Western Journal of Nursing Research最新文献

Background: Including patients in mutual goal setting is one mechanism to personalize care delivery and improve patient outcomes.

Objective: The purpose of this study was to examine the impact of a nurse educational intervention about mutual goal setting on nurse engagement and self-efficacy for goal setting and the nurse/patient experience of goal setting.

Methods: During this explanatory, sequential mixed-methods study, nurse engagement in goal setting and goal quality was assessed through chart audits 1-month pre-intervention (n = 173) and 1 and 3-months (n = 144, n = 137) post-intervention. Nurse self-efficacy was measured with the Appraisal Inventory Tool. Patient experience was examined with the Patient Experience of Mutual Goal Setting Tool 1-month pre-intervention (n = 111) and 1 and 3-months post-intervention (n = 111, n = 109), and nurse experience was examined using focus groups (n = 16).

Results: Goals were present in charts twice as often 1-month post-intervention when compared to 1-month pre-intervention, and goal quality significantly improved at the 1st and 3rd month post-intervention. Nurse self-efficacy in goal setting was significantly higher following the intervention and patients' goal achievement improved. Nurses discussed their experience in terms of facilitators (education, engaging others, using visual cues, and taking small steps), barriers (patients not prepared, medical obstacles, and system constraints), and benefits to their practice.

Conclusion: Educating nurses is just one strategy to improve the multi-faceted mutual goal setting process. Involving patients in care planning at its inception, when goals are constructed, can assist with early identification of barriers by eliciting the patient voice and ensures that care is individualized to each patient's unique situation.

Protocol registration: The study was registered at Clinicaltrials.gov, ID:NCT04977206.

Background: Cardiometabolic syndrome (CMS) affects approximately 39% of US women and increases risk for cardiovascular disease, diabetes, and stroke. Telomere length, a biomarker of cellular aging, is associated with CMS and may be influenced by physical activity (PA), potentially mitigating telomere shortening. Black women have higher CMS prevalence compared to white women and may exhibit distinct telomere length dynamics influenced by interactions between CMS and PA.

Methods: Data were drawn from the Cardiovascular Health Study and included black and white women who provided data on PA, CMS risk factors, and telomere length (N = 417). Linear regression models examined the associations between CMS, PA, and telomere length cross-sectionally and prospectively, with analyses conducted separately for black and white women.

Results: No associations between PA and telomere length were observed in black or white women. High-density lipoprotein levels <50 mg/dL were significantly associated with longer telomere length among black women, but no other CMS risk factors were associated with telomere length. There were no interaction effects between PA and telomere length when accounting CMS risk factors.

Conclusions: PA did not significantly relate to telomere length in older black or white women, and CMS risk factors did not influence the PA-telomere length association. The association between low high-density lipoprotein levels and longer telomere length in black women warrants further investigation. Future research should consider larger samples, objective PA measures, and additional confounders to clarify the roles of PA and CMS in telomere length dynamics among older black and white women.

Background: The suicide mortality rate for women in South Korea was the highest among Organization for Economic Co-operation and Development countries in 2021. Middle-aged women face heightened vulnerability due to sociocultural stressors and interpersonal factors influencing suicidal behavior.

Objective: This study aimed to examine the effect of interpersonal needs and attitudes toward suicide on suicidal risk among middle-aged Korean women.

Methods: This study utilized a cross-sectional descriptive design. Participants were recruited from communities between September 1 and October 5, 2024. Suicidal risk, interpersonal needs, depression, and attitudes toward suicide were measured using the Suicidal Behavior Questionnaire, the Interpersonal Needs Questionnaire, the Patient Health Questionnaire-9, and the Attitudes Towards Suicide Scale, respectively. The data collected through online surveys were analyzed using SPSS version 26.0.

Results: Among 301 female participants, the mean age was 52.5 (SD = 5.6) years old, and 65.8% (n = 198) of them resided in urban areas. Residence area (β = 0.27, P < .001), perceived mental health status (β = 0.13, P = .017), perceived burdensomeness (β = 0.14, P = .020), and attitudes toward suicide (β = 0.05, P < .001) explained 28.6% of variance (F = 14.27, P < .001) on suicide risk.

Conclusion: Urban residence, perceived poor mental health, and maladaptive attitudes toward suicide are key determinants of suicidal risk among middle-aged Korean women. Findings emphasize the need for a comprehensive suicide risk assessment addressing psychological distress and sociocultural perceptions to enhance suicide prevention.

Background: Artificial intelligence (AI) is increasingly used in qualitative research to support tasks such as coding, thematic identification, and pattern recognition. While AI enhances productivity in processing large volumes of unstructured data, it presents challenges that include limited contextual understanding, algorithmic bias, ethical concerns, and potential privacy issues.

Objective: This article aims to explore the integration of AI-assisted tools into qualitative content analysis, focusing on methodological rigor, ethical standards, and how AI tools can effectively support, rather than replace, human insight.

Methods: We designed an AI-assisted, thematic content analysis study of an animal-assisted therapy with farm animal's intervention involving domesticated ducks to support individuals with traumatic brain injury. We utilized Insight7, an AI software, chosen for its thematic detection capabilities and robust data security. Human researchers and the AI independently analyzed semistructured exit interview transcripts to allow for comparative validation of findings.

Results: There was general agreement between human and AI-generated themes. However, the AI occasionally misclassified typical participant experiences as challenges, highlighting the tool's limitations in contextual interpretation. Human oversight proved essential in ensuring accurate and nuanced data analysis.

