Journal Of Nursing Research Articles

Social Connectedness Resource Preferences of Older Adults in Assisted Living: A Scoping Review Based on the WHO-ICF Framework.

The current scoping review identified emerging evidence on social connectedness resource preferences of older adults in assisted living facilities (ALFs) and the community. A literature search was performed using several databases. We included review articles published between January 2000 and September 2022 in English and related to social connectedness resources in ALFs and the community. Of 134 titles and abstracts, eight studies were included. Study participants comprised 2,482 older adults from 233 ALFs in the United States. Themes were framed using the World Health Organization's International Classification of Functioning, Disability, and Health. For social activities, older adults preferred facility-based recreation and leisure resources. For community social connectedness, residents preferred participation in civic life activities. Participants of older age preferred facility resources, whereas those of younger age preferred more demanding physical activities. Those from larger enrollment facilities preferred facility-based resources compared to community resources. For moderately and less active residents, participation was limited to less demanding activities. Older adults' preferences varied based on age, physical limitations, and size and location of the facility. Findings suggest opportunities for further research on developing ALF- and community-based resources for older adults' social well-being and quality of life. [Journal of Gerontological Nursing, 49(9), 35-42.].

An Expert Evaluation of Oncology Website Resources for Use in Pediatric Oncology Clinical Nursing Education in Low-Resource Settings.

Background: Online healthcare information is often used by pediatric oncology nurse educators in low- and middle-income countries (LMICs) for teaching clinical nurses as part of their initial orientation or continuing education. Access to peer-reviewed nursing journals via paid subscriptions or sub-specialty nursing textbooks in these settings is rare. This project identified and evaluated websites appropriate for pediatric oncology nurse educators in LMICs for teaching staff nurses, and for clinical staff nurses engaging in self-directed learning. Method: A strategic Google search for childhood cancer websites and an appropriate scoring tool was conducted. The Currency, Relevance, Authority, Accuracy, and Purpose Test, along with a previously published scoring rubric that was further adapted by the authors for pediatric oncology were used. Pediatric content, language options, and reading levels were appraised. Results: Of 86 identified websites, 51 met the inclusion criteria for evaluation. Websites were classified as highly recommended (n = 36), recommended (n = 12), or not recommended (n = 3) based on scores (range 14-30; maximum possible score = 30). Half offered content in multiple languages. Most websites were 9-10th-grade reading level. Discussion: Childhood cancer information appropriate for clinical nurse orientation and self-directed learning by LMIC nurses is available on free websites. Some information (diagnosis, chemotherapy, psychosocial support) is repeated across websites, while some is lacking (pediatric cancer genetics and health equity disparities). Reading levels are higher than recommended for health literacy. The reviewed websites were rarely peer-reviewed, inconsistently updated, and generally self-regulated. However, 48 websites on childhood cancer were deemed appropriate pediatric oncology clinical nursing education resources.

Solving the shortage of psychiatric - mental health nurses in acute inpatient care settings.

This debate essay proposes possible remedies to the shortage of nurses in acute inpatient mental health settings and draws inspiration from a Journal of Psychiatric and Mental Health Nursing editorial, Glascott and McKeown (2022, 29, 767). The aim is to stimulate debate within the profession. The art and science of nursing continues to develop but staffing shortages in key areas undermine practice, leadership, academic and policy efforts to improve the quality of care for people attending services. This is a debate essay which draws on the authors' experience and presents ideas based on extant literature. Organisational, professional and wider societal challenges are explored. Practice-based solutions as well as recommendations for improving the terms and conditions of employment of nurses are made. Opportunities which may empower the nursing profession are promulgated. It is intended that this paper will provoke further discourse and may reflect the 'call to action' advocated by Glascott and McKeown (Journal of Psychiatric and Mental Health Nursing, 2022, 29, 767). While the focus is on acute inpatient mental health nursing, the ideas presented may have an application to wider nursing groups or a wider cadre of public sector workers.

Effect of an Anti-Stigma Program on Self-Stigma for Chinese Individuals With Schizophrenia: A Pilot Study With a Quasi-Experimental Design.

