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"We have met the enemy and it is us": Healthcare professionals as the barrier to health equity for people with intellectual and developmental disability. "我们遇到了敌人,它就是我们:医疗保健专业人员是智力和发育障碍人士实现健康公平的障碍。
IF 2.1 4区 医学 Q2 NURSING Pub Date : 2024-06-01 Epub Date: 2024-02-28 DOI: 10.1002/nur.22376
Dianne C Miner, Sarah H Ailey, Roy A Thompson, Allison Squires, Amyela Adarlo, Holly Brown
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引用次数: 0
Classic grounded theory: identifying the main concern. 经典基础理论:确定主要关注点。
IF 2.1 4区 医学 Q2 NURSING Pub Date : 2024-06-01 Epub Date: 2024-03-24 DOI: 10.1002/nur.22381
Justine Connor, Tracy Flenady, Deb Massey, Trudy Dwyer

Grounded theory comprises a family of research approaches designed to support the generation of a theory explaining a phenomenon experienced by a group of participants. One style of grounded theory, Classic grounded theory, is used less often than other types of grounded theory. The less frequent use of Classic grounded theory may be attributed to the limited availability of clearly articulated processes for conducting this method. Particularly important within Classic grounded theory, and not used in other forms of grounded theory, is identifying the participants' main concern. Identifying the participants' main concern is a signature feature of Classic grounded theory and is a prerequisite for ascertaining the core category and subsequent discovery of theory. In this article we provide a detailed explanation of how to identify the participants' main concern, and in so doing, we offer an exemplar to illustrate the process involved.

基础理论由一系列研究方法组成,旨在支持生成一种理论,解释一群参与者所经历的现象。与其他类型的基础理论相比,有一种基础理论,即经典基础理论,较少被使用。经典基础理论使用较少的原因可能是,这种方法的清晰阐述过程有限。在经典基础理论中,尤其重要的是确定参与者的主要关注点,这一点在其他形式的基础理论中并不使用。确定参与者的主要关注点是经典基础理论的一个标志性特征,也是确定核心类别和随后发现理论的先决条件。在本文中,我们将详细解释如何确定参与者的主要关注点,并提供一个范例来说明其中的过程。
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引用次数: 0
Adaptation and validation of a patient-reported compassion measure in the Spanish population: The Spanish version of the Sinclair Compassion Questionnaire (SCQesp). 在西班牙人群中改编并验证患者报告的同情心测量方法:西班牙版辛克莱同情心问卷(SCQesp)。
IF 2.1 4区 医学 Q2 NURSING Pub Date : 2024-06-01 Epub Date: 2024-02-05 DOI: 10.1002/nur.22373
Ana Soto-Rubio, Yolanda Andreu, Beatriz Gil-Juliá, Carmen Picazo, Sergio Murgui, Cara C MacInnis, Shane Sinclair

International practice guidelines and policies recognize compassion as a fundamental dimension of quality care. A key element in enhancing compassion in healthcare settings is having reliable patient-reported experience measures. In the Spanish context, there is a need for a valid Spanish patient-reported compassion measure for use in both research and clinical practice. The Sinclair Compassion Questionnaire (SCQ) represents the gold standard for patient-reported compassion measures in English-speaking settings. The primary aim of this study is to culturally adapt and validate the SCQ in a Spanish population. A Spanish version of the SCQ (SCQesp) was used to collect data from 303 Spanish patients (in two contexts: hospitalized and medical visit). Confirmatory factor analysis confirmed a one-factor solution in the 15-item (SCQesp) and five-item (SCQesp-SF) short form version. The SCQesp showed excellent values of reliability: Cronbach's α = 0.98; composite variance = 0.98 (0.905-0.854); and stratified variance = 0.78. The SCQesp-SF showed similar values of reliability. The SCQesp has excellent psychometric properties, making it a valid and reliable measure for assessing compassion in healthcare research and clinical care. This scientifically rigorous and psychometrically robust compassion measure in Spanish could allow healthcare providers, researchers, and leaders to routinely assess compassion.

