Journal of Nursing Research最新文献

Background: Healthcare professionals' "cultural prejudices" toward individuals' cultural beliefs, attitudes, and perceptions affect the care they provide. Their awareness of their bias is closely associated with the quality of healthcare provided.

Purpose: This study was designed to assess nurses' perceptions regarding providing care to Syrian refugee patients using metaphors and to evaluate their views based on these metaphors.

Methods: The participants in this qualitative study consisted of 80 nurses who worked in Level 1 and Level 2 health institutions. Data were collected using an interview form prepared by the researchers. The form included descriptive characteristics of the nurses and two expressions used to determine the nurses' opinions on providing care for Syrian refugee patients. The nurses were given an incomplete sentence, which was "Providing care for a Syrian refugee patient…because…," and were asked to complete the blanks. The data were analyzed using the content analysis method.

Results: On the basis of "providing care for Syrian refugee patients," four categories of metaphors were determined: occupational awareness, health promotion, a difficult process/resistance, and providing service in vain. The participants generated 50 metaphors, with "humanity," "a baby/little child," and "a barrier" as the three most used metaphors, belonging to the "occupational awareness" and "a difficult process/resistance" categories, respectively.

Conclusions/implications for practice: The metaphors of nurses regarding giving care to Syrian refugee patients were mostly concentrated in the categories of "occupational awareness" and "a difficult process/resistance." Metaphors generated by the nurses offer a powerful research tool to reveal, understand, and explain nurses' personal perceptions and to develop and support nursing care accordingly. In addition, the subject of transcultural nursing should be discussed more extensively in nursing education programs. Understanding the social context of refugees is very important during the nursing care process.

Background: Improving patient activation can lead to better health outcomes among patients with chronic obstructive pulmonary disease (COPD). However, no studies have focused on the issue of activation in patients with COPD in China.

Purpose: This study was designed to explore the status of activation in patients with COPD in China and explicate the significant influencing factors.

Methods: One hundred seventy patients with COPD were recruited using a convenience sampling method from eight tertiary and secondary hospitals in Nanjing, China. Sociodemographic, clinical, and patient-reported factor data were collected. Univariate analysis and multivariate linear regression were performed.

Results: Only 10.6% of the patients were identified as activated for self-management. Multivariate linear regression analysis revealed four explanatory elements as significantly associated with patient activation, including social support (β = .463, p < .001), free medical insurance (β = .173, p = .007), smoking status (β = -.195, p = .002), and health status (β = -.139, p = .04).

Conclusions/implications for practice: The findings of this study indicate that a minority of patients with COPD are activated for self-management in China. Having a higher level of patient activation was associated with having better social support, having free medical insurance, being a nonsmoker, and having a better health status. Creating a supportive environment, promoting smoking cessation, and improving medical security and health status may be considered as potential strategies to activate patients into better self-management.

Background: The birth rate in Taiwan has declined rapidly; thus, encouraging women to give birth is an important issue in the country. Pregnant women may experience psychological distress, which may negatively impact the health of children and mothers. Prenatal psychological distress is more common in multiparous women than in primiparous women. In addition, compared with that in the second and third trimesters, psychological distress in the first trimester is relatively high. Understanding psychological distress and the associated factors for multiparous women in the first trimester is important to providing early interventions and preventing subsequent maternal and child health problems.

Purpose: This study was designed to examine the important predictive factors related to depression, anxiety, and stress among Taiwanese multiparous women in the first trimester.

Methods: A cross-sectional design was used. In all, 216 multiparous women at 16 weeks of pregnancy were recruited from three hospitals in Taiwan. Self-reported questionnaires were used to gather data on demographic characteristics, the parenting stress of motherhood, spousal support, and psychological distress. A multiple logistic regression analysis was conducted to examine the factors associated with psychological distress.

Results: The prevalence of depression, anxiety, and stress in multiparous women was found to be 31.9%, 42.6%, and 11.1%, respectively. The multiple logistic regression analysis indicated that the stress related to parent-child interaction was a significant predictor of depression and anxiety, the stress related to child-rearing was a significant predictor of anxiety, and low spousal instrumental support was a significant predictor of stress. The model respectively explained 30%, 27%, and 23% of the variance in depression, anxiety, and stress.

Conclusions/implications for practice: Reducing the stress related to parent-child interaction and child-rearing and encouraging spousal instrumental support should be considered during prenatal care when designing interventions to reduce the psychological distress of multiparous women in their first trimester.

Background: Work-related stress (WRS) is one of the most common stressors in healthcare workplace settings.

Purpose: This research study was designed to examine and discuss perceived WRS, job performance, social support, and the desire of immigrant nurses to work in a multicultural workplace.

Methods: A case research mixed-methodology approach, a quantitative survey, and semistructured qualitative interviews were used in this research study. Three hundred twenty-one respondents were invited, of which 246 (76.6%) returned valid questionnaires. A purposeful sampling technique was used in the qualitative portion of the study. A semistructured interviewing system was used on 20 nurses.

Results: "Workload" was the most common traumatic occurrence, whereas "treatment" and "death and dying" were the least common traumatic occurrences. Similarly, the mean of the social support scale, as defined using the McCain and Marklin Social Integration Scale, was moderate to high, suggesting that most of the participants received strong social support from their colleagues. The qualitative research found that the participants faced high pressures related to work and have struggled to acquire cultural skills, while having difficulties meeting their patients' cultural and spiritual needs and sustaining high-quality nursing care.