The current study explored the effectiveness of an anti-stigma group program for people with schizophrenia. Thirty-four participants recruited from a psychiatric day hospital were allocated to the experimental group (EG) or control group (CG). The Internalized Stigma of Mental Illness Scale (ISMIS), Perceived Psychiatric Stigma Scale (PPSS), and Beck Depression Inventory-II (BDI-II) were used to measure outcomes, which were evaluated at baseline, immediately post program, and 3-month follow up. Generalized estimating equations showed that the EG attained a greater reduction in the stigma resistance subscale of the ISMIS than the CG at posttest and 3-month follow up. Scores on the self-deprecation subscales (p = 0.025) and concerns about marital preclusion (p = 0.037) on the PPSS and BDI-II (p = 0.027) in the EG showed significant improvement over those of the CG at 3-month follow up. The anti-stigma group program seems to be effective in reducing self-stigma and depressive symptoms in people with schizophrenia. [Journal of Psychosocial Nursing and Mental Health Services, 62(2), 37-45.].

Psychosocial Correlates of Internalized Stigma Among Chinese Individuals With Severe Mental Illness.

The current study aimed to examine internalized stigma and its psychosocial factors among people with severe mental illness in China. A cross-sectional study was performed with 202 adults diagnosed with schizophrenia, bipolar disorder, or schizoaffective disorder in Beijing, China. Participants were evaluated using the Chinese version of the Internalized Stigma of Mental Illness (ISMI) scale, Perceived Devaluation and Discrimination scale, and the Medical Outcomes Study Social Support Survey. Correlation analysis and multiple linear regression analysis demonstrated that 19.8% of participants had moderate-to-high ISMI scores, whereas the sample as a whole indicated a mild level of internalized stigma. A higher level of internalized stigma was associated with greater perceived discrimination, lower social support, lower family income, older age, and distancing coping. These factors may be important to consider for developing tailored interventions in the future. [Journal of Psychosocial Nursing and Mental Health Services, 62(1), 37-44.].

Evidence-Based Practice Among Psychiatric Nurses: Knowledge, Attitudes, Organizational Readiness, Levels of Implementation, and Barriers and Facilitators.

The current study examined psychiatric nurses' views, knowledge, attitudes, organizational readiness, levels of evidence-based practice (EBP), as well as barriers and facilitators to EBP in a Nigerian tertiary neuropsychiatric hospital. This study used a cross-sectional descriptive research approach. Structured questionnaires were administered to all psychiatric nurses (N = 131) at the hospital. Results showed that psychiatric nurses had an acceptable degree of EBP knowledge and a positive attitude toward EBP. Levels of EBP implementation were below average, and organizational culture and preparation for EBP were moderate. Participants reported a moderate degree of barriers to EBP adoption (mean = 40.08, SD = 9.63), and a high level of assertion to positive facilitators of EBP (mean = 19.88, SD = 4.16). Findings show that although most psychiatric nurses had adequate knowledge and good attitudes toward EBP, certain barriers prevented its application. Thus, there is a need for a policy framework to mitigate existing barriers and improve EBP facilitators in psychiatric nursing practices in Nigeria to improve productivity measures. [Journal of Psychosocial Nursing and Mental Health Services, 61(9), 47-55.].

Adverse Childhood Experiences and Depression: The Mediating Role of Resilience and Emotional Regulation.

The current study examined the mediating roles of resilience and emotional regulation in the association between childhood trauma and depressive symptoms among individuals who experienced adverse childhood experiences (ACEs). Data from 200 women aged 17 to 77 years who were psychiatric outpatients were collected using self-reported questionnaires assessing child adversity, depressive symptoms, resilience, and emotional regulation. A positive correlation was found between a subscale of the ACE-IQ and depression. Childhood trauma was associated with higher risk of depressive symptoms among participants with lower resilience (an association that was partly explained by resilience level [mediation]). Emotional regulation was not a significant mediator in the childhood trauma-depression association. Our findings indicate that resilience is a key mediator between childhood trauma and depression. Individuals who experienced childhood trauma may benefit from evidence-based interventions focused on strengthening resilience and improving coping strategies. [Journal of Psychosocial Nursing and Mental Health Services, 62(1), 45-54.].

Evaluation of Renal Functions of Inpatients With Mental Disorders.

