Kristen Sethares

University of Massachusetts Dartmouth | UMD · College of Nursing and Health Sciences

Background Recent research has focused on the relationship between heart failure (HF) symptom clusters and outcomes, including mortality, hospitalization, functional status, and quality of life. No known studies to date have explored the role of physical HF symptom clusters and delays in seeking treatment. Objectives Describe physical symptom clus...

Background There has not been a significant improvement in cardiovascular disease (CVD) statistics among women; 44.4% of women older than 20 years have a diagnoses of CVD. Only 24.3% of adults meet physical activity (PA) guidelines, women have significantly lower levels of PA significantly lower levels than men. There is a call to action from the A...

BACKGROUND: The incidence of stroke has increased for those < 64 years of age over the last decade. Control of hypertension is one of the greatest modifiable risk factors for preventing stroke but remains elusive. In 2017, the American College of Cardiology and American Heart Association national blood pressure guidelines tightened the definition o...

Heart failure is a chronic, progressively worsening condition afflicting more than 64 million individuals worldwide. Heart failure outcomes are influenced by self-care, a naturalistic patient-centered decision-making process. The situation-specific theory of heart failure self-care addresses how this decision-making process determines actions and o...

A time burden, financial strain, and prioritizing care recipient needs over their own are key barriers preventing informal caregivers from engaging in health-promoting self-care. Primary healthcare providers are well positioned to assess and support informal caregivers. A cross sectional descriptive, correlational study was used to examine the know...

Background: This integrative review synthesized the findings of studies to determine the uses and outcomes of guided reflection in simulation-based education (SBE) with prelicensure nursing students. Method: A search of Cumulative Index to Nursing and Allied Health (CINAHL) Plus, Education Resources Information Center (ERIC), Education Research...

Background: Research suggests that clinical practicums in hospital-based settings are important, even if condensed, to provide students with the opportunity for real-world learning experiences. Rational dialogue makes learning meaningful and empowers students to learn by reflecting on experiences. Problem: The COVID-19 pandemic minimized availab...

Background Gender differences exist in structure and function of the heart resulting in HF symptom variation. Previous HF symptom cluster research described symptom clusters that were linked to functional status, mortality, quality of life and rehospitalization. Age and gender differences between cluster groups were described in one study. Objecti...

A theory-guided non-experimental, descriptive, correlational design was used to evaluate how entry and passage variables were related to nursing home adjustment for individuals with dementia. Older adults with dementia may be unable to speak for themselves, therefore proxy responses of Certified Nursing Assistants (CNAs) provided the data for compl...

Introduction There is a lack of lesbian, bisexual and gay (LGB)-focused nursing research, in part, because the population is traditionally difficult to access. This article explores the effectiveness, benefits, and limitations of online recruitment of a distinct population of LGB-identified nurses in a study of substance use and minority stress. M...

Background The role of uncertainty, unpredictable symptoms, and unknown illness trajectory are frequent concerns reported in heart failure (HF) literature. Illness uncertainty can lead to difficulty interpreting symptoms, potentially impacting outcomes. Impaired functional status, quality of life, all-cause mortality, rehospitalization, and event-f...

Background Individuals with underlying cardiovascular disease (CVD) have an increased vulnerability to COVID-19 and poorer outcomes. Little is known about the impact social distancing guidelines have had on the health behaviors of this population. Objective The purpose of this study was to examine levels of social isolation, anxiety, depression, l...

Background: Metacognitive knowledge and regulation are critical to nursing students who must apply knowledge to rapidly changing and complex conditions. Exam wrappers assist learners to consider past study habits with the goal of improving future exam preparation. However, little is known about use of exam wrappers in nursing education. Purpose:...

Background Exam wrapper, a structured self-regulated learning strategy, assists students to review study habits and performance on an exam with the goal of improving future study habits. Little is known about the use of this strategy in nursing students, particularly associate degree students. Objectives To describe and compare demographic charact...

Aim: This study aimed to explore how nursing students define and describe academic and clinical integrity and to identify social and psychological influences on student decisions to act with integrity. Backgroud: Nursing students are exhibiting a decline in academic and clinical integrity. Academic dishonesty often correlates to clinical dishone...

Purpose: Nurse practitioners (NPs) are in a unique position to address the problem of opioid use disorders (OUDs) because they provide a large percentage of primary care services (Agency for Healthcare Research and Quality, 2014). This study aimed to increase doctoral NP students' beliefs/attitudes about their ability to care for and about individ...

