Nursing Research最新文献

Background: Racial and ethnic minoritized individuals have lower uptake of lung cancer screening (LCS). It is unclear how perceived racial discrimination in health care setting affects LCS uptake.

Objectives: The purpose of this study was to investigate the association between perceived racial discrimination in health care and LCS use among LCS-eligible adults in the U.S.

Methods: We used population-based, cross-sectional data from the 2022 Behavioral Risk Factor Surveillance System Survey Reaction to Race module. Eligible participants were adults aged 50-79 who currently use cigarettes or quit within the past 15 years and have ≥ 20 pack-years of tobacco use history. The outcome was LCS use in the past year. The key predictor was self-reported racial discrimination experienced in a health care setting within the past 12 months. We conducted descriptive statistics, including frequencies, weighted means, and percentages and weighted multinomial multivariable logistic regression analysis.

Results: The majority of study participants were men, aged 50-64 years, non-Hispanic White, metropolitan county residents, and held high school or less education. Individuals perceiving racial discrimination had lower odds of LCS uptake in the past year compared to those who did not report such experience. The odds of LCS utilization in the past year were higher among individuals with certain characteristics, such as men (vs. women), aged 65-79 (vs. 50-64 y), retired (vs. employed), and metropolitan area residents (vs. nonmetropolitan residents).

Discussion: LCS utilization remains low, and perceived racial discrimination is associated with low uptake of LCS. Strategies such as digital LCS resources, diversifying the health care workforce, and cultural competence training for the providers may address perceived racial discrimination and ensure equitable LCS initiatives in order to improve LCS participation.

Background: Manual transcription can be resource- and time-consuming, while software-based audio coding offers a potentially cheaper and faster alternative.

Objectives: This study aimed to compare the time efficiency, cost effectiveness, and researcher experience of thematic analysis of audio recordings versus transcripts.

Methods: This was a mixed-methods crossover study with two conditions (audio coding, transcript coding) and three categories of coders (novice, competent, and expert). Ten researchers coded 18 interview segments using NVivo, half in each format. Demographics, coding times, and coding experiences were collected.

Results: On average, transcript coding took less time than audio coding, and NVivo experience was negatively associated with coding time across conditions. Economic analysis showed that audio was<60% the cost of transcript coding. Audio coding was perceived as be more difficult, yet coders agreed that both methods led to similar code quality. Audio coding may be a cost-saving alternative to transcript coding.

Discussion: The potential cost savings, coupled with the more "naturalistic" source of audio data, may make audio coding an appropriate approach to consider for the qualitative researcher, despite coder perceptions of its greater difficulty. Audio coding should be considered as part of a qualitative project to enhance immersion in the data or improve coding efficiency. However, this approach should be preceded by careful consideration of the most effective computer-assisted qualitative data analysis software and extensive training and familiarization with audio coding procedures prior to analysis.

Background: Vaccine hesitancy remains a significant public health challenge, even in countries with high vaccination coverage, such as Italy. Understanding the sociodemographic, informational, and psychological characteristics associated with hesitancy is essential for designing effective, targeted interventions.

Objective: To describe and compare the sociodemographic, behavioral, informational, and psychological profiles of vaccine-hesitant and non-hesitant Italian parents.

Methods: A descriptive cross-sectional study was conducted between October 2024 and February 2025 using an anonymous online survey distributed through social media and parenting websites. Eligible participants were parents or legal guardians of children aged 0-18 years, residing in Italy. Vaccine hesitancy was assessed using the Parent Attitudes about Childhood Vaccines short form (PACV-5), alongside validated measures of health literacy (HLS-EU-Q6), vaccine literacy (HLVa-IT), adult vaccine hesitancy (aVHS), vaccine confidence (VCI), and parental health locus of control (PHLOC). Descriptive and bivariate analyses were performed to examine the differences between hesitant and non-hesitant parents.

Results: Of the 308 participants, 13% were classified as vaccine-hesitant. Hesitancy was significantly associated with lower educational attainment, absence of a health care background, reliance on television and health assistants for vaccine information, lower health and vaccine literacy, lower vaccine confidence, and higher scores in the Fate subscale of the Chance domain and the Child subscale of the Internal domain of the Health Locus. A total of 89.94% of parents reported full adherence to vaccination schedules, yet hesitant parents were more likely to partially vaccinate their children and express selective vaccination intentions. Discrepancies between past vaccination behavior and future intentions were observed, suggesting that hesitancy is dynamic and potentially unstable.

Discussion: Vaccine hesitancy among Italian parents is associated with low health literacy and confidence levels, distinct health beliefs, and specific information-seeking patterns. These findings suggest public health efforts should include trust-building approaches that address cognitive skills, fatalistic beliefs, and preferred communication channels. Longitudinal research is necessary to monitor changes in parental attitudes and to guide adaptive intervention strategies.

Background: Antiretroviral therapy (ART) is crucial for prolonging the lives of people with human immunodeficiency virus (HIV), but adherence remains suboptimal. Psychosocial interventions show promise for improving ART adherence, yet no consensus exists on the most effective approach.