The current study aimed to investigate the renal functions of inpatients with mental disorders. Data for this retrospective and descriptive study were collected from January 2021 to April 2021 from the records of patients who were hospitalized in the psychiatry clinic of a training and research hospital between 2018 and 2020. The study sample comprised hospital records of 376 patients. A significant negative relationship was determined between patients' glomerular filtration rate (GFR) and glucose level, duration of mental disorder, number of hospitalizations, and duration of medication use (p < 0.05). According to the analysis of patients' renal functions, mean GFR was statistically significantly lower in women with physical chronic diseases and diagnosed with personality disorders. Psychiatric-mental health nurses should evaluate and monitor renal functions of individuals with mental disorders and take precautions before kidney diseases develop. [Journal of Psychosocial Nursing and Mental Health Services, 62(2), 47-55.].

"Let Them Know That They're Appreciated": The Importance of Work Culture on Direct Care Worker Retention.

Retaining direct care workers (DCWs) in all areas of long-term services and supports (LTSS) remains an unending challenge. The current study purposively selected 12 high-performing LTSS communities (e.g., nursing homes, assisted living, home care agencies) in Ohio with high family satisfaction and staff retention. Qualitative interviews were conducted in 2022 with 21 personnel in leadership positions and 16 DCWs (e.g., certified nursing assistants, personal care aides). Interviews were audio recorded, transcribed, and a team of two coders conducted the thematic analysis. Three themes of work culture emerged as important for retention: (1) Family-Like Organizational Approach, (2) Supportive Working Conditions, and (3) Worker Empowerment. DCWs valued empathic relationships with their clients and supervisors. Favorable working conditions consisted of choice, participative leadership, and effective communication. DCWs experienced empowerment through appreciation, financial incentives, and career advancement opportunities. Findings suggest practical changes for person-centered care practitioners that are feasible across any organizational work culture setting. [Journal of Gerontological Nursing, 49(8), 7-13.].

Adult Cannabis Use: An Exploratory Case Study.

Cannabis use is on the rise among adults and older adults managing chronic health conditions in the United States. There is limited understanding of this trend and the factors influencing cannabis use in the health care community. The current study explores the perceptions and experiences of adults and older adults with chronic health conditions who use cannabis regularly. Case study data were gathered through interviews guided by the Biopsychosocial Model. Biological, psychological, and social reasons for cannabis use emerged in the interviews. Despite reporting adverse events, cannabis was reported as an effective treatment for participants' chronic health issues, and participants were more comfortable with its use compared to prescription medications. A feeling of autonomy contributed to cannabis use being perceived as positive. Cannabis use is rising in the United States. Primary care providers must regularly screen older adults to identify appropriate and inappropriate use patterns. [Journal of Gerontological Nursing, 49(8), 19-26.].

Association of Perceived Neighborhood Environments With Cognitive Function in Older Adults.

The current study examined the associations between perceptions of the social and physical neighborhood environments and cognitive function in older adults. This cross-sectional study analyzed 821 adults aged ≥65 years from the Adult Changes in Thought study. Perceived neighborhood attributes were measured by the Physical Activity Neighborhood Environment Scale. Cognitive function was assessed using the Cognitive Ability Screening Instrument. The associations were tested using multivariate linear regression. One point greater perceived access to public transit was associated with 0.56 points greater cognitive function score (95% confidence interval [CI] [0.25, 0.88]), and an additional one point of perceived sidewalk coverage was related to 0.22 points higher cognitive function score (95% CI [0.00, 0.45]) after controlling for sociodemographic factors. The perception of neighborhood attributes alongside physical infrastructure may play an important role in supporting older adults' cognitive function. [Journal of Gerontological Nursing, 49(8), 35-41.].

Providing High-Quality Care During a Pandemic: Nursing Home Administrator Perspectives.

