Research and Theory for Nursing Practice最新文献

Background and Purpose: Chronic renal failure is a common public health problem worldwide, and hemodialysis has become the standard treatment. During this long and exhausting process, it is extremely important that individuals undergoing hemodialysis receive effective and high-quality nursing care so that accurate prognoses can be made and complications prevented. This study aimed to determine the effect of comfort theory-based nursing care on intolerance to uncertainty and comfort levels in hemodialysis patients. Methods: The sample of this randomized controlled study consisted of individuals receiving hemodialysis at a private dialysis center. The sample comprised a total of 60 patients, 30 in the experimental group and 30 in the control group. Patients in the experimental group received training during an 8-week dialysis period using nursing care interventions based on Katharine Kolcaba's comfort theory for health care needs. The training content covered holistic nursing care and consisted of physical, psychospiritual, sociocultural, and environmental dimensions in order to reduce uncertainty and increase comfort levels in the individuals receiving dialysis. This care was based on Kolcaba's comfort theory. A Personal Information Form including the individuals' descriptive, disease, and treatment characteristics, the Intolerance of Uncertainty Scale (IUS), and the General Comfort Questionnaire (GCQ) were used for data collection. Independent two-sample comparisons were performed using the χ² test for qualitative variables and the t test for quantitative variables. Results: In the comparison of the groups, there were significant results for the total GCQ and its subdimensions except for the relief subdimension (p < 0.05). The scores for the total IUS and its subdimensions were significant (p < 0.01). Implications for Practice: It was determined that comfort theory-based nursing care interventions were effective in reducing the level of intolerance of uncertainty and increasing the comfort level. It is recommended that comfort theory-based nursing care guidelines should be used to reduce the sense of uncertainty and increase the comfort levels of individuals receiving hemodialysis.

Purpose: The purpose of the study is to propose a new conceptual definition for cognitive health motivation and identify its attributes, antecedents, consequences, and empirical referents. Methods: Walker and Avant's method was used to analyze the concept of cognitive health motivation. The PubMed, Web of Science, Wiley Online Library, Embase, China National Knowledge Infrastructure, Wanfang Data, and CQVIP Chinese Journals Platform databases were searched. The Preferred Reporting Items for Systematic Reviews and Meta-Analyses 2020 checklist was used. Results: Five attributes of the concept of cognitive health motivation were identified: cognitive health beliefs, cognitive health intentions, perception of cognitive health risks, perception of cognitive health benefits, and dynamically evolving. The antecedents are knowledge related to cognitive health, cognitive health assessment, and cognitive decline. The consequences are cognitive health behavior, cognitive health enhancement, and successful cognitive aging. Based on these attributes, a conceptual definition was proposed. Conclusion: In the context of aging, a clarified definition of cognitive health motivation will aid in understanding the concept, explaining the process of changes in cognitive health behavior, providing guidance for the implementation of cognitive health interventions, and improving cognitive health.

Purpose: This study aimed to identify and compare the chemotherapy-induced symptoms perceived as distressing by pediatric oncology patients and nurses, utilizing both patient-reported outcomes and proxy report outcomes frameworks. Methods: This cross-sectional, descriptive study was conducted in three university hospitals in Türkiye between January 2023 and December 2023. A total of 122 pediatric oncology patients and 139 pediatric oncology nurses participated. The Children's Memorial Symptom Assessment Scale was used to rank the perceived distress of symptoms. Results: Both pediatric oncology patients and nurses identified lack of energy, pain, nausea, feeling nervous, and feeling drowsy as the five most distressing symptoms. However, discrepancies were noted between the two groups: Pediatric oncology nurses reported higher distress rankings for symptoms such as nausea (p = .018), dry mouth (p = .027), cough (p = .030), mouth sores (p < .001), and difficulty swallowing (p = .003) compared with the patients. Conversely, pediatric oncology patients reported higher distress rankings for feeling nervous (p = .016), weight loss (p = .003), constipation (p = .014), and swelling of arms/legs (p < .001). Conclusions: The study revealed a general alignment in the ranking of distressing symptoms between pediatric oncology nurses and patients, with some notable differences. Practice Implications: Understanding the differences in symptom perception between patients and nurses is crucial to enhancing patient-centered care in pediatric oncology. Tailoring interventions to address the specific distress identified by patients and nurses can improve care outcomes and patient well-being.

