A Grounded Theory: Natural Wholeness through Moving Meditation, the Paradigmatic Shift in Community-Dwelling Tai Chi Practitioners

The Center for Collaborative Intervention Research (CCIR) was developed to promote and support interdisciplinary collaborations to facilitate development, testing, and evaluation of cost-effective interventions. Training, education, mentoring, and research resources have been tailored to promote collaborative opportunities for faculty at all levels. The CCIR is based on a conceptual model adapted from Pender’s Model of Health Promotion and the ANA conceptualization of collaboration (interdisciplinary/interagency/community/international). Center processes were created to promote research collaborations and included: monthly interdisciplinary seminars, intervention-focused workshops cosponsored with other disciplines, and sophisticated web-based technology which allowed Center resources to be accessed by faculty across disciplines. These efforts facilitated knowledge-sharing and close collaborations across disciplines, fostering appreciation for the unique contribution of nursing to developing intervention science. Research assistance, biostatistical and editing services were provided to developing and experienced researchers. Outcomes included pilot funding for 15 multidisciplinary research teams. All projects included strong collaborative research partnerships. Funded studies have contributed to intervention science in the following areas: (1) interventions to improve health services for disadvantaged or marginalized populations (immigrants, victims of abuse, mentally ill); (2) to improve health outcomes (chronic illness, treatment adherence); and (3) community-based participatory research. Completed CCIR pilot grants have resulted in a range of subsequent successful submissions (RO3, R21, and RO1 level funding) in all of these areas. Center faculty have established knowledge-sharing relationships with local, national and international research centers to further develop science surrounding the development of interventions. These relationships have provided opportunities for interdisciplinary faculty to share resources and enhance research scholarship. Sunny Y. Alperson, PhD, CRNP National Institute of Nursing Research, NIH, DHHS A Grounded Theory: Natural Wholeness through Moving Meditation, the Paradigmatic Shift in Community-Dwelling Tai Chi Practitioners Abstract Background: Short term trials have claimed multidimensional benefits from Tai Chi (TC) forBackground: Short term trials have claimed multidimensional benefits from Tai Chi (TC) for human health, but no theoretical framework exists to understand the mechanism of its benefits. Purpose: We sought to better understand TC by giving voice to the practitioners about their experience of TC and to develop a grounded theory. Method: In-depth interview data from (n=29) self-described “committed” TC practitioners aged 49-82 years were audio-recorded, transcribed, coded and analyzed to derive a grounded theory, utilizing qualitative research methodology, Nvivo software and dimensional analysis. Results: The core dimension of the practitioners experience presents TC as an agent of change. Participants experienced changing lifestyles and views of self and the world. With development of body mindfulness, TC movements and centering, TC became a meditation in motion, facilitating self exploration and new perspectives. They adopted a philosophy of “Natural Wholeness in the present moment.” Numerous symbolic meanings were linked to this new perspective, such as stillness in motion, beauty of the present moment, self acceptance, connectedness with others, universal energy and vitality and health and well-being. Based on these data, a grounded theory “Natural Wholeness through moving meditation, the paradigmatic shift in community-dwelling TC practitioners” was developed. Conclusion: Participants experienced TC as a process integral to their life journey; it provided them with a vehicle for self development that benefited their health and wellbeing. Implications for future research include refinement and testing of the developed theoretical model with TC naive clinical populations of varying age groups, as well as randomized controlled clinical trials. Jane M Armer, RN, PhD, FAAN University of Missouri Sinclair School of Nursing Genetic Predisposition to Secondary Lymphedema Abstract We know little about how genetic factors associated with other (primary) lymphatic disorders may impact the development of (secondary) lymphedema (LE) following cancer treatment. ThisWe know little about how genetic factors associated with other (primary) lymphatic disorders may impact the development of (secondary) lymphedema (LE) following cancer treatment. This study is a pilot for a larger-scale genetics study with primary aims to: (1) examine associations among specific candidate genes and human growth factors known to be associated with primary LE in a cohort of breast cancer patients with secondary LE, and (2) seek to identify novel genetic mutations associated with LE risk through Genome Wide Association Study (GWAS) analysis. Institutional funding was obtained for a GWAS-design feasibility study with 96 breast cancer survivors with and without LE (48/48). Genetic material (from buccal swabs), limb volume (by perometry and circumferences), and self-reported LE-related symptoms are collected in one laboratory