Objectives: To identify the most effective psychosocial interventions for improving ART adherence in people with HIV.

Methods: Six databases (EMBASE, MEDLINE, Web of Science, CINAHL, PsycINFO, and CENTRAL) were searched from their inception to April 2024, yielding 35 studies with 7,808 participants. Traditional pairwise and network meta-analyses were conducted to compare psychosocial interventions. Meta-regression and subgroup analyses were performed to examine the relationships among intervention efficacy and participant characteristics as well as intervention duration.

Results: Eight interventions were identified. Pairwise meta-analysis showed psychosocial interventions significantly improved ART adherence. Network meta-analysis found that multicomponent interventions were the most effective. Meta-regression showed no significant effect of participant characteristics on efficacy. The subgroup analyses found that multicomponent interventions were effective in both the short and long term, whereas case management had positive but less robust short-term effects.

Discussion: Multicomponent interventions appear to be the most effective psychosocial strategy to promote ART adherence. However, feasibility and cost-effectiveness may constrain use in resource-limited settings. Future research should focus on identifying optimal and simplified intervention packages tailored to specific subpopulations of people living with HIV.

Background: Patient self-care and caregiver contribution to self-care in chronic illnesses should be considered together as a dyadic phenomenon called "dyadic illness management." The possibility of classifying dyadic engagement in chronic conditions care may uncover behavioral patterns useful for improving disease management. Mixed-effects models have been used to obtain dyadic scores, which serve as inputs for latent class analysis. However, the advantages of this approach over simpler synthetic dyadic measures remain unclear.

Objective: The aim of this study was to compare two methods for obtaining dyadic scores to serve as inputs for identifying distinct patterns of dyadic illness management for type 2 diabetes (T2D) through latent class analysis.

Methods: This work uses data from a cross-sectional study on 251 patients with T2D and their informal caregivers. Patient self-care and caregiver contribution to self-care were measured by the Self-Care of Diabetes Inventory and the Caregiver Contribution to Self-Care in Diabetes Inventory, respectively. To assess dyadic illness management, we first adopted the incongruence model, a mixed-effects model with a specific codification that enables the estimation of both the average and incongruence in the outcome within each dyad, through random intercepts and random slopes. These estimated coefficients were then used to perform a latent class analysis that was able to identify patterns of dyadic management. As an alternative approach, we calculated the dyadic average and incongruence using the raw means and difference between patient and caregiver scores. These values were then used as inputs for latent class analysis.

Results: The latent class analysis clustered the same dyads into the same classes across both approaches, with identical fit indices. The three-class model showed the best performance in terms of both fit and characterization of the dyads.

Discussion: Mixed-effects models account for interdependence within the dyad and measurement error, returning predicted measures that are shrunk toward the overall mean. However, this approach yielded the same clusters as the simpler method based on observed measures.

Background: Chronic stress contributes to adverse health outcomes and may be transmitted intergenerationally. Hair cortisol concentration is a noninvasive biomarker of chronic stress; yet the feasibility and acceptability of optional remote collection in rural families remains unclear.

Objectives: We evaluated the feasibility and acceptability of remote hair sample collection, identified factors associated with hair sample completion, and assessed the preliminary effects of a family-centered, mindfulness-based, motivational interviewing intervention on hair cortisol concentration.

Methods: In this pilot randomized trial, 46 rural parent-child dyads were assigned to either a remote mindfulness meditation-based motivational interviewing intervention or an active control. Hair sample collection was optional at baseline and post-intervention. Families opting in received mailed kits with written/video instructions, optional Zoom support, and a $40 incentive. Descriptive and exploratory analyses assessed participation patterns and associations with demographic and behavioral characteristics.

Results: Of 46 families, 36 (78%) consented to hair collection; 24 (67%) returned baseline samples, and 12 (50%) returned post-intervention samples. The average turnaround from mailing to receipt was 14 days. Participants rated instructions as clear and helpful; no families used Zoom assistance. Demographics were not significantly associated with completion, though trends indicated lower return rates among minority and full-time employed parents. At baseline, non-completers reported higher physical activity and greater child sugary beverage intake. Nonsignificant trends also suggested that completers had more depressive symptoms and greater body fat percentage compared to non-completers. No significant intervention effects on HCC were observed.

Discussions: Optional remote HCC collection is feasible and acceptable among many rural families, though retention declined over time. Future studies should investigate strategies to reduce barriers and promote sustained engagement when biospecimen submission is voluntary.

Background: The ABC123 care planning framework may facilitate an improved understanding of the unique conditions of older adults with advanced cancer and support the creation of an individualized, patient-centered care plan that is both medically feasible and aligned with patients' health, goals, and values.

Objectives: To present a study protocol designed to (a) assess the preliminary feasibility of ABC123 intervention through recruitment, retention, and clinician feedback, (b) evaluate ABC123 as measured by goal concordant care, and examine patients' quality of life, value clarity, decisional efficacy, and care team communication over a 6-month period following ABC123 intervention exposure.

