Western Journal of Nursing Research最新文献

Background: Negative attitudes toward mental illness hinder both social integration and the effectiveness of health care services. Nursing students should overcome these biases, cultivate empathy, and adopt a patient-centered approach through clinical experience and structured education. This study explores how psychiatric nursing students' implicit associations, discriminatory attitudes, and empathy skills are influenced by exposure to documentaries and psychiatric interviews.

Method: A single-center, single-blind, randomized controlled trial was conducted in the nursing department of a university located in Sakarya, Türkiye. The study involved 44 third-year nursing students (experimental group = 22; control group = 22). The Implicit Association Test and the Attitudes Toward Mental Patients Scale were used to assess students' implicit biases and attitudes, while the Jefferson Scale of Empathy measured their level of empathy.

Results: Although the implicit association categories changed significantly within both groups, there was no significant difference in change between the groups. Significant effects were found for group (F = 7.37, P = .01, ηp² = 0.15), time (F = 26.46, P < .001, ηp² = 0.39), and the group × time interaction (F = 7.08, P = .01, ηp² = 0.14) on attitude scores. However, no significant effects were observed in empathy scores with respect to group, time, or the group × time interaction.

Conclusion: Documentaries containing patient narratives and psychiatric interviews improved attitudes toward individuals with mental illness and positively influenced implicit associations; however, they did not lead to a significant change in empathy levels.

Trial registration: ClinicalTrials.gov identifier: NCT06808893.

Background: Individuals with sickle cell disease (SCD) face unique challenges and barriers to care as they age and transition from pediatric to adult care settings.

Objective: The purpose of this scoping review was to explore the factors that influence the health behaviors of individuals with SCD after they have transitioned to adult care settings.

Methods: This scoping review followed the Joanna Briggs Institute methodology. PubMed, Web of Science, and CINAHL were searched in March 2024 to identify articles meeting the inclusion criteria. A total of 162 articles were identified and imported into Covidence and screened for eligibility.

Results: A total of 19 articles were included in this review. The content analysis revealed 2 main themes with underlying subthemes. Theme 1: interpersonal factors with subthemes (a) the need for independence and (b) identity conflict, and Theme 2: environmental factors with subthemes (a) lack of knowledge and resulting stigma and (b) access to care.

Discussion: The results of this scoping review demonstrate that there is a complex interaction of interpersonal and environmental factors that influence the health behaviors of individuals with SCD after they transition to adult care settings. Further research should explore the social environment and individual psychosocial challenges that patients with SCD face. Results can help inform interventions to prepare adolescents and young adults, as well as their families, for the transition to adult care settings.Review Protocol Registration:https://doi.org/10.17605/OSF.IO/DZCGS.

Objective: Heart disease is the leading global cause of mortality, and its management necessitates understanding the interaction between physiological and psychological factors. This study aims to explore the relationship between insecure attachment style, psychological distress, and the mediating impact of mindfulness among patients with coronary heart disease.

Method: This cross-sectional study was conducted using convenience sampling among 199 patients with coronary heart disease from medical centers in Aran-Bidgol and Kashan during 2022-2023. Data collection involved the use of the Depression, Anxiety, and Stress Scale (DASS-21) for psychological distress assessment, the Collins and Reed attachment style questionnaire (RAAS) to gauge attachment style, and the Brown and Ryan mindfulness scale questionnaire (MAAS) to measure mindfulness. Data analysis was performed using structural equation modeling.

Results: The findings indicated a fit for the proposed model. Mindfulness was observed to mediate the relationship between avoidant attachment and psychological distress, while no mediating role was identified for anxious attachment and psychological distress.

Conclusion: The study highlights the significance of attachment style in influencing both mindfulness and psychological distress levels among patients with coronary heart disease. Moreover, enhancing mindfulness emerges as an avenue for mitigating the impact of insecure attachment styles and subsequently reducing psychological distress in this patient population.

Background: Enrollment challenges in pre-licensure nursing programs represent a new threat to the ongoing shortage of registered nurses in the United States. One way to avert declining enrollments is through proactive engagement with students in kindergarten through 12th-grade education to promote nursing as a viable career choice.

Objective: Our pilot study evaluated the feasibility and acceptability of a nursing pipeline summer program targeting high school students in career technical education (CTE), a federally funded program focused on preparing high school students for a variety of careers through structured curriculum planning and experiences.

Methods: This pilot feasibility study involved 11th- and 12th-grade high school students. We administered electronic surveys to collect data on program acceptability from students.

