Research in Nursing & Health最新文献

The primary prevention of stroke high-risk groups is contingent upon health behavior intervention, and the key to such interventions is health behavioral decision-making. The present study aims to explore the potential classification of the health behavior decision-making of high-risk stroke groups using latent profile analysis (LPA) and the key influencing factors of the LPA classes. A cross-sectional study was conducted from January to May 2023 with 264 high-risk individuals of stroke in Henan Province, China. Data were collected using the Behavioral Decision Assessment Scale of Stroke Patients, the Revised Health Promoting Lifestyle Profile-II and the Social Support Rating Scale. LPA showed that a three-profile model of health behavior decision-making best fit this study. Health behavior decision-making of stroke high-risk groups were divided into three latent classes: high-output behavior type (23.1%), influence-impervious type (60.6%), and influence-sensitive type (16.3%). Comparisons between the three LPA classes showed that living situation, per capita monthly household income, hypertension, overweight/obesity, health promoting lifestyle behavior were significantly different between the participants' latent classes of behavior decision-making. Clinical staff can develop targeted interventions according to different problems existing in the decision-making processes, and improve and implement the screening content and process among community high-risk stroke groups, which has practical significance for promoting their healthy behaviors. Patient or Public Contribution: In our study, survey questionnaires were completed by participants at high risk of stroke.

Extensive evidence demonstrates higher rates of anxiety and depression in sexual and gender minorities (SGM) compared to the general population. However, few studies have examined the intersection of sexual orientation and gender identity. Status as a multiple minority may further increase the risk for anxiety and depression. The goal of this study was to assess the extent to which anxiety or depression diagnosis, clinical cutoff, or symptom severity differed by gender identity, sexual orientation, or the intersection of the two. A sample of 554 US adults (75.6% White, between 18 and 65 years) were recruited through social media to complete an online survey. Of the sample, 44.2% were sexual minorities and 35.6% were gender minorities. Results from logistic regression analyses indicated that heterosexuals were 41% more likely to be diagnosed with anxiety, but sexual minorities were nearly three times more likely to be diagnosed with depression and 20 times more likely to meet PHQ-9 cutoffs. Based on analyses of covariance, gender minority participants reported significantly greater depression severity than cisgender participants. Sexual orientation and gender identity interacted in the depression, but not the anxiety symptom severity model. Cisgender sexual minorities had greater depression severity than cisgender heterosexuals, but lower depression severity than gender minorities who were also sexual minorities. These findings suggest that dual minorities experience greater minority stress, which worsens depression symptom severity. This has important clinical implications for nurses caring for SGMs. Future studies should consider intersectional analysis to elucidate further the compounding effects of dual minority status on SGMs.

Poststroke fatigue severely affects stroke survivors (SSs) physically and mentally. Although the literature acknowledges the critical role of care partners (CPs) in survivors' fatigue adaptation, this topic remains under-explored. This study, guided by the Adaptive Leadership Framework for Chronic Illness, explored how SSs and CPs managed fatigue collaboratively within 6 months poststroke. This longitudinal qualitative analysis included nine first-time ischemic SSs and their CPs who consented to interviews. Semistructured interviews were conducted during the index hospitalization (or within 10 days postdischarge) and at 1, 3, and 6 months poststroke. Directed content analysis was used to analyze the data. Four themes were identified. First, SSs and CPs engaged in collaborative work by achieving a mutual understanding of fatigue levels but misalignment was found during 3-6 months poststroke. Second, CPs provided emotional and practical support, exercising adaptive leadership to help survivors adapt to fatigue. The support squad, including informal and formal helpers beyond the primary CPs, also undertook adaptive leadership behaviors to facilitate the post-stroke adaptation to fatigue for both SSs and CPs. Third, the day-to-day realities of post-stroke fatigue presented persistent challenges for SSs. Fourth, SSs managed fatigue (adaptive work) by using self-awareness, resting, and pacing activities. Results suggested the need for SSs and CPs to develop a shared understanding of fatigue. Healthcare professionals should treat SSs and CPs as an adaptive unit, ensuring access to support resources at discharge to facilitate post-stroke adaptation to fatigue.

In this cross-sectional study, we aimed to explore the latent profiles of fatigue-pain-sleep disturbance symptom cluster in patients with lung cancer and analyze its influencing factors. A total of 310 patients with lung cancer who received systemic anticancer therapy were recruited as the research participants by convenience sampling. The fatigue-pain-sleep disturbance symptom cluster was assessed using the Cancer Fatigue Scale, Brief Pain Inventory, and Pittsburgh Sleep Quality Index. Additionally, patients' basic information, psychological resilience, and social support were evaluated through the general information questionnaire, the 10-item Psychological Resilience Scale, and the Perceived Social Support Scale. Latent profile analysis was employed to explore the profiles of the fatigue-pain-sleep disturbance symptom cluster, and binary logistic regression was used to analyze the influencing factors of the symptom cluster profiles. Results indicated that 297 patients (95.81%) exhibited the fatigue-pain-sleep disturbance symptom cluster, which comprised two profiles: low symptom group (79.80%) and high symptom group (20.20%). Logistic regression analysis revealed that those patients with a religion, a lower body mass index, and low family support were independent influencing factors for the high symptom burden group. To improve patients' quality of life, clinical staff should promptly identify those with a high symptom burden and implement targeted interventions based on these factors.

