Nursing Research最新文献

Background: Double-duty caregivers are healthcare professionals caring for family members or friends outside the workplace. Although they may communicate frequently with colleagues in their professional role, little is known about communication with healthcare providers in the caregiving role.

Objectives: The aims of this study were to measure double-duty caregiver satisfaction when communicating with healthcare providers and to identify correlates and predictors of satisfaction.

Methods: A cross-sectional, nonexperimental, correlational study was used. Participants included registered nurses who were current or former caregivers of a family member or friend aged 50 or older. Correlation and multiple linear regression analyses were performed to examine the associations between double-duty caregivers' personal and professional attributes, factors, and satisfaction with communication.

Results: Double-duty caregivers reported above-average satisfaction with communication. Personal beliefs about caring and trust had the highest influence on satisfaction. Stress was associated with lower satisfaction with communication.

Discussion: This study is the first to examine double-duty caregiver satisfaction when communicating with healthcare providers and associated factors. Healthcare providers must implement strategies to maximize their acknowledgment of personal beliefs about caring and foster the building of trusting relationships to support colleagues in this role.

Background: The analysis of health diary data has long relied on inferential statistical methods focusing on sample means and ad hoc methods to calculate each individual's variation in health outcomes.

Objectives: In this paper, an advanced statistical model is applied to daily diary self-reported health outcomes to simultaneously study an individual's likeliness to report an outcome, daily mean intensity level, and variability in daily measures.

Methods: Using observational, secondary data from 782 adults, we analyzed self-report daily fatigue symptoms, distinguishing between whether an individual reported fatigue and its severity when reported. Self-reported depressed affect and participant characteristics were used as predictors of daily fatigue symptoms.

Results: A higher likeliness to report fatigue correlated with higher mean fatigue severity and greater stability in severity ratings. Higher mean severity correlated with greater stability in severity ratings. Females and those with high depressed affect were more likely to report fatigue. Females and those with high depressed affect reported greater mean severity.

Discussion: The model applied to daily measures allowed for the simultaneous study of an individual's likeliness to report a symptom, daily mean symptom severity, and variability in severity across days. An individual's daily variation in symptom severity was represented as a model parameter that did not contain measurement error that is present in ad hoc methods.

Background: Infants with developmental risk factors are more likely to have feeding problems and develop chronic feeding disorders. Early detection and understanding of the progression of problematic feeding and its relationship with a child's biological functioning and the family feeding environment will enhance effective symptom management and development of interventions to prevent pediatric feeding disorders.

Objectives: The New Through Two (NewThru2) feeding study protocol is described. Study aims are to (a) characterize symptoms of problematic feeding and trajectories of symptoms from predischarge from neonatal intensive care through 24 months of age, (b) determine the relationship of child biological function at discharge with symptom characteristics and trajectories, (c) describe the child's feeding environment and its relationship to symptoms from discharge through 24 months, and (d) determine the relationship between problematic feeding symptoms and growth and developmental outcomes.

Methods: NewThru2 is a prospective, longitudinal, mixed-method study following over 200 infants who received care in a neonatal intensive care unit and were identified as at risk for compromised development. The study follows enrolled infants through 24 months of age. Symptoms of problematic feeding are measured predischarge by clinical observation and medical record review and postdischarge by parent report. Biological function is measured by medical history and cardiorespiratory and autonomic nervous system function during feeding prior to discharge. Child feeding environment is measured by strategies parents use to manage feeding, the effect of feeding on the parent and family, and the use of feeding services. A subset of parents is interviewed to achieve a contextual understanding of the family feeding environment. Child outcome measures include parent-reported feeding skills and clinician-reported growth and neurodevelopment.

Discussion: The results of this study will improve understanding of pediatric feeding disorders during a time of development sensitive to adequate nutrition and with infants at risk for developmental delays or impairments.

Background: Emerging adults with type 1 diabetes are at risk of poorer diabetes-related health outcomes than other age groups. Several factors affecting the health and experiences of the emerging adults are culture and healthcare specific.

Objectives: The aim of this study was to explore the experience of emerging adults living with type 1 diabetes in Lebanon, describe their diabetes self-care and diabetes-related health outcomes (HbA1c and diabetes distress), and identify the predictors of these outcomes.