A focus group methodology was employed to elicit information from Certified Nursing Assistants (CNAs) about their views of the personality, social, institutional and cultural factors that affect the success or failure of elders' adaptation to nursing home life. The focus group (N = 6) was conducted in one long-term care facility. CNAs identified th...

Social determinants of health (SDH) are known to influence health. Adequate self-care maintenance improves heart failure (HF) outcomes. However, the relationship between self-care maintenance and SDH remains unclear. Explore the relationship between sociodemographic indicators of social position and self-care maintenance in adults with HF. This was...

Background Heart failure patients experience multiple concurrent symptoms called symptom clusters. Understanding the role and characteristics of symptom clusters in heart failure (HF) patients is limited. Illness uncertainty may lead to difficulty interpreting symptoms and timely treatment. Before person-centered interventions can be developed, mor...

Aim Guided by the Individual and Family Self-Management Theory, this study examines demographic and self-management variables that impact the outcome of physical activity. Background Multiple sources indicate relationships between physical activity and reduced incidence of cardiovascular disease. Women engage in significantly less physical activit...

Purpose The aim of this study was to explore the incidence of problematic substance use (PSU) and the relationship between level of substance use, minority stress, and general stressors in a population of lesbian, gay and bisexual (LGB) identified nurses. Methods: A national, convenience sample of 394 self-identified LGB nurses completed an online...

Background: The ways in which patients with heart failure (HF) and their care partners work together to manage HF are often overlooked. Objective: The aim of this study was to identify and compare different patterns of HF dyadic illness management. Methods: This was a secondary analysis of data on HF dyads. Heart failure management was measure...

Presently, there is a dearth of theoretical models to guide research on the population of former dementia caregivers. The purpose of this article is to describe the development of the Post-caregiving Health Model and its potential for generating a more nuanced understanding of the health of family caregivers following the death of a care recipient...

Aim To explore differences in self-care maintenance, management and confidence levels between American heart failure (HF) patients with and without executive dysfunction. Background Evidence indicates some aspect of cognitive impairment is prevalent in up to 75% of the HF patient population. Moreover, cognitive impairment has been identified as a...

Background Early electronic identification of patients at the highest risk for heart failure (HF) readmission presents a challenge. Data needed to identify HF patients are in a variety of areas in the electronic medical record (EMR) and in different formats. Objective The purpose of this paper is to describe the development and data validation of a...

Dissemination of the integrative review is the planned process of presenting findings to a targeted audience. Approaches include peer-reviewed publications, podium, or poster presentations at conferences, social media, and news media. Integrative reviews critically analyze and synthesize diverse literature for varied audiences. Analysis of current...

Background There has been growing interest in meditation techniques as an intervention in chronic disease populations. Little is known of the effect meditation practice has on outcomes among patients with heart failure. Purpose To identify and examine current literature on meditation interventions on heart failure outcomes. Method The review util...

Background: Negative healthcare provider attitudes may contribute to healthcare disparities in adults with intellectual disabilities. This study identified predictors of nurses' attitudes and emotions toward caring for adults with intellectual disabilities in the United States. Method: A convenience sample of 248 nurses was used to collect nurse...

Undergraduate research, a high-impact learning practice, peaks interest and enthusiasm for research and contributes to development of research process knowledge, skills, and competency. Fifty millennial sophomore nursing students participated in the innovative learning activity using lyrics from popular songs to complete qualitative analysis in a r...

Background: Family-witnessed resuscitation is not consistently practiced in critical care despite the fact that it is recommended and research shows that it supports the emotional needs of families and patients and improves decision-making, care, and communication. Nurses support the idea of family-witnessed resuscitation but may not believe it sh...

Objectives: To test concurrent validity and acceptability of the Single Item Literacy Screener (SILS), Test of Functional Health Literacy (S-TOFHLA) and the Newest Vital Sign (NVS) in hospitalized adults with heart failure (HF). Background: Health literacy is not routinely evaluated in adults hospitalized with HF. Low health literacy is linked t...

Objectives: The stress-related psychological symptoms experienced by informal family caregivers do not always improve or resolve after the death of the care recipient. The purpose of this study was to explore the independent associations of sociodemographic variables, personality and coping, environmental variables, and caregiver guilt with the sle...

