Papers by Marjorie McCullagh
SAGE Open Nursing, 2021
Introduction Novel approaches to address the most vexing problems facing patients and vulnerable ... more Introduction Novel approaches to address the most vexing problems facing patients and vulnerable populations are needed. The purpose of this project was to establish an innovative research Center based on the principles of transformational organizations. Methods A new Center formed included faculty members with expertise in cancer, serious illness, and population health. Applying Sinek’s “why, how, and what” framework, members developed and refined a purpose statement and strategic objectives. The Center now includes members representing diverse disciplines. Year 1 accomplishments included a refined mission and vision statement, two funded research proposals, one submitted training grant, one administrative hire, and active recruitment of two-research faculty to support Center activities. Conclusions The newly-formed Center for Improving Patient and Population Health has enabled scholars within a research-intensive school of nursing to forge new partnerships to compete successfully ...
Clinical Journal of Oncology Nursing, 2020
Translational Behavioral Medicine, 2019
Noise-induced hearing loss is common among farm and rural youth. There is a lack of programs prep... more Noise-induced hearing loss is common among farm and rural youth. There is a lack of programs preparing this high-risk population to use hearing conservation strategies. Safety Days are 1-day workshops that teach 100,000 rural children safe farm practices in 400 sites across the USA annually. As part of a larger study for fourth graders, a hearing conservation lesson was delivered at 25 sites nationwide. However, the fidelity to the study-designed curriculum and quality of instruction was unknown. We examined whether community volunteers are capable of delivering, with adequate fidelity and quality, a planned intervention designed to increase use of hearing conservation strategies among farm and rural youth. We invited instructors (n = 22) to deliver a health lesson to fourth graders and provide lesson recordings. We developed instruments rating (i) fidelity of the teaching to the curriculum and (ii) quality of instruction. Initial instruments were modified based on the review for cl...
AAOHN Journal, 1998
tional and environmental health nurses and demonstrate approaches tailored to this worker group.
BMC Public Health, 2018
Background: Many youth and young adults experience high noise exposure compounded by lack of acce... more Background: Many youth and young adults experience high noise exposure compounded by lack of access to hearing health education. Although the need for hearing health education programs is evident, the efficacy of these programs for youth is unclear. We evaluated the literature for efficacy of various hearing conservation programs aimed at youth and young adults, and analyzed their strengths and limitations. Methods: Studies reporting results of hearing conservation or hearing loss prevention programs with youth or young adults, using randomized controlled trials, quasi-experimental designs, experimental design, or qualitative research, and published in peer-reviewed journals in English between 2001 and 2018 were included. Studies were found through searches of selected literature databases (i.e., PubMed, Google Scholar, NIOSH Toxline, and Scopus). Identified publications were assessed for relevance, and data were extracted from the studies deemed relevant. Results: A total of 10 studies were included. Very little evidence of efficacy of hearing conservation educational programs was found in these studies. Several methodological limitations including lack of rigorous study designs, inadequate power, and application of inappropriate statistical analysis were noted. Some use of technology in programs (e.g., smartphone apps, mobile phone text messages, and computers) was observed, but conclusions as to the effectiveness of these tools were limited by the small number of studies and small sample sizes. Conclusions: The number of studies of educational hearing conservation programs for youth and young adults was low. The efficacy of the program was not reported in most studies, and it is difficult to draw public health conclusions from these studies due to their multiple methodological limitations. While use of technology in hearing conservation educational programs offers promise, its effectiveness has not been studied.
