Research and Theory for Nursing Practice最新文献

Background and Purpose: Family presence during resuscitation (FPDR) has been discussed for about three decades, yet nurses differ in their attitudes toward FPDR. This study aimed to investigate critical care (CC) and emergency department (ED) nurses' attitudes and perceptions regarding the benefits, limitations, and challenges of FPDR in their specific settings. Methods: Qualitative descriptive approach. Participants in the Midwestern United States were recruited through purposeful sampling online and in person. Results: A total of 21 participants were recruited. The study identified key themes, including varying definitions of "presence" and "family member," setting-specific attitudes toward FPDR, and nursing and family cultural influences on FPDR. Benefits of FPDR included family support, increased family trust in nurses, and family communication of valuable patient information to nurses. Nurses' perspectives and attitudes regarding FPDR in CC and ED settings ranged from support and advocacy to opposition. CC nurses from cardiothoracic units strictly opposed FPDR practice due to the perceived risk of interference with advanced life support machines, limited space, and potential for trauma, but suggested remote presence via the webcam as an alternative. Implications for Practice: Findings can provide a foundation for an educational program that highlights variant benefits of FPDR with consideration of the risks noted by CC and ED nurses and enhances stakeholder awareness of FPDR limitations and possibilities in these settings.

Background: Detecting cues of pediatric deterioration is challenging for nursing students due to pediatric physiological responses. The aims were to identify cues students noticed, how they interpreted and responded to cues, and how external factors influence decision-making during signal detection trials. Methods: A qualitative secondary analysis examined second-semester senior nursing students' cue recognition during signal detection trials. A convenience sample (n = 14) from a cohort at a private university participated. Data were collected using semi-structured interviews and analyzed via content analysis. Results: Three themes emerged: noticed cues, student responses, and external factors. Noticed cues included assessments and vitals. Student responses included correct and incorrect responses to trials, and external factors included future plans, scenario characters, prior knowledge, and time elapsed. Conclusions: Key cues identified were respiratory rate, oxygen saturation, and work of breathing, correctly recognizing respiratory signals but misinterpreting others. Students relied on external factors to decide on patients' statuses.

Background and Objective: Guided by the cognitive avoidance theory of worry, the study examines school locations that victims of certain types of bias-based bullying or verbal hate tend to avoid. Methods: The 2017 National Crime Victimization Survey was used. Findings and Conclusions: The latent class analysis results revealed that Class 2 ("Intensive Multiple Bias-Based Bullying Victimization") exhibited higher rates of bias-based bullying victimization related to race, ethnic/origin, and physical appearance. Class 2 demonstrated a higher mean of avoidance than Class 1 ("Low-Level Bias-Based Bullying Victimization") in various locations. Moreover, Class 3 ("Gender and Sexual Orientation-Centered Verbal Hate Victimization") showed a higher mean of avoidance in school activities than Class 1 ("Disability-Centered Verbal Hate Victimization") and Class 2 ("Race and Ethnicity-Centered Verbal Hate Victimization"). Class 3 exhibited a higher mean of avoidance in classes compared with Class 2.

Background: Parkinson's disease is a challenging, progressive neurodegenerative process projected to affect more than 1.2 million patients by 2030, with an economic burden that will surpass $79 billion annually in the United States. Pharmacological interventions are the hallmark of treatment for symptom management for this lifelong disease. Multiple medications and a variety of dosing times have an increasingly negative effect on medication adherence. Purpose: This article will discuss medication adherence challenges, describe a theory-guided evidence-based intervention to improve medication adherence, and explore the economic implications in an outpatient clinic setting. Methods: A pilot chart review of 40 cases over 30 days found 60% of patients indicated medication nonadherence. An evidence-based practice quality improvement project was implemented using pre- and postmeasurements of physical, social, and adherence metrics separated by medication adherence teaching. The metrics used include the Parkinson's Disease Questionnaire 39, part of the International Movement Disorder Society's Unified Parkinson's Disease Rating Scale, and the Morisky, Green, Levine Scale. Results: Results were encouraging; medication adherence increased by 26%, while quality of life improved by 18%. Medication adherence improvement efforts follow the Centers for Medicare & Medicaid Services proposed guidelines to stabilize health care reimbursement and pharmaceutical economics. Implications for Practice: Consistent implementation of medication adherence teaching into the current office visit structure identifies patients at risk and improves provider-patient relationships using evidence-based adherence interventions. Any health care system can improve patient outcomes and facilitate revenue growth using medication adherence teaching coupled with the appropriate diagnostic and visit coding.

Background: Advance care planning (ACP) is underutilized. To facilitate ACP and prepare adult children to be surrogates, we must understand how families communicate. This understanding can help prepare surrogates and reduce negative outcomes associated with medical decision-making for a loved one. Objectives: This study investigated the nature of family communication around ACP, the extent of young adults' engagement in ACP discussions with their parents, and the influence of family communication patterns on these conversations. Methods: A mixed-methods approach was utilized in the study. Thirty-nine young adults from a suburban college in Pennsylvania participated. Participants completed the revised family communication patterns instrument and participated in focus group interviews. Results: Analysis of the data revealed an average score of 3.56 (± 0.64) for conversation orientation and 2.93 (± 0.64) for conformity orientation. Structural coding identified distinct family communication patterns with some inconsistencies between measured and self-reported family types. Conclusions: The findings indicate that young adults can engage in ACP discussions with their parents, and family communication patterns may play a significant role in influencing these discussions. Future research should aim to leverage family communication patterns to foster more effective ACP conversations between young adults and their parents. Implications for Practice: Early and frequent advance care planning is essential to patient-centered care. Understanding family communication patterns can allow nurses to tailor conversations to patients and their families. This will assist individuals in making decisions congruent with their family members' wishes, reducing adverse outcomes related to medical decision-making.

