Nursing Research最新文献

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.

Background: Nurses experience high rates of mental health stressors. Mental health support services can mitigate the burden of these stressors and mental health sequelae, but nurses may not access them due to stigma, unavailability, or concerns regarding professional standing.

Objective: The aim of the study was to examine the association between nurse characteristics and perceived need for and utilization of mental health services, and to identify barriers to nurses accessing mental health services.

Methods: Cross-sectional survey data were analyzed from 367 nurses in one large urban health system. Descriptive statistics and multinomial logistic regression were used to examine demographic, workplace, and mental health characteristics that were independently associated with perceived need for and utilization of mental health services.

Results: Nurses who reported experiences of verbal abuse, anxiety, or burnout and who were younger and partnered were more likely to have utilized mental health services and have perceived they would benefit from these services. The most prevalent barriers to care included not knowing how to find a provider, inconvenient hours, and embarrassment or concerns about judgment from others.

Discussion: Several barriers prevent nurses who perceive a need for mental health services from accessing them. Interventions targeting these barriers may help mitigate the burden of mental health conditions in this population.

Background: Each year in the United States, approximately 42,211 women and men die from breast cancer. Individuals experiencing homelessness are disproportionately affected, facing a higher incidence of the disease. People experiencing homelessness (PEH) have a higher incidence of breast cancer and mortality than domiciled individuals. Across all 50 states, the Centers for Disease Control and Prevention provides free breast cancer screenings for eligible individuals with limited financial resources. However, PEH have screening rates that remain below the national average. Early detection is critical to identifying breast cancer. When detected in the earliest local stages, there is a 90% or better survival rate.

Objective: The objective of the study was to examine the perspective of PEH regarding perceived challenges of obtaining breast cancer screenings, education, and care.

Methods: We used a qualitative hermeneutic phenomenology design. Data were gathered using a focus group consisting of PEH in the state of New Jersey. This approach allowed the researchers to access multiple viewpoints of the phenomenon through robust discussions while prioritizing individual contributions and shared experiences. This qualitative hermeneutic phenomenology design used trustworthiness to establish rigor, using essential details in credibility, dependability, transferability, and confirmability.

Results: Eighteen individuals participated. Major considerations for this PEH focus group were finances, family, time, accessibility, emotions, and education.

Discussion: The results may be used to assist healthcare practitioners in becoming more informed about barriers to breast cancer education, screenings, and care. Identifying needs about finances, obligations, accessibility, and education may assist healthcare practitioners in discussing these key factors with patients, which may lead patients to become more open to breast cancer screenings. More dialogue about breast cancer screenings with PEH may lead to more screening participation.

Background: Communication is an important tool in combatting racial and economic healthcare disparities in cancer care. The ability to communicate treatment-related distress and troubling symptoms can allow proactive symptom mitigation and adherence to a prescribed cancer treatment. Few studies have explored how racial and economic differences in patient-clinician interactions in cancer care influence symptom distress and chemotherapy adherence.

Objectives: This study aimed to examine racial differences in interpersonal processes of care and their association with symptom distress and optimal chemotherapy dose among women diagnosed with early-stage breast cancer (ESBC).

Methods: Black and White women newly diagnosed with ESBC and prescribed chemotherapy for a diagnosis of invasive breast cancer were recruited. The Interpersonal Processes of Care Survey and Symptom Distress Scale were included in this analysis. Ratios of prescribed chemotherapy to received chemotherapy were recorded as total chemotherapy percentage.

Results: Persons who were Black perceived worse scores in communication, including "lack of clarity," "discrimination due to race/ethnicity," and "disrespectful office staff." Participants who lived in areas of greater deprivation perceived worse levels of "discrimination due to race/ethnicity" compared to those living in areas of less deprivation. Participants who perceived higher "discrimination due to race/ethnicity" were less likely to achieve optimal chemotherapy doses. Those who perceived worse scores for "lack of clarity," "discrimination due to race/ethnicity," "disrespectful office staff," and "compassion" had significantly higher levels of symptom distress.

Discussion: Symptom distress during ESBC chemotherapy must be communicated via patient-provider interaction. Patients' perceptions of discrimination and bias may inhibit this process. This interaction requires further interrogation to develop an inclusive symptom communication protocol.

Background: Computable phenotyping is a data science method that systematically synthesizes clinical attributes, such as a disease, condition, or patient cohort, enabling a database to be queried for entries matching these characteristics. Developing computable phenotypes will enhance current clinical and research efforts and is foundational for effective nurse scholar participation in future data science endeavors, such as artificial intelligence (AI) and machine learning (ML) research.

Objective: The aim of the study was to (a) present a foundational, disease-agnostic framework for systematic computable phenotype construction; (b) demonstrate the framework used by exploring the following question: "Does early pubertal timing increase the risk of developing type II diabetes in males?"; and (c) outline the methodological utility and limitations of computable phenotyping for nursing research.

Methods: A proof-of-concept pilot project explored computable phenotype research utility by querying the TriNetX de-identified health record database. Various computable phenotypes were constructed to retrieve complete case frequency counts of specific health records for children experiencing puberty. These retrieved records allowed for quantifying type 2 diabetes (T2D) risk by comparing children diagnosed with precocious puberty (medically diagnosed early puberty) to those without an abnormal puberty diagnosis. A translational science lens informed the extraction and synthesis of the underlying scientific and operational principles relevant to systematic computable phenotyping.

Results: A six-step, disease-agnostic, computable phenotyping framework is synthesized for nurse researchers and clinicians to leverage "big data" applications in their work. The puberty case example-illustrating foundational use of the framework-suggests that males with precocious puberty may be six times more likely to develop T2D when 14-18 years old than those without diagnosed early puberty. The framework provides a foundation for sophisticated statistical analyses, such as leveraging computable phenotypes in multivariate modeling and ML algorithms.

Discussion: The six-step, computable phenotype framework will introduce nurse scholars and clinicians to leverage data science principles in real-world interfaces. Applications using the framework can include generating and testing epidemiologic hypotheses, identifying participants for research with specific clinical attributes, deploying statistical models for healthcare monitoring and decision-making, and participating in future research on AI and ML algorithms. The puberty case example generates foundational evidence to justify future puberty research.