Nursing Research最新文献

Background: Substance use disorder (SUD) research has shifted to focus on strength-based approaches and resilience. The Connor-Davidson Resilience Scale-25 (CD-RISC-25) has been widely used to measure resilience in the general population, individuals with SUD, and individuals with mental health conditions. However, there is no globally accepted standard measure of resilience, and the lack of a consistent conceptual definition and limited psychometric information for instruments in SUD research publications contribute to methodological challenges.

Objectives: The purpose of this study was to appraise the psychometric properties of the CD-RISC-25 and evaluate the scale's performance in SUD research using the Psychometric Reliability & Investigation of Research Instruments (PRIORI) rubric.

Methods: Cochrane Rapid Review criteria were used to synthesize and evaluate 48 published peer-reviewed articles that used the CD-RISC-25 to measure resilience in individuals with SUD. The PRIORI rubric was used to appraise the articles for the conceptual definition of resilience, reliability, validity, results related to resilience, and performance of the CD-RISC-25.

Results: Cronbach's alpha for the CD-RISC-25 in populations with SUD provided support for use of the measure among different populations with SUD. Most authors reported face validity; however, sufficient data were available in most publications to also support criterion and construct validity. Appraisal scores for the CD-RISC-25 used in populations with SUD suggested the CD-RISC-25 scale was a good measure of resilience.

Discussion: The PRIORI rubric allowed researchers to critically appraise the performance of the CD-RISC-25 in the reviewed SUD research articles. Findings suggest the CD-RISC-25 was valid and reliable when used to measure resilience in diverse populations with SUD. Adopting the CD-RISC-25 as the gold standard measure of resilience could help address the methodological challenges identified in SUD research.

Background: Weight stigma-a social phenomenon in which individuals can be treated differently due to their weight and physical appearance-can be associated with stress-related conditions and poor health. Sexual minority women (SMW) have an increased prevalence of obesity and overweight compared to heterosexual women, potentially making them more susceptible to experiencing weight stigma.

Objectives: No studies have examined weight stigma in a national sample of SMW. Therefore, the purpose of this study was to examine the prevalence of external weight stigma and internal weight stigma in a sample of SMW and in relevant subgroups defined by demographic data.

Methods: This study used online survey methods to determine the prevalence of external and internal weight stigma in a national sample of adult SMW ( n = 459).

Results: Most participants identified as non-Hispanic White, more than half identified as bisexual, and the sample ranged in age from 18 to 76 years. The prevalence of external weight stigma ranged from 26% to 65% depending on type (e.g., discrimination vs. mistreatment), and the prevalence of internal weight stigma was 57%. All body mass index categories were positively correlated with some forms of weight stigma, with the obese category associated with all forms of weight stigma.

Discussion: To address weight stigma, including eliminating discrimination based on weight and establishing caring and empathetic relationships, healthcare providers should support an individualized and holistic approach to weight management with attention to marginalized identities and other social determinants of health.

Background: The prevalence of Type 2 diabetes mellitus (T2DM) is rapidly increasing, and adopting a healthy lifestyle can have a significant positive effect on the prognosis of diabetes. However, the lifestyle of persons with T2DM is not optimistic, influenced by various factors, with social networks being one of the important ones.

Objectives: The aims of this study were to identify social network type and further explore the relationship between social network type and healthy lifestyle among persons with T2DM.

Methods: A total of 450 participants with T2DM completed the sociodemographic questionnaire, the self-developed healthy lifestyle questionnaire, and the social network information questionnaire. A latent class analysis was used to identify the social network type of participants with T2DM. Univariate analysis and hierarchical linear regression analysis were utilized to explore the relationship between social network type and healthy lifestyle.

Results: The results show that the participants were divided into five latent classes regarding social network type: "diverse-active," "diverse-normal," "friend-restricted," "family-centered," and "family-restricted." Relative to the diverse-active type, participants in the friend-restricted, family-centered, or family-restricted network type had significantly lower healthy lifestyle scores. However, the diverse-normal type was not significantly different from the diverse-active type.

