Research in Nursing & Health最新文献

Online survey research has become an increasingly popular and effective method in the social sciences for exploring and addressing health-related issues. However, the increasing prevalence of fraudulent activities, particularly survey bots, threatens data integrity and can compromise health research by generating misleading data. The purpose of this paper was to describe the implementation of bot detection strategies in an online survey with Latine sexual minority men (SMM). Eleven bot detection indicators, including AI-detection software for open-ended responses, were used in two approaches to differentiate bot-generated from human responses. In the first approach, bot detection indicators were applied stepwise to identify valid entries. In the second approach, a fraud detection algorithm was used to identify three fraud categories. Key demographics and study variables were compared across fraud categories using chi-square/Fisher's Exact tests for categorical data and Kruskal-Wallis tests for continuous data (significance set at 0.05). Of the 1147 total survey entries, 837 (73%) completed at least 20% of the survey (814 completed all items). A total of 739 (88%) of the 837 completed surveys were classified as fraudulent. Among the 837 completed surveys, 333 (40%) had an AI-generated open-ended response and fast completion time (≤ 20 min) and 234 (28%) entries were flagged for all three of these indicators. Sociodemographic characteristics and HIV prevention outcomes were largely similar across bot-generated and human responses. Findings suggest that survey bots are a pervasive threat to online research and are effective at providing human-like responses. To protect data integrity and ensure the development of effective health policies and interventions, health science researchers should adopt comprehensive bot detection and prevention strategies.

The aim of the study was to evaluate the effect of Transition Model-Based Discharge Training for Mothers of Preterm Infants (TRAMPRE) on (1) Kenner's three components of the transition to home; (2) post-partum depression; (3) unplanned hospital/family health center visits; and (4) post-discharge complications. Our study was conducted with 133 mothers who received services in the NICU of a hospital providing tertiary health care in Türkiye. The content of the intervention protocol consists of "Discharge Training for Mothers on Infant Care," the "Preterm Infant Care Guide," and "Telephone Follow-up and Counseling." Data were analyzed using descriptive statistics, t-tests, repeated measure ANOVA and chi-square tests. The time 2 scores for the Transition Questionnaire (TQ) were 101.88 ± 11.04 and 67.03 ± 7.71 for the intervention and control groups, respectively (p < 0.05). The time 2 scores for the intervention group on postnatal depression levels (4.55 ± 4.51) were significantly lower than those of the control group (10.94 ± 4.69) (p < 0.05). Comparing the intervention and control groups revealed a significant difference between the rates of thrush (i: 1.5%, c: 12.1%), diaper rash (i: 4.5%, c: 30.3%), hospitalization after discharge (i: 3%, c: 13.6%), attending routine controls (i: 100%, c: 90.9%), and exclusive breastfeeding (i: 43.3%, c: 19.7%). It was concluded that transition model-based discharge training offered to mothers of LPT infants was effective in improving the mothers' transition to home care and reducing the incidence of post-partum depression. Trial Registration: Clinical Trials number: NCT05525624.

Cultural differences, along with various social and political determinants, affect the social isolation experienced by older adults. This study aimed to investigate the factor structure of the Traditional Chinese version of the Friendship Scale (FS-TC) and to assess its psychometric properties in relation to social isolation among Taiwanese older adults. In Phase 1, the scale underwent cultural adaptation and translation before being evaluated for face and content validity by ten older adults and five experts in nursing and geriatric care. Phase 2 involved a cross-sectional study with a convenience sample of 500 older adults from southern Taiwan to establish construct validity, criterion validity, and reliability. Of these participants, 100 were retested 2 weeks later to assess test-retest reliability. The scale-level content validity index was 1.0. A confirmatory factor analysis showed a two-factor structure of the FS-TC, consisting of "connection" and "isolation" factors. The Cronbach's α for the scale was 0.82, while the intraclass correlation coefficient reached 0.96. Convergent validity was demonstrated through significant correlations with the Geriatric Depression Scale, the Social Support Scales, and the Loneliness Scale. The FS-TC showed a sensitivity of 56% and a specificity of 89% for predicting Lubben Social Network Scale-6 measured social isolation. An optimal cut-off score of 14.5 was identified for predicting social isolation in older adults. Overall, the FS-TC was shown to be a reliable and valid measure of social isolation, making it a valuable tool for healthcare providers and researchers assessing the severity of social isolation among Taiwanese older adults.

The COVID-19 pandemic created a crisis in healthcare throughout the world, which may have influenced perioperative nursing roles and responsibilities. The aims of this study were to assess the perioperative nurse's work experience during the COVID-19 pandemic and to evaluate the impact of their perceived stress, burnout, and job satisfaction on their intent to stay (ITS) in the workforce. A descriptive, exploratory design was conducted using an electronic survey methodology. The study was guided by the Job Demands-Resources model. The primary outcome variable was ITS. Data analysis included univariate and multivariate techniques. The mean age of respondents (N = 1436) was 50; 92% were female; 54% reported a BSN as their highest degree. Over half were clinical nurses (59%) and the majority (64%) reported working in their usual unit during COVID-19. Nurses providing direct care to COVID-19 patients reported significantly higher burnout and secondary traumatic stress (p < 0.001); however, there was no significant difference in ITS. Significant predictors of ITS included a greater number of years as a perioperative nurse, higher compassion satisfaction, and a positive perception of workload. Results support years in practice and higher compassion satisfaction as positive predictors of ITS in the workforce and a perception of heavier workload as negative. Perioperative nurses took on a variety of roles that could be helpful in the future support of pandemics. Institutional and policy support of actions to enhance perioperative nurses' perceived workload and compassion satisfaction is important to foster nurses staying within perioperative nursing and the organization.

