Nursing Research最新文献

Background: Gender-based violence (GBV) has profound health effects on survivors, and there is a critical need to identify culturally relevant protective factors that support trauma recovery and healing.

Objective: To develop and validate the Motivators and Resources for Trauma Recovery (I-MOVE) scale to assess internal and external resources and motivators supporting trauma healing among GBV survivors across different cultural and social contexts.

Methods: We used a structured, multiphase methodology for scale development, incorporating feedback from international experts and survivors. The I-MOVE tool was developed using a three-phase process: (a) identifying core domains through the extraction of relevant concepts from survivor narratives; (b) generating scale items using survivor language; (c) assessing content and face validity, as well as evaluating acceptability, via a content validity index with experts and cognitive interviews with GBV survivors aged 30 to 60 from diverse cultural backgrounds.

Results: The I-MOVE scale, consisting of 57 items, assesses resources and motivators crucial to trauma recovery. Expert evaluations and cognitive interviews ensured clarity, relevance, and cultural sensitivity.

Discussion: The I-MOVE scale fills a critical gap by offering a culturally responsive tool to assess internal and external motivators of trauma recovery among GBV survivors. Its development incorporated multicultural survivor input, enhancing clarity and relevance across diverse populations. Unlike existing tools, I-MOVE addresses the full spectrum of healing resources, including legal status, parenting roles, and culturally appropriate services, particularly relevant for immigrants. These findings suggest the scale's strong potential to support survivor-centered care and inform targeted interventions across varied forms of GBV.

Background: Positive deviance (PD) methods, initially used to improve health in low-income countries, are now being applied across U.S. health sectors. "Positive deviants" are persons who maintain good outcomes despite facing the same adversity as their neighbors. One strength of PD in intervention development is building on successful local solutions.

Objective: The purpose of this study was to illustrate a quantitative approach to conducting a positive deviant analysis of postpartum coping strategies that were associated with good maternal health when stress was high.

Method: We described the process for identifying positive deviants and a normative group with high stress in a cross-sectional survey of 427 persons between 2 and 22 months postpartum. Measures included postpartum stress, physical and mental health, and postpartum coping strategies: self-regulation, spiritual care, self-care, use and seek support, internal and external resources, and health promotion. We used the Mann-Whitney U statistic to compare coping strategies of positive deviants and a normative group.

Results: Among 163 individuals with high stress, we identified 52 positive deviants with good physical health and 21 with good mental health. Positive deviants with good physical health more often used self-regulation and health promotion than the normative group, but those with good mental health used all coping strategies more often. Positive deviants did not differ significantly from the normative group in terms of demographic variables.

Discussion: Use of a quantitative PD approach resulted in identifying potentially efficacious coping content for interventions to promote postpartum health during high stress. In community and clinical interventions, use of PD to identify existing beneficial coping practices could aid populations facing health-related problems.

Background: Caregivers of home care patients with stroke cope with physical, psychological, social, and economic problems. In addition, their inexperience in patient care affects patient outcomes.

Objectives: This study aimed to evaluate the effect of a training program based on the PRECEDE-PROCEED Model on caregivers of home care of persons with stroke on caregivers' caregiving responses, perceived social support levels, and patient outcomes.

Methods: The study was conducted with 70 stroke patients and 70 caregivers using a quasi-experimental design between July and December 2023. Caregivers were assessed using the "Caregiver Personal Information Form," "Caregiver Reaction Rating Scale," and "Multidimensional Perceived Social Support Scale." Home care patients with stroke were evaluated using the "Patient Personal Information Form," "Braden Pressure Injury Risk Assessment Scale," and "Hospital Admission Follow-up Form".

Results: The caregivers who participated in the study had a mean age of 53 years, and 76% were female. Additionally, 84% received care support. Many caregivers simultaneously had a chronic disease, were first-degree relatives of the patient, and required assistance in providing patient care. Over time, a significant improvement was observed in caregivers' responsiveness and perceived social support. Regarding patient outcomes following the intervention, notable improvements were found in the incidence of aspiration/pneumonia, incontinence, constipation, diarrhea, and falls. The risk of pressure injury significantly decreased over time. Furthermore, hospitalization rates showed a marked reduction after the intervention.

Discussion: The training program based on the PRECEDE-PROCEED Model led to positive changes in caregiving responses and the perceived social support of caregivers of stroke patients. The training program was also associated with improvedpatient outcomes. These findings suggest that the PRECEDE-PROCEED Model can be effectively utilized for caregivers of home care patients with stroke.

Background: As the negative effects of climate change on health increase, interest in responding to the climate crisis within the health care community is rising. Nurses, who comprise the majority of health care professionals, have significant potential to mitigate the health effects of climate change and can play a key role in addressing this global challenge.

Objectives: This study aimed to explore nurses' perspectives on climate change and propose strategies to enhance their ability to respond to climate issues based on the results.

Methods: Q methodology-which combines qualitative and quantitative research methods-was used. Thirty-seven Q statements were selected from 197 statements derived from literature reviews, newspaper articles, books, and interviews. Forty-four nurses in South Korea, who were expected to hold diverse perspectives on climate change, were purposively recruited and participated in Q sorting. The data were collected in July and August 2024 and analyzed using principal component analysis with varimax rotation in PQMethod software.

