Nursing Research最新文献

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: 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 school 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.

Objective: The objective of this report is to describe approaches used to ensure fidelity in the B-SWELL feasibility trial.

Methods: A virtual randomized feasibility trial was conducted. Intervention fidelity was evaluated in accordance with Borrelli's five principles of fidelity: design, training, delivery, receipt, and enactment. In addition to the rigorous oversight by the research team, tools were developed or adapted for the virtual trial. Tools used in the trial included a Visual Analog Attendee Engagement Tool, weekly feedback surveys, audio recordings, a facilitator's checklist, an overall satisfaction survey, and a technology survey.

Results: Using Borrelli's framework for treatment fidelity, the researchers noted high ratings from the overall satisfaction survey, designed to assess ongoing participant satisfaction with the intervention materials and continued enactment. The tools successfully guided the intervention process from design to enactment.

Discussion: Adherence to Borrelli's principles of fidelity enables rigorous oversight of an intervention and its delivery. The growing use of technology to deliver programmed interventions requires that tools be adapted and created to monitor fidelity. Validation of the research-developed and -adapted tools is recommended in a larger trial.

Background: Community connectedness, outness, and internalized phobia are potential protective and risk factors for mental health in lesbian, gay, bisexual, transgender, and queer (LGBTQ) individuals. However, these interrelated factors have generally been examined in isolation and for the LGBTQ community in aggregate. As such, there may be undetected effects of factors on mental health for each LGBTQ group.

Objectives: We examined the associations between mental health (i.e., depression and anxiety) and risk/protective factors (i.e., internalized phobia, community connectedness, outness) in each LGBTQ subgroup separately.

Method: A large national U.S. sample ( N = 1,030) of individuals who identified as LGBTQ completed an anonymous Internet survey during fall 2019. Participants answered questionnaires about community connectedness, outness, internalized homophobia or transphobia, anxiety, and depression.

Results: On average, most subgroups reported symptoms of depression and anxiety above clinical cutoffs. Less outness and greater internalized phobia were associated with more severe depression and anxiety, but this pattern was not consistent across LGBTQ subgroups. Greater community connectedness was generally associated with more severe anxiety and depression.

Discussion: LGBTQ subgroups vary in how risk and protective factors relate to mental health outcomes. Our findings highlight the importance of examining LGBTQ subgroups separately and examining risk/protective factors simultaneously to identify the unique contribution of each factor. More research is needed to understand potential LGBTQ mental health risks and protective factors, and future researchers should examine the unique roles of risk and protective factors in separate LGBTQ subgroups.

Background: Recent research has focused on the relationship between heart failure (HF) symptom clusters and outcomes, including mortality, hospitalization, functional status, and quality of life. No known studies to date have explored the role of physical HF symptom clusters and delays in seeking treatment.

Objectives: Describe physical symptom clusters in a population of HF patients and determine if a specific cluster is predictive of delay in seeking treatment for HF symptoms.

Method: We analyzed combined data from two studies ( n = 406) collected during acute HF hospitalization. The Heart Failure Somatic Awareness Scale quantified physical HF symptoms. Delay, measured in days, was collected from the medical record and confirmed by interview. Hierarchical agglomerative clustering techniques determined physical HF symptom clusters. Hierarchical multiple regression analysis was computed to explore predictors of delay.

Results: Participants were primarily White, male sex older adults. Three physical HF symptom clusters were identified: discordant, edema-related, and dyspnea-related symptoms. Hierarchical multiple regression analysis revealed in Step 1 that age was a significant predictor of delay.

Discussion: Our findings provide valuable insight into the role of physical symptom clusters on delay in persons with HF. Through agglomerative hierarchical clustering techniques, we found three physical HF symptom clusters that were then used to determine differences in cluster membership by demographic and clinical variables. Significant age differences were noted by cluster membership with youngest older adults in a discordant symptom cluster.

Background: Safe and reliable implementation of complex study protocols in multisite clinical trials requires that all study personnel have 24/7 access to up-to-date study materials. Study websites can serve as an electronic manual of operations (eMOO) to support trial conduct.

Objective: We describe the development, organization, and maintenance of a study website and eMOO to facilitate quick and efficient communication during conduct of a complex, multisite, international clinical trial.

Methods: We worked closely with our information technology department to develop and maintain our study website, which includes a public home page, a section for parents and families, and three password-protected portals that serve as an eMOO for (a) study sites, (b) study site investigators, and (c) the operations team (e.g., clinical coordination center, data coordination center).

Results: The public home page is helpful for families contemplating study participation and for nonparticipating sites considering joining our trial. The patient and family education section supports family participation in the study. The study site portal contains all information needed for local study teams to safely manage a study patient. The investigator portal provides access to research-specific materials needed to lead the study at each site. The operations team portal supports overall study management. For other scientists considering use of a study website for their multisite research, we recommend close collaboration with information technology for development and maintenance, limited and clearly defined roles for version control, and use of unmodifiable file formats to prevent unapproved alterations of study materials.

Discussion: Although investment in development and maintenance has been significant, we have appreciated marked value to our operations team and study sites. Our study website development process is relevant to other scientists conducting multisite clinical research.