Black male adolescents and young adults (BMAYA) experience pronounced and persistent sexual health disparities compared to other groups in the US. This original research focuses on the early-stage development of The TALK, a nurse-led multi-pronged web-based eHealth intervention to improve shared parent-adolescent sexual health knowledge and communication. A community-engaged approach was used to codesign the intervention with a community advisory council and two Black-owned barbershop owners. Researchers leveraged human-centered design process using dscout, a virtual ethnographic research tool, to examine the usability, feasibility and acceptability of The TALK with parents of BMAYA (n = 13). Open- and close-ended questions captured qualitative data of end-users' experiences of and preferences for intervention technology and content within the three primary intervention components: videos, website, and an interactive activity. Feedback from participants on digital design, functionality, and overall ease of use and navigation of The TALK was beneficial for the initial intervention codesign process. Feedback was positive and constructive, highlighting where the intervention was culturally relevant and satisfying for users with recommendations for changes in areas of design friction and content accessibility before efficacy and effectiveness testing. This study helps understand how The TALK engaged participants and assisted in parent-adolescent communication through beta testing the technological design and content. Considering the potential for eHealth technologies in sexual health promotion and prevention for BMAYA, thoughtful design and quality experience should be developed early in the intervention design through human-centered processes and community-engaged approaches.

Respiratory disease is one of the main causes of morbidity and mortality in adults with cerebral palsy (CP). The main objective of the study was to investigate the maintenance over time of improvements in respiratory parameters achieved with inspiratory muscle training (IMT). This was a randomized, controlled, double-blind trial and with allocation concealment performed on 27 institutionalized CP patients randomly distributed in two groups: "high intensity training group" (HIT) trained with a load of 40% of the maximum inspiratory pressure (MIP) and "low intensity training group" (LIT) with 20%. Respiratory strength and pulmonary function were evaluated throughout the study. Four weeks after IMT most improvements persisted. Twelve weeks after IMT, only HIT maintained significant improvements (p = 0.001) in MIP; 24 weeks after IMT, in the HIT group, MIP was 10% higher than the initial results and pulmonary function parameters were 1% lower. In the LIT group, respiratory strength and pulmonary function were lower than at baseline. Improvements achieved with IMT are reduced over time once the treatment ends. During the first 4 weeks posttreatment, the benefits persist but from the 12th week there was a progressive loss of the improvement reaching a total loss at 24 weeks. To be most effective, a higher MIP load is suggested for respiratory treatment, which must be maintained over time and interruptions should not be longer than 4 weeks. Clinical trial registration. The study was registered in the clinical trials database of the United States National Library of Medicine (www.clinicaltrials.gov) with the number of registration NCT04915170.

Advancing evidence-based practice requires nurses to have competence in the spectrum of evidence-translation process known as evidence-based healthcare. A scoping review was conducted to identify the instruments used to measure nurses evidence-based healthcare competence and map the associated background factors. The review followed the JBI guidelines with a search made to seven databases CINAHL (EBSCO), PubMed, Scopus, Medic and gray literature EBSCO Open Dissertations & MedNar in 2021 and 2023. A total of 52 studies were included. Nurses' evidence-based healthcare competence related areas were measured with various instruments (n = 23). A total of 24 background factors were examined of which the six most frequently examined with reported associations to nurses' evidence-based competence were: educational level, work experience, EBP education, age, clinical setting, and research experience. Future research should examine the relation of measurement instruments to evidence-based healthcare competence, healthcare requirements and nursing roles, with further exploring the significance of background factors.

The Practice Environment Scale of the Nursing Work Index (PES-NWI) is widely used to assess nursing practice environments; however, existing versions available for primary health care still need to capture the unique aspects of this healthcare setting fully. This study aimed to develop and validate an adapted PES-NWI version tailored for primary health care. A cross-sectional study and a test-retest design were conducted among primary health care nurses. Structural validity was assessed using confirmatory factor analysis, while internal consistency and test-retest reliability were evaluated through Cronbach's alpha and Intraclass Correlation Coefficients (ICCs), respectively. A total of 528 nurses participated, achieving a response rate of 78% with minimal missing data (0-0.6%). The confirmatory factor analysis showed a good model fit, with subscale Cronbach's alpha values between 0.70 and 0.95. Test-retest reliability was strong, with ICCs above 0.70. The adapted PES-NWI demonstrated adequate structural validity, internal consistency, and reliability, supporting its use in primary health care. This adapted measurement tool can support nursing workforce policies by improving the assessment of work environments in primary health care settings. PATIENT OR PUBLIC CONTRIBUTION: No direct patient or public involvement. Primary health care nurses contributed to the content validity assessment of the adapted PES-NWI.