Advances in Nursing Science最新文献

Health care systems are facing soaring workforce shortages, challenging their ability to secure timely access to good-quality care. In this context, nurses make difficult decisions about which patients to deliver care to, transfer to other providers, or strategically ignore. Yet, we still know little about how nurses engage in situated practices of bedside rationing. Building on the work of Giorgio Agamben and Judith Butler, we have developed a research agenda that homes in on a politics of bedside rationing. We argue that this agenda is essential to better understand the implications of scarcity for nursing and to explore new ways to cope with challenges faced.

The aim of the current study was to explore the applicability of Swanson's middle-range theory of caring within the context of end-of-life care provided to nursing home residents. A secondary analysis of data collected from 5 individual interviews and 1 focus group with a total of 9 nurses employed at nursing homes was conducted using qualitative deductive content analysis. The findings highlight the influence of nurses' caring attitudes and behaviors on providing end-of-life care, which are described as caring processes. Additionally, the study emphasizes the valuable role of Swanson's theory in guiding end-of-life care practices in nursing homes.

The extent of the application of the Individual and Family Self-Management Theory (IFSMT) in research has yet to be determined. The purpose of this analysis was to review the use of the IFSMT in published research and evaluate posited constructs and relationships. Dimensions and categories of the IFSMT and the interrelationships were generally supported in the 77 articles reviewed. A majority focused on self-management of chronic conditions in the adult population. More research on the strength, direction, and interaction of relationships is needed. Defining and exploring social constructs, including race, ethnicity, and gender, should be prioritized in future IFSMT research.

This grounded theory study explored the processes and actions enacted by oncology nurses to enhance professional quality of life and the related meaning, facilitators, and barriers. Oncology nurses described a process by which they continually Reconcile Incongruencies. This process involves 4 categories: Accepting the Context of Oncology Nursing, Bettering the World, Pursuing a Calling, and Being Valued. External facilitators and barriers, self-driven actions to maintain, and consequences of professional quality of life were also revealed. The findings from this study offer an operational definition, a foundation for instrument development, and the consequences of oncology nurses' professional quality of life.

At a time when new and veteran nurses are fleeing the profession and the term resilience is as worn out as the workers it is meant to inspire, scholars and educators must excavate the intuitive and creative core of nursing. Science addresses facts but lacks language for nuance. This article asserts that nursing, which lags behind medicine in appreciating the value of its stories, must recognize the essential diversity the humanities bring to our understanding of the human condition. As workforce deficits, moral distress, and vicarious trauma proliferate, a consilience between the art and science of nursing and a reminder of their ability to potentiate one another are overdue.

Clients who identify as lesbian, gay, bisexual, transgender, queer/questioning (LGBT+) may experience barriers in health care access and services. LGBT+ clients want a welcoming, inclusive, and affirming encounter with nurses and other health care providers. This concept analysis used a modified Walker and Avant method to clarify the concept of LGBT+ inclusive health care. Antecedents, attributes, and consequences of LGBT+ inclusive health care were identified from the literature. The results of this concept analysis of LGBT+ inclusive health care can inform future research, policy, education, and practice to address the health care needs of this population.

The Ri Majel (Marshallese) migrants of Washington State have endured health inequities and unique laws dictating their access to health care once they arrive to the United States. These health inequities can be seen to be a result of historical trauma and militarization of their islands. The research question was an inquiry regarding access to health care for the Ri Majel in Washington State. We first provide detailed historical data in the background to contextualize our research inquiry. We interviewed 12 people and using manifest content analysis found 2 main themes regarding the health of the Ri Majel: (1) health care access and inequity and (2) historical trauma and embodiment. Health care access was impeded by (1) ongoing effects of radiation, (2) repeated denial of services, (3) lack of health care and insurance, (4) lack of language interpretation during health care visits, and (5) poverty. Historical trauma and embodiment were evidenced by these findings: (1) illness and early mortality; (2) provider lack of knowledge and understanding of the Ri Majel; (3) structural discrimination; (4) feelings of sadness and despair; (5) shyness and humility; and (6) a sense of "cannot/will not" and fatalism. Our findings demonstrate the need to examine structural factors when assessing health inequities and a need to understand and mitigate the effects of historical trauma enacted by structural racism, violence, and colonialism. Strategies to mitigate the embodiment of historical trauma require further investigation.

Asian family caregivers of older adults with dementia have stressful caregiving situations over long periods; they must become resilient to recover from adversity. A conceptual definition of resilience specific to Asian family caregivers is important for understanding their caregiving phenomena and the relationships with mental health and psychological well-being. The purpose of this concept analysis was to define resilience in family caregivers of Asian older adults with dementia using Walker and Avant's method. The findings of the analysis will guide future research about the modifiable factors that will prevent negative health outcomes in this population of caregivers.

Real-word data (RWD) refer to data relating to patient health status and/or the delivery of health care routinely collected from a variety of sources, including electronic health records, medical claims data, and patient-generated data. Data sets that combine personal health data stored in different sources can provide a more complete picture of an individual's health and can be used to improve population health through research and practice. The 2-tiered aim of this article is to provide a brief introduction to using RWD in health care research and to present a case study that demonstrates data curation and data merge from different sources while highlighting the benefits and limitations of using RWD. The current digital health ecosystem and value-based care approach highlight the need to use RWD to catalyze the advancement of health care research and practice. This is an excellent field that nurse researchers can lead, as they have an innate understanding of such data and data sources.