国际实践指南和政策认为,同情心是优质护理的一个基本维度。在医疗机构中增强同情心的一个关键因素就是要有可靠的患者报告体验测量方法。在西班牙,研究和临床实践都需要一种有效的、由患者报告的西班牙同情心测量方法。辛克莱同情心问卷(Sinclair Compassion Questionnaire,SCQ)是英语环境中患者报告同情心测量的黄金标准。本研究的主要目的是在西班牙人群中对 SCQ 进行文化适应性调整和验证。研究人员使用西班牙语版本的 SCQ(SCQesp)收集了 303 名西班牙患者的数据(两种情况:住院和就诊)。确认性因素分析证实了 15 个项目(SCQesp)和 5 个项目(SCQesp-SF)简表版本的单因素解决方案。SCQesp 显示出极佳的可靠性:Cronbach's α = 0.98;综合方差 = 0.98 (0.905-0.854);分层方差 = 0.78。SCQesp-SF 也显示了类似的信度值。SCQesp 具有出色的心理测量特性,因此是在医疗保健研究和临床护理中评估同情心的有效而可靠的测量方法。这种科学严谨、心理测量稳健的西班牙语同情心测量方法可以帮助医疗服务提供者、研究人员和领导者对同情心进行常规评估。
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引用次数: 0
Moral distress and moral sensitivity in clinical nurses. 临床护士的道德困扰和道德敏感性。
IF 2.1 4区 医学 Q2 NURSING Pub Date : 2024-06-01 Epub Date: 2023-12-24 DOI: 10.1002/nur.22366
Mustafa Sabri Kovanci, Azize Atli Özbaş

Health care providers are expected to have a certain moral sensitivity (MS) to make an ethical assessment. Moral distress (MD) is a common phenomenon in nursing. It can negatively affect nurses physically, psychologically, socially, and spiritually. This study aimed to investigate the relationship between MD and MS among nurses using a cross-sectional descriptive design. The study was conducted in two stages. The first stage was a methodological study that analyzed validity and reliability of the Measure of MD-Healthcare Professionals. The second stage was a descriptive- predictive analysis that investigated the relationship between MD and MS. The MD intensity and frequency scores of the participants were high and moderately high, respectively. There was no direct effect on the total score and frequency of MS and MD. However, a direct and significant negative effect of MS was seen on the intensity of MD. Based on the results of this study, MS should be considered as a measure in studies aimed at understanding MD among clinical nurses. Empowerment programs should be established to increase the awareness of health workers about ethical and moral situations and to support them to cope with the problems they experience in these areas.

医疗服务提供者应具备一定的道德敏感性(MS),以便进行道德评估。道德困扰(MD)是护理工作中的一种常见现象。它会对护士的身体、心理、社会和精神造成负面影响。本研究采用横断面描述性设计,旨在调查护士的 MD 与 MS 之间的关系。研究分两个阶段进行。第一阶段是方法学研究,分析了 "MD-医疗保健专业人员测量 "的有效性和可靠性。第二阶段是描述性预测分析,调查 MD 与 MS 之间的关系。参与者的 MD 强度和频率得分分别为高分和中高分。MS和MD的总分和频率没有直接影响。然而,MS 对 MD 的强度有直接和显著的负面影响。根据本研究的结果,在旨在了解临床护士 MD 的研究中,MS 应被视为一种衡量标准。应制定赋权计划,以提高医务工作者对伦理道德状况的认识,并支持他们应对在这些领域遇到的问题。
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引用次数: 0
Improving pain communication between limited English-speaking Hmong patients, medical interpreters, and health care providers in primary care: A pilot study. 改善英语水平有限的苗族患者、医疗翻译和初级医疗服务提供者之间的疼痛沟通:试点研究。
IF 2.1 4区 医学 Q2 NURSING Pub Date : 2024-06-01 Epub Date: 2024-01-04 DOI: 10.1002/nur.22363
Maichou Lor, Angie Li, Roger Brown, Matthew P Swedlund, John G Hawkins, Evan T Nolander, Betty Chewning

This pilot study assessed the feasibility of implementing a pain assessment information visualization (InfoViz) tool to address cultural and language barriers among limited English proficiency (LEP) Hmong patients in primary care. We used a static group comparison design to collect data from 20 patient, interpreter, and provider triads under usual care (i.e., interpreter using verbal pain descriptions), followed by another 20 triads under the intervention (i.e., interpreter using verbal pain descriptions and the InfoViz tool). Feasibility outcomes included recruitment and retention rates, InfoViz tool completion, acceptability, and fidelity. We also assessed mutual understanding (MU) and pain electronic health record (EHR) documentation. Descriptive data were calculated and thematic analysis was conducted. Thirty-six LEP Hmong patients (n = 29 female, mean age = 59.03), 27 providers (n = 15 female), and four interpreters participated in this study. The patient recruitment rate was 18% while the retention rate was 81%. Interpreter recruitment rate was 80%, and 75% for retention rate. The intervention fidelity mean score was 83%. In the intervention condition, patient-provider MU of pain severity improved by 30%, coupled with a 28% increase in pain severity EHR documentation compared to usual care. While communication of pain quality did not improve, there was a higher mean number of pain descriptors (3.31 in the intervention vs. 1.79 in usual care) in EHR documentation. All participants had a positive experience with the tool, reporting it as valuable with 100% completeness of all tools. Findings revealed the tool was acceptable and feasible to use among LEP patients-interpreters-providers, providing support for an efficacy study.