The purpose of this study was to evaluate the effects of guided reflection on self-care behaviors, confidence scores, and diabetes knowledge among adults with diabetes. A randomized controlled trial with a pre/posttest design was used to generate data from a convenience sample of 62 adults with diabetes recruited from a single site. After viewing a...

The detrimental effects of active caregiving on the health of caregivers has been examined, but less is known about caregiver health after caregiving ends. Research revealed stress-related health conditions diagnosed during caregiving failed to improve for many years post-caregiving. The purpose of this cross-sectional, correlational study was to e...

Background: Self-care is essential in people with chronic heart failure (HF). The process of self-care was refined in the revised situation specific theory of HF self-care, so we updated the instrument measuring self-care to match the updated theory. The aim of this study was to test the psychometric properties of the revised 29-item Self-Care of...

As Internet accessibility grows among adults in the United States, researchers’ utilization of Internet-based surveys and recruitment strategies has increased, but there is a paucity of knowledge about their use in different age groups of former dementia caregivers. The purpose of this secondary analysis is to describe 1) the use of Internet-based...

Introduction Moderate-vigorous exercise, an important self-care behavior, is recommended in multiple clinical practice guidelines. In HF, exercise improves clinical outcomes but participation rates are low. Knowledge of exercise and physical activity guidelines may play a role in exercise participation; however, prior studies have included small sa...

Aim To develop and psychometrically test the Self‐Care of Chronic Illness Inventory, a generic measure of self‐care. Background Existing measures of self‐care are disease‐specific or behavior‐specific; no generic measure of self‐care exists. Design Cross‐sectional survey. Methods We developed a 20‐item self‐report instrument based on the Middle...

Background: Informatics has rapidly developed over the last decade as an ntegral part of health care. Knowledge in informatics can improve both the safety and quality of care given to patients. While there is a significant body of literature related to informatics, many nursing schools have been slow to adopt informatics education into curriculum....

Problem: This integrative review aims to synthesize the findings of studies on chronic sorrow in parents, to analyze the findings along three specific research questions, and to identify areas for future research. Eligibility criteria: Studies of parents, mothers and/or fathers of non-adult children published in peer-reviewed journals that answe...

Background: Up to 50% of heart failure patients demonstrate aspects of cognitive impairment, including memory deficit. Novel interventions are needed to address memory deficit among heart failure patients. Aim: The goal of this study was to evaluate the testing effect as an intervention to improve memory performance in heart failure patients. M...

Objective: Evaluate the effect of structured, guided reflection on patient descriptions of self-care maintenance and management. Background: Inadequate HF self-care behaviors are linked to hospitalizations. Symptom monitoring and recognition are precursors to adequate HF self-care. Reflection on actions taken during HF exacerbations may lead to...

Background Immigration policies can cause significant public health consequences, posing detrimental social and health effects for migrants, their families and communities. Migrants often face obstacles to health due to access, discrimination, language and cultural barriers, legal status, economic difficulties, social isolation, and fear of deporta...

Background: Peer review is an expectation of PhD-prepared nurses but a lack of evidence in the best methods to train students is of concern. Method: Guided by the ADDIE (Analysis, Design, Development, Implementation, and Evaluation) model, faculty at two universities developed, implemented, and evaluated a peer review assignment for 22 second-ye...

Fatigue, one of the most prevalent and underassessed nonmotor symptoms in patients with Parkinson disease (PD), is reported to be a major cause of disability and reduced quality of life. The purpose of this review was to systematically examine the scientific literature and report how fatigue is defined and measured and what interventions are used t...

To evaluate the current utilization of the Health Education Systems, Inc. (HESI) examinations in nursing education. HESI exam results are frequently predictive of NCLEX-RN results in nursing education. The integrative review method of Whittemore and Knafl was used to search and evaluate the existing evidence to answer the following research questio...

Persons with heart failure (HF) symptoms delay up to 7 days before seeking treatment. Delay can result in worse symptoms and potentially impact outcomes. The purpose of this review was to describe predictors and outcomes of delay in HF patients. Demographic factors, increased symptom number, social factors, greater HF knowledge, lower anxiety, and...

Current healthcare mobile monitoring solutions do not offer the ability to autonomously recognize cardiac arrhythmias. The proposed electrocardiogram detection and classification software is designed to run on a mobile cardiovascular disease detection sensor suite alleviating the need for human interpretation. The electrocardiogram is filtered usin...