Background and Purpose: A good understanding of nursing organizational well-being can allow nurse managers to monitor their work context, guide clinical practice, and improve care quality. Theoretical studies of nursing organizational well-being are limited, and this article proposes a situation-specific theory. Methods: The article's content explains the development of this situational theory of nursing organizational well-being following the integrative approach by Im and Meleis by checking assumptions for theorization, initiating theorization through multiple sources, reasoning through critical analyses, documenting theorization, and reporting and sharing theorization. Results: Eight theoretical propositions are conceptualized, emphasizing the interconnectedness of various professionals and work context factors with nursing organizational well-being and related outcomes. Nursing demands and nursing resources have been identified in this situational theory as crucial in determining nursing organizational well-being. Implications for Practice: This article discusses the implications of developing knowledge on nursing organizational well-being. Using this situational theory, researchers can understand the variables determining nursing organizational well-being, and the theory can guide their research study. Health care managers can also use this situational theory to evaluate the nursing work environment and the variables influencing it, subsequently improving outcomes for nurses, organizations, and patients.

Purpose: The objective was to compare the body images of breast cancer patients undergoing postoperative chemotherapy and the varying degrees of their anxiety and depression. The comparison involved those who received four consecutive cycles of cosmetic makeup and those who did not. Patients and Methods: Seventy-four breast cancer patients receiving postoperative chemotherapy were randomly assigned to either the control group or the intervention group. The control group received usual care, while the intervention group received four consecutive cycles of chemotherapy along with cosmetic makeup intervention on top of usual care. The intervention was carried out on the first day after the completion of each chemotherapy cycle. Assessments were made before the first intervention and 1 month after the fourth intervention using the Hospital Anxiety and Depression Scale and the Scale of Body Imagery. Results: After four cycles of intervention, significant differences emerged between the intervention and control groups regarding anxiety, depression, and body imagery. Additionally, within the intervention group, notable changes in these aspects were observed over time. Conclusion: The results showed that cosmetic interventions can effectively reduce the level of anxiety and depression of breast cancer patients receiving postoperative chemotherapy and effectively improve the body imagery of patients.

Introduction: The purpose of this secondary analysis, from a pilot randomized controlled trial of guided participation (GP), was to describe patterns of coparenting for mother and father dyads caring for an infant with complex congenital heart disease and to examine the influencing factors at infant age 6 months. Our theoretical framework included GP treatment, severity of neonatal illness (severity), coparenting pattern, and parent attention to infant weight gain (weight gain). Method: From transcribed interviews with 25 parent dyads at infant age 2 and 6 months, data relevant to coparenting were categorized for entry into a matrix table. These categories included family circumstances; infant health status, feeding, and sleeping; and how the parents worked in relation to each other for caregiving, the caregiving issues they were working on, and their caregiving goals. Results: The tabled data showed two coparenting patterns, collaborative and cooperative, with very little change from 2 to 6 months, and 6-month weight gain mention. We used Bayesian sensitivity network analysis to examine, at 6 months, GP effect in contrast to usual care (control group) effect and the effect of higher or lower severity on coparenting pattern and weight gain. The treatment group had greater percentage of collaborative coparenting pattern with higher severity. In contrast, the control group showed the percentage of dyads with a collaborative coparenting pattern was similar for higher and lower severity. Weight gain mention was higher with higher severity. Conclusion: Further coparenting pattern identification and study replication with a larger, diversified sample is planned.