Results: Over the 12 months from August 2023 to August 2024, we recruited 31 high school students into the blended-learning summer pipeline program. Twenty-seven students completed all program components and obtained 5 industry-recognized certifications. Those who responded to the program evaluation surveys (n = 16) rated their program experience favorably. For example, 93.8% reported that they truly enjoyed attending the course, and 87.5% would recommend this course to other students.

Conclusions: We contribute to the nursing pipeline programs' research by highlighting the role of CTE as a potentially valuable, yet underutilized partner in creating a sustainable conduit of youth into nursing. To expand the pipeline of students into nursing, nursing programs should consider partnerships with high schools offering CTE.

Purpose: This study evaluated the effectiveness of a virtual hospital experience game designed to enhance patient safety learning among first-year nursing students, focusing on knowledge, attitudes, confidence, and willingness to promote patient safety.

Methods: A quasi-experimental design was employed. The virtual hospital experience game, developed using the Analysis-Design-Develop-Implement-Evaluate model, focused on outpatient orthopedic care and included 3 interactive scenarios. Participants included 55 first-year nursing students (experimental group = 29; control group = 26). The experimental group engaged in the virtual hospital experience game, while the control group received standard patient safety education. Outcomes were measured at pre-test, post-test, and 2-week follow-up using validated scales. Data were analyzed using repeated-measures analysis of variance with Bonferroni adjustment.

Results: A significant Time × Group interaction was found for patient safety knowledge (F = 4.56, p = .023, η_p² = 0.079), with the experimental group showing significant improvement from pre-test (M = 22.10; SD = 2.90) to post-test (M = 24.41; SD = 1.59; p < .001), sustained at follow-up (M = 24.72; SD = 1.73; p = .552). The control group showed no significant changes. For attitude toward patient safety, confidence in patient safety promotion, and willingness to participate in patient safety promotion, significant main effects of time were observed, but no significant Group × Time interaction effects were found.

Conclusions: The virtual hospital experience game was effective in enhancing nursing students' patient safety knowledge and sustained behavioral intention. Future studies should apply these interventions to diverse scenarios and integrate them into nursing curricula for greater impact.

Background: The management of type 1 diabetes (T1D) in schools is a critical and complex responsibility for health teachers in South Korea. Despite legislative advancements, school health teachers encounter challenges such as role ambiguity and insufficiency due to legal constraints, inadequate resources, and evolving care demands.

Objective: This study explored the experiences and perceptions of school health teachers in managing T1D, focusing on their partnerships with parents and students, through the lens of role theory.

Methods: A qualitative study was conducted with 22 health teachers using semi-structured interviews. Data were analyzed through inductive content analysis, yielding 4 main categories, 10 generic categories, and 49 subcategories.

Results: The following 4 main categories were highlighted: (1) role identification in collaborative care, wherein health teachers strengthened their professional identity by developing individualized care plans and creating supportive environments; (2) role insufficiency in meeting diabetes care expectations, reflecting their perceived knowledge gaps in advanced diabetes management; (3) role consensus in family-school coordination, emphasizing effective communication and shared responsibilities with parents; (4) role ambiguity in complex school-based care responsibilities, stemming from the complexity of managing unique care needs, unclear guidelines, and conflicting expectations with families. The participants emphasized the need for updated guidelines, tailored training, and legal protection.

Conclusions: This study underscores health teachers' pivotal role in T1D management and the challenges they face. Institutional support, professional development, and strengthened collaboration between health teachers and parents are essential. These findings could inform the development of web-based partnership programs to enhance T1D care in schools.

Background: Nursing is one of the most stressful occupations today and the pandemic brought new stressors that still prevail.

Objective: The present study aimed to adapt and validate the Nursing Stress Scale. The adaptation consists of 2 main aspects: (1) including stressors that arose during the COVID-19 pandemic and remain and (2) reducing the length of the scale to make it easier and faster to respond to.

Methods: This cross-sectional study was conducted in 2 countries: Spain and the United States. The invariant structure of the 5 dimensions of the scale has been tested through a multigroup confirmatory factor analysis (CFA), using a sample of 660 nurses from different countries and hospitals. Content validity was established through expert judgment. Construct, convergent, and discriminant validity were tested through confirmatory factor analyses, average variance extracted (AVE), and correlations, and reliability was tested with Cronbach alphas and composite reliability.

Results: Results from the CFA supported the construct validity and the invariant structure of the 5 dimensions of the questionnaire. Convergent validity was assessed using the AVE, which yielded values above 0.50. Discriminant validity was also established, as the square root of the AVE for each dimension exceeded the intercorrelations among the dimensions in the model. Finally, internal consistency of the scale was verified through Cronbach's alpha coefficients, all exceeding .70.