Nursing outlook
Although noise as a cause of hearing loss and tinnitus among civilian (Hearing health care for ad... more Although noise as a cause of hearing loss and tinnitus among civilian (Hearing health care for adults: Priorities for improving access and affordability, 2016) and military populations (Noise and military service: Implications for hearing loss and tinnitus, 2006) is well known, studies conducted in the past 15 years document that noise exposures negatively affect health by contributing to many diseases, including cardiovascular diseases, obesity, developmental delays, mental illness, and reduced job and academic performance (
Oncology Nursing Forum, 2017
Purpose/Objectives-To examine patterns and organizational correlates of personal protective equip... more Purpose/Objectives-To examine patterns and organizational correlates of personal protective equipment (PPE) use and hazardous drug spills. Design-Cross-sectional mailed survey. Setting-Ambulatory practices in California, Georgia, and Michigan. Sample-252 Oncology Nursing Society members who administer hazardous drugs. Methods-Bivariate and multivariable regression analyses. Main Research Variables-Outcomes were PPE use and hazardous drug spills. Covariates included nursing workloads, nurses' practice environments, and barriers to PPE use. Findings-26% reported a recent drug spill. 90% wore only one pair of chemotherapy-tested gloves. Increased PPE use was significantly associated with nurse participation in practice affairs (β = 0.25, 95% CI 0.10 to 0.41), non-private ownership (β= 0.37, 95% CI 0.10 to 0.64), increased nursing workloads (β = 0.03, 95% CI 0.01 to 0.04), and fewer barriers to PPE use (β = 0.65, 95% CI 0.36 to 0.93). Spills were significantly associated with less favorable manager leadership and support (OR 0.68, 95% CI 0.47 to 0.98), and higher workloads (OR 1.03, 95% CI 1.01 to 1.06).
Journal of Occupational & Environmental Medicine, 2017
Objective-We examined prevalence, frequency, duration, and recency of injury leave and the associ... more Objective-We examined prevalence, frequency, duration, and recency of injury leave and the association of duty-related injury with perceived stress in U.S. police officers. Methods-This cross-sectional study contained 422 active duty police officers from a mid-sized urban police department. For each participating officer, work history records were used to assess on-duty injuries that lead to work absences. Linear regression analyses were used for analyses. Results-Most participants had experienced at least one injury (62%), and among those injured, 67% experienced more than one duty-related injury. The average number of injuries per officer was three (range 1 to 12). There was a significant linear trend in mean perceived stress across injury count even after adjusting for age, rank, and sex (P = 0.025). Conclusion-Findings suggest that work-related injury is common and repeated work-related injuries are psychologically distressing in U.S. police officers. Police work involves exposure to multiple critical incident stressors including the risk of being seriously injured or killed. The most common nonfatal injuries among law enforcement officers are attributable to assaults, transportation incidents, and training incidents that result in sprains, strains, contusions, and abrasions. 1-4 Such incidents may occur more than once throughout an individual's work history. In 2011, as part of the Survey of Occupational Injuries and Illnesses (SOII), states reported total nonfatal injuries and illnesses for public sector employees.
Workplace Health & Safety, 2017
The purpose of this study was to identify factors predicting occupational health nurses’ provisio... more The purpose of this study was to identify factors predicting occupational health nurses’ provision of smoking cessation services. Data were collected via a self-administered questionnaire distributed to 254 occupational health nurses in Thailand. Analysis by structural equation modeling revealed that self-efficacy directly and positively influenced smoking cessation services, and mediated the relationship between workplace factors, nurse factors, and smoking cessation services. The final model had good fit to the data, accounting for 20.4% and 38.0% of the variance in self-efficacy and smoking cessation services, respectively. The findings show that self-efficacy is a mediator that influences provision of smoking cessation services by occupational health nurses. Interventions to enhance nurses’ self-efficacy in providing smoking cessation services are expected to promote provision of smoking cessation services to workers.
Farmers are exposed to high noise at work from equipment and livestock, and experience higher rat... more Farmers are exposed to high noise at work from equipment and livestock, and experience higher rates of noise-induced hearing loss (NIHL) than their non-farming age cohorts. Although use of hearing protection devices (HPDs) is an effective self-protective behavior in preventing NIHL, their use among farmers is low. Previous research has identified several major factors influencing use: barriers, access, and gender. The specific aims of this study were to (a) identify the predictors of HPD use among farmers; and (b) describe farmers' personal experiences in overcoming barriers to adoption of this self-protective behavior and becoming consistent HPD users. The study was guided by Pender's Health Promotion Model. A hypothesized model of HPD use among farmers was developed and tested through computer-assisted telephone administration of a scientifically-developed survey instrument to a population-based sample. Second, face-to-face interviews were conducted with a purposive sample...