Conclusions: The findings of this study support that immigrant nurses working in the Kingdom of Saudi Arabia are stressed. A significant difference between the qualitative and quantitative results was found. The findings further contribute to our understanding of WRS, social support, job performance, and intention to stay among immigrant nurses in the Kingdom of Saudi Arabia.

Background: Meaning in life plays an important role in, and is associated with all dimensions of, well-being. Finding meaning in life has been shown to increase life satisfaction in residents of long-term care (LTC) institutions, whereas social support has been found to relate positively with meaning of life. Interactions with LTC staff are the main source of social support for LTC residents.

Purpose: The purpose of this study was to explore the factors related to meaning in life in LTC residents, especially those associated with interactions between nursing assistants and residents.

Methods: A cross-sectional study design was applied to interview participants from October 2015 through July 2016. One hundred fifty-four residents from six LTC institutions participated in this study. The Staff-Patient Interaction Scale and Meaning-in-Life Scale were used to collect data. The statistical methods of t test, Pearson's correlation, and stepwise regression of forward selection analysis were used to explore the factors related to meaning in life in the study population.

Results: The participants were found to perceive a moderate level of meaning in their lives, with a Meaning-in-Life Scale average total score of 42.75 (range: 17-63, SD = 10.19). Staff-patient interaction (β = .50), financial support from government subsidies and social assistance (β = -.41), and number of medical diagnoses (β = -.18) were the three most important factors related to meaning in life, explaining 44.2% of the variance.

Conclusions/implications for practice: Improving the quality of interactions between nurse assistants and residents and health promotion may increase meaning in life in LTC residents.

Background: Clinical performance is an important competence for nursing students to achieve. However, little is known about the degree to which self-regulated learning mediates the relationships among emotional intelligence, collaboration, and clinical performance in nursing students.

Purpose: This study was designed to investigate the mediating effect of self-regulated learning on clinical performance.

Methods: A cross-sectional, descriptive, correlational design was used, and a convenience sample of 302 nursing students in Years 3 and 4 of a bachelor's degree program were recruited as participants from five universities in South Korea. Information on participant characteristics, emotional intelligence, collaboration, self-regulated learning, and clinical performance was collected from the participants using self-reported questionnaires from September to October 2019. Partial least squares structural equation modeling was used to evaluate the research model.

Results: Emotional intelligence, collaboration, and self-regulated learning were found to be statistically significantly related to clinical performance. Moreover, self-regulated learning was identified as a full mediator of the relationship between emotional intelligence and clinical performance (accounting for 62.0% of the variance) and a partial mediator of the influence of collaboration on clinical performance (accounting for 25.4% of the variance).

Conclusions/implications for practice: Nursing educators should encourage self-regulated learning among their students and provide a collaborative learning environment to enhance their students' clinical performance.

Background: Delirium remains significantly undetected in the intensive care unit (ICU). Little is known regarding the level of delirium care knowledge among critical care nurses in Taiwan.

Purpose: This study was designed to investigate the level of knowledge about delirium care among critical care nurses using a multiple-choice question quiz.

Methods: A descriptive, cross-sectional approach was used, and data were collected using a web-based survey. The demographic characteristics including age, years worked as critical care nurse, gender, advanced ICU training, educational level, and type of ICU, along with a delirium care knowledge quiz, were collected. The quiz consisted of 16 items measuring (a) symptoms, types, and outcomes; (b) high-risk groups; (c) predisposing and precipitating factors; and (d) assessment and detection of delirium. Data were collected between October 6 and November 16, 2020.

Results: In total, 324 critical care nurses completed the survey. The rate of correct response on the delirium care quiz for each domain was measured: (a) symptoms, types, and outcomes: 67.1%; (b) high-risk groups: 76.2%; (c) predisposing and precipitating factors: 78.9%; and (d) assessment and detection: 41.5%. The item with the lowest correct response rate was related to the interpretation of delirium assessments.

Conclusion/implications for practice: The findings of this study suggest that future studies and education should focus on the use and interpretation of the assessment using a valid delirium assessment tool to improve the ability of critical care nurses to detect delirium in ICU settings.

Background: Hip fractures are one of the most serious injuries affecting older adults. Evidence-based knowledge regarding the functional status of older persons after hip fracture can provide information critical for developing effective continuous-care and rehabilitation programs.

Purpose: This study was developed to examine the post-hospital-discharge outcome measures and predictors of functional status in older adults in Indonesia after hip fracture surgery.

Methods: The functional status of 109 patients discharged from an orthopedic hospital in Indonesia after hip fracture surgery was evaluated in this prospective cohort study. Functional status was evaluated using measures of physical and independent activities of daily living (PADL and IADL, respectively) at 1, 3, and 6 months postdischarge. Predictors of changes in functional status, including age, length of hospital stay, comorbidity, prefracture walking ability, type of surgery, status of depression and nutrition, type of insurance, and residential status (urban vs. rural), were also examined. Data were analyzed using generalized estimating equations.

Results: Significant improvements in PADL were found at 3 and 6 months, and significant improvements in IADL were found at 6 months. Predictors of poor outcomes found in this study included age, a dependent prefracture walking ability, depression, and having public health insurance.

Conclusions/implications for practice: The findings of this study support the effectiveness of using presurgery assessments to identify individuals at a higher postdischarge risk of having poor PADL and IADL outcomes. Home nursing or subacute rehabilitation is recommended to improve and maintain functional status in older persons after hip fracture surgery. In addition, interventions and rehabilitation should take into consideration different recovery periods for PADL and IADL after hospital discharge after hip fracture surgery.