Research and Theory for Nursing Practice最新文献

Background and purpose: Parents' communication and problem-solving interaction with each other and with clinicians influences the caregiving of infants with a chronic health problem, making in-depth study of this interaction critical for design of interventions to support caregiving. This study, however, has been severely limited by lack of observational methods that can be applied in home, clinic and community settings. The Iowa Family Interaction Rating Scales provide comprehensive description of communicative and problem-solving behavior and emotion, but have only been applied to video-recorded interaction. Audio recording, in contrast to video recording, has the advantage of being unobtrusive, readily accessible, and generally acceptable, increasing the opportunity for focused examination and intervention of parents' interaction with each other or with clinicians. Our study objective was to examine the agreement of scores obtained on parents' interactive problem-solving behavior coded with the Iowa Family Interaction Rating Scales using an audio-recorded source for coding compared with coding from a video-recorded source.

Method: In secondary analysis, audio-recordings were derived from video recordings of 15 parent-parent interactions. Audio recordings were created and coded blind of the original video recording and coding.

Results: Using Gwet's AC₁ coefficient, agreement was at least moderate (0.61 - 0.80) for 69.1% of paired codes, signifying reliability of coding from audio recording for most codes.

Implications for practice: Selected Iowa Family Interaction Rating Scales can be used with acceptable reliability for coding parents' interactive problem-solving behavior from audio source, advancing the study of parent interactive-problem solving behavior and potentially parents' problem solving with clinicians.

Background and purpose: This study explored pattern recognition practices of experienced pediatric nurses caring for children with chronic, complex healthcare needs and their families. Nurses worked in the inpatient settings of two different freestanding pediatric hospitals.

Methods: Margaret Newman's theory of Health as Expanding Consciousness (1999) was used to explore the pediatric nurses' experiences. During interviews, participants (n = 8) related their stories in caring for these children and their families. Individual interview data were blended to examine themes.

Results: Participants described people and events in practice that allowed them to use pattern recognition in the care of children with chronic, complex healthcare needs. Pattern recognition developed in acknowledgement of their past experiences in nursing, as well as with each individual patient and family.

Implications for practice: Participants had the opportunity to reflect on relationships between their day-to-day practice and their experiences building knowledge and understanding in practice. They considered their abilities to move from skills and tasks to appreciating what each patient and family has taught them about their practice of pattern recognition.

Background and purpose: The goals of heart failure (HF) management include lowering adverse outcomes through optimal self-care. Health literacy has a significant role in ensuring optimal and effective HF self-care. Unfortunately, the proportion of low health literacy in HF patients is higher than those with other chronic diseases as well as the general population. Thus, healthcare providers need to screen HF patients. The HF-Specific Health Literacy Scale is a specific questionnaire to screen the health literacy in HF patients; however, the Korean version has not yet been validated. The study aimed to investigate the reliability and validity of the Korean version of the HF-Specific Health Literacy Scale.

Methods: We adopted a cross-sectional study design with 386 outpatients with chronic HF from a tertiary care hospital in Cheonan, South Korea. Data were collected from April to December 2020.

Results: The exploratory factor analysis revealed a three-factor (functional, communicative, and critical health literacy) 12-item structure of the scale. The result of the confirmatory factor analysis confirmed a good statistical fit for the data. The Korean version of the tool demonstrated satisfactory convergent and discriminant validity. The criterion validity analysis revealed significant correlation with general health literacy and knowledge about HF. The Korean version of the tool for 12 items had adequate overall internal consistency.

Implications for practice: The Korean version of the HF-Specific tool can be easily utilized for assessing health literacy level for HF patient education. Moreover, the tool can help healthcare providers develop strategies for promoting HF patients' health literacy.

Background and purpose: Children with medical complexity (CMC) experience poor health outcomes despite the high cost of care, and their parents face challenges in providing complex care. Poor health outcomes may be related to an imbalance between parental demands to manage care and their ability to meet the demands needed to provide complex care. However, this phenomenon has not been explored. In addition, much of the existing research focused on CMC lacks an overarching theoretical framework. The purpose of this article is to outline factors that impact families of CMC described in the literature. This article proposes a modified framework using theory derivation, which highlights the concepts of parental workload and capacity and demonstrates how they are related to CMC health.

Methods: A revised theoretical framework using theory derivation by Walker and Avant is presented using findings from the CMC literature that most affect the parents of these children.

Results: Applying content from two existing theories using concepts of relevance results in a framework that provides richer insight into the relationship between parental workload and parental capacity, particularly when parental workload outweighs parental capacity. This framework allows for the examination of how an imbalance between workload and capacity impacts CMC health outcomes.

Implications for practice: Although further study is needed to test the proposed theory, the framework can be used to examine these relationships with hopes of developing interventions to decrease parental workload and enhance parental ability.

This study aimed to evaluate the effects of a transtheoretical model (TTM)-based foot care program on foot self-care behaviors and self-efficacy among adults with type 2 diabetes (T2DM). A prospective, assessor-blinded, randomized controlled trial was conducted between January 2020 and October 2020 at the endocrinology outpatient unit of a hospital in the north-west Turkey. The sample was composed of 51 adults with T2DM randomly allocated to the intervention group (n = 25) and control group (n = 26). The intervention group received the TTM-based foot care program during a 6-month period. The data were analyzed using the two-way repeated measure analysis of variance (ANOVA). After intervention, the intervention group's the diabetic foot care self-efficacy scale scores increased significantly at 3 and 6 months, compared with the control group. Similarly, the intervention group's the foot self-care behavior scale scores also increased significantly at 3 months and 6 months.