Poor sleep quality and psychological stress are interrelated and disproportionately affect adults with multiple cardiovascular disease (CVD) risk factors. Maintaining an optimal home environment and engaging in healthy bedtime behaviors are important components of sleep hygiene practices that influence sleep health. This study sought to examine: (1) the association between sleep hygiene and psychological stress, and (2) the moderating effect of sleep quality in the relationship between sleep hygiene and psychological stress, among adults with multiple CVD risk factors. A cross-sectional study was conducted with 300 adults diagnosed with hypertension and diabetes. Individuals were recruited from a large academic health center and were asked to complete an online survey. Sleep hygiene was assessed by nine individual factors focusing on negative household environment (safety, physical comfort, temperature, noise, and light) and poor bedtime behaviors (watching TV, playing video games, using small screens, and eating), and by a composite score. Multivariable linear regression was employed to examine the associations. Of the sample, 78% reported poor sleep quality and 44% reported high psychological stress. The composite sleep hygiene score was significantly associated with higher psychological stress after controlling for sleep quality, and the relationship was not modified by sleep quality. Unsafe household, uncomfortable physical environment, uncomfortable temperature, and eating at bedtime were independently related to increased stress levels. The study highlights strong links between sleep hygiene and psychological stress. Current evidence suggests that promoting home environment and bedtime behaviors may alleviate psychological burdens in adults with multiple CVD risk factors.

The purpose of this study was to examine the association between hospital nurse staffing levels and 30- and 60-day readmissions among patients with intellectual and/or developmental disabilities (IDD). This cross-sectional correlational study utilized secondary data from 595 acute care, nonfederal hospitals in California, Florida, New Jersey, and Pennsylvania in 2016. Data were obtained from three sources: the American Hospital Association Annual Survey, the RN4CAST-US nurse survey, and state patient hospital discharge summaries. The analytic sample included 39,558 hospital stays for 28,446 adults with IDD aged 18 and older who were discharged alive. In adjusted models, every additional patient added to a nurse's workload was associated with 7% higher odds of 30-day readmission OR = 1.07 (95% CI [1.03, 1.12], p = 0.001) and 9% higher odds of 60-day readmission OR = 1.09 (95% CI [1.04, 1.13], p < 0.001) among patients with IDD. The average nurse staffing level across hospitals was 4.7 patients per nurse (SD = 0.99). Staffing levels varied by hospital characteristics, with large hospitals, major teaching hospitals, and hospitals in California having better staffing ratios. The study population had a 30-day readmission rate of 17.1%, which is 27% higher than the average adult hospital 30-day readmission rate in the US in 2018. This study demonstrates the association of nurse staffing levels with readmission odds for patients with IDD. Improving nurse staffing levels is a system-based solution that can potentially improve outcomes for patients with IDD, who often require intensive nursing care.

Black, Hispanic, and multiracial women in the U.S. experience higher rates of discrimination and mistreatment in perinatal care compared to White women, which can lead to fear, anxiety, and reduced engagement with obstetric healthcare providers. Black women are also more likely to experience high-risk pregnancies and health complications such as gestational diabetes and hypertensive disorders. As a result, Black women face a heightened risk of birth trauma and subsequent posttraumatic stress disorder (PTSD) in the postpartum period. Despite these inequities, little is known about Black birthing individuals' experiences of healthcare interactions. This study explores Black women's accounts of negative experiences of perinatal care in the context of high-risk pregnancy. Fourteen individuals from across the U.S. participated in semi-structured interviews conducted within 6 months postpartum between September 2022 and December 2024. Interview responses were analyzed using directed content analysis, with coding of their emotional distress guided by the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition, Text Revision (DSM-5-TR) definition of PTSD. Their accounts aligned with the four DSM-5-TR symptom clusters: intrusive symptoms, avoidance, negative alterations in cognition or mood, and alterations in arousal and reactivity. PTSD-like symptoms resulted from pregnancy complications, traumatic birth experiences, mistreatment by clinicians or a combination of these factors. The findings suggest that birth trauma and mistreatment in perinatal care have significant emotional and behavioral impacts on Black women. The study results underscore the urgent need for trauma-informed, antiracist approaches in perinatal care to address these disparities and improve outcomes for Black birthing individuals.

Positive childhood experiences (PCEs), such as supportive relationships and household routines, promote and protect well-being in later life. However, the mechanisms through which PCEs act remain unclear. This study examines whether emotion regulation mediates the association between PCEs and flourishing in a large sample of Chinese young adults. Data were collected from 9468 Chinese university students via online surveys (August-November 2020). Measures included the Chinese versions of the PCE Scale, Flourishing Measure (which characterized point-in-time flourishing and secure flourishing over an extended period), and Emotional Regulation Questionnaire (which assessed cognitive reappraisal and expressive suppression). Bivariate Pearson correlations assessed associations, and mediation analysis was conducted using the PROCESS procedure in SPSS 4.1. Experiencing more PCEs was correlated with greater cognitive reappraisal (r = 0.28, p < 0.01), lower expressive suppression (r = -0.11, p < 0.01), and greater flourishing (r = 0.49, p < 0.01). Cognitive reappraisal was correlated with greater flourishing (r = 0.43, p < 0.01), while expressive suppression was correlated weakly with lower secure flourishing (r = -0.02, p < 0.05). Mediation analysis showed cognitive reappraisal (indirect effect b = 0.06, 95% CI [0.05, 0.06]) and expressive suppression (b = 0.002, [-0.004, -0.001]) significantly mediated the PCEs-flourishing relationship. Similar results were found with secure flourishing. Findings suggest that emotion regulation, particularly cognitive reappraisal, may be a key psychological mechanism linking PCEs to flourishing later in life among young adults in China.