Western Journal of Nursing Research最新文献

Background: More than half of surrogate decision-makers experience regret after making decisions for a patient in the intensive care unit (ICU). This risk is enhanced following patient death yet may be buffered by their emotion regulation tendencies.

Objective: We investigated how a patient's survival outcome (alive/deceased) influenced their surrogate decision-maker's risk of developing decision regret and how their cognitive reappraisal tendencies for emotion regulation mitigate this risk.

Methods: Using data collected from a randomized controlled trial, we performed a secondary analysis of 158 surrogate decision-makers for incapacitated, mechanically ventilated adults within 4 ICUs at a tertiary medical center. We measured cognitive reappraisal tendency at study enrollment and decision regret 90 days post-enrollment. Adjusting for individual and process-related factors, we used logistic regression to examine the association between a patient's survival outcome and their risk of experiencing decision regret and the moderating role of cognitive reappraisal tendency on this relationship.

Results: Fifty percent of surrogate decision-makers reported decision regret. Surrogates of deceased patients had 5.7 times greater odds of regret than those of survivors. Among these surrogates, a 1 standard deviation increase in their cognitive reappraisal tendency was associated with a 4-fold reduction in their odds of experiencing regret.

Conclusions: Surrogate decision-makers of decedents are more likely to experience regret. These odds decrease as the surrogate's tendency to use cognitive reappraisal increases. Reappraisal-based interventions could improve psychological outcomes for surrogate decision-makers, highlighting a novel opportunity for targeted support in critical care settings.

Background: Cardiac patients often experience sleep problems and reduced physical activity (PA) after cardiac surgery. Sleep and PA are known to have a reciprocal interaction, but their temporal dynamic relationship remains unexplored in this population.

Objective: This study aimed to examine the temporal bidirectional relationship between sleep and PA after cardiac surgery using a cross-lagged panel model (CLPM).

Methods: This exploratory, longitudinal study involved a secondary analysis of previous data. The sample consisted of 33 adults who had undergone open-heart surgery at least 10 weeks prior. Five sleep and four PA variables were measured over 7 days using a wrist-worn ActiGraph. Data were analyzed using CLPM.

Results: Participants (mean age = 60.8 ± 10.1 years) had undergone cardiac surgery an average of 85.7 ± 91.2 months previously. The most common surgery type was coronary artery bypass grafting. Mean total sleep time was 6.4 ± 1.2 hours, below the recommended average of 7 hours, while average moderate-to-vigorous PA (117.8 ± 70.3 min/day) exceeded US guidelines. CLPM revealed unidirectional causation between sleep and PA; improved sleep efficiency predicted higher kilocalories expended and lower sedentary time the next day, while no PA predicted subsequent sleep.

Conclusions: Improving sleep quality may enhance postsurgery PA, emphasizing the importance of integrated strategies targeting both behaviors in clinical and home-based rehabilitation programs. Future studies should explore the temporal dynamics between sleep and PA with a larger sample at different time points after surgery, while incorporating relevant covariates and mediators to deepen the understanding of these complex interactions.

Background: Cognitive impairment is the most common residual symptom following COVID infection, reported in approximately 22% of adults diagnosed with COVID-19. Subjective cognitive decline is considered a significant early indicator of the progression of Alzheimer's disease. There is limited research investigating subjective cognitive decline following COVID-19 infection.

Purpose: The purpose of this study was to examine the relationship between COVID-19 infection and subjective cognitive decline in adults.

Methods: In this comparative and cross-sectional study, data were collected via an online survey involving 98 adults diagnosed with COVID-19 and 317 adults never diagnosed with COVID-19. The mean age of participants was 30.2 ± 8.4 years, and 36.6% were female. The revised Everyday Cognition Scale was used to assess subjective cognitive decline. Data analysis included descriptive statistics, one-way analysis of covariance, and hierarchical multiple regression.

Results: After controlling for covariates, adults diagnosed with COVID-19 experienced significantly greater subjective declines in memory (P = .002), language (P = .002), organizational ability (P = .03), attention (P = .003), and global cognition (P = .007) than those never diagnosed with COVID-19. Furthermore, COVID-19 diagnosis was a significant predictor of worse subjective declines in these domains of cognition.

Conclusion: Findings highlight the associations between COVID-19 infection and subjective cognitive decline across various domains. These results underscore the need for longitudinal studies to explore the progression of cognitive decline. Early detection and management of cognitive dysfunction can prevent further deterioration of cognitive function.

Aim: This study aimed to investigate the differences in healthy eating, body image dissatisfaction (BID), and social media use between sedentary and physically active young adults. Additionally, the research sought to clarify the relationship between physical activity (PA), its purpose, BID, and social media use and dependency.

Design: A descriptive, correlational, cross-sectional design was employed to achieve the study objectives.

Methods: A sample of 322 undergraduate students participated in the study, completing a self-report questionnaire measuring PA and healthy eating (Arab Teens Lifestyle Questionnaire), BID (Contour Drawing Rating Scale and Body Shape Questionnaire-8D), and social media use and dependency (Media and Technology Usage and Attitudes Scale).

Results: Physically active participants exhibited lower levels of BID, healthier eating habits, and lower social media dependency compared to sedentary counterparts. Regression analyses identified social media dependence, body mass index, gender, and the purpose of PA (fitness, weight control, or enjoyment) as significant predictors of BID. Notably, weight control-related PA was associated with higher BID.

