Nursing - Tacoma

Permanent URI for this collectionhttps://digital.lib.washington.edu/handle/1773/20067

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Uncovering Adverse Eye Movement Desensitization and Reprocessing Events: A Descriptive Study Among Approved Consultants
(2024-09-09) Keltgen-Lo, Joan; Johnson, Susan
Background: There is scant research into adverse Eye Movement Desensitization and Reprocessing (EMDR) events or how Shapiro’s EMDR protocol is being applied by practitioners. Aim: The objectives of this study were to: describe adverse events following EMDR that were reported to EMDR International Association (EMDRIA) Approved Consultants by EMDRIA approved EMDR therapy trained practitioners; to report which adverse EMDR event the consultants' thought was the most destabilizing; and to determine whether consultants believe there was insufficient application of Shapiro's EMDR protocol. Method: This descriptive study used a 12-item survey. Results: A total of 55 surveys were collected and 34 surveys met criteria for analysis. While participants reported most EMDR consultations were unrelated to adverse EMDR events, 82% (n=27) described at least one adverse EMDR event reported to them in the past 18 months. The main adverse EMDR events identified were: increased emotional dysregulation (n=14); “flooding” (n=13); distressing or intrusive memories (n=10); emotional numbing (n=9); spontaneous trance or “zoning out” (n=8); and unplanned/unanticipated abreactions (n=7). 21% (n=7) identified no adverse EMDR events reported to them during consultation. 79% (n=23) reported that up to 81% of the adverse EMDR events reported to them were due, at least in part, to consultees’ inadequate use of Shapiro’s EMDR protocol Phase 1, and 76% (n=22) reported the adverse event was, in part, related to inadequate application of Phase 2. Conclusions: This study identified that adverse EMDR events do occur and suggests they may be associated with insufficient application of Shapiro’s EMDR protocol Phase 1 and 2. Adverse EMDR effects must be closely scrutinized using both qualitative and quantitative methods and thoroughly reported from both client and practitioner perspectives. Studies also need to examine the impact of deviations in treatment fidelity from Shapiro’s 8 phase EMDR protocol on outcomes and client experiences.
HYPERTENSION MANAGEMENT IN WOMEN IN RURAL MURANG'A COUNTY
(2015-09-29) Wakaba, Purity Wanjiku; EVANS-AGNEW, ROBIN A
ABSTRACT Introduction- Hypertension is a challenge for women in rural Kenya, yet little is known about the barriers or facilitators to their ability to manage hypertension. The purpose of this study is to illuminate how African women farmworkers in rural Murang’a County, Kenya, cope with high blood pressure. Specifically, it describes 1) obstacles to high blood pressure management and 2) what helps women manage high blood pressure. Methods - The participant group in this study was comprised of eight adult women farm workers in rural Murang’a County, all of whom had been diagnosed with HTN. Individual meetings were held at potential participants’ homes. After obtaining consent, a short demographic interview was verbally conducted by the researcher with each recruited participant. Participants were invited to attend a focus group meeting. The researcher facilitated the focus group meeting in a discussion loosely structured by a questionnaire. Field notes and an audio record were used to document the discussion. Results- It was noted that limited education and a poverty and corrupt economy were among the major barriers affecting management of HTN in rural Murang’a County. Other barriers identified included lack of information regarding high-risk blood pressure readings, poor care, diet and inadequate healthcare resources compounded by inadequate government support. Facilitators for managing HTN included social support from the other women and family. Conclusion- This research highlights the need for societal-level transformations within Kenya, including its government, healthcare system and economy. There is need to increase government support for education, agriculture and improve healthcare systems by training nurses in HTN care/education.
Effect of Lymphocyte Count and AML Prognosis
(2015-02-24) Park, Hanahlyn; Shannon Dorcy, Kathleen
Studies revealed a relationship between lymphocyte count and prognosis of certain cancers. Some studies found that decreased absolute lymphocyte count (ALC) correlates to poorer outcomes of the cancers. Many studies were done and revealed important prognostic factors of acute myeloid leukemia (AML), but prognosis of AML is not always promising. In order to improve prognosis of AML, other unknown independent prognostic factors should be evaluated and studied. The purpose of this study was to evaluate the effect of ALC on prognosis of AML. A total of 259 AML patients were selected for the final analysis. The patients were >18 year-old newly diagnosed AML patients, received induction treatment between January 2008 to June 2013 and got partial or complete responses from the induction therapy. Both univariate and multivariate analyses revealed that higher-than-normal ALC at diagnosis has a positive correlation with poorer AML outcomes. This study concluded that higher-than-normal ALC at diagnosis of the disease was associated with shorter remission, relapse-free survival and overall survival durations. Lower-than-normal ALC at remission was associated with a longer overall survival duration while ALC at remission was not statistically significant in remission and relapse-free survival durations. Further studies are needed to evaluate frequency of Treg cells, a subpopulation of T cells that is known as immune activation inhibitor, since high frequency of Treg cells may result in increased ALC.

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