这项试点研究评估了实施疼痛评估信息可视化(InfoViz)工具的可行性,以解决基层医疗机构中英语水平有限(LEP)的苗族患者的文化和语言障碍。我们采用静态组比较设计,收集了 20 个接受常规护理(即口译员使用口头疼痛描述)的患者、口译员和医疗服务提供者三方的数据,然后收集了另外 20 个接受干预(即口译员使用口头疼痛描述和 InfoViz 工具)的三方的数据。可行性结果包括招募率和保留率、InfoViz 工具完成率、可接受性和忠实性。我们还对相互理解(MU)和疼痛电子健康记录(EHR)文档进行了评估。我们计算了描述性数据,并进行了主题分析。36 名精通英语的苗族患者(女性 29 人,平均年龄 59.03 岁)、27 名医疗服务提供者(女性 15 人)和 4 名口译员参与了这项研究。患者招募率为 18%,保留率为 81%。口译员招募率为 80%,保留率为 75%。干预忠实度平均得分为 83%。与常规护理相比,在干预条件下,患者和医疗服务提供者对疼痛严重程度的沟通提高了 30%,同时疼痛严重程度的电子病历记录也增加了 28%。虽然疼痛质量的交流没有得到改善,但电子病历记录中疼痛描述的平均数量增加了(干预中为 3.31,常规护理中为 1.79)。所有参与者都对该工具有积极的体验,认为它很有价值,所有工具的完整率达到 100%。研究结果表明,该工具可在 LEP 患者-译者-提供者之间接受和使用,为疗效研究提供了支持。
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引用次数: 0
Integrating safety and health practices in therapeutic communities: Insights from Taiwan's Chieh‐Lo‐Shan Villa 在治疗社区中整合安全与健康实践:台湾鸡笼山别墅的启示
IF 2 4区 医学 Q2 NURSING Pub Date : 2024-05-05 DOI: 10.1002/nur.22390
Jen‐Chin Lee, Lien‐Chung Wei
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引用次数: 0
Validation of a short form of the practice environment scale of the nursing work index: The PES‐5 护理工作指数实践环境量表简表的验证:PES-5
IF 2 4区 医学 Q2 NURSING Pub Date : 2024-04-26 DOI: 10.1002/nur.22388
Eileen T. Lake, Jennifer Gil, Lynne Moronski, Matthew D. Mchugh, Linda H. Aiken, Karen B. Lasater
The Practice Environment Scale of the Nursing Work Index (PES‐NWI) has been utilized for two decades globally to measure nurse work environments. Its 31 items in five domains present a substantial respondent burden, threatening survey response rates. The purpose of this study was to derive and validate a short form: the PES‐5. We conducted a cross‐sectional, secondary analysis of survey data from nurses in 760 hospitals in six U.S. states in 2016 or 2019. One representative item per subscale was selected by highest item‐to‐subscale R2 from the original PES‐NWI publication. Five psychometric properties of the PES‐5 were evaluated. The reproduced structure of the full form was confirmed in the 2016 data by the highest R2 for the selected items. The unidimensional structure of the PES‐5 was confirmed through confirmatory factor analysis. The correlation between the composite values of the 28‐item and 5‐item versions was 0.94. The Cronbach's alpha reliability of the PES‐5 was >0.80. The intraclass correlation coefficient (ICC 1, k), which evaluates the stability of aggregated values when data are clustered, i.e., nurses are nested within hospitals, was >0.80 in both datasets, demonstrating satisfactory aggregate properties. Construct validity was supported by the selected items being ranked highly in their respective subscales by an expert panel. Criterion validity was supported by an analysis of variance of the PES‐5 mean value across responses to a single‐item work environment measure. Similar patterns of relationships with other key variables were identified by statistically significant odds ratios in regression models predicting patient mortality from the PES‐5. The classification accuracy of the PES‐5 was high, with 88% of hospitals classified identically by both versions. The PES‐5 shows promise for measurement of nurses’ work environments while maximizing response rate by reducing participant burden.