Conclusion: The present findings have essential implications for nursing practice and education. Nurses are at the forefront of promoting well-being and are uniquely positioned to address social media dependency, enhance media literacy, and advocate for healthy eating and PA for health and wellness rather than solely aesthetic purposes. By integrating these findings into nursing education, future nurses can be equipped with the skills to screen for body image concerns and provide culturally sensitive counseling and interventions.

Background: Internet-mediated research (IMR), increasingly prominent in social sciences and health care, uses online platforms for data gathering, offering cost-effectiveness and wide accessibility. Despite assumptions that older adults are less active on social media, recent trends indicate otherwise, with a notable presence on platforms like Facebook, making it a valuable recruitment tool.

Methods: The Saskatchewan Caregiver Experience Study employed purposive maximum variation sampling to recruit caregivers via paid Facebook ads, manually shared Facebook posts, and community newsletters. Metrics such as reach, impressions, and link clicks from Facebook advertisements were used to evaluate recruitment effectiveness. Data quality was ensured through "one response per IP address" restrictions on SurveyMonkey.

Results: We recruited 355 survey respondents who met the study inclusion criteria. Participants had a mean age of 60.9 years (range: 22-87). Paid Facebook ads were the most effective recruitment method, indicated by higher engagement and response rates. The 355 survey responses totaled 40 746 words, reflecting strong participant engagement. The absence of financial incentives in the study also likely improved data quality.

Discussion: This method requires participants to have both device access and technological literacy. The study demonstrates the effectiveness of using social media for recruiting in qualitative research, highlighting its potential for inclusivity and representativeness, while also underscoring the importance of ethical considerations in IMR.

Background: While COVID-19 has lessened in urgency for the general United States population's day-to-day functioning, it continues to have significant impact for those who live with a wide range of ongoing sequelae. Wide variation of Long COVID symptoms must be considered as nurses facilitate holistic patient-centered care.

Objectives: We aimed to describe patients' symptom experiences from 3 to 12 months following COVID-19 hospitalization.

Methods: A longitudinal descriptive design was used to explore adults' symptom experiences of Long COVID at 4 time points up to 12 months following hospital admission for COVID-19 between October 2020 and May 2022.

Results: Most of the 37 participants (87%) continued to experience at least 1 physical symptom at 12 months, which was not significantly different than at 3 months (90%). Fatigue was the most common symptom reported at all the time points. Group mean scores on all PROMIS measures and the Impact of Events Scale-Revised did not indicate dysfunction; however, 37% reported having somewhat or a lot of symptom impact on their normal routines. In addition, at least 50% reported currently experiencing quality of life worse than prior to COVID at each time point.

Conclusions: Long COVID symptoms continue to affect significant numbers of people with ongoing impact to daily routines and quality of life. Nurses are in a unique position to generate new evidence on identifying the subset of patients recovering from COVID-19 who are at higher risk for developing Long COVID and provide holistic assessments, monitoring, and interventions to mitigate patients' physical, emotional, and mental health symptoms.

Background: Little has been published on the lesbian, gay, bisexual, queer, and intersex (plus) (LGBTQI+) curriculum in US nurse practitioner (NP) programs. With many known LGBTQI+ health disparities, it is imperative that NP educators prepare their students for the care of LGBTQI+ persons, families, and communities.

Purpose: The purpose of this descriptive exploratory study was to describe the current state of LGBTQI+ curricular goals and content in a sample of US NP education programs.

Methodology: Using an adaptation of the Tool for Assessing LGBTQI+ Health Training, researchers electronically surveyed NP program directors for the perceived applicability of LGBTQI+ curricular goal statements and content inclusion in NP education programs.

Results: Completed surveys (N = 62) were received from respondents in 8 NP specialty areas. Across the specialties, 22 of the 32 goal statements were rated as applicable by 90% or more of respondents. Primary care NP respondents indicated higher numbers of applicable goal statements than other specialties. Levels of content inclusion varied widely across the 32 goal statements and by NP specialty.

Conclusions: A large majority of respondents endorse the applicability of LGBTQI+ curricular goals across multiple domains and competencies. Specific content for most of the goal statements was generally not well covered, and content beyond individual health care was poorly addressed.

Implications: While US NP program faculty express support for a broad array of LGBTQI+ curricular goals, actual content inclusion may be lagging and may only be covering information needed for more basic-level competencies.

Objective: Excessive gestational weight gain, driven by the global raise in obesity, poses significant health risks for both mothers and infants. This study aimed to validate and assess the reliability of the Korean version of the self-efficacy scale for healthy eating and physical activity to support pregnancy-related weight management research in Korea.

Methods: This study is a secondary data analysis using previously collected data from an online survey of pregnant women in South Korea. The self-efficacy scale underwent linguistic validation, including translation, back-translation, and expert review. Exploratory factor analysis (EFA) and confirmatory factor analysis (CFA) were conducted to assess content and construct validity, along with internal consistency reliability testing.

Results: A total of 369 pregnant women participated, primarily in their 30s (85.1%) and college-educated (79.1%). Content validity was high, with a scale-level content validity index of 0.99. Construct validity was confirmed through EFA and CFA, with the final model achieving satisfactory fit indices (χ²/df = 2.19, CFI = 0.90, TLI = 0.89, SRMR = 0.07, RMSEA = 0.06). The scale demonstrated high reliability, with Cronbach's alpha values of 0.93 for both subscales.

Conclusion: The validated Korean self-efficacy scale is a reliable tool for assessing pregnancy-related weight management behaviors. This culturally adapted instrument can support research and interventions promoting healthy eating and physical activity among Korean pregnant women.