Methods: A convergent mixed-methods design was used with 90 participants aged 18-29 years. Sociodemographic, clinical data, and measures of diabetes distress, social support, and self-care were collected. Fifteen emerging adults participated in individual semistructured interviews. Multiple linear regression was used to determine predictors of diabetes outcomes. Thematic analysis was used to analyze qualitative data. Data integration was used to present the mixed-methods findings.

Results: The study sample had a mean HbA1c of 7.7% ( SD = 1.36), and 81.1% reported moderate to severe diabetes distress levels. The participants had good levels of diabetes self-care and high levels of social support. HbA1c was predicted by insulin treatment type, age at diagnosis, and diabetes self-care; while diabetes distress was predicted by diabetes knowledge, blood glucose monitoring approach, and diabetes self-care. "Living with type 1 diabetes during emerging adulthood: the complex balance of a chemical reaction" was the overarching theme of the qualitative data, with three underlying themes: "Breaking of bonds: changes and taking ownership of their diabetes," "The reactants: factors affecting the diabetes experience," and "Aiming for equilibrium." The integrated mixed-methods results revealed one divergence between the qualitative and quantitative findings related to the complexity of the effect of received social support.

Discussion: The suboptimal health of the emerging adults despite good self-care highlights the importance of addressing cultural and healthcare-specific factors such as diabetes knowledge and public awareness, social support, and availability of technology to improve diabetes health. Findings of this study can guide future research, practice, and policy development.

Background: Due to significant gaps in knowledge around women's health, Congress commissioned the National Academies of Sciences, Engineering, and Medicine (National Academies) to conduct a consensus study on funding allocation, workforce needs, and priority research areas for the National Institutes of Health (NIH).

Objectives: This manuscript summarizes the key points of the new National Academies report on women's health research for NIH, presents the relevance and importance for nursing research, and briefly discusses the need for increased representation of nurse scientists on National Academies panels.

Methods: Beginning in the Fall of 2023, a multidisciplinary panel of 17 experts was convened by National Academies to address gaps in women's health research at NIH. The committee was tasked to identify research priorities for NIH-funded research with a focus on conditions that are female specific, are more common in women, or affect women differently. In addition, the committee was asked to make recommendations on NIH training and education to strengthen the women's health research workforce; changes to NIH structural, systems, and review processes; and allocation of funding to more equitably reflect the burden of disease among women.

Results: The committee found that, from 2013 to 2023, only 8.8% of NIH research dollars focused on women's health research and that basic knowledge about women's physiological, hormonal fluctuations, and chromosomal differences is lacking. Data are also needed to better understand diseases that are female specific, are more common in women, or affect women differently. The committee made eight recommendations for transformative change at NIH related to women's health research.

Discussion: Overall, the report describes the need for transformative change at NIH to advance the science on women's health research and improve outcomes. This includes a comprehensive approach and recommendations that would double the NIH's investment in women's health research, enhance accountability, and provide rigorous oversight, prioritization, and integration of women's health research across NIH.

Background: With an increasing number of nursing faculty approaching retirement, it is critical to prepare PhD students to take on tenure-track faculty roles. There are a multitude of competing time demands for nursing faculty, and one way that PhD students can prepare for faculty roles is leading team-based science with their peers during their predoctoral program.

Objectives: The aim of this study was to describe the process of PhD students leading an independent research project, in addition to their dissertation work, which aimed to incorporate the tripartite mission-scholarship, teaching, and service.

Methods: This paper outlines the components of the PhD-student-led project as well as provides recommendations for leadership and schools of nursing as well as sponsors interested in funding this type of work.

Results: Students were able to conduct independent research using diverse research approaches, practice mentoring skills, and provide service and helpful information about the nursing workforce to their academic clinical partner. A key component of this relationship building was incorporating a clinical fellowship during the PhD program for students that directly aided the transition from BSN to PhD programs.

Discussion: PhD students learned valuable lessons about time management and collaborating in a team setting with peers. We recommend schools of nursing seek funding opportunities for PhD students to conduct independent team science, encourage academic partnerships with affiliated medical centers and public health settings, and facilitate peer mentorship across cohorts.

