American Journal of Hospice and Palliative Medicine®, 2022
Statement of Problem: A discrepancy exists between where people would like to die and what actual... more Statement of Problem: A discrepancy exists between where people would like to die and what actually occurs. More research about the factors influencing the location of death is required. Sources of Data and Research Design: Multinomial logistic regression was used to examine a sample taken from the fourth round of data collection performed by the National Health and Aging Trends Study conducted in 2014. Conclusions Reached: Census location, age, dementia, and use of hospice were found to have a statistically significant ( P < .05) influence on the location of death ( P = .000). The results suggest that the use of hospice increased the odds of dying at home (OR = 17.467, CI = 7.43–41.063) and in a nursing home (OR = 34.334, CI = 12.444–94.727) as compared to dying in the hospital. Further research is required on the topic of geographic location and place of death.
general delegate discussion followed. Authors ’ Note The opinions represented in this text are th... more general delegate discussion followed. Authors ’ Note The opinions represented in this text are those of the authors and do not reflect the official policy or positions of California State University, the United States Government, the
: The major aim of this evidence based practice (EBP) project was to continue the development of ... more : The major aim of this evidence based practice (EBP) project was to continue the development of the Evidence-Based Protocol: The Back to Basics Bundle of Nursing Care (BBBNC) while simultaneously determining the effectiveness of the evidence-based intervention, Back-to-Basics (BTBI. Design: A multiple time series design was used to evaluate the effectiveness of the intervention. Outcomes of interest included Staff Knowledge, Patient Satisfaction with Nursing Care, Skin Integrity, Sleep Quality, Pain Intensity, Infection Rates, and the contribution of BBBNC elements to these outcomes. Methods: The Iowa Model of Research Practice to Promote Quality Care (Titler, et al, 2001) was used to guide the project. The major aim was accomplished through synthesis of the literature while simultaneously determining the effectiveness of the BBBNC and BTBI. Sample: The patient sample included all patients receiving nursing care over a seven-month period on three inpatient wards that organizational...
This article describes a practice change intended to improve patient activation, also described a... more This article describes a practice change intended to improve patient activation, also described as self-care management, in a sample of uninsured and underinsured patients with one or more chronic diseases who received care at a nurse-managed student-run free clinic project. Chronic diseases are the leading causes of death and disability in the United States. Individuals with chronic illnesses may be uninsured or underinsured and often do not receive adequate medical management, resulting in complications and unnecessary hospitalizations. Lack of knowledge related to self-care has been identified as one risk factor associated with poor health outcomes in medically underserved populations. Student-run free clinics have emerged to provide care to groups that would otherwise not receive health care while simultaneously providing experiential learning for healthcare students. Guided by the Chronic Care Model, an intervention was designed to improve patients' self-care management and chronic disease care delivery offered by the family nurse practitioner and baccalaureate nursing students. The evaluation plan for the Patient Activation Intervention utilized a pretest-posttest design. The Patient Activation Measure tool was administered at the beginning and end of the intervention. Additional outcomes were evaluated using a chart audit tool. A total of 19 unique patients, representing 42 free clinic visits, were evaluated during the intervention period. The mean Patient Activation Measure score was 60.95 (standard deviation AE 12.03) and was indicative of a good foundational understanding of chronic illness and working toward self-management. Chi-square and Fischer's exact test statistics demonstrated a statistically significant (p < .05) difference in the documentation of medication reconciliation, patient-centered goals, and self-management education from baseline to post intervention follow-up appointments. The evidence-based Patient Activation Intervention demonstrated promise as an effective method to increase patient's self-care management and improve patient-centered outcomes for underserved patients when delivered at a nurse-managed student-run free clinic.
This text is the foundation from which a distinguished lecture was developed focusing on the nece... more This text is the foundation from which a distinguished lecture was developed focusing on the necessity for research in healthcare carried out with attention to issues of integrity, the hallmark of all commendable research. A cautionary historical review of research misconduct and related topics is provided. Research within a cultural context and the related subject of international collaborations are also discussed.
This study assessed patient satisfaction with the use of a spiritually based (mantram/sacred word... more This study assessed patient satisfaction with the use of a spiritually based (mantram/sacred word) intervention in expecting couples. A mixed-methods design, experimental repeated measures with interviews at 6-month follow-up was conducted. Satisfaction was moderate to high. Mantram was used for labor pains and uncertainty. Implications include scheduling flexible classes earlier in pregnancy. A larger randomized study is needed to assess intervention effectiveness.
Purpose: The purpose of the paper is to describe the implementation of the Advanced Practice Nurs... more Purpose: The purpose of the paper is to describe the implementation of the Advanced Practice Nurse Intervention (APNI). The APNI was created to develop curriculum and clinical sites for family nurse practitioner (FNP) students to address five disease states (asthma, depression, diabetes, hypercholesterolemia, and hypertension) in medically underserved people residing in San Diego County. Background: Chronic diseases are prevalent in medically underserved populations. In response to the need for free healthcare for vulnerable people living in San Diego County, the Student Healthcare Project was developed at five point-of-care sites. The APNI was implemented at these locations. Methods: The Effectiveness Evaluation for this project used a time series design of specified outcomes of interest at the five Student Healthcare Project sites. Results: The total patient sample for the intervention was 1,854 patients. Major depressive episodes in patients previously diagnosed with depression (...
