Nursing Research最新文献

Background: Due to significant gaps in knowledge around women's health, Congress commissioned the National Academies of Sciences, Engineering, and Medicine (National Academies) to conduct a consensus study on funding allocation, workforce needs, and priority research areas for the National Institutes of Health (NIH).

Objectives: This manuscript summarizes the key points of the new National Academies report on women's health research for NIH, presents the relevance and importance for nursing research, and briefly discusses the need for increased representation of nurse scientists on National Academies panels.

Methods: Beginning in the Fall of 2023, a multidisciplinary panel of 17 experts was convened by National Academies to address gaps in women's health research at NIH. The committee was tasked to identify research priorities for NIH-funded research with a focus on conditions that are female specific, are more common in women, or affect women differently. In addition, the committee was asked to make recommendations on NIH training and education to strengthen the women's health research workforce; changes to NIH structural, systems, and review processes; and allocation of funding to more equitably reflect the burden of disease among women.

Results: The committee found that, from 2013 to 2023, only 8.8% of NIH research dollars focused on women's health research and that basic knowledge about women's physiological, hormonal fluctuations, and chromosomal differences is lacking. Data are also needed to better understand diseases that are female specific, are more common in women, or affect women differently. The committee made eight recommendations for transformative change at NIH related to women's health research.

Discussion: Overall, the report describes the need for transformative change at NIH to advance the science on women's health research and improve outcomes. This includes a comprehensive approach and recommendations that would double the NIH's investment in women's health research, enhance accountability, and provide rigorous oversight, prioritization, and integration of women's health research across NIH.

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: The aim of this study was 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 schools 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.

Background: Heart failure (HF) is a debilitating condition affecting over 6.7 million adults in the United States. Social risks and complexity, or personal, social, and clinical aspects of persons' experiences, have been found to influence healthcare utilization and hospitalizations in persons with HF. Low-value utilization, or irregular outpatient visits with frequent emergency room use, or hospitalization is common among persons with complex conditions and social risk and requires further investigation in the HF population.

Objectives: The purpose of this research was to assess the influence of complexity and social risk on low-value utilization in persons with HF using machine learning approaches.

Methods: Supervised machine learning, tree-based predictive modeling was conducted on an existing data set of adults with HF in the eight-county region of Western New York for the year 2022. Decision tree and random forest models were validated using a 70/30 training/testing data set and k -fold cross-validation. The models were compared for accuracy and interpretability using the area under the curve, Matthews correlation coefficient, sensitivity, specificity, precision, and negative predictive value.

Results: Area deprivation index, a proxy for social risk, number of chronic conditions, age, and substance use disorders were predictors of low-value utilization in both the decision tree and random forest models. The decision tree model performed moderately, whereas the random forest model performed excellently and added hardship as an additional important variable.

Discussion: This is the first known study to look at the outcome of low-value utilization, targeting individuals who are underutilizing outpatient services. The random forest model performed better than the decision tree; however, features were similar in both models, with area deprivation index as the key variable in predicting low-value utilization. The decision tree was able to produce specific cutoff points, making it more interpretable and useful for clinical application. Both models can be used to create clinical tools for identifying and targeting individuals for intervention and follow-up.

Background: Older adults with heart failure often exhibit poor self-care maintenance. Frailty could exacerbate self-care, leading to deteriorating health. Social support and depression may play a role in self-care maintenance in older adults with heart failure combined with frailty. Confirming this potential mechanistic relationship could provide valuable reference for nurses to formulate and improve the targeted intervention strategies and health education programs for older adults with heart failure.

Objectives: This study analyzed the relationship between frailty and self-care maintenance in older adults with heart failure and determined the sequential mediation effect of social support and depression. Its goal was to provide valuable theoretical insights for formulating targeted clinical nursing interventions for older adults with heart failure.

Methods: A cross-sectional study was conducted from July 2023 to February 2024, during which older adults with heart failure were recruited using a convenience sampling method from the cardiovascular department of a tertiary Class A hospital in Qingdao, China. A total of 241 completed the Tilburg Frailty Indicator, the Self-Care of Heart Failure Index, the Social Support Rating Scale, and the Patient Health Questionnaire-9. t -Tests and one-way analysis of variance were used to examine differences in self-care maintenance among participants with distinct characteristics; correlation analysis was used to identify variable relationships within the study. The mediation model was tested using the SPSS PROCESS macro and the bootstrap method.

Results: Frailty was negatively correlated with self-care maintenance, and both social support and depression were significantly related to frailty and self-care maintenance. Social support and depression not only independently mediated the relationship between frailty and self-care maintenance but also exhibited a significant sequential mediation effect.

Discussion: The frailty of older adults with heart failure and its correlation with self-care maintenance is a complex and multidimensional phenomenon. Frailty not only directly influenced self-care maintenance in participants but also indirectly affected it through the mediating factors of social support and depression. Future research should emphasize innovative, targeted interventions to enhance social support quality and accessibility and alleviate depression, ultimately boosting patients' self-care capabilities and elevating their quality of life.