Conclusions: AI offers valuable support in qualitative research, especially in handling large datasets. However, its limitations underscore the importance of human involvement to maintain interpretive accuracy and ethical integrity. Future research should refine AI tools to enhance their contextual sensitivity while preserving the foundational role of human interpretation in qualitative inquiry.

Background: To manage the turnover intention of nurses working in integrated nursing care service wards in small- and medium-sized hospitals, it is essential to identify influencing factors by considering not only various environmental factors surrounding individuals, but also personal and structural factors.

Aim: We aimed to construct and verify a structural equation model of the turnover intention of nurses working in integrated nursing care service wards in small- and medium-sized hospitals.

Methods: Data were collected from 244 nurses working in integrated nursing care service wards of small- and medium-sized hospitals. We conducted confirmatory factor analysis, determining the goodness-of-fit of the hypothetical model, and verifying path significance. The verification results of the structural equation model indicated that the fit indices of the hypothetical model satisfied the thresholds, confirming its fit.

Results: The results of the path analysis of major variables indicated the presence of direct and indirect effects of external employment opportunities, gratitude disposition, nursing work environment, job satisfaction, and organizational commitment on turnover intention, with an overall explanatory power of 60.8%.

Conclusion: To reduce the turnover intention among nurses working in integrated nursing care service wards of small- and medium-sized hospitals, it is essential to enhance job satisfaction and organizational commitment by managing external employment opportunities, cultivating a gratitude disposition, and improving the nursing work environment.

Background: Needlestick and sharp injuries (NSIs) are common in nurses. Although sleep-related factors such as shift work have been associated with occupational accidents, to date no reviews have synthesized all the current knowledge about shift work, sleep quality, and NSIs.

Objective: We aimed to explore the relationship between shift work and sleep-related problems and NSIs in nurses.

Method: A systematic literature review was conducted using PubMed, Embase, Scopus, CINAHL, and PsycINFO. All studies analyzing the association between NSIs alone or jointly with other occupational injuries and sleep problems or sleep-related problems were included. Sleep factors were coded into different groups: shift work, sleepiness, sleep quality, hypnotic use, and other personal and work-related factors.

Findings: Twenty-four articles met the inclusion criteria. Shift work and poor sleep quality were generally associated with a higher risk of having NSIs, while evidence regarding sleepiness and hypnotic use was limited and inconclusive. Additionally, other factors such as nurses' workload and unsafe practices (eg, needle recapping) were identified as relevant contributors to NSIs.

Conclusion: Sleep-related variables and workload in nurses are associated with the occurrence of NSIs. Implementing reasonable shift systems and reducing workload should be priorities for institutions to protect the health of their workers. Safety education interventions and protocols should also be developed to decrease NSI incidence.

Prospero id: CRD42023434443.

Background: Nurses may experience decreased job performance and increased turnover intentions. It is thus important to identify the factors that may influence their attitudes and behaviors at work.

Objective: The aim of this research was to examine whether nurses' perceptions of organization segmentation norms have an effect on their work passion, while investigating the direct and indirect effects of work passion on their attitudes and behaviors.

Methods: We used a cross-sectional research design. A sample of 368 nurses and assistant nurses working in various French health care centers completed a self-report questionnaire including measures of nurses' perceptions of organization segmentation norms, work passion, job satisfaction, job performance, and turnover intentions. We tested a structural equation model specifying relationships between these variables in line with our hypotheses.

Results: The results showed that nurses' perceptions of organization segmentation norms were associated with higher levels of harmonious passion (HP) and lower levels of obsessive passion (OP). HP had positive effects on job satisfaction and performance, and negative effects on nurses' turnover intentions. In contrast, OP was negatively related to job satisfaction and performance, while the relationship between OP and turnover intentions was positive. Finally, HP and OP were indirectly linked to performance and turnover intentions through their effects on job satisfaction.

Conclusions: Health care organizations are encouraged to implement actions to promote work-home segmentation norms to enhance nurses' HP while limiting their OP, in order to improve individual and organizational functioning.

Background: Urinary incontinence (UI) affects over half of adult women in the United States and negatively impacts physical and psychological health. Our understanding of UI self-management is limited to older, urban women despite the prevalence of UI in all women, particularly during the midlife period.

Purpose: The purpose of this study was to examine how contextual factors influence UI self-management behaviors of rural, midlife women with UI.

Methods: A convergent, mixed-methods study was conducted with 31 rural women aged 30-60 years who were recruited via social media. Participants completed a demographics questionnaire, individual interview, and questionnaires to assess contextual factors: UI subtype, incontinence severity, access to care, and quality of life (QOL) impact. Analyses included qualitative description, descriptive statistics and correlations, and data integration to assess for convergence.

Results: Qualitative interview results have been published. The strongest correlation was seen between incontinence severity and QOL impact. Significant correlations were found between postmenopausal status, UI subtype, incontinence severity, and QOL impact. Integration of qualitative and quantitative data revealed difference between incontinence severity and the qualitative themes self-management behaviors and medical encounters. As incontinence severity increased, the intensity of self-management behaviors increased. Lacking knowledge about symptom reduction and providers' fatalistic attitudes were barriers to improving UI self-management in this rural sample.

Conclusion: Findings demonstrate a need for specific health care educational resources and supportive interactions to reduce the QOL impact of UI in rural midlife women.