Results: Four perspectives of climate change were identified among the nurses: being crisis-conscious and solidarity response-oriented, emphasizing the irrelevance to nursing and being corporate response-oriented, recognizing the relevance to nursing and having a strong will to act, and being critically indifferent and passive response-oriented.

Discussion: The findings reveal that nurses' perspectives on climate change can be categorized based on the presence of a professional perspective in viewing the climate issue and the level of climate change response considered desirable. To encourage nurses' active participation in responding to climate change, it is necessary to develop appropriate strategies according to their various perspectives on this issue. The results of this study could be used to formulate solutions that enable nurses to contribute positively to climate change in countries with similar backgrounds to South Korea and those that have achieved rapid economic growth.

Background: Although research is emerging about fathers' experiences in the neonatal intensive care unit, there is a scarcity of tools that measure their needs.

Objective: The purpose of this study was to test the reliability and validity of a tool specifically designed to measure the physical, emotional, and psychological needs of fathers whose infants are in the neonatal intensive care unit.

Method: We administered the Neonatal Parental Needs Inventory to 210 fathers who currently had an infant in the neonatal intensive care unit. The Neonatal Parental Needs Inventory is a 42-item tool consisting of six subscales (Information Regarding Baby's Status, Paternal Social Support, Professional Communication, Paternal Priorities, Paternal Support-Who Takes Care of Me, and Paternal Space and Emotional Needs) and uses a visual analog scale to measure fathers' physical, emotional, and psychological needs. Confirmatory factor analysis was performed to determine overall model fit and Cronbach alpha was calculated for internal consistency.

Results: Cronbach alpha showed moderate to high internal consistency for all the subscales and the Neonatal Paternal Needs Inventory overall. Overall model fit was confirmed by root-mean-square error of approximation, comparative fit index and Tucker-Lewis Index.

Discussion: The study established the construct validity of the Neonatal Paternal Needs Inventory that measures the physical, emotional, and psychological needs of neonatal intensive care unit fathers. The instrument could be used to assess fathers' needs and develop father-specific interventions. Further research is needed to see if fathers' needs change over time.

Background: Approximately 60% of patients who have a stroke are discharged to their homes, after which they require ongoing community-based rehabilitation to support long-term recovery. Transitional care services (TCS) serve as an intervention aimed at reducing hospital readmissions by maintaining treatment continuity, either when patients transition between different levels of care within the same setting or when they move to a new care environment.

Objectives: The purpose of this review was to evaluate the efficacy of TCS in reducing readmission rates, enhancing functional outcomes, improving self-efficacy, and boosting the quality of life for patients who had a stroke while also alleviating caregiver burden.

Methods: To review randomized clinical trials performed between January 2014 and December 2023, we adhered to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines for reporting systematic reviews. We established a search strategy combining "transitional care," "stroke," "cerebrovascular disorders," "patient discharge," and "continuity of patient care" and used the PubMed, Embase, Cochrane Library, and CINAHL databases. We selected readmission rate and functional status as the primary outcomes and quality of life, self-efficacy, and care burden as secondary outcomes. We conducted a meta-analysis for each outcome indicator where quantitative synthesis was possible. For the meta-analysis, we used RevMan 5.4 and performed subgroup analyses according to intervention intensity, postdischarge intervention method, and intervention duration.

Results: In the meta-analysis for each outcome indicator, we observed that TCS was effective in reducing the readmission rate of individuals living with stroke and improving their functional status. Additionally, patients with stroke who received TCS showed better quality of life, improved self-efficacy, and reduced caregiver burden compared to those who received usual care. Subgroup analyses revealed that patients with stroke who received moderate or higher intensity of TCS for 2 months demonstrated improvements in functional status compared to those who received lower intensity or 3-month interventions.

Discussion: This is the first known systematic review to synthesize studies on the efficacy of TCS for patients with stroke over the past 10 years, examining outcome indicators such as readmission rates and functional status. Based on subgroup analysis, we derived an effective TCS strategy (e.g., intensity and duration) to improve functional status.

Background: Adolescents who experience dating violence victimization (DVV) have much higher rates of suicidal ideation and suicide attempts.

Objectives: This research investigates the association between DVV and depressive symptoms and suicidality among high school (HS) students by sex in the United States. This research also investigates whether students who dated and did not experience physical or sexual dating violence are at greater risk of depressive symptoms and suicidality than students who never dated.

Methods: The HS Youth Risk Behavior Survey is a cross-sectional nationally representative U.S. survey conducted biennially by the Centers for Disease Control and Prevention. For this research, data were analyzed from four waves (2013-2019) to investigate the relationship between DVV and depressive symptoms and suicidality by sex. The R survey package was used for analyses.

Results: Results showed a high prevalence of depressive symptoms and suicidality among students who reported DVV. Also, DVV was significantly associated with each of the variables: depressive symptoms, suicidal ideation, and suicide attempts. Additive interactions show that the positive association between DVV and depressive symptoms within the past year was significantly greater among female HS students; additive interactions showing a positive association between DVV and suicidal ideation or suicide attempts within the past year did not vary significantly by sex. Both male and female students who did not date were significantly less likely to have depressive symptoms, suicidal ideation, and suicide attempts than those who dated but did not experience dating violence.