Background: Nurse faculty routinely balance many caregiving roles in their work duties. Approximately 61% of the workforce is also an unpaid caregiver, adding to the possibility that nurse faculty have caregiving roles associated with the classroom, clinical area, and at home. Purpose: The aim of this article is to determine the state of the literature on compound caregivers and determine a definition in the context of nurse faculty. Methods: The method used for this study was a concept analysis by Walker and Avant's framework. CINAHL, MEDLINE, Scopus, ERIC, and Complementary Index databases were searched from 2004 to 2024. Results: Nine peer-reviewed articles were examined for this discussion. Implications for Practice: A concept definition was proposed for compound caregivers in the context of nurse faculty. Defining this concept helps administrators recognize factors that place nurse faculty at risk for negative consequences from caregiving and may improve retention in the faculty workforce.

Background: Medication nonadherence is a significant threat to the treatment of hypertension in African Americans. Nonadherence to medications negatively impacts treatment efficacy, safety, and cost. Purpose: This paper aims to identify potential predictors of medication adherence among African Americans based on the Health Belief Model (HBM). In addition, this analysis provides insight into medication nonadherence, interventions to reduce the risk of nonadherence, and the impact of the Social Determinants of Health (SDOH). Conclusion: African American patients with hypertension continue to have lower hypertension medication adherence, due to factors that health care providers may not understand. Besides modifiable and nonmodifiable risk factors, African Americans also experience both unintentional and intentional adherence barriers that are influenced by SDOH, historical constructs, mistrust of the health care system, myths about medications, potential side effects, and passed-down beliefs. The HBM provides a viable theoretical model for promoting hypertension health promotion and disease prevention in African Americans. Clinical Implications: In addition to considering modifiable and nonmodifiable risk factors, health care providers should understand how intentional and unintentional rationales for taking medications can affect a patient's decision. The HBM can be used as a foundation for education and establishing patient willingness to take prescribed medications. Future studies must examine African Americans' readiness and intention to use medications to treat hypertension.

Background and Purpose: Most mobile health applications may be unstandardized and have not been simplified for use by a wide range of community users. Therefore, it can potentially affect data quality due to a lack of validated translation and cross-cultural adaptation. This study aimed to evaluate the validity of the Turkish version of the Simplified Omaha System Terms (T-SOST) for use within a consumer-facing application, MyStrengths MyHealth (MSMH). Methods: The descriptive study comprised three phases: (a) language validity, (b) content validity, and (c) readability assessment and pilot testing. A total of 20 experts assessed the content validity. The Ateşman Readability Formula was used to conduct the readability assessment of T-SOST. The MSMH was used by 74 participants to test the T-SOST in the study. Results: The scale-level content validity index of T-SOST ranged from 0.963 to 0.999. The reading level of T-SOST averaged 82.66 ± 15.62. In the pilot test, the most frequently reported strengths were Speech and Language (f = 67) and Cleaning (f = 63). The most frequent challenges were for Emotions (f = 177) and Income (f = 95). Information/guidance was the most frequent need for Emotions (f = 19). Check-ins were the most frequent need for Income (f = 17). Implications for Nursing Practice: The T-SOST had acceptable psychometric properties and was found to be understandable for secondary education. It is suitable for self-reported strengths, challenges, and needs embedded in MSMH. Consumer-generated data may allow individuals to directly participate in their own health and provide insight for nurses and other clinicians to tailor interventions from a patient-centered perspective.

Background: Integrating evidence into nursing practice remains challenging due to gaps in nurses' research experience, knowledge, and skills. Purpose: To address these challenges, an Evidence Resource Nurse (ERN) program was developed using implementation science frameworks to enhance nurses' research literacy and skills and foster a culture of inquiry. Methods: Baseline data identified deficiencies in nurses' knowledge and confidence in utilizing research to inform practice. The ERN program was designed using the Consolidated Framework for Implementation Research and the Capability, Opportunity, Motivation, and Behavior model. The 4-hour core course is supplemented by quarterly seminars and self-paced activities in collaboration with governance councils, policy owners, and quality improvement coaches. This approach ensures that participants acquire both theoretical knowledge and practical experience in applying evidence in clinical settings. Results: The program has engaged over 100 nurses since its launch, with the latest evaluations showing improvements in participants' knowledge and skills. The program's integration into nursing professional development specialists' onboarding demonstrates institutional commitment to facilitating evidence-informed practice. Future evaluations will assess the programs' influence on nurses' initiation of evidence-informed practice changes at the unit and institutional level. Implications for Practice: The ERN program offers a model for bridging the gap between research and practice and demonstrates the use of implementation science methods to create targeted programs designed for specific populations and settings. Data-driven approaches better address nurses' professional development needs and enhance educational offerings.