Western Journal of Nursing Research最新文献

Background: Visitation plays a number of positive roles for critically ill patients and their families. It reduces the physical and mental stress of intensive care unit (ICU) patients and their families and allows family members to participate in patient care. Visit prohibition during the COVID-19 pandemic has raised unprecedented challenges to patients, family members, and health care providers.

Objective: This qualitative study aimed to explore the experiences of families of patients in the ICU with no-visitor policies due to COVID-19.

Methods: Data collection was conducted through 8 individual in-depth semi-structured interviews conducted between October 2021 and March 2022. Data analysis was performed following the qualitative method proposed by Colaizzi. The researchers independently analyzed the data, checked the findings, derived subthemes, and categorized them into overarching themes.

Results: Four themes emerged from the data analysis: (a) experiencing emotional distress, (b) being fearful of in-person patient contact, (c) being dissatisfied with the access control policy in the ICU, and (d) making efforts to reach the patient.

Conclusions: It is critical to provide support and develop interventions for families denied visitation with loved ones in ICUs. Since in-person visits are crucial for families, hospitals should establish clear and reasonable visitation guidelines, communicate effectively with families, and offer alternative methods for them to connect with loved ones in the ICU.

Background: The Head and Neck Patient Symptom Checklist (HNSC) is a validated 2-part instrument used to ask patients with head and neck cancer about the nutrition impact symptoms they experience (part 1) and how these interfere with their eating (part 2).

Purpose: The purpose of this work was to translate and culturally adapt the HNSC into Swedish in accordance with the guidelines of the International Society for Health Economics and Outcomes Research (ISPOR).

Methods: The ISPOR guidelines include 10 steps, and these were thoroughly followed. In step 7, 9 health care professionals from the field of head and neck cancer assessed the perceived relevance (content validity) of each item in the HNSC, as well as the full HNSC. A total of 522 participants with head and neck cancer were included and followed up on 7 occasions using the HNSC to assess internal consistency.

Results: The HNSC was translated from English into Swedish, ensuring accuracy through forward and backward translation and harmonization in the research team. Content validity for each part of the HNSC was rated excellent (scale content validity index 0.96). Internal consistency demonstrated a good Cronbach's alpha score (>0.8) across the 7 follow-up time points (from baseline [before the start of treatment] and up to 24 months posttreatment).

Conclusions: The HNSC has been successfully translated and culturally adapted into Swedish. The HNSC can be used in both clinical practice and research to screen for nutrition impact symptoms and symptoms that interfere with eating in patients with head and neck cancer.

Trial registration: ClinicalTrials.gov NCT03343236 (date of registration: November 17, 2017).

Background: Ways to help older adults overcome barriers to performing regular exercise is a challenge to nurses.

Objective: The study evaluated the acceptability of a portable exercise bike for arm/foot pedaling among older patients with cardiovascular diseases (CVDs).

Methods: Participants reported their physical activity levels using the International Physical Activity Questionnaire (short form) and thereafter performed two 6-minute-long arm/foot pedal biking sessions using a portable exercise bike. Participants provided qualitative feedback (one open-ended question) on the bike while exercising and completed the quantitative Acceptability Use Questionnaire following the two exercise sessions.

Results: Twenty-five older adults (52% male and 48% female), with a mean (SD) age of 70 (6.4) years and a body mass index of 30 (7.4), completed the study. Most participants performed moderate to light physical activity at home with a daily mean (SD) sitting/sedentary time of 8 (3.4) hours. The mean scores from the Acceptability Use Questionnaire and the participants' comments alluded to the bike's multitasking utility and acceptability. Three broad themes derived from the qualitative analysis were: (1) the acceptability of the bike with participants who had musculoskeletal problems; (2) the ability to operate and use the bike for aerobic exercise engaging both arms and legs; and (3) the importance of overall utility, ease of use, and cost of the bike.

Conclusions: The portable exercise bike was found acceptable in a group of older adults with CVDs. The bike has the potential to be applied in home-based exercise interventions.

Background: Exposure to suffering can lead to compassion fatigue in undergraduate nursing students.

Objective: Guided by resilience theory, a cross-sectional, correlational design was used to investigate the potential moderating effect of positive thinking skills on the relationships between views of suffering, compassion fatigue, and compassion satisfaction.