Discussion: Results from this study highlight the importance of dating violence prevention and screenings for female and male adolescents.

Background: Authentic leadership in nursing is associated with positive nurse outcomes globally. However, the last published systematic review, in 2018, showed no evidence from the United States and little evidence of effect on patient or health system outcomes.

Objectives: The aim of this study was to systematically review, appraise, and synthesize evidence focused on the effect of authentic leadership on nurse, patient, and health system outcomes in acute care hospitals in the United States.

Methods: A search of six databases for quantitative, peer-reviewed research focused on authentic leadership in nursing. Studies with registered nurses in any role conducted in acute care hospitals and published in English between 2004 and 2025 were included. Studies with nonregistered nurse participants were excluded. Quality appraisal was conducted using Joanna Briggs Institute tools. Results were narratively synthesized, as heterogeneity in study instruments and methodologies rendered meta-analysis unsuitable.

Results: The final sample consisted of primarily descriptive cross-sectional surveys published between 2017 and 2025. Most sample sizes were <200, with only two including >500 participants. Five different scales measured authentic leadership. All studies focused on nursing outcomes. Three studies showed to have a negative predictive relationship between authentic leadership and burnout, with a small to moderate effect size. Two studies showed authentic leadership predicted compassion satisfaction with small to moderate effect sizes. The final sample had moderate risks of bias.

Discussion: Evidence suggests authentic leadership may have a favorable effect on burnout and compassion satisfaction among U.S. nurses in acute care settings. This finding aligns with nationwide reports of nurse burnout and diminished well-being. No evidence is presented that links authentic leadership to patient or system outcomes. For nursing faculty and practice leaders, this limited evidence base poses a challenge in developing evidence-informed curricula and leadership programs. To address this critical gap, nurse scientists should prioritize research examining the effect of authentic leadership on nurse, patient, and system outcomes in U.S. healthcare settings.

Background: Inflammatory cytokines are linked to cognitive function in older adults with dementia; however, their associations with physical activity (PA) and noninvasive biomarkers, such as sweat, remain unclear.

Objectives: This study aimed to examine the relationships among cognitive function, PA, and sweat cytokines, as well as the moderating effect of cognitive function on the association between PA and cytokine levels.

Methods: Data from 40 older adults with dementia were analyzed to assess correlations between cognitive function, PA measured via wearable devices, and sweat cytokine levels. Pearson's correlation, multiple linear regression, and the Johnson-Neyman method were employed to evaluate these associations. Interleukin-6 and tumor necrosis factor-alpha (TNF-α) levels were measured from sweat samples, and cognitive function was assessed using standardized cognitive tests.

Results: PA was positively associated with interleukin-6 and TNF-α, whereas lower cognitive function was linked to higher TNF-α levels. Cognitive function moderated the association between PA and TNF-α; specifically, higher PA was associated with lower TNF-α levels among participants with moderate-to-severe levels of dementia.

Discussion: These findings suggest that sweat cytokine measurement is a viable noninvasive biomarker for inflammatory responses in dementia and that the effect of PA on inflammation may be influenced by cognitive function. Nurses should consider patients' cognitive function when interpreting the association between PA and cytokine levels.

Background: Health disparities in maternal health outcomes persist among Black birthing populations in the United States. Given the historical harms experienced by Black populations in research, culturally tailored approaches to ensure ethical research are needed. Community-engaged research strategies have been found to be effective in a variety of investigations; however, little has been documented regarding their use within biologically focused research among pregnant populations.

Objectives: The purpose of this paper was to describe the process of engaging with a community advisory board (CAB) of a biologically focused research study focused on reducing perinatal health disparities and promoting health equity. Specifically, we outline the methods followed to meaningfully involve the community in each step of the research process.

Methods: The research team utilized intentional team-building activities and feedback methods to relay information between the community and research partners regarding study protocols and community-led dissemination strategies. Online sessions with community partners were created utilizing community-engaged research principles to guide the sessions. Information obtained from the CAB during these sessions was used to modify and optimize this study's data collection protocol, recruitment strategies, and dissemination efforts. A quantitative and qualitative survey was conducted during the process to gather feedback from CAB members about their experiences.

Results: The CAB ( n = 8 community members) shared in the operation of the project and collaborated on everything from study onset, recruitment/retention strategies, informed consent processes, and dissemination to data sharing. Scores from the quantitative questionnaire ( n = 5) about their experiences demonstrated that members overall reported good or excellent experiences as participants in the CAB. Additionally, feedback from community members about how they felt working within a research team included feeling that they were (a) making the research study better, (b) learning about research, (c) providing voice for the community, and (d) building a community of trust. Detailed feedback on each session resulted in changes in study protocols, recruitment practices, and dissemination activities.

Discussion: Safety is a crucial tenant of all research investigations. When research focuses on populations who have experienced perpetual harm, utilization of community expertise is necessary to ensure just and equitable research experiences.