Methods: This feasibility trial will enroll up to 48 older adults who have advanced cancer that is not curable with surgery and are beginning treatment with an oncologist from one of four clinics in the Denver Metro area. Patients who consent will complete a series of assessments grounded in geriatric, oncologic, and palliative care that make up the ABC123 intervention. Findings from these assessments will be documented in their medical records and shared with their oncologists by an advanced practice provider. Patient participants will be followed for 6 months, with follow-up questionnaires, including a goal-of-treatment question, and interviews administered at 1, 3, and 6 months. Patients' oncologists will also be asked to assess goal of care for each participant to assess goal alignment.

Results: Since January 2023, 54 potential patient participants have been approached, 29 have enrolled, and 14 have completed the ABC123 intervention and the first follow-up visit.

Discussion: This study introduces a novel multicomponent care planning intervention for older adults with advanced cancer that implements expert-recommended tools early in a patient's care planning process. The pilot will evaluate its effect on aligning care with patient goals, the feasibility and acceptability of implementation across different oncology clinics, and its potential to guide future pragmatic approaches to improve goal-concordant care.

Background: Psychosocial adaptation is a key indicator for chronic disease rehabilitation. Many instruments have been proposed to evaluate psychosocial adaptation in individuals with chronic disease, but their measurement properties are unknown.

Objectives: This systematic review aims to identify and critically assess the measurement properties of all existing instruments intended for measuring psychosocial adaptation in adults with chronic disease.

Methods: A systematic search was conducted in PubMed, Embase, CINAHL, PsycINFO, Chinese databases including China National Knowledge Infrastructure (CNKI), and Wan Fang from their inception to July 10, 2025. The search followed the COSMIN guideline for systematic reviews of patient-reported outcome measures.

Results: Out of the 8,399 retrieved studies, only 24 studies that concerned 13 instruments were eventually included. Five instruments showed high-quality evidence from one measurement property, and two instruments were rated high-quality evidence from three and four measurement properties, respectively. There was no sufficient evidence for which instruments identified for assessing psychosocial adaptation in adults with chronic disease appears to be generally superior to the others. Therefore, further studies are recommended to validate the measurement properties of existing psychosocial adaptation instruments for adults with chronic disease.

Discussion: A total of 13 instruments were identified. However, current evidence for selecting instruments suitable for assessing psychosocial adaptation in adults with chronic disease was insufficient.

Background: Despite studies confirming that violence against nurses in the workplace is a critical issue, research concerning the factors associated with violence is sparse. Workplace violence is significantly associated with nurse well-being, which is a national priority.

Objective: In this study, we sought to uncover the factors associated with experiencing violence among nurses to facilitate the development of well-being strategies in the workplace.

Methods: In December 2023, hospital-based nurses at two major hospitals in Hawaii responded to email invitations for an online survey to identify factors affecting their well-being. This analysis is from data collected from the 470 nurses who completed the violence-related question.

Results: A total of 51.7% (n=243) of the participants reported the experience of one or more incidents of violence at work during the past year. In the final model, the factors significantly associated with workplace violence included the type of unit, leadership responsibility, frequency of being asked to work additional shifts, and perceptions related to a healthy work environment.

Discussion: Recognizing the factors associated with workplace violence is essential for developing evidence-based interventions that protect the well-being (physical and mental health) of nurses and foster wellness cultures.

Background: As online data collection proliferates, healthcare researchers face challenges with fraudulent research participants. While substantial literature on preventing and detecting fraudulent responses in surveys is available, a dearth of nursing literature focuses on identifying and addressing fraudulent participation in online qualitative studies.

Objectives: The aims of this article are to highlight the researchers' experience with fraudulent research participants in an online qualitative study, enhance awareness of imposter participants, and propose strategies for identification of imposters' participation that threaten research validity.

Methods: A qualitative, descriptive study was designed to explore nursing professional development (NPD) specialists' use of NPD practice judgment. Participants were recruited for online focus groups via email using a national association's email list. A $25 gift card was offered to participants. Suspected fraudulent participants led to the cancellation of focus groups and prompted a review of initial recruitment email responses. A framework for detecting fraudulent responses was developed based on this review.

Results: Out of 2,368 volunteers, 28 were invited to participate in 4 focus groups. During the initial focus group, participants did not use their cameras despite the facilitator's request, and they failed to provide meaningful responses. These suspicious actions prompted the facilitator to end the focus group. Subsequently the researchers investigated the phenomenon of imposter participants in qualitative research and analyzed their respondent's applications for signs of fraud. Indications of fraudulent responses to the call for volunteers included an unexpectedly large number of applications received in rapid succession, Gmail addresses with similar naming conventions, and common IP addresses originating outside the United States.

Discussion: Examination of recruitment survey responses, including volume, timing, and email structure, suggest potential "bot" use for volunteer survey completion. Qualitative researchers must implement measures to prevent fraudulent participants, enhance data scanning protocols to detect suspicious responses, and exclude fraudulent data to maintain research integrity.