二十年来,护理工作指数实践环境量表(PES-NWI)一直在全球范围内用于测量护士的工作环境。该量表包含五个领域的 31 个项目,给受访者带来了很大的负担,威胁到调查的回复率。本研究的目的是开发并验证一个简表:PES-5。我们对美国 6 个州 760 家医院的护士在 2016 年或 2019 年的调查数据进行了横断面二次分析。我们从 PES-NWI 的原始出版物中,根据最高的项目与分量表 R2,为每个分量表选择了一个具有代表性的项目。对 PES-5 的五个心理测量属性进行了评估。在 2016 年的数据中,所选项目的最高 R2 证实了全表的再现结构。通过确认性因素分析,证实了 PES-5 的单维结构。28 个项目和 5 个项目版本的综合值之间的相关性为 0.94。PES-5 的 Cronbach's alpha 信度为 0.80。类内相关系数(ICC 1,k)用于评估数据聚类(即护士嵌套在医院内)时汇总值的稳定性,两个数据集的类内相关系数均为 0.80,显示出令人满意的汇总特性。结构效度得到了专家小组的支持,所选项目在各自的子量表中排名靠前。PES-5 均值在单项工作环境测量中的方差分析支持了标准效度。通过 PES-5 预测患者死亡率的回归模型中具有统计学意义的几率比,确定了与其他关键变量的类似关系模式。PES-5 的分类准确性很高,两个版本对 88% 的医院进行了相同的分类。PES-5显示了测量护士工作环境的前景,同时通过减轻参与者的负担最大限度地提高了应答率。
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引用次数: 0
Issue Information ‐ TOC 发行信息 - TOC
IF 2 4区 医学 Q2 NURSING Pub Date : 2024-04-19 DOI: 10.1002/nur.22318
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引用次数: 0
Trajectories of self‐management and independence in youth with spina bifida: Family‐related predictors of growth 脊柱裂青少年的自我管理和独立性轨迹:与家庭相关的成长预测因素
IF 2 4区 医学 Q2 NURSING Pub Date : 2024-04-16 DOI: 10.1002/nur.22387
Monique M. Ridosh, William Adams, Colleen F. B. Driscoll, Fabiola Magaña, Kathleen J. Sawin, Grayson N. Holmbeck
The purpose of this study was to assess family‐related predictors of self‐management trajectories in youth with spina bifida (SB). Participants with SB completed the Adolescent/Young Adult Self‐Management and Independence Scale (AMIS II) interview across four time points. Family functioning, family‐related stress, and perceived family support were assessed by multiple reporters and multiple methods. Growth in AMIS II total self‐management and the AMIS II subscales (Condition and Independent Living) were estimated using linear mixed effect models as a function of family factors, after controlling for socio‐demographic, condition‐related, and neuropsychological variables that had been found to be significant predictors of self‐management in prior studies. Model fit and parsimony were assessed using Akaike's information criterion (AIC). This diverse community sample included 99 respondents aged 18–27 years old. About half were female (52.5%) and White (52.5%); 15.2% were Black, and 32.3% were Hispanic/Latino. Observed family cohesion at baseline was associated with all self‐management scales at age 18 (all p < 0.05). Growth in self‐management was associated with parent‐reported number of family stress events. For growth in total self‐management, the best model included age, race/ethnicity, family income, shunt status, lesion level, neuropsychological function, observed family cohesion, and an age‐by‐number of family stress events interaction effect. The study findings suggested that family factors were important predictors of self‐management trajectories, even after controlling for socio‐demographic, condition‐related, and neuropsychological covariates. Risk and protective factors identified in families of youth with SB can inform family‐focused interventions for self‐management.