Nursing home administrators are responsible for promoting quality improvement (QI), a challenging task during a pandemic. In the current study, a convenience sample of 28 administrators of non-profit nursing homes was recruited for interviews regarding leadership during the coronavirus disease 2019 pandemic. The purpose was to elicit administrator insights into sustainable QI initiatives and factors contributing to QI success during a pandemic. Open-ended interview items focused on QI initiatives, pandemic-related advice to new administrators, and ways external parties can contribute to QI during a pandemic. Administrators highlighted QI initiatives in social connections, infection control, and innovative activities. Advice to new administrators included team development, maintaining a positive attitude, and extensive communication. Administrators recommended that external parties respect infection control measures, seek alternatives to restrictive regulations, and commend staff. Nurses may be better able to lead or assist in implementing nursing home QI initiatives informed by findings from this study. [Journal of Gerontological Nursing, 49(8), 14-18.].

Treatment in Children and Adolescents With Obsessive-Compulsive Disorder: Review for Practitioners.

Obsessive-compulsive disorder (OCD) is one of the most debilitating mental health conditions, interrupting functioning at school and social well-being in children and adolescents. Youth tend to delay interventions and when sought, response to treatment might not be optimal. The current article discusses treatment guidelines for youth with OCD and pediatric autoimmune neuropsychiatric symptoms. [Journal of Psychosocial Nursing and Mental Health Services, 61(8), 11-15.].

Role Identity Transition: A Conceptual Framework for Being the Spouse of a Person With Early Onset Dementia.

Informal caregivers of persons with early onset dementia (PWEOD) are usually the spouses of affected individuals. These caregivers face unique challenges related to the unexpected nature of disease onset at this early life stage along with the accompanying symptoms, which can be different from those in late onset dementia. The current study explores the meanings these caregivers make of their situations and actions in response to their experiences. Findings provide a basis for development of a conceptual framework illustrating the basic, psychosocial processes underlying their shared situation. Grounded theory methodology was used. Qualitative data were collected through semi-structured interviews with 15 participants. Data were analyzed using constant comparative techniques and situational analysis. A distinction was made across participants between identifying as spouse versus caregiver for their PWEOD. Each participant had made or was making an identity transition from viewing their role as becoming more caregiver-like toward an eventual, complete shift to that of caregiver in a stepwise fashion. Incremental shifts in identity reflected challenges to the notion held of what it means to be a spouse. Results support prior research highlighting the unique experiences of caregivers of PWEOD while providing a framework for understanding the unique situations of these care-givers. Findings also inform nursing interventions tailored for spouses of PWEOD. [Journal of Gerontological Nursing, 49(8), 27-34.].

Stepping On Fall Prevention Program Reduces Falls in Older Adults: An Observational Prospective Study.

The purpose of the current study was to assess the impact of the Stepping On fall prevention program on the incidence of falls and frailty measures in older adults. Participants completed pre- and post-fall prevention program questionnaires and the Frail Scale Assessment at baseline and post-program. They also completed a follow-up questionnaire and Frail Scale Assessment at 6- and 12-month intervals post-program. Univariate analysis was performed comparing robust (n = 11), pre-frail (n = 29), and frail (n = 7) participants. Frail participants were significantly older (mean age = 77.7 years [SD = 4.9 years] vs. 74 years [SD = 5.9 years] vs. 70.4 [SD = 3.9], respectively; p = 0.026) and more likely to live alone (71.4% vs. 65.5% vs. 18.2%, respectively; p = 0.017) compared to pre-frail and robust participants. At 12-month post-program, reported falls and frailty scores decreased compared to baseline (12.8% vs. 29.8%, p = 0.044 and 0.91 [SD = 1.1] vs. 1.3 [SD = 1.082], respectively; p = 0.009). Data show that 41.4% of pre-frail participants at baseline improved to robust. Participation in Stepping On led to a decrease in reported falls and frailty scores 12 months post-program, suggesting that participation in the program may help delay frailty progression. [Journal of Gerontological Nursing, 49(8), 43-50.].