Noise and Health, 2015
This study explored the attitudes, beliefs, and behaviors of rural and farm adolescents regarding... more This study explored the attitudes, beliefs, and behaviors of rural and farm adolescents regarding hearing conservation strategies. This qualitative study took place at two high schools in rural Michigan. Twenty-five adolescents living and working on farms or living in rural areas participated in one of two focus groups. Interviews were audio-recorded and transcribed verbatim. Transcripts were coded and analyzed by two researchers and checked by an additional researcher to ensure reliability. Noise exposure was ubiquitous among participants, both in farm-related (e.g., equipment, livestock) and non-farm-related (e.g., music, firearms) activities. Perceived barriers to use of hearing protection devices outweighed perceived benefits, resulting in uncommon use of protection. When hearing protection was used, it was usually earmuffs or earplugs. Participants indicated a lack of training in noise hazards and protective strategies. Despite their acknowledged risk of hearing loss, participants did not associate their use of hearing protection today with their hearing ability later in life. Categories emerging that relate to hearing protector use included: Barriers, benefits, self-efficacy, situational influences, impersonal influences, cues to action, susceptibility, and severity. Farm and rural adolescents are at risk for noise exposure and hearing loss. The findings stress the significance of work environment and adult modeling in facilitating hearing conservation behaviors. As indicated by the youths' recommendations, school-based interventions may be an effective approach to address this health concern. Intervention studies are needed to test various approaches that can effectively promote use of hearing conservation strategies among rural and farm adolescents.
Trials, Jan 17, 2015
Three decades of research findings have documented the health effects of handling hazardous drugs... more Three decades of research findings have documented the health effects of handling hazardous drugs. Oncology nurses are vulnerable due to frequent administration of antineoplastics, low adherence to equipment use, reported barriers to use, and perceived low risk of health effects. No interventions have been tested in a controlled, multi-site trial to increase nurses' use of protective equipment when handling hazardous drugs. The Drug Exposure Feedback and Education for Nurses' Safety (DEFENS) study will compare the efficacy of education (control) versus an audit and feedback intervention (treatment) on nurses' self-reported use of personal protective equipment when handling hazardous drugs. The treatment intervention will include tailored messages based on nurses' reported barriers to protective equipment use. The DEFENS Study is a cluster randomized controlled trial. We are enrolling cancer centers and will recruit nurse participants in April 2015. Eligible cancer ce...
Journal of Nursing Education, 2015
The objective of this study was to conduct an assessment of the need for advanced practice, maste... more The objective of this study was to conduct an assessment of the need for advanced practice, master's-prepared public health nurses in Michigan. A cross-sectional design was used to conduct interviews with former students, community leaders, and faculty. Content was analyzed qualitatively for themes. Participants were enthusiastic about the practice environment, but funding was a major concern. Almost all participants thought jobs were available and that public health nursing was cost-effective, yet there was concern about the aging work force and the need for higher education. Other disciplines serving in public health roles and hospitals were identified as competition to the public health nurse. Epidemiology, prevention, community assessment/program planning, health policy/law/ethics, leadership, health services, informatics, research, and grant writing were noted as skills needed. The results of this study are favorable for the future of advanced practice public health nursing practice and education.
Cancer nursing
Exposure to antineoplastic drugs confers health risks to workers, yet little is known about the e... more Exposure to antineoplastic drugs confers health risks to workers, yet little is known about the exposure after a drug spill, nor has the relationship between exposure and organizational factors such as staffing and work environment been studied. The aim of this study was to evaluate drug spills prospectively using biological measures and correlate drug spills with organizational factors. Prospective questionnaires with 8-hour timed urine samples were collected from nursing and pharmacy personnel who reported drug spill events in 1 academic health center's infusion center. Urine was collected similarly from workers who did not report a spill. Liquid chromatography tandem mass spectrometry techniques identified detectable drug levels. After the prospective sampling period, workers were surveyed on workloads, practice environment, and safety behaviors. From 81 eligible individuals, 40 participated in the prospective study and 19 completed retrospective questionnaires. Four spills w...