American Journal of Hospice and Palliative Medicine®, 2022
Statement of Problem: A discrepancy exists between where people would like to die and what actual... more Statement of Problem: A discrepancy exists between where people would like to die and what actually occurs. More research about the factors influencing the location of death is required. Sources of Data and Research Design: Multinomial logistic regression was used to examine a sample taken from the fourth round of data collection performed by the National Health and Aging Trends Study conducted in 2014. Conclusions Reached: Census location, age, dementia, and use of hospice were found to have a statistically significant ( P < .05) influence on the location of death ( P = .000). The results suggest that the use of hospice increased the odds of dying at home (OR = 17.467, CI = 7.43–41.063) and in a nursing home (OR = 34.334, CI = 12.444–94.727) as compared to dying in the hospital. Further research is required on the topic of geographic location and place of death.
general delegate discussion followed. Authors ’ Note The opinions represented in this text are th... more general delegate discussion followed. Authors ’ Note The opinions represented in this text are those of the authors and do not reflect the official policy or positions of California State University, the United States Government, the
: The major aim of this evidence based practice (EBP) project was to continue the development of ... more : The major aim of this evidence based practice (EBP) project was to continue the development of the Evidence-Based Protocol: The Back to Basics Bundle of Nursing Care (BBBNC) while simultaneously determining the effectiveness of the evidence-based intervention, Back-to-Basics (BTBI. Design: A multiple time series design was used to evaluate the effectiveness of the intervention. Outcomes of interest included Staff Knowledge, Patient Satisfaction with Nursing Care, Skin Integrity, Sleep Quality, Pain Intensity, Infection Rates, and the contribution of BBBNC elements to these outcomes. Methods: The Iowa Model of Research Practice to Promote Quality Care (Titler, et al, 2001) was used to guide the project. The major aim was accomplished through synthesis of the literature while simultaneously determining the effectiveness of the BBBNC and BTBI. Sample: The patient sample included all patients receiving nursing care over a seven-month period on three inpatient wards that organizational...
This article describes a practice change intended to improve patient activation, also described a... more This article describes a practice change intended to improve patient activation, also described as self-care management, in a sample of uninsured and underinsured patients with one or more chronic diseases who received care at a nurse-managed student-run free clinic project. Chronic diseases are the leading causes of death and disability in the United States. Individuals with chronic illnesses may be uninsured or underinsured and often do not receive adequate medical management, resulting in complications and unnecessary hospitalizations. Lack of knowledge related to self-care has been identified as one risk factor associated with poor health outcomes in medically underserved populations. Student-run free clinics have emerged to provide care to groups that would otherwise not receive health care while simultaneously providing experiential learning for healthcare students. Guided by the Chronic Care Model, an intervention was designed to improve patients' self-care management and chronic disease care delivery offered by the family nurse practitioner and baccalaureate nursing students. The evaluation plan for the Patient Activation Intervention utilized a pretest-posttest design. The Patient Activation Measure tool was administered at the beginning and end of the intervention. Additional outcomes were evaluated using a chart audit tool. A total of 19 unique patients, representing 42 free clinic visits, were evaluated during the intervention period. The mean Patient Activation Measure score was 60.95 (standard deviation AE 12.03) and was indicative of a good foundational understanding of chronic illness and working toward self-management. Chi-square and Fischer's exact test statistics demonstrated a statistically significant (p < .05) difference in the documentation of medication reconciliation, patient-centered goals, and self-management education from baseline to post intervention follow-up appointments. The evidence-based Patient Activation Intervention demonstrated promise as an effective method to increase patient's self-care management and improve patient-centered outcomes for underserved patients when delivered at a nurse-managed student-run free clinic.
This text is the foundation from which a distinguished lecture was developed focusing on the nece... more This text is the foundation from which a distinguished lecture was developed focusing on the necessity for research in healthcare carried out with attention to issues of integrity, the hallmark of all commendable research. A cautionary historical review of research misconduct and related topics is provided. Research within a cultural context and the related subject of international collaborations are also discussed.
This study assessed patient satisfaction with the use of a spiritually based (mantram/sacred word... more This study assessed patient satisfaction with the use of a spiritually based (mantram/sacred word) intervention in expecting couples. A mixed-methods design, experimental repeated measures with interviews at 6-month follow-up was conducted. Satisfaction was moderate to high. Mantram was used for labor pains and uncertainty. Implications include scheduling flexible classes earlier in pregnancy. A larger randomized study is needed to assess intervention effectiveness.
Purpose: The purpose of the paper is to describe the implementation of the Advanced Practice Nurs... more Purpose: The purpose of the paper is to describe the implementation of the Advanced Practice Nurse Intervention (APNI). The APNI was created to develop curriculum and clinical sites for family nurse practitioner (FNP) students to address five disease states (asthma, depression, diabetes, hypercholesterolemia, and hypertension) in medically underserved people residing in San Diego County. Background: Chronic diseases are prevalent in medically underserved populations. In response to the need for free healthcare for vulnerable people living in San Diego County, the Student Healthcare Project was developed at five point-of-care sites. The APNI was implemented at these locations. Methods: The Effectiveness Evaluation for this project used a time series design of specified outcomes of interest at the five Student Healthcare Project sites. Results: The total patient sample for the intervention was 1,854 patients. Major depressive episodes in patients previously diagnosed with depression (...
Uploads
Papers by Linnea Axman