Results: In 157 undergraduate nursing students, multiple regressions revealed that views of suffering and positive thinking explained 23.8% of the variance in compassion satisfaction (F_11,145 = 4.121, P < .001), and 21.9% of the variance in burnout (F_11,144 = 3.786, P < .001). The Suffering God view, which stresses the presence of a compassionate deity amid suffering, and positive thinking had significant main effects on compassion satisfaction (β = 0.349, P = .025; and β = 0.309, P < .001, respectively). Positive thinking, the Suffering God view, and the Random view, in which the occurrence of suffering is random and purposeless, had significant main effects on burnout (β = -0.280, P < .001; β = -0.392, P = .014; and β = -0.206, P = .014, respectively). The Unorthodox view, in which a deity exists that allows suffering, had a significant main effect on secondary traumatic stress (β = 0.232, P = .027). Positive thinking did not moderate any of the relationships between the views of suffering and the dependent variables.

Conclusions: Knowledge of these relationships can aid in the assessment of nursing students at risk for poor outcomes and guide intervention development to promote professional quality of life.

Background: Memorializing nurses' experiences during the COVID-19 pandemic had the potential to allow scientists and policymakers to learn about the impact on the nursing profession and health care systems. Yet, nurses are considered a difficult population to recruit for research.

Objective: To describe an innovative qualitative data collection method for capturing current practice experiences among nurses working during the COVID-19 pandemic.

Methods: Guerilla theory served as the theoretical framework. Utilizing a qualitative descriptive design, a telephone voicemail messaging system was developed to capture nurses' experiences.

Results: Nurses were recruited with convenience and snowball sampling via social media and state listservs. The telephone voicemail messaging system, Twilio, was used. After listening to the recording of the consent form, the participants shared their experiences by leaving a voice message where they answered the prompt, "Tell us about your experiences working during the COVID-19 pandemic." Seventy voicemails were included, and the voicemails were transcribed. After a nurse shared their experience via an email sent to the research team, emails were added to the data collection; 16 emails were received. Transcripts and emails were uploaded to the qualitative data analysis software program, Dedoose, and coded by 2 researchers using content analysis. Main themes were derived and discussed among the research team.

Conclusion: Allowing participants multiple modes of expressing their experiences promote inclusivity in data collection. Further development and standardization of this method is needed for future research.

Background: It is unclear how family factors affect health care utilization among youth with persistent or recurrent pain, despite potential relevance to interventions targeting treatment barriers.

Objective: We aimed to examine health care utilization among young adolescents with persistent or recurrent pain and family factor influences toward higher health care utilization.

Methods: We analyzed longitudinal data from the Adolescent Brain Cognitive Development Study and coded pain as none, infrequent (present 1-2 years), or persistent/recurrent pain (present 3-4 years). Higher health care utilization was coded as nonroutine or emergency department visit at ≥2 years. Parent-reported education, pain status, family income, and insurance status were recorded. Logistic regression examined the contributions of the child's pain and family factors toward higher health care utilization.

Results: Among 5960 youth, 1908 (32%) had persistent/recurrent pain and 2199 (37%) had infrequent pain. Youth with persistent/recurrent pain were more likely to have higher health care utilization compared to those without pain (adjusted odds ratio [OR]: 2.39) or those with infrequent pain (OR: 1.79). Higher health care utilization was associated with parents' pain (adjusted OR: 1.22) and higher education (adjusted OR: 1.44), and family income below the poverty line (adjusted OR: 1.26), controlling for child characteristics and pain status.

Conclusion: Findings show how youths' persistent/recurrent pain, parental, and family socioeconomic factors affect health care utilization among young adolescents, emphasizing a need for family-centered care and economic policies.

Background: There is limited research on how fatalism influences risky health behaviors that are linked to higher cancer risks. This study investigates the relationship between risky health behaviors (tobacco smoking, electronic cigarette use, and heavy alcohol drinking) and fatalistic cancer beliefs while controlling for health care-related self-efficacy and sociodemographic and clinical factors among adults without a history of cancer.

Methods: We used cross-sectional data from the 2020 Health Information National Trends Survey (HINTS) 5 Cycle 4. The study sample included noninstitutionalized adults (aged ≥18 years without a self-reported cancer history (n = 2464). The outcome variable was risky health behaviors comprised of tobacco smoking, electronic cigarette use, and heavy alcohol drinking. We combined these 3 risky behaviors into a binary variable (0, not having risky health behavior; 1, having ≥1 risky health behavior). The key independent variable was cancer fatalistic beliefs. We used descriptive statistics and multivariate logistic regression analyses.