Background and Purpose: Nurses frequently care for patients who make decisions against medical advice, a challenge that continues during and after the COVID-19 pandemic. This article explores U.S. nurses' experiences caring for unvaccinated COVID-19 patients and the resulting impacts using Swanson's Theory of Caring (STC). Methods: Data were gathered through an online survey collecting nurses' demographics, mental health screening data, and an open-ended question asking about a personal experience providing care to an unvaccinated COVID-19 patient. Researchers analyzed 128 responses using content analysis. STC served as the analytical framework. Results: Nurses' experiences were summarized into two main themes and four subthemes: (a) anger, frustration, fatigue, and resentment (24.2%) and (b) feeling a professional commitment to a nurse's duty (60.9%). Within the professional commitment theme, subthemes include the following: (a) patients can make an autonomous decision (15.6%); (b) feeling concerned for the patient (6.3%); (c) wanting to take action, educate, and vaccinate (29.7%); and (d) feeling moral conflict (9.3%). Results aligned with STC's five caring actions: knowing, doing for, being with, enabling, and maintaining belief. Implications for Practice: Nurses experienced emotional challenges caring for the unvaccinated during the pandemic resulting in psychological sequelae, including compassion fatigue and moral distress, in addition to positive outcomes of resilience and enhanced coping mechanisms. This study underscores the multifaceted nature of nurses' experiences and the emotional, ethical, and professional challenges they encountered when caring for unvaccinated COVID-19 patients. Nurse leaders should address these issues to enhance nurses' wellbeing and reduce compassion fatigue and dissatisfaction.

Background and Purpose: Patient privacy and confidentiality are fundamental ethical principles in healthcare. Protecting patient privacy, which is accepted as a patient's right, is one of the responsibilities of nurses. Few studies on patient privacy among nurses have used social cognitive approaches. The purpose of this study is to examine nurses' intentions to protect patient privacy using the theory of planned behavior (TPB). Methods: This is a cross-sectional and correlational design study. The study sample consisted of 202 nurses working in the emergency departments, operating rooms, inpatient wards, and intensive care units of the hospitals. Research data were collected using a face-to-face questionnaire that included TPB components on patient privacy. The proposed research model was tested using structural equation modeling. Results: Attitude (β = .238, p < .05), subjective norm (β = .295, p < .05), and moral norm (β = .337, p < .05) toward patient privacy are positive predictors of intention. The moral norm is the most effective component of intention. Perceived behavioral control is not a significant predictor of intention (β = .049, p > .05). Implications for Practice: Norms that create a sense of moral obligation in nurses are a significant determinant in increasing the intention to protect patient privacy. Interventions that improve moral norms, attitudes, and subjective norms will increase the intention to protect privacy. Nurse managers should provide nurses with adequate skills, resources, and an appropriate work environment to ensure perceived behavioral control regarding patient privacy.

Background: Offering high-quality care is a shared goal among all health systems. Unfortunately, the prevalence of nurse burnout jeopardizes the quality of care, patient safety, and staff well-being, thereby creating a serious practice concern. Purpose: This article aims to discuss how the Conservation of Resources (COR) theory can assist in examining the link between burnout and the quality of care service. Discussion: The COR theory was built around stress and the assumption of four resources necessary for human functioning. These resources are objects, personal characteristics, conditions, and energies. A lack of any of these four resources leads to increased levels of stress, causing burnout, which in turn affects nurses' ability to provide professional high-quality care to patients. Implications for Nursing: Guided by this theory, researchers can examine the relationship between lack of resources, burnout, and quality care. As a result of this effort, interventions may be proposed to reduce burnout and improve quality of care and patient outcomes.

Spaces produced in healthcare settings and research institutions tend to perpetuate marginalized populations' state of social otherness. We believe nurses from borderlands are best suited to walk between dominant (striated) spaces and margins in healthcare settings. Borderlands is a liminal space where multiple identities, places, cultures, paradigms, or ways of thinking intersect. We believe nurses can navigate these spaces by becoming walkers/travelers between worlds or as nepantleras Anzaldúa's critical rhetorical analysis framework can assist borderlands nurses to create geographies of inclusion for equity-denied groups as it is within these borderlands spaces that the dominant narratives are relegated to the margins and new spaces are imagined.