appointment. Ninety-fine percent of survivors participating in an on-going longitudinal study consented to participate in the genetic pilot. Buccal swabs have provided adequate yield for DNA extraction (concentration average 174.94 ng/ul). The Illumina HumanOmni1-Quad BeadChip is the microarray used for the GWAS analysis. These pilot findings form the basis for a larger multisite study aimed at examining genetic predisposition to secondary LE, leading to the design and timing of subsequent interventions aimed at reducing LE risk and improving overall survivorship quality of life. Additionally, findings concerning interactions among breast cancer treatments and LE genetic predisposition will have the potential to guide the selection of cancer treatment to minimize these complications when survival outcomes are equivalent across competing treatment approaches. Jane M Armer, RN, PhD, FAAN University of Missouri Sinclair School of Nursing QUALITY OF LIFE TRENDS AMONG BREAST CANCER SURVIVORS Abstract Breast cancer (BC) survivors are faced with numerous life-changing issues, including a lifetime risk for developing lymphedema (LE), a chronic condition that also negatively impacts quality ofBreast cancer (BC) survivors are faced with numerous life-changing issues, including a lifetime risk for developing lymphedema (LE), a chronic condition that also negatively impacts quality of life. The goal of this research was to examine trends in scores on selected psycho-social instruments related to quality of life for a group of breast cancer survivors. Participants enrolled following BC diagnosis and followed quarterly for 12 months, then every 6 months thereafter (N = 214). Psychosocial data were collected at baseline and annually using Problem-Solving Inventory (PSI) and Psychological Adjustment to Illness Scale Self-Report (PAISSR). Preliminary analysis indicate that PSI scores remained relatively stable from post-op to 24 months (77.7 to 75.3) while scores on PAIS were lower from post-op to 24 months (28.2 to 22.6) indicating more positive adjustment. Problem-solving predicted psychological adjustment over time, with greater contribution from the Personal Control subscale (r = .31, p<.05). Younger BC survivors had significantly higher PAIS scores reflecting poorer psychological adjustment than older survivors (p<.05), but perceived problem-solving ability between the two groups was not statistically different. These preliminary findings provide evidence that BC survivors continue to cope with issues related to BC diagnosis after treatment has concluded. As survivorship increases, they tend to be more positive in adjustment to dealing with disease-related issues. Younger survivors tend to report more negative adjustment than older women. Moreover, women’s problem-solving is an important predictor of psychological adjustment over time, which suggests more focus on interventions containing problem-solving components is warranted. Suzanne Bakken, RN, DNSc, FAAN Columbia University Center for Evidence-based Practice in the Underserved Abstract The aims of the Center for Evidence-based Practice in the Underserved (CEBP) are to: 1) Facilitate the development of biobehavioral research capacity in self-management forThe aims of the Center for Evidence-based Practice in the Underserved (CEBP) are to: 1) Facilitate the development of biobehavioral research capacity in self-management for underserved populations through the funding of research studies and the implementation of four interdisciplinary cores (Administrative; Design, Methods, Biostatistics, and Economic Analysis; Self-Management, Biobehavioral, and Informatics; Dissemination and Translation); 2) Implement and maintain a social software-based approach, building upon the infrastructure of the CTSA “WorkWeb” Portal to enable interdisciplinary researchers in self-management to communicate and collaborate through a variety of information and communication technologies and services; 3) Enhance the expertise of CEBP investigators in informatics-based approaches that enable self-management interventions for underserved populations in a manner appropriate to culture and level of health literacy; 4) Develop the expertise of CEBP investigators in application of appropriate economic methods and analyses for selfmanagement studies in underserved populations; 5) Facilitate dissemination of research findings into the interdisciplinary scientific literature and translation into practice and policy; and 6) Implement a formative and summative evaluation plan. Our approaches capitalize on outstanding interdisciplinary collaborations and resources and the use of innovative information technologies including social/collaborative and knowledge management software to facilitate the development of biobehavioral research capacity for scientists conducting selfmanagement research in underserved populations. CEBP feasibility study investigators apply CEBP core resources to identify and test strategies to enhance self-management in four vulnerable populations (adolescents with diabetes, persons living with HIV, diabetics with hypertension, and community-dwelling elders at risk for injury by falls). Taura L. Barr, PhD, RN West Virginia University School of Nursing and Department of Neuroscience and the National Institute of Nursing Research Inflammatory Regulation as a Biomarker of Ischemic Stroke Diagnosis: Evidence from Gene Expression Profiling