Loyola University Chicago

Marcella Niehoff School of Nursing

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Shining a Light on Research

Stories by Dirk Johnson

While research scholarship was once considered a field far apart from the practical study of nursing, Niehoff students are showing it’s now central in the changing landscape of health care.


RESEARCH TOPIC: Vitamin D Benefits

Jennifer Woo, a PhD candidate in nursing, trains physicians, nurses, medical assistants, and social workers on “Centering” at a Christian health center in Chicago.

JENNIFER WOO
PhD candidate in nursing
MENTOR: Sue Penckofer, PhD, RN, FAAN • STUDY: What are
the potential benefits of vitamin D supplements for underserved,
pregnant women?

For all of her academic success, Jennifer Woo is not dazzled by the prospect of a lucrative career. She is driven by a deeper moral imperative.

“There is such a wide disparity in health care, and that is just unacceptable,” Woo says. “I want to help change that. That’s what drew me to Loyola.”

Under professor Sue Penckofer, PhD, RN, FAAN, Woo is assisting with a study funded by the National Institutes of Nursing
Research to determine if vitamin D supplements improve the mood and health of women with type 2 diabetes. Woo is actively recruiting women for the study, particularly those impacted by health disparities.

In the vitamin D research being conducted at Loyola, Woo works with women who have depressive symptoms and type 2 diabetes. The vitamin, which is typically absorbed through sunlight, works to strengthen bones and may also provide other beneficial effects such as improved mood and a reduction in blood pressure. Research has shown that deficiency in vitamin D is associated with diseases such as osteoporosis, hypertension, cardiovascular disease, and depression. African American and Hispanic women are at greater risk for a deficiency due to the darker pigmentation of their skin, which prevents adequate absorption of the vitamin through sunlight.

The researchers postulate that the supplements might help these women feel better, which could lead them to take better care of themselves.

For her dissertation, Woo will explore the potentially beneficial effects of vitamin D in pregnant women who are underserved. She sees the research as a way to advance her larger mission: improving health care for the least among us.

In addition, she works as a midwife and women’s health care practitioner at a large Christian health center on Chicago’s West Side. Among the pregnant women she serves, many have little social support and are struggling financially.

To build a network of support for these women, she started a program called “Centering” in which eight to 12 women receive their prenatal care and education as a group, which allows them to provide emotional support to one another. The women are grouped with others who share due dates in the same month.

This program has made an impact on many new moms, including a vulnerable, pregnant 13-year-old, who had grown up largely on her own with a mother in and out of jail. In Centering, this pregnant teen came to rely on the women in her group, many of whom would serve as mother figures to her. When she went into labor, one of them was with her to support and encourage her during the birth of her baby.

“It was beautiful to watch,” Woo says.

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RESEARCH TOPIC: Pregnancy Stressors

KAREN KOTZ FISHE
PhD candidate in nursing
MENTOR: Linda Janusek, PhD, FAAN • STUDY: Can past
childhood traumas increase the risk of depression and
anxiety for pregnant women?

Karen Kotz Fishe specializes in maternal infant health and how stressors during pregnancy influence health outcomes across the lifespan.

With her background as a neonatal nurse practitioner and her predoctoral training in psychoneuroimmunology, she uses  scientific investigation in her scholarship. She is examining potential biologic and immune pathways by which adversities  endured in childhood might later lead to adverse mother-infant health outcomes.

Fishe is conducting a study of 64 pregnant women at Loyola University Medical Center’s Women’s Health Clinic. Fishe’s  research, overseen by Linda Janusek, PhD, RN, FAAN, a professor in the nursing program, finds that the experience of traumas prior to age 18 can increase the incidence of depression and anxiety in pregnant women. It does this by altering their immune response, which makes them more physically and emotionally vulnerable.

As a result, research shows that these women are more likely to deliver a premature and lower birth weight infant. The complications of a premature birth can be devastating, including lasting health issues such as asthma, cognitive problems, and neurobehavioral challenges. These complications can impose overwhelming burdens on the family. In addition to the emotional and physical demands on families in such circumstances, the toll of high health care costs “can wipe them out financially,” Fishe says.

Her research indicates that having “support buffers,” such as partners who are engaged and supportive, can help ameliorate the stressors affecting women with a history of childhood adversity. She says the next step in the research will be trying to determine precisely what kinds of “buffers,” or modes of support, are most effective.

Fishe hopes to find a teaching position after graduation that will allow her to continue her research. She is grateful for Janusek’s tremendous support and guidance, which has been paramount in her academic career development. Janusek encouraged her to find innovative ways to investigate how the prenatal environment influences mother-infant health outcomes, and as the middle of nine children, including a sister with special needs, Fishe knows from experience what is at stake for families coping with difficult challenges.

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RESEARCH TOPIC: Tactics for Foster Children Success

As a McNair Scholar, Karen Aguirre, a Health Systems Management major, was able to conduct her research under the tutelage of a Loyola professor.

KAREN AGUIRRE
BSN ’15, Health Systems Management
MENTOR: Scott Leon, PhD • FACILITATOR: MaryMargaret Sharp-
Pucci, EdD, MPH • STUDY: Is the level of engagement foster parents
show at all related to the length and number of children’s hospital stays?

Allied, or non-nursing, majors at Niehoff also have a desire to work in health care. One of them is Karen Aguirre, who earned her Bachelor of Science degree this spring in Health Systems Management.

The program draws on the strengths and connections of health systems management and Loyola’s excellent liberal arts tradition.