Persons with heart failure (HF) symptoms delay up to 7 days before seeking treatment. Delay can result in worse symptoms and potentially impact outcomes. The purpose of this review was to describe predictors and outcomes of delay in HF patients. Demographic factors, increased symptom number, social factors, greater HF knowledge, lower anxiety, and...

The purpose of this article is to describe the use of Newman's theory of health as expanding consciousness by baccalaureate nursing students in clinical learning experiences. After a brief overview of Newman's perspective, the authors report the context, the process, the challenges, and possibilities of participating in theory-based nursing care as...

Telehealth offers a great opportunity to provide follow-up care and daily monitoring of older adults in their homes. Although there is a significant body of literature related to telehealth in regard to design and adoption, little attention has been given by researchers to the perceptions of the older-adult end users of telehealth. As the numbers o...

This longitudinal study describes the heart failure (HF) patient's perceived benefits and barriers to self-care during hospitalization, 1 week, and 1 month after hospitalization. Seventy-eight patients with acute HF completed the Health Belief Scales to determine the greatest benefits and barriers to self-care at each time point. Findings suggest t...

Current mobile monitoring solutions do not offer the ability to recognize cardiac problems without human interpretation. A combination of electrocardiogram (ECG) detection and classification software running on a mobile cardiovascular disease detection sensor is proposed to replace the need for human interpretation. The ECG is filtered using the Wa...

Despite reports that persons with heart failure (HF) symptoms delay up to 7 days before seeking treatment, few studies have prospectively explored specific factors influencing treatment-seeking delay in this population. The purpose of this study was to explore how factors related to the symptom experience, such as perception (number and intensity),...

Pain is a distressing and often undertreated symptom of cardiac surgery. Little is known about pain levels, interference and treatment strategies beyond the 9week period. The purpose of this study was to describe pain intensity, interference and strategies used to manage pain in post-operative CABG patients. Baseline data were collected by intervie...

Health literacy is discussed in papers from 25 countries where findings suggest that approximately a third up to one half of the people in developed countries have low health literacy. Specifically, health literacy is the mechanism by which individuals obtain and use health information to make health decisions about individual treatments in the hom...

To evaluate the effect of guided imagery as an intervention to reduce pain and anxiety in patients undergoing a total joint arthroplasty. A total of 121 patients scheduled for elective total joint arthroplasty. The design for this study was a 2-group quasi-experimental design. The intervention group listened to a guided imagery CD containing a mess...

Patients with heart failure (HF) report multiple symptoms. Change in symptoms is an indicator of HF decompensation. Patients have difficulty differentiating HF symptoms from comorbid illness or aging. The study purpose was to identify the number, type, and combination of symptoms in hospitalized HF patients and test relationships with comorbid illn...

Nurse-patient encounters are rarely witnessed, resulting in minimal opportunities for reflexive practice or thoughtful dialogue. This study used Halldorsdottir’s (1991) “five basic modes of being with another” to guide reflection on the relationship between a nurse and a woman with heart failure during a series of teaching interventions in her home...

This study aimed at evaluating the effect of a preoperative interdisciplinary educational intervention on understanding postoperative expectations following a total joint arthroplasty. The study sample consisted of 156 patients scheduled for elective total joint replacement surgery. The approach for this study was a two-group quasi-experimental des...

Chronic illness burdens some groups more than others. In studies of ethnic/racial groups with chronic illness, some investigators have found differences in health-related quality of life (HRQL), whereas others have not. Few such comparisons have been performed in persons with heart failure. The purpose of this study was to compare HRQL in non-Hispa...

This article describes the journey of an innovative partnership among nurse researchers and nurse clinicians. The Chronic Illness Consortium (CIC) is an academic-service partnership between a university and its neighbors in a region without an academic medical center. It began with a small group of nurse researchers seeking a strategy to maximize r...

The purpose of this study was to determine the effect of a tailored message intervention on heart failure readmission rates, quality of life, and health beliefs in persons with heart failure (HF). This randomized control trial provided a tailored message intervention during hospitalization and 1 week and 1 month after discharge.Theoretic framework...

As a growing number of older adults recover from cardiac events, volunteer programs have emerged to provide low-cost community support to vulnerable elders. Although an increasing number of studies have described the beneficial relationships between patients and volunteers, little is known about the unique partnership between the advanced practice...

As a growing number of older adults recover from cardiac events, volunteer programs have emerged to provide low-cost community support to vulnerable elders. Although an increasing number of studies have described the beneficial relationships between patients and volunteers, little is known about the unique partnership between the advanced practice...