本研究旨在评估脊柱裂(SB)青少年自我管理轨迹的家庭相关预测因素。脊柱裂患者在四个时间点完成了青少年自我管理和独立量表(AMIS II)访谈。家庭功能、与家庭相关的压力和感知到的家庭支持由多个报告人和多种方法进行评估。在控制了社会人口学、病情相关变量和神经心理学变量(这些变量在之前的研究中被认为是自我管理的重要预测因素)后,使用线性混合效应模型估算了 AMIS II 自我管理总分量表和 AMIS II 分量表(病情和独立生活)的增长情况,并将其作为家庭因素的函数。采用阿凯克信息准则(AIC)对模型的拟合度和简约性进行了评估。这个多样化的社区样本包括 99 名 18-27 岁的受访者。约半数为女性(52.5%)和白人(52.5%);15.2%为黑人,32.3%为西班牙裔/拉丁裔。基线观察到的家庭凝聚力与 18 岁时的所有自我管理量表相关(所有 p 均为 0.05)。自我管理能力的增长与家长报告的家庭压力事件数量有关。对于总自我管理能力的增长,最佳模型包括年龄、种族/民族、家庭收入、分流状态、病变程度、神经心理功能、观察到的家庭凝聚力以及年龄与家庭压力事件数量的交互效应。研究结果表明,即使在控制了社会人口学、病情相关和神经心理学协变量后,家庭因素仍是自我管理轨迹的重要预测因素。在患有SB的青少年家庭中发现的风险和保护因素可以为以家庭为中心的自我管理干预提供参考。
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引用次数: 0
Effect of digital technology interventions for cognitive function improvement in mild cognitive impairment and dementia: A systematic review and meta‐analysis 数字技术干预对改善轻度认知障碍和痴呆症认知功能的效果:系统回顾与荟萃分析
IF 2 4区 医学 Q2 NURSING Pub Date : 2024-04-03 DOI: 10.1002/nur.22383
Hyojin Park, Juyoung Ha
The development and commercialization of digital therapeutics are increasing. The aim of this study was to determine the effects of digital technology interventions on cognitive function, thereby providing evidence for the development and practical application of interventions to manage cognitive function in patients with mild cognitive impairment and dementia. We conducted a systematic review and meta‐analysis of randomized controlled trials according to PRISMA (Preferred Reporting Items for Systematic Reviews and Meta‐Analysis) guidelines. Randomized controlled trials on digital technology interventions published until April 2023 were searched in PubMed, Embase, Cochrane Library, and Cumulative Index to Nursing and Allied Health Literature (CINAHL) databases without a period limit. Articles that identified the effects of digital technology interventions on cognitive function improvement in dementia and mild cognitive impairment were integrated and analyzed. RevMan software 5.4 was used for quality assessment and meta‐analysis. Twelve out of 708 studies were included in the review and meta‐analysis. Digital technology interventions had significant effects on global cognitive function (standardized mean difference [SMD] = 0.31; 95% confidence interval [CI] = 0.04–0.57; p = 0.02; I² = 60%). In addition, these interventions had significant effects on neuropsychological characteristics, including attention (SMD = 1.17; 95% CI = 0.36–1.97; p = 0.004; I² = 84%), visuospatial perception (SMD = 0.68; 95% CI = 0.19–1.17; p = 0.006; I² = 57%), and memory (SMD = 0.45; 95% CI = 0.19–0.71; p = 0.0007; I² = 22%). The results suggest that digital technology interventions help improve cognitive function in patients with dementia and mild cognitive impairment.
数字疗法的开发和商业化正在不断增加。本研究旨在确定数字技术干预对认知功能的影响,从而为开发和实际应用干预措施管理轻度认知障碍和痴呆症患者的认知功能提供证据。我们根据 PRISMA(系统综述和元分析首选报告项目)指南对随机对照试验进行了系统综述和元分析。在 PubMed、Embase、Cochrane Library 和 Cumulative Index to Nursing and Allied Health Literature (CINAHL) 数据库中检索了 2023 年 4 月之前发表的有关数字技术干预的随机对照试验,没有时间限制。对确定了数字技术干预对痴呆症和轻度认知障碍患者认知功能改善效果的文章进行了整合和分析。采用RevMan软件5.4进行质量评估和荟萃分析。708 项研究中有 12 项被纳入综述和荟萃分析。数字技术干预对总体认知功能有显著影响(标准化平均差异 [SMD] = 0.31;95% 置信区间 [CI] = 0.04-0.57;P = 0.02;I² = 60%)。此外,这些干预措施对神经心理学特征也有显著影响,包括注意力(SMD = 1.17;95% CI = 0.36-1.97;p = 0.004;I² = 84%)、视觉空间感知(SMD = 0.68;95% CI = 0.19-1.17;p = 0.006;I² = 57%)和记忆(SMD = 0.45;95% CI = 0.19-0.71;p = 0.0007;I² = 22%)。结果表明,数字技术干预有助于改善痴呆症和轻度认知障碍患者的认知功能。
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引用次数: 0
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