Aguirre is a McNair Scholar, a program that offers undergraduate minorities the opportunity to do tutor-led research with a faculty member of their choosing. She asked Scott Leon, PhD, an associate professor in the Department of Psychology, to be her mentor. The program published her research, which she presented at the Loyola University Chicago Stritch School of Medicine.

Aguirre, herself a daughter of Mexican immigrants, grew up in the Back of the Yards neighborhood on Chicago’s South Side. She graduated from Cristo Rey Jesuit High School.

“It was drilled into me from the beginning that I needed to do something for the community,” she says. “That gift was given to me by the Jesuits.”

As a Loyola senior, Aguirre worked on a study involving 33 foster children between the ages of 6 and 13 who had complicated medical issues such as diabetes, cerebral palsy, or cancer.

She asked them how much time their foster parents spent with them at home and in the hospital, and whether their guardians were supportive. She asked the same questions in separate interviews with the foster parents.

The study aimed to see if there was any correlation between the foster parents’ level of engagement and the number of hospital admissions as well as the length of those stays.

Aguirre says the research found that highly involved guardians made a big difference in the health care outcomes of the children. When foster parents were more engaged, the children experienced fewer hospital admissions and the stays were significantly shorter.

“The hospital was more likely to discharge a child,” Aguirre says, “if they could trust that there would be caregiving at home.”

Foster parents who were extended family members, the study found, spent more time with the children than those who were not related. Aguirre says the research indicated that support and education for caregivers might yield better health results for the children and lower hospital costs.

Aguirre speaks fluent Spanish and was able to interpret for Latino families in the study. She found that cultural bonds played an important role in the comfort level of the families in health and child services. In some cases, Latino families were reluctant to work with outsiders, especially those who were not from immigrant communities.

This reluctance typically stemmed from concerns surrounding the family’s immigration status. She says undocumented immigrants feared they would be referred to deportation authorities.

These findings have potential policy implications. If Latino relatives are fearful of interacting with authorities from the state and consequently decline to serve as foster parents, children miss out on potentially good care.

For Aguirre, the issues of health care and immigration hit close to home. She was born in Chicago, but her parents were not documented.

She noted that undocumented people live with levels of anxiety that can lead to severe psychological and emotional woes.

Aguirre is the first person in her family to go to college. Her parents, who won legal residential status after a long wait, will be sitting proudly in the audience at her graduation in May.

“We will celebrate,” she says.

She plans to seek a master’s degree in public health administration and ultimately hopes to open a health clinic that serves immigrants.

The challenges faced by her family played a key role in her desire to go into health care.

“And it’s one of the main reasons I wanted to go to school here,” she says. “Loyola has a good record on health—and a good record on human rights.”

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RESEARCH TOPIC: Strategies for the Next Ebola

AMELIA BUMSTED
PIPES DNP candidate
MENTORS: Alexander Tomich (MSN ’07, DNP ’12) and
Diana Hackbarth, PhD, RN, FAAN • STUDY: How can
researchers help prepare health care workers to handle
the next Ebola?

Amelia Bumsted is pursuing the Doctor of Nursing Practice (DNP), a relatively new terminal clinical degree in the nursing profession. Loyola’s Population-Based Infection Prevention & Environmental Safety (PIPES) DNP program, one of the first in the nation to specialize in infection prevention, focuses on populations at risk for disease. It produces graduates who become leaders and collaborators in addressing problems in health care systems.

One such challenge arose in 2014 when cases of Ebola first surfaced in the United States. Bumsted is a member of the national Practice Guidance Committee for the Association for Professionals in Infection Control & Epidemiology (APIC).

She reviewed storyboards for videos developed by Johns Hopkins Medicine and the Centers for Disease Control and Prevention to demonstrate protocols for the donning and doffing of personal protective equipment (PPE) to care for Ebola patients. A significant problem for clinicians, despite attempts to demonstrate with videos, was how to translate the CDC guidelines into practice.

Alexander Tomich (MSN ’07, DNP ’12) was a leader in the state’s preparedness efforts to safeguard against the infection of health care workers. He is the director of Infection and Control at Rush University Medical Center, one of only 48 designated Ebola Treatment Centers in the nation. Bumsted and Tomich partnered to present a national Q&A session webinar for APIC titled “Developing an Ebola Center—What Does it Take? And What if You are Not Equipped to be an Ebola Center?”

Tomich is now a preceptor (clinical instructor), to Bumsted as she works on her capstone project to help clinicians follow CDC guidelines for proper PPE use. The nursing profession has been debating the best ways to guide health care workers in such perilous situations. Bumsted remembers thinking: “There should be an app for that.”

She has since worked to develop such an app that helps clinical personnel follow CDC guidelines for donning and doffing protective equipment properly in cases of caring for a suspected or confirmed Ebola patient.

This addresses precisely the calls being made by nursing advocates, such as the American Nurses Association, which are vocal in expressing serious concerns about whether health care workers are safe.

“They were saying, ‘We need to have proper equipment and training,’” Bumsted says.

The DNP program’s objective is translational research. In other words, Bumsted and other such professionals are tasked with figuring out effective ways to translate policy guidelines into actual practice at the bedside.

Honored to have the chance to work on such an important issue, Bumsted credits the culture and camaraderie of Niehoff with building professional networks and local experts in the area of infection prevention, which is what first connected her with Tomich.

Expressing gratitude for the time Loyola graduates invest in mentoring students in the program, she says “it’s the Loyola spirit for leaders to never stop learning.”

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