Funding provided by a 2009 Social Science Funding Program (SSFP) Grant [University excluded in blinded copy]
    2012 Western Institute of Nursing Annual Communicating Nursing Research Conference; 04/2011
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    ABSTRACT: The extent to which individuals' perceptions of risk for type 2 diabetes are related to their actual risks and health-promoting behaviours is not well known. Yet perception of risk for type 2 diabetes may influence the likelihood that individual would engage in preventive behaviours. The purpose of this study was to evaluate the psychometric properties of the perception of risk factors for type 2 diabetes (PRF-T2DM). A descriptive, correlational, methodological design was used to conduct this study. The sample consisted of 629 adults from 42 states of the United States. A demographic questionnaire, the PRF-T2DM, the health-promoting lifestyle profile II and the depressive cognition scale were used to collect the data. Data analyses consisted of descriptive statistics, scale and item analyses, Pearson's correlation analysis, and exploratory and confirmatory factor analyses. The PRF-T2DM has a Cronbach's alpha of 0.81. Both extracted factors had Cronbach's alphas of 0.74 and 0.80, respectively. Most inter-item and item-to-total correlation coefficients for factor 1 and factor 2 met the recommended criteria of r=0.30 to r=0.70. The PRF-T2DM achieved all minimum recommended criteria for model fit (χ(2) /d.f.=2.33, goodness of fit index=0.95, adjusted goodness of fit index=0.93, comparative fit index=0.94, root mean square error of approximation=0.05, root mean residual=0.05 and the P value for test of close fit=0.33). All statistical estimates and measures of model fit were above the standard recommended criteria. The scale has potential uses in research and clinical practice. Further development and psychometric evaluation of the PRF-T2DM is warranted.
    Journal of Evaluation in Clinical Practice 12/2010; 16(6):1096-102. · 1.51 Impact Factor

Publication Stats

138 Citations
36.50 Total Impact Points


  • 2006–2013
    • University of Iowa
      • College of Nursing
      Iowa City, Iowa, United States
  • 2005–2013
    • Oregon Health and Science University
      • School of Nursing
      Los Angeles, CA, United States
  • 2010
    • Johns Hopkins University
      Baltimore, Maryland, United States
  • 2007
    • University of North Carolina at Charlotte
      • College of Health and Human Services
      Charlotte, NC, United States