Creative Nursing最新文献

Being the least-represented ethnic/racial group in college settings, American Indian students may experience loneliness and self-doubt related to the challenges of adapting to an environment that embodies values, norms, and culture so different from those represented in their traditional culture. Ongoing health disparities and psychosocial inequities, and persisting impacts of historical colonization, have led to additional hardships for these students that further complicate their academic experiences. Fostering culturally safe learning environments where compassionate and caring faculty provide culturally aligned teaching is important in addressing these complex disparities. Derived from American Indian values and teachings, we present a culturally safe intergenerational mentoring approach that emphasizes the nursing mentors' responsibility to support the growth and success of American Indian nursing students. This approach, drawn from the wisdom of American Indian teachings, focuses on students' strengths and culturally based protective factors. Culturally informed faculty who are aware of the historical impacts of colonization and who have adequate mentoring capacity (time, interest, and commitment) contribute to safe and effective learning environments. Culturally safe mentoring is one approach to promoting American Indian students' potential for academic and professional success.

Nursing theories and conceptual models shape nursing knowledge. This study applied the philosophical and theoretical basis of the Neuman Systems Model, which focuses on the use of primary, secondary, and tertiary nursing prevention for retention, attainment, and maintenance of patient system wellness, to a patient with pre-existing mental health conditions struggling to cope with depression and COVID-19 in a dedicated COVID-19 hospital in an urban area of Iran. The single intrinsic case study design used interviews, nursing observations, and document analysis to evaluate environmental factors and intra-, inter-, and extra-personal stressors. An advanced, outcome-oriented nursing care plan was developed.

Background: Diabetes mellitus is a chronic disease that needs long-term management. Mobile health is an emerging field that is being used for diabetes self-management. Aim: Evaluate the effect of a diabetes self-management mobile application on self-efficacy, self-care agency, and self-care management among 128 Jordanian patients with Type 1 Diabetes Mellitus. Methods: The study utilized a non-equivalent controlled groups quasi-experimental design, with 64 patients in the control and in the intervention groups. Results: There was significant improvement in mean self-efficacy in the intervention group, improved self-care agency between the groups, and improved self-care management both within the intervention group and between the groups, after controlling for self-efficacy and self-care agency. Conclusion: Using a diabetes self-management mobile application may help improve patients' confidence in managing diabetes, and better commitment to and performance of self-care activities.

Background: Virtual reality (VR) simulation in nursing education, especially about non-acute care including community health, is an emerging learning strategy; more research is needed about its effectiveness. Purpose: This study aimed to evaluate the effectiveness of an innovative community health nursing VR simulation on prelicensure students' knowledge about social determinants of health and cultural competence, with a goal of enhancing students' preparation for practice. Methods: In a convergent mixed methods study, 100 prelicensure nursing students in a community health nursing course at a Midwestern U.S., urban, public university completed a pretest, a VR simulation, a posttest, and an evaluation. Pre- and posttests containing content questions adapted from leading community health nursing text faculty resources were used to assess learning, and the Simulation Effectiveness Tool-Modified (SET-M) was used to assess perceived effectiveness of the intervention. Results: The majority of participants' posttest scores were higher than their pretest scores. Most participants strongly agreed that the VR simulation was effective, and reported on new knowledge/skills learned, material found most helpful, and benefit to their nursing practice. Conclusions: The community health nursing VR simulation was effective at increasing participants' knowledge and their confidence in their knowledge and abilities.

In April 2022, Adtalem Global Education sponsored a virtual summit entitled Advancing Equity in Healthcare, in which several of the authors of this article and other prominent health-care professionals examined the need to diversify the health-care profession. Topics included educational justice and its impact on health care, the business case for transforming and advancing health equity, and addressing systemic inequities and improving health outcomes for historically marginalized persons. The summit inspired the authors to write this paper to advocate for authentic, sustainable partnerships led by Historically Black Colleges and Universities, as a means to diversify nursing leadership and to stem systemic and structural inequities in health care.

This article explores the power of resilience in helping nurse executive leaders who are working to effect change in structural determinants of health at direct care, interprofessional, organizational, and policy levels. It leverages research, literature, and personal experiences to outline techniques that can help leaders in health care overcome challenges. Specifically, it considers self-care, building relationships, seeking support, maintaining a positive attitude, and practicing mindfulness as critical to driving meaningful change.

Access to and the skills to use technology provide the digital equity necessary for civic and cultural participation, employment, lifelong learning, and access to essential services. However, existing digital disparities and the resultant 'digital divide' risk exacerbating health and health-care inequalities. The COVID-19 pandemic amplified these disparities and accelerated the adoption of technology-driven health care such as telehealth, electronic health records, and digital health technologies. Unfortunately, pre-existing disparities influence the adoption and utilization of these technologies, often leaving disadvantaged groups further behind. Efforts toward digital inclusion, access to technology, and digital literacy are necessary to ensure universal access to and meaningful engagement with digital resources. Nurses play a vital role in promoting digital equity, serving as educators, advocates, and digital navigators, guiding patients through the complexities of the digital health landscape.

The World Health Organization defines social determinants of health as "the conditions in which people are born, grow, work, live, and age, and the wider set of forces and systems shaping the conditions of daily life." This current journal issue has the theme of structural determinants of health. In 2016 (Creative Nursing Vol. 22), we published 49 articles in four issues addressing Determinants of Health: Social Determinants, Structural Determinants, Caregiver Determinants, and Global Determinants. This editorial presents the highlights of those four journal issues, then connects each of the articles in this current issue to the theme; these articles reveal the systems and structures that support our caring from many angles, levels, and perspectives. Readers are challenged to recognize the potential, embedded in every system and structure, for disparities in the provision of our care.

The care of the person who has been sexually assaulted is challenging because of the neurobiology of trauma, susceptibility to re-victimization, and time constraints. Everyone involved with their care needs to be cognizant of the psychological-physiological phenomena of trauma in order to provide sensitive, high-quality care to these individuals. The neurobiology of trauma explains why the person's memory may be fragmented or impaired. Trauma-informed care offers choices and empowerment to the person along with safety, cultural awareness, trust, and collaboration. Shared decision making empowers the person by educating them on their care choices in collaboration with the health-care provider. This article discusses the development of a decision aid that supports the information used in shared decision making, for use in planning the care for a person who has been sexually assaulted. Based on the understanding of the neurobiology of trauma, the decision aid incorporates a written tool that provides education and information to prepare the person to make care/treatment decisions which are important to them, within a trauma-informed environment.

Background: Nursing education in South Africa is undergoing reforms to respond to changes brought about by a new higher education qualifications framework. These reforms are happening in an era when leaders, educators, and students in higher education institutions are engaged in dialogs about decolonizing institutions, curricula, and pedagogy. Of the numerous calls for this decolonization, few have given attention to decolonizing the self. Confronting coloniality in educational institutions may elicit resistance to change and feelings of discomfort, anxiety, and fear. Engagement in personal mastery practices could be useful for nurse educators engaged in efforts to confront and deal with their own discourses that may embody and promote coloniality. Aim: This article explores how nurse educators can utilize personal mastery in dealing with their own perceived coloniality, focusing on taking ownership of self-leadership during a reflection on one's own behavior as a nurse educator. Methods: Drawn from the findings of a mixed-methods study, the integrated data prompted three themes addressing self-leadership: Taking ownership, motivational factors, and facilitating self-leadership in nurse educators. Conclusion: Engagement in personal mastery could assist nurse educators in bringing about decoloniality in nursing education institutions. Implications for Practice: Institutions should provide nurse educators with environments that support continuous professional development.