Background: Heart failure (HF) is a debilitating condition affecting over 6.7 million adults in the United States. Social risks and complexity, or personal, social, and clinical aspects of persons' experiences, have been found to influence healthcare utilization and hospitalizations in persons with HF. Low-value utilization, or irregular outpatient visits with frequent emergency room use, or hospitalization is common among persons with complex conditions and social risk and requires further investigation in the HF population.

Objectives: The purpose of this research was to assess the influence of complexity and social risk on low-value utilization in persons with HF using machine learning approaches.

Methods: Supervised machine learning, tree-based predictive modeling was conducted on an existing data set of adults with HF in the eight-county region of Western New York for the year 2022. Decision tree and random forest models were validated using a 70/30 training/testing data set and k -fold cross-validation. The models were compared for accuracy and interpretability using the area under the curve, Matthews correlation coefficient, sensitivity, specificity, precision, and negative predictive value.

Results: Area deprivation index, a proxy for social risk, number of chronic conditions, age, and substance use disorders were predictors of low-value utilization in both the decision tree and random forest models. The decision tree model performed moderately, whereas the random forest model performed excellently and added hardship as an additional important variable.

Discussion: This is the first known study to look at the outcome of low-value utilization, targeting individuals who are underutilizing outpatient services. The random forest model performed better than the decision tree; however, features were similar in both models, with area deprivation index as the key variable in predicting low-value utilization. The decision tree was able to produce specific cutoff points, making it more interpretable and useful for clinical application. Both models can be used to create clinical tools for identifying and targeting individuals for intervention and follow-up.

Background: Older adults with heart failure often exhibit poor self-care maintenance. Frailty could exacerbate self-care, leading to deteriorating health. Social support and depression may play a role in self-care maintenance in older adults with heart failure combined with frailty. Confirming this potential mechanistic relationship could provide valuable reference for nurses to formulate and improve the targeted intervention strategies and health education programs for older adults with heart failure.

Objectives: This study analyzed the relationship between frailty and self-care maintenance in older adults with heart failure and determined the sequential mediation effect of social support and depression. Its goal was to provide valuable theoretical insights for formulating targeted clinical nursing interventions for older adults with heart failure.

Methods: A cross-sectional study was conducted from July 2023 to February 2024, during which older adults with heart failure were recruited using a convenience sampling method from the cardiovascular department of a tertiary Class A hospital in Qingdao, China. A total of 241 completed the Tilburg Frailty Indicator, the Self-Care of Heart Failure Index, the Social Support Rating Scale, and the Patient Health Questionnaire-9. t -Tests and one-way analysis of variance were used to examine differences in self-care maintenance among participants with distinct characteristics; correlation analysis was used to identify variable relationships within the study. The mediation model was tested using the SPSS PROCESS macro and the bootstrap method.

Results: Frailty was negatively correlated with self-care maintenance, and both social support and depression were significantly related to frailty and self-care maintenance. Social support and depression not only independently mediated the relationship between frailty and self-care maintenance but also exhibited a significant sequential mediation effect.

Discussion: The frailty of older adults with heart failure and its correlation with self-care maintenance is a complex and multidimensional phenomenon. Frailty not only directly influenced self-care maintenance in participants but also indirectly affected it through the mediating factors of social support and depression. Future research should emphasize innovative, targeted interventions to enhance social support quality and accessibility and alleviate depression, ultimately boosting patients' self-care capabilities and elevating their quality of life.

Background: Perceived stigma significantly impedes access to public health resources for women living with HIV/AIDS, highlighting the crucial need for interventions to empower individuals to overcome such barriers.

Objectives: This paper outlines the protocol for a pilot study aimed at evaluating the efficacy of the Helping Overcome PErceived Stigma (HOPES) intervention employing the mixed methods-grounded in narrative transportation-theory in reducing perceived stigma among women living with HIV/AIDS.

Methods: A total of 100 women living with HIV/AIDS will be randomized into two groups: the HOPES group and the control group. Participants in the HOPES group will watch the narrative transportation videos about perceived stigma experiences and coping strategies recorded by peer volunteers and write notes.

Results: The study commenced in September 2023 and concluded data collection in May 2024.

Discussion: Findings from this study will inform effectiveness trials of HOPES, advancing the evidence base for reducing stigma and improving mental health in women living with HIV/AIDS.