Discussion: There was significant heterogeneity in the types of social networks among persons with T2DM. Healthcare professionals should consider the types of social networks of persons with T2DM when working to improve their healthy lifestyle, helping them to develop diverse-active social network.

Background: The "National Cancer Patient Home-Care Pilot Program" was launched in South Korea to provide continuous management for cancer patients with a stoma. However, participation by medical institutions was low, and services were inconsistently provided.

Objective: We investigated nurses' satisfaction with and demand for the pilot program for home care of cancer patients with a stoma.

Methods: Data were collected through a survey administered to 196 nurses from November 13, 2022, to January 19, 2023. The questionnaire gathered information on the respondents' characteristics, the status of stoma patient management, their satisfaction with the program, and their needs.

Results: Of the 196 nurses surveyed, 42 (21.4%) participated in the home-care pilot program. Among them, 35 nurses (85.4%) were satisfied with the program, and 30 nurses (71.4%) reported that home-care implementation needed to be expanded and standards of care needed to be improved.

Discussion: To enhance the home-care pilot program for cancer patients with a stoma, better medical services must be provided by improving the medical fee standard. This will enable more patients and medical institutions to participate in the program.

Background: The American Heart Association's Life's Essential 8 (LE8) metrics of blood pressure, body mass index, glucose, cholesterol, smoking, diet, sleep, and physical activity are measurable outcomes to gauge cardiovascular health in individuals and populations.

Objective: The aim of this study was to determine the utility of using the National Institutes of Health All of Us Research Program data to quantify LE8 contemporary in a United States cohort.

Methods: This was a cross-sectional observational study of primary (participant-reported and researcher-measured) and secondary (electronic health records) data from Version 7 All of Us data. Adults aged 20-100 years were included. Our primary outcome was percentage of participants with complete data for all LE8 cardiovascular health indicators within 1 year of enrollment. We used All of Us researcher-measured blood pressure and body mass index, health record serum glycosylated hemoglobin (HbA1c), total and non-high-density lipoprotein cholesterol, and participant-reported cigarette use, age, race, and sex data. We described the availability of LE8 in the dataset and then calculated sex differences in LE8 using independent samples t -tests with equal variance, Wilcoxon rank sum test, or chi-square tests.

Results: There were no data for diet, sleep, or physical activity. The final sample with complete data was 56,565 primarily middle-aged adults, and over half were female. Overall, the sample had higher mean systolic blood pressure, high mean body mass index indicating obesity, and average to high HbA1c, indicating few participants meet the definition of ideal cardiovascular health. Nearly half of participants reported lifetime cigarette use of ≥100 cigarettes. Data for non-high-density cholesterol were missing in half of participants. Compared to males, females were younger by 4.2 years and had lower average systolic and diastolic blood pressure, higher mean body mass index, higher total cholesterol, and lower median HbA1c, and fewer reported lifetime cigarette use.

Discussion: Important data for modifiable lifestyle factors of diet, physical activity, and sleep are missing from the All of Us dataset. We recommend adding these missing variables to future surveys. Nevertheless, this snapshot of cardiovascular health shows that, on average, adults in the United States had poorer than recommended cardiovascular health for cardiovascular disease risk.

Background: Psychosocial stigma represents a significant burden in persons with lung cancer-particularly among those undergoing chemotherapy-yet the heterogeneity of stigma experiences remains understudied. While prior research has explored stigma in cancer populations, factors such as psychological resilience, social support, and clinical characteristics (e.g., smoking history, comorbidities) in shaping distinct stigma profiles have not been comprehensively examined. Latent profile analysis-a statistical method to identify unobserved subgroups-offers a novel approach to understanding stigma variability and its predictors in this population.

Objectives: This study aimed to (a) characterize sociodemographic and clinical profiles of persons with lung cancer receiving chemotherapy, (b) identify latent stigma subgroups based on psychosocial burden, and (c) examine factors associated with subgroup membership, including psychological resilience, social support, and health-related covariates.

Methods: A cross-sectional analysis of 273 persons with lung cancer was conducted using validated instruments (Chinese Lung Cancer Stigma Scale, Connor-Davidson Resilience Scale, Multidimensional Scale of Perceived Social Support). Latent profile analysis and multivariate logistic regression were employed to classify stigma subgroups and determine predictors.

