Western Journal of Nursing Research最新文献

Background: Maintaining a good quality of life improves treatment outcomes and overall survival rate among patients with hepatobiliary and pancreatic cancers. However, known factors influencing the quality of life are fragmented and require a comprehensive investigation of influencing factors to improve the quality of life among patients with hepatobiliary and pancreatic cancers during treatment periods.

Objective: We aimed to comprehensively identify the factors influencing the quality of life among patients with hepatobiliary or pancreatic cancer during illness and treatment periods.

Methods: Patients with hepatobiliary or pancreatic cancer were recruited from a university hospital between September 2022 and November 2023. Along with collecting medical and treatment information, pain, depression and anxiety, and quality of life were assessed using the Numeric Rating Scale, Hospital Anxiety and Depression Scale, and Functional Assessment Cancer Therapy-General Scale, respectively. Multiple regression analysis was performed to identify factors influencing the quality of life using SPSS 26.0.

Results: Among the 204 participants, 141 (69.1%) were male and 141 (69.1%) were diagnosed with hepatobiliary cancers. The mean (±SD) age was 66.7 ± 8.5, and the mean quality of life was 72.5 ± 15.8. Depression, anxiety, pain, and serum albumin significantly influenced the quality of life, which explained 67.8% of the variance.

Conclusions: To improve the quality of life of patients with hepatobiliary and pancreatic cancers, we suggest providing appropriate psychosocial support, pain control, and nutritional management during the cancer treatment.

Background: The presence of health care workplace violence (WPV) significantly impacts victims, patients, and the organization. Registered nurses' experience of vertical WPV is not well understood, in part because the extant literature uses inconsistent and ambiguous terminology or focuses on bullying or incivility, excluding other violent behaviors.

Objective: This critical ethnography study explored the perceptions and experiences of registered nurses who have been victims of vertical violence in the health care workplace.

Methods: Eight registered nurses who self-identified as victims of vertical violence were recruited via purposive and snowball sampling. Data analysis used the constant comparative method described by Glaser and Strauss. Beck's criteria for rigor in qualitative studies was used to enhance the credibility of findings.

Results: Data analysis revealed 4 categories of the registered nurses' victim experience of vertical violence: (1) encountering vertical violence, (2) understanding vertical violence, (3) struggling with vertical violence, and (4) reflecting on the experience of vertical violence.

Conclusions: The use of power, influence, and organizational mechanisms to commit vertical violence has the potential to harm nurses and suppress the nurses' willingness to advocate for others. Despite widespread attempts to prevent WPV, vertical violence continues and poses a significant threat to health care organizations' core values, culture, reputation, and patient care outcomes. Health care organizations must prioritize the well-being of nurses, create effective systems that support nurses, and foster a culture of accountability to adequately address vertical violence and reduce the detrimental impacts on nurses, patients, and the organization.

Background: Negative respiratory outcomes have been reported in people diagnosed with COVID-19. Breast cancer, the most common cancer diagnosed in women globally, is an important cancer to investigate regarding COVID-19 outcomes. We hypothesized that women with breast cancer and infected with COVID-19 would demonstrate a greater risk for negative respiratory outcomes than people without breast cancer.

Objective: We sought to examine associations between breast cancer diagnosis, COVID-19 infection, and negative respiratory outcomes using an Oracle Real World dataset.

Method: Horn and Gassaway's Practice-Based Evidence Framework structured this retrospective cohort study. Regression analysis identified associations among negative respiratory outcomes and breast cancer and COVID-19 diagnosis. Associations between preexisting comorbidities and COVID-19 infection complications in the dataset were also examined.

Results: Breast cancer and COVID-19 diagnoses significantly predict increased odds of developing a negative respiratory outcome (OR = 1.11, CI 1.01-1.23, P = .03). Additional predictors of negative respiratory outcomes include advanced age (OR = 4.88, CI 4.21-5.65, P < .001); Black race (OR = 1.19, CI 1.11-1.28, P < .001); history of emergency department visits (OR = 1.33, CI 1.27-1.40, P < .001); and history of respiratory illness (OR = 2.60, CI 2.41-2.81, P < .001). Race/ethnicity (Asian or Hispanic), age 20 to 34, and pre-index ischemic stroke or atrial fibrillation were not significantly associated with increased odds of negative respiratory outcomes.

Conclusion: Black and older women with breast cancer are at increased risk of developing negative respiratory outcomes following a COVID-19 infection compared to younger and White women with breast cancer. Implications for clinical practice are discussed.

Background: Frailty and Parkinson's disease share overlapping clinical features, making it challenging to distinguish between the two. Therefore, it is important to understand the characteristics of frailty in people with Parkinson's disease (PwP) to prevent the progression of frailty.

Aims: We sought to understand existing evidence on frailty in PwP.

Design: This study was a scoping review. A literature search was conducted using 7 databases and hand-searching in September 2023.

Results: A total of 14 studies met the inclusion criteria. In both clinical and community settings, the frailty phenotype was most commonly used to assess frailty. The prevalence of frailty was inconsistent according to the measures used, and frailty measures assessing cumulative deficits tended to result in higher frailty rates. Compared with PwP who exhibited robustness, PwP with frailty were older, had more severe Parkinson symptoms, and took higher doses of levodopa. Frailty worsened as Parkinson symptoms became more severe, and doses of levodopa increased.

Conclusion: Recognizing the specific characteristics of PwP with frailty is important to identify at-risk individuals and initiate timely interventions. Considering that PwP requires regular monitoring, it is recommended to use frailty measures that can capture multidimensional and cumulative aspects of frailty.Trial and protocol registration:https://doi.org/10.17605/OSF.IO/CUGEY.