Purpose-Oncology nurses in ambulatory settings are at increased risk for unintentional chemothera... more Purpose-Oncology nurses in ambulatory settings are at increased risk for unintentional chemotherapy exposure, due to the large volumes of agents delivered and the absence of regulatory enforcement. Given the limited data regarding the correlates of exposure, we sought to identify the relationship between the organizational structures and processes of care in ambulatory oncology settings associated with increased risk of unintentional chemotherapy. Methods-Between April 2010 and June 2010, we surveyed a statewide sample of oncology nurses who reported their employment outside of hospital inpatient units (n=1,339). We examined the likelihood of self-reported exposure to chemotherapy as a function of perceived quality of the practice environment, nursing workload, and seven ambulatory chemotherapy administration safety standards. Results-The response rate was 30.4%, with minimal demographic differences observed between respondents and non-respondents. The overall rate of exposure to the skin or eyes in the past year was 16.9%. In multivariable logistic regression models that controlled for demographic characteristics and clustering of nurses in practices, the likelihood of exposure decreased when nurses reported adequate staffing and resources (OR 0.35, 95% CI, 0.17 to 0.73; P = .001), and when nurses reported that chemotherapy doses were verified by two nurses frequently or very frequently (OR 0.17, 95% CI, 0.05 to 0.59; P = .001). Conclusions-Oncology nurses in the ambulatory setting report substantial unintentional skin and eye exposure to chemotherapy. Ensuring adequate staffing and resources and adherence to recognized practice standards may protect oncology nurses from harm.
Journal of health care for the poor and underserved, 2014
Hypertension is a major health concern among Haitian immigrants, one of the largest Caribbean imm... more Hypertension is a major health concern among Haitian immigrants, one of the largest Caribbean immigrant groups in the United States. Yet, little is known about how Hatian immigrants define and manage hypertension. For this qualitative study, face-to-face semi-structured interviews were conducted with 31 Haitian immigrants in Miami Dade County, Florida. Results indicated that most Haitian immigrants used the Haitian Creole word tansyon to represent hypertension. Tansyon was considered as either a normal condition of the human body or a maladi (illness). Both traditional biomedical and alternative approaches were used to manage hypertension. The findings show that how Haitian immigrants defined hypertension shaped their beliefs about its occurrence and the resulting management strategies used. Those who believed tansyon was a normal body condition did not take any management measures. Awareness and understanding of Haitian immigrants' beliefs about and approaches to hypertension m...
Research in Nursing & Health, 2010
Farmers experience higher rates of noise-induced hearing loss (NIHL) than workers in most other i... more Farmers experience higher rates of noise-induced hearing loss (NIHL) than workers in most other industries. We developed a model of farmers' use of hearing protection, and tested it with a random sample (n ¼ 532) of farmers from the upper Midwest. Barriers to using hearing protection (e.g., difficulty communicating; OR ¼ .44, p < .003) were negatively related to use. Greater access/availability of hearing protectors (OR ¼ 1.75, p < .010) and male gender (OR ¼ .43, p < .019) were positively related to use. The model correctly predicted use of hearing protection for 74% of the cases. Overall, farmers demonstrated low hearing protector use, and results were similar to those from previous studies of non-farm workers. Findings from this study will be useful in designing interventions to increase farmers' hearing protector use and decrease their rates of NIHL.
Orthopaedic Nursing, 2002
Noise-induced hearing loss (NIHL) affects 10 million Americans. The number of affected people is ... more Noise-induced hearing loss (NIHL) affects 10 million Americans. The number of affected people is expected to increase as hearing loss is experienced by younger people and life expectancy expands. The problem of noise-induced hearing loss is very common among younger as well as older members of the orthopaedic population. These patients are at risk for experiencing difficulties in communication with care providers as well as family members. However, the nurse is in a strategic position to provide care that enhances communication and minimize problems associated with hearing loss. This article outlines several nursing interventions for caring for a patient with NIHL.
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Papers by Marjorie McCullagh