Results: Three latent subgroups emerged: low stigma-positive coping, moderate stigma, and high stigma-excessive anxiety. Lower psychological resilience and social support significantly predicted membership in moderate and high stigma subgroups. Smoking history and chronic comorbidities uniquely distinguished the high stigma subgroup. Higher education and stronger social support were protective against severe stigma.

Discussion: Stigma heterogeneity in persons with lung cancer underscores the need for tailored psychosocial interventions. Enhancing psychological resilience and social support may mitigate stigma burden-particularly in high-risk subgroups. Clinical strategies for persons receiving chemotherapy should integrate stigma assessment and target modifiable predictors to improve mental health outcomes. This study highlights the clinical complexity of stigma management in oncology palliative care.

Background: Women from diverse socioeconomic status (SES) face a higher risk of preterm birth, increasing their infants' vulnerability to neurodevelopmental and other health disorders; however, the predictive role of maternal ZIP code level SES in these outcomes remains underexplored.

Objectives: To investigate the associations between maternal racial disparity, ZIP code-level SES, and infant breastfeeding, growth, and neurodevelopmental trajectories.

Methods: In this cohort study, preterm infants were recruited from two Connecticut neonatal intensive care units (NICUs). Infant demographic data, feeding regimens, and growth during the NICU stay were documented. Neurodevelopmental outcomes were assessed using the NICU Neonatal Neurobehavioral Scale, the Bayley scale of infant and toddler development (3rd ed.), and the Brief Infant Toddler Social Emotional Assessment. To compare SES differences between infants born to Black and White mothers, both t-tests and Wilcoxon tests were conducted. We used XGBoost to analyze infant health outcomes and SHapley Additive exPlanations (SHAP) values to identify SES-related risk factors associated with feeding, growth during NICU stay, and neurodevelopmental outcomes up to 2 years of age.

Results: In total, 181 preterm infants from eight ZIP code areas were included in the study. The majority of infants were born to mothers who were White and non-Hispanic. Compared with infants born to White mothers, those born to Black mothers had younger birth gestational age (GA), lower birth weights, shorter birth lengths, smaller head circumferences, and higher Score of Neonatal Acute Physiology with Perinatal Extension-II (SNAPPE-II), with all differences being statistically significant. Compared to White mothers, Black mothers were younger, single, and less educated. Black mothers also had lower median household incomes, larger average family sizes, and higher levels of poverty compared to White mothers. Based on SHAP values, the risk factors predicting infants' feeding, growth, and neurodevelopment are ranked as follows: birth weight, birth GA, SNAPPE-II score, average family size, maternal age, median household income, poverty level, and school enrollment.

Discussion: Maternal racial disparity and SES serve as predictors of feeding, growth, and neurodevelopmental outcomes in preterm infants. Understanding these associations can inform health care strategies for vulnerable preterm populations to improve long-term health outcomes.

Background: Self-regulated fatigue (SRF) can seriously damage the physical and mental health of persons with colorectal cancer (CRC) undergoing chemotherapy. Understanding how to improve self-regulation ability is of crucial importance.

Objectives: To investigate the status of potential profiles of SRF in persons with CRC treated with chemotherapy and the factors associated with these profiles.

Methods: A convenience sampling method was used to conduct a questionnaire survey with 322 hospitalized persons with CRC who were undergoing chemotherapy at three tertiary-grade A hospitals in China. Data were collected through the General Information, Self-Regulatory Fatigue Scale, Family Health Scale, the 10-item Kessler Psychological Distress Scale, and cancer information overload scale. Latent profile analysis and multiple logistic regression were used to analyze the data.

Results: SRF among persons undergoing chemotherapy for CRC could be divided into three potential profiles: low SRF-extensive social profile (53.1%), moderate SRF profile (32.3%), and high SRF-low mood profile (14.6%). Gender, per capita family monthly income, family health, psychological distress, and cancer information overload were predictive factors for different profiles of SRF.