Background: Sleep is an important determinant of health and well-being. Poor sleep among nurses is associated with medical errors, poor decision-making, and decreased patient safety. National research priorities have underscored the need to understand the impact of nursing job characteristics on sleep health and mitigation strategies.

Objective: We aimed to test whether sleep hygiene behaviors moderated the association between job characteristics and sleep health among nurses.

Methods: A cross-sectional analysis was conducted on data from the Nurses' Health Study 3 (N = 1272). Logistic regression analysis tested the modifying effect of sleep hygiene behaviors when examining the association between job characteristics and sleep health among nurses practicing in various care settings and specialties.

Results: Sleep hygiene behaviors were associated with increased odds of healthy sleep on workdays and work-free days; however, sleep hygiene did not moderate associations between job characteristics and sleep health. Working 12-hour or longer shifts was not associated with decreased odds of healthy sleep compared with working <12-hour shifts on workdays or work-free days. Working in schools and critical care was associated with 50% or higher odds of unhealthy sleep compared with working in the operating room and oncology on work-free days.

Discussion: Findings suggest sleep hygiene behaviors cannot fully mitigate the effect of job characteristics on sleep health. Study results indicate sleep health may vary by nursing care setting and specialties. Future research should consider factors that may impact sleep health such as short staffing, commuting during work, and time off between shifts.

Background: Shift work, a nonstandard work arrangement, is increasingly popular in the hospitality industry to meet consumer demands and boost productivity. However, its effects on the health and well-being of hotel workers in the United States remains underexplored.

Objective: We aimed to explore the effects of shift work on mental health, sleep, and chronic fatigue among hotel workers.

Methods: We collaborated with a community advisory board to develop a survey and recruit participants. Individuals aged 18 years or older, working in hotels in a Midwest state, completed surveys online or on paper. Data analysis included descriptive statistics, linear and logistic regression, and stepwise moderation to examine the impact of work schedules on chronic sleep problems, fatigue, and mental health outcomes.

Results: Data from 518 participants were analyzed. The majority identified as white and female, with an average age of 32.05 years. Most were employed in housekeeping or front desk positions. Regression analyses showed that those working nonstandard hours were significantly more likely to report chronic fatigue and screen positive for posttraumatic stress disorder. Paid overtime was significantly associated with decreased symptoms of depression and anxiety. Significant interactions by job type were also observed, with front desk workers reporting increased depression with more overtime compared to other job types.

Conclusion: These findings address a crucial gap in understanding shift work's impact on US hotel workers' health and well-being. Future longitudinal studies should explore shift work's effects on sleep, fatigue, and mental health. Tailored interventions and policies may mitigate the adverse effects of shift work.

Background: Chronic low back pain (CLBP) directly causes reduced work productivity and increased absenteeism, disability, and health care costs. However, further research is necessary to identify whether employment correlates with better health outcomes for workers with CLBP.

Objective: We aimed to explore differences in biological, psychological, and social variables between individuals with CLBP who have employment and those who receive disability benefits.

Methods: This exploratory cross-sectional study used data from adults with nonspecific CLBP (15 employed and 10 receiving disability benefits) who are part of an ongoing study of epigenetics and gene expression signatures of racial and socioeconomic status disparities. Data were collected on depressive symptoms, perceived injustice, internalized stigma, social support, life orientation, pain intensity, pain interference, and various measures of biological aging.

Results: On average, unemployed individuals (receiving disability benefits) reported significantly higher levels of internalized stigma of chronic pain (t₂₃ = -2.282, p = .016), pessimism (t₂₃ = -2.646, p = .007), insomnia severity (t₂₃ = -4.201, p < .001), perceived injustice (t₂₃ = -4.108, p < .001), depressive symptoms (t₂₃ = -4.195, p < .001), pain intensity (t₂₃ = -4.195, p < .001), and pain interference (t₂₃ = -5.288, p < .001), but lower pain resilience (t₂₃ = 3.422, p = .001) than participants who were employed. On average, participants receiving disability benefits had GrimAge epigenetic age acceleration, while employed participants had epigenetic age deceleration (t₂₁ = -2.256, p = .017).

Conclusion: Among individuals living with CLBP, employment may be associated with a more positive health outcome. To foster an active and healthy workforce, it is essential to understand the biological, psychological, and social factors affecting employment status when addressing CLBP.

Background: Training and education may benefit nurses whose nonstandard work hours put them at risk of poor sleep, fatigue, and ensuing adverse health and safety outcomes. The National Institute for Occupational Safety and Health (NIOSH) published "Training for Nurses on Shift Work and Long Work Hours" in 2015 as a free online resource which remains one of the few trainings available on this topic. However, the extent to which nurses have completed the program and the characteristics of current learners have not been examined.

Objective: We aimed to describe the potential reach of the NIOSH Training for Nurses between May 2015 through December 2020.

Methods: Data were obtained on learners who received continuing education credits upon completion of the NIOSH Training for Nurses. We applied a widely used implementation and evaluation framework, RE-AIM (Reach, Effectiveness, Adoption, Implementation, Maintenance), to describe the potential reach of the nurses' training and provide descriptive statistics of learners.

Results: From 2015 to 2020, 7899 learners from different occupations received continuing education credits for completing the training. Approximately 60% of learners were nurses and 30% were students. Among nurses, most were Registered Nurses (93%), with few Licensed Practical Nurses (6%) and Advanced Practice Nurses (2%). In 2020, the number of learners who were nurses represented only 0.09% of all licensed US nurses.

Conclusion: A renewed dissemination plan may help extend training reach to the larger population of licensed US nurses. The NIOSH training remains a seminal, freely available, online resource for nurses, filling a critical gap in training to manage work-related fatigue.