Conclusions: Stress among nurses continues to be a serious problem that has been aggravated after COVID-19. This scale is a valuable tool for quickly and reliably assessing current stressors for nurses.

Background: Chronic stress may play a significant role in disease progression in individuals with multiple sclerosis (MS), but traditional methods of measuring stress through salivary and blood cortisol have limitations. Hair cortisol has emerged as a promising objective measure for chronic stress assessment, but its application in those with MS remains understudied.

Objective: To explore the feasibility of hair sample collection for cortisol analysis among community-dwelling individuals with longstanding MS (disease duration ≥20 years), including factors associated with participation and relationships between hair cortisol and self-reported measures, including perceived stress.

Methods: In this cross-sectional study, 75 participants completed surveys and provided usable hair samples for cortisol analysis. Factors associated with participation and correlations among study variables were examined.

Results: The completion rate for hair sample collection was 59.6% (n = 90). Of the samples returned, 83.3% (n = 75) were used in the analysis. Younger survey participants and those with shorter MS duration were more likely to provide usable hair samples. Hair cortisol showed no significant linear relationships with self-reported variables. In a multiple regression model to predict hair cortisol, employment was significantly associated with increased hair cortisol levels.

Conclusion: Hair sample collection for cortisol analysis is feasible in community-dwelling individuals with longstanding MS. The lack of correlation between hair cortisol and perceived stress reflects the complexity of measuring chronic stress in MS, as in other populations. Future research may consider multi-method approaches to collect hair samples and explore relationships between hair cortisol, perceived stress, and health promotion variables.

Background: Dementia is a rapidly growing global health challenge, affecting an estimated 57 million people worldwide and placing escalating demands on individuals living with the condition and those who care for them. As needs rise, many turn to digital platforms like ALZConnected, a moderated online forum offering space for sharing, support, and connection. While its use in research is expanding, to our knowledge, no scoping review has yet examined how ALZConnected has been leveraged as a data source in dementia-related studies.

Objective: This scoping review aimed to identify and describe published studies that used the ALZConnected forum data to explore caregiver and persons living with dementia experiences, research approaches applied, and areas of focus.

Method: A systematic search of peer-reviewed journal articles, dissertations, and preprints published between 2011 and 2025 was conducted following Preferred Reporting Items for Systematic Reviews and Meta-Analyses Extension for Scoping Reviews reporting guidelines. Eligible studies analyzed ALZConnected content, centered on dementia caregivers or persons living with dementia, and reported original research. A total of 163 records were screened, with 28 studies included.

Results: Studies applied qualitative and computational methods to explore caregiver emotional well-being, information-seeking, systemic challenges, peer support dynamics, and technological applications. ALZConnected was also used to model sentiment, develop algorithms, and analyze caregiver communication. A smaller number of studies examined posts authored by people living with dementia.

Conclusions: ALZConnected provides a rich, naturalistic data source for exploring dementia care discussions. Findings highlight its value for nursing research, intervention development, and care planning, particularly in under-resourced settings.

Background: Mobile chatbot technology is a promising tool for delivering prenatal education, particularly during public health crises such as the COVID-19 pandemic. However, little is known about pregnant women's firsthand experiences with such digital tools in clinical settings.

Objective: The purpose of this study was to explore women's perceptions of a specific chatbot intervention.

Methods: A qualitative descriptive study was conducted with 11 first-trimester pregnant women recruited from a university-affiliated hospital in Taipei, Taiwan. Participants used a maternal chatbot for approximately 30 minutes while waiting for their scheduled outpatient consultation, followed by semi-structured, face-to-face interviews. Data were analyzed using thematic analysis supported by MAXQDA software.

Results: Three main themes emerged: initial perceptions, usability, and acceptability of the maternal chatbot. Participants found the chatbot convenient and helpful for learning about early pregnancy, and expected it to be especially useful during wait times. They also identified certain limitations, such as inadequate keyword search, a lack of personalized content, and the absence of empathetic human interaction. Some preferred the immediacy and familiarity of Google searches, while others valued the credibility of the vetted health information provided by the chatbot.

Conclusion: The maternal chatbot was generally perceived as a useful supplementary tool for prenatal education. However, users' expectations of emotional engagement and system functionality were found to influence its perceived effectiveness. Designs in the future should incorporate improved searchability, broader health topics, and optional human support to enhance users' experiences of digital maternal care.