Discussion: There were three latent profiles of SRF in persons with CRC. Family health, psychological distress, and information overload were significant predictors of SRF. Health care providers should adopt individualized interventions to help patients improve disease coping, reduce SRF, and provide support through family care, information filtering, and psychological support.

Background: While emerging literature has documented worsening staff nurse shortages due to higher prevalence of workplace violence, bullying, discrimination, and burnout among nurses post-pandemic, there is limited evidence to identify specific work environment factors that either induce or mitigate nursing turnover intentions in relation to these workforce challenges.

Objectives: This study aimed to evaluate nurses' experiences with workplace violence, bullying, discrimination, and burnout within work environments and examine their associations to determine their subsequent effects on nurses' intentions to leave.

Methods: In 2024, we conducted a quantitative cross-sectional study using online, anonymous surveys with multiple validated instruments to gauge nurses' work environment perceptions, experiences with workplace violence, bullying, discrimination, burnout, and intent to leave. We used descriptive and inferential statistics to analyze the data collected from 222 nurses from New York State.

Results: Of the 194 eligible nurses who completed our survey, most respondents had high exposure to negative acts or bullying and endorsed an intention to leave their jobs. Burnout, bullying, and discrimination experiences emerged as significant predictors of intention to leave. While workplace violence was reported to adversely affect personal well-being and mental health, it was not significantly associated with burnout or intention to leave. Nurses reported that their work environments need improvement, particularly in terms of staffing and leadership. Appropriate staffing has a significant association with workplace violence and reduces discrimination, bullying, and intention to leave perceptions. Although authentic leadership has substantial associations with workplace violence, bullying, and discrimination, it showed a lack of statistical significance on nurses' intention to leave. Notably, burnout was not significantly associated with the six essential standards for a healthy work environment.

Discussion: The complex interplay among workplace violence, bullying, discrimination, and burnout highlights the importance of various work environment factors, such as appropriate staffing, meaningful recognition, and authentic leadership, in effectively shaping nurses' intentions to remain in or leave their jobs. Study results provide a foundation for health care organizations to conduct future research that centers on building more supportive and inclusive work environments to holistically sustain an efficient nursing workforce.

Background: Women commonly experience lower urinary tract symptoms (LUTS), such as frequent urination, urgent urination, and urinary incontinence. Health education for women rarely focuses on LUTS prevention and promotion of bladder health. The Theory of Reasoned Action and Theory of Planned Behavior has been used to explain and change a variety of health behaviors. Missing from the literature is an explicit test of whether constructs of these theories are associated with LUTS and bladder health, and whether toileting habits explain this association.

Objectives: To inform prevention strategies, this investigation tested whether the Theory of Reasoned Action and Theory of Planned Behavior constructs (attitudes towards, perceived norms of, and perceived control over specific toileting behaviors) are associated with women's toileting habits, and whether these habits mediate associations of theoretical constructs and women's LUTS and bladder health.

Methods: The Prevention of Lower Urinary Tract Symptoms Research Consortium developed theoretical constructs to match four toileting behavior domains (delayed voiding, straining, crouching/hovering over toilets when away from home, and avoiding public toilets) assessed by the validated Toileting Behaviors: Women's Elimination Behaviors scale. Using a population-based survey, data were then collected from women at nine sites in the United States. Cross-sectional regression analyses tested whether toileting habits in a given domain mediated associations of corresponding theoretical constructs with reported LUTS, bladder health, and bladder function.

Results: The overall analytic sample included 1,472 women with a mean age of 48 years. Associations of norms favoring delayed voiding and low perceived control over timing of voiding with more frequent LUTS and poorer bladder health and function were partially mediated by delayed voiding habits. Favorable attitudes towards and norms of straining (i.e., pushing down to urinate) and avoiding public toilets were associated with more frequent LUTS through corresponding toileting habits.

Discussion: Longitudinal research is needed to confirm study findings. Future prevention intervention research may include nursing and public health messaging designed to shape attitudes towards and perceived norms of specific toileting behaviors, as well as policies to enhance control over healthy toileting practices in public spaces, including schools and workplaces.