Background: Perceived stigma significantly impedes access to public health resources for women living with HIV/AIDS, highlighting the crucial need for interventions to empower individuals to overcome such barriers.

Objectives: This paper outlines the protocol for a pilot study aimed at evaluating the efficacy of the Helping Overcome PErceived Stigma (HOPES) intervention employing the mixed methods-grounded in narrative transportation-theory in reducing perceived stigma among women living with HIV/AIDS.

Methods: A total of 100 women living with HIV/AIDS will be randomized into two groups: the HOPES group and the control group. Participants in the HOPES group will watch the narrative transportation videos about perceived stigma experiences and coping strategies recorded by peer volunteers and write notes.

Results: The study commenced in September 2023 and concluded data collection in May 2024.

Discussion: Findings from this study will inform effectiveness trials of HOPES, advancing the evidence base for reducing stigma and improving mental health in women living with HIV/AIDS.

Background: Deciding to learn one's Alzheimer's disease (AD) biomarker status is a high-stakes endeavor that requires comprehending and deliberating about complex and nuanced information. Assessing capacity to consent to AD biomarker testing and disclosure is further complicated when candidates have cognitive impairment and present with family care partners.

Objective: The objective of this analysis was to identify predictors of decisional capacity for an amyloid positron emission tomography disclosure study among persons with mild cognitive impairment (MCI) and their family care partners.

Methods: This analysis used an analytical correlational design, using baseline data from a randomized controlled trial of amyloid positron emission tomography results disclosure. Simple linear regression was used to examine predictors of decisional capacity. Focusing on persons with MCI, the predictor variables of interest were sociodemographic characteristics, level of knowledge of MCI/AD, global cognition, and neuropsychological tests of language and executive functioning. Dyadic analyses were conducted with data from 82 dyads of persons with MCI and care providers using the Actor-Partner Interdependence Model to assess for presence of actor and partner effects among key variables.

Results: Capacity-to-consent scores demonstrated sufficient capacity for all participants to consent to the study. For persons with MCI, lower age, higher mental status scores, MCI/AD knowledge scores, and better performance on measures of language and executive functioning were predictors of decisional capacity. The model revealed positive actor relations for MCI/AD knowledge with decisional capacity for both persons with MCI and family care partners and negative partner relationships for family care partners' MCI/AD knowledge with the decisional capacity of persons with MCI.

Discussion: Assessment of decisional capacity is imperative when considering participation in AD research, including studies with high-stakes procedures like biomarker results disclosure. Our findings highlight that not only do individual characteristics put persons with MCI at risk for lower decisional capacity, but dyadic effects from family care partners may also be present.

Objective: The aim of this study was to determine the pooled prevalence of and risk factors for PBT.

Methods: The Cochrane Library, Web of Science, PubMed, Embase, and Scopus databases were systematically searched between their inception and October 1, 2023. Pooled prevalence, odds ratio, and 95% confidence intervals were calculated using fixed- or random-effects models using Stata 15.0.

Result: The pooled prevalence rate of PBT was 19%. We performed subgroup analysis based on age, parity, region, and measurement tools. The results showed differences in the prevalence of PBT between these subgroups, suggesting the need for clinical personalization in different populations. The pooled odds ratio showed that fear of childbirth, cesarean section, operative vaginal birth, pain during labor, and dissatisfaction with support from midwives were significantly associated with PBT.

Discussion: The study found that the pooled prevalence of PBT was 19%. PBT risk factors are diverse, and understanding the prevalence and risk factors for PBT has important implications for healthcare and social care systems.

Background: Tongue-tie is associated with nipple pain and early breastfeeding cessation. To date, research has been limited by small sample sizes and a dearth of evidence on the effects of tongue-tie on infant feeding symptoms and physiologic breastfeeding mechanics.

Objectives: In this article, we describe the protocol for our study exploring infant feeding, negative breastfeeding symptoms, maternal anatomy, and physiologic sucking data between infants with and without tongue-tie.

Methods: A prospective cohort study design is being employed. Over 8 weeks, three visits will be conducted with a sample of mothers and their infants without tongue-tie and a sample of mothers and their infants diagnosed with tongue-tie undergoing treatment via frenotomy. The aims of the study were to compare breastfeeding symptoms, breast anatomy, infant feeding symptoms, feeding efficiency, and nutritive sucking parameters between infants with and without tongue-tie, further comparing these metrics pretreatment and posttreatment via frenotomy with the non-tongue-tied age-matched counterparts.

Results: This study is currently ongoing.

Discussion: Tongue-tie is an everyday problem; clear guidelines are needed to decide whether to treat it. This novel, innovative, and multidisciplinary research study aims to fill critical gaps in understanding the physiological and functional effects of tongue-tie on breastfeeding, offering evidence to inform better clinical decisions and support effective interventions.