Results: Overall, 50% of the sample were women, 64.7% of participants self-identified as non-Hispanic White, 16.4% as Hispanic, and 10.6% as non-Hispanic Black. About 43% of participants reported having at least one risky health behavior. While holding all other factors constant, each unit increase in cancer fatalism score was associated with 30.0% higher odds of increased risky health behaviors (odds ratio = 1.30, 95% confidence interval 1.04-1.62, P = .021) among adults without a history of cancer.

Conclusion: By understanding the relationship between cancer-related fatalistic beliefs and risky health behaviors, cancer prevention outreach programs can be personalized to suit the unique needs of specific individuals and communities.

Background: While longitudinal designs can provide significant advantages compared to single measurement/cross sectional designs, they require careful attention to study infrastructure and the risk of attrition among the sample over multiple time points.

Objective: The strategies used to design and manage an appropriate infrastructure for a longitudinal study and approaches to retain samples are explored using examples from 2 studies, a 25-year study of persons living with multiple sclerosis and a 10-year longitudinal follow-up of breast cancer survivors.

Results: Key strategies (developing appropriate infrastructure, minimizing costs to participants, and maximizing rewards of study participation) have helped address the serious threat of attrition in these longitudinal samples.

Conclusion: Implementation of these strategies can help mitigate some of the disadvantages and leverage the strengths of longitudinal research to produce reliable, insightful, and impactful outcomes.

Background: The aim of this study was to estimate the prevalence of cardiovascular disease (CVD) risk factors among adults in Vihiga County, Western Kenya.

Methods: A cross-sectional population-based study was completed. Participants (n = 575) were selected at the household level using a systematic random sample, and sociodemographic, anthropometrical, clinical, and biochemical data were collected.

Results: The sample consisted of 71.8% women and 28.2% men. The prevalence of high blood pressure (BP) was 56.4%. A greater proportion of women (62.8%) had low levels of high-density lipoprotein (HDL) compared with men (44.7%) (odds ratio [OR], 2.99; 95% CI, 1.59-5.64). High triglyceride levels were more prevalent in men (16.4%) compared with women (15.4%) (OR, 0.37; 95% CI, 0.19-0.71). Based on average waist to hip ratio, abdominal obesity was significantly higher in women (55.4%) compared with men (27.6%) (OR, 2.62; 95% CI, 1.52-4.49). Low levels of physical inactivity were prevalent in women (36.3%) at significantly higher proportions compared with men (22.7%) (OR, 1.73; 95% CI, 1.02-2.92). Women used tobacco at significantly lower proportions (0.5%) compared with men (27.2%) (OR, 0.01; 95% CI, 0.00-0.06). A higher proportion of women (47.9%) rated their general health as poor compared with men (37.1%), a statistically significant difference (OR, 2.0; 95% CI, 1.23-3.28).

Conclusion: The prevalence of CVD risk factors, such as hypertension, obesity, dyslipidemia, low physical activity, and tobacco use indicates the urgent need for comprehensive health promotion programs to improve public health in rural areas of Kenya.

Aim: We sought to explore the processes of methodologic and data-analysis triangulation in case studies using the example of research on nurse practitioners in primary health care.

Design and methods: We conducted a scoping review within Arksey and O'Malley's methodological framework, considering studies that defined a case study design and used 2 or more data sources, published in English or German before August 2023.

Data sources: The databases searched were MEDLINE and CINAHL, supplemented with hand searching of relevant nursing journals. We also examined the reference list of all the included studies.

Results: In total, 63 reports were assessed for eligibility. Ultimately, we included 8 articles. Five studies described within-method triangulation, whereas 3 provided information on between/across-method triangulation. No study reported within-method triangulation of 2 or more quantitative data-collection procedures. The data-collection procedures were interviews, observation, documentation/documents, service records, and questionnaires/assessments. The data-analysis triangulation involved various qualitative and quantitative methods of analysis. Details about comparing or contrasting results from different qualitative and mixed-methods data were lacking.

Conclusions: Various processes for methodologic and data-analysis triangulation are described in this scoping review but lack detail, thus hampering standardization in case study research, potentially affecting research traceability. Triangulation is complicated by terminological confusion. To advance case study research in nursing, authors should reflect critically on the processes of triangulation and employ existing tools, like a protocol or mixed-methods matrix, for transparent reporting. The only existing reporting guideline should be complemented with directions on methodologic and data-analysis triangulation.