Analysis of publications on surgical gloves

Aims: This bibliometric analysis aimed to examine the trends and characteristics of publications related to surgical gloves. The study analyzed articles retrieved from the Elsevier Scopus database, focusing on topics such as the history of glove usage, the importance of sterility, glove punctures, and advancements in glove designs. Methods: The data in this study were obtained by searching the Elsevier Scopus database. The search was selected from records containing the keywords in the title “surgical gloves” and a single day was chosen for the sake of being unbiased. In this study, only the articles were analyzed and the online library and digital resources of Çanakkale Onsekiz Mart University were used. Scopus' visuals were used for visualization after data analysis. Results: A total of 568 publications were included in the analysis, consisting of articles, letters, reviews, and other study documents. The majority of articles were written in English, and the top three countries in terms of publication output were the United States, United Kingdom, and Germany. Medical journals accounted for the largest share of publications, followed by nursing journals. Notably, there was a rising trend in the number of studies on glove punctures and advancements in glove designs. Richard F. Edlich from the University of Virginia School of Medicine emerged as the most productive author, and the Association of periOperative Registered Nurses (AORN) Journal was the most prolific journal in this field. Conclusion: Today, studies on surgical gloves; focuses on latex glove allergy and surgical site infections. These studies; It is important for the prevention of infection during surgery in the future and the prevention of infectious diseases in healthcare workers.

Locked external doors on inpatient mental health units: A scoping review.

The principles of least restrictive care and recovery-focused practice are promoted as contemporary practice in the care of individuals with mental ill health, underpinning legislation concerning mental health and illness in many jurisdictions worldwide. Inpatient mental health units with locked doors are incompatible with this style of care and throwback to a time where care for mental illness was primarily custodial. The aim of this scoping review is to determine whether evidence exists for locking mental health unit doors, whether this practice is compatible with recovery-focused care and to determine whether door locking has changed since a review conducted by Van Der Merwe et al. (Journal of Psychiatric and Mental Health Nursing, 16, 2009, 293) found that door locking was not the preferred practice in the management of acute mental health units. We used Arksey and O'Malley's (International Journal of Social Research Methodology: Theory and Practice, 8, 2005, 19) framework for scoping reviews, with our initial search locating 1377 studies, with screening narrowing final papers for inclusion to 20. Methodologies for papers included 12 using quantitative methodology, 5 qualitative and 3 that used mixed methods designs. Poor evidence was found for door locking to mitigate risks such as absconding, aggression or illicit substance importation. Furthermore, locked doors had a detrimental impact on the therapeutic relationship, nurse job satisfaction and intention to leave the profession. This scoping review indicates that research is urgently needed to address a mental healthcare culture where door locking is an entrenched practice. Studies of alternative approaches to risk management are required to ensure inpatient mental health units are truly least-restrictive, therapeutic environments.

Assessment of a Unit-Level Acuity Tool in Inpatient Psychiatry.

Assessing acuity is deemed essential to staffing in intensive care nursing; however, it has not received sufficient attention in inpatient psychiatry, where acuity can fluctuate greatly within shifts. Staffing and admission decisions rely on the accuracy of this information. The current mixed methods study surveyed nurses from two hospitals within the same hospital system: one using an acuity tool and one naïve to acuity tools. The survey was followed by a focus group on the specific factors influencing acuity and nurses' assessment of needs. Results suggest that the current tool is not satisfactory for nurses who use it to help with staffing or admission decisions and it is not user-friendly. Most nurses from both hospitals indicated they would prefer an electronic version with automated features reflecting up-to-date patient and unit acuity that would assist in interprofessional collaborative admissions decisions and staffing. [Journal of Psychosocial Nursing and Mental Health Services, 62(1), 13-18.].

Creating Space for Adolescents and Families With Lived Experience of Homelessness to Build Familial Empathy, Communication, and Emotional Regulation: A Qualitative Study of Facilitators of Implementation.

Youth experiencing homelessness are vulnerable to commercial sexual exploitation (CSE). Structural racism disproportionately entraps marginalized youth into CSE while simultaneously obscuring their identification as victims. Adaptation and tailoring of effective interventions to mitigate associated sequelae and inequities is warranted. Support To Reunite, Involve, and Value Each Other (STRIVE) is a strengths-based dyadic intervention with demonstrated efficacy in reducing delinquency, substance use, and high-risk sexual behaviors among marginalized adolescents experiencing homelessness. The adapted STRIVE+ was piloted to explore potential for reducing youth risk factors for CSE. The current article reports findings from interviews exploring participants' experiences with STRIVE+. Youth and caregivers reported increased empathy, communication, and emotional regulation post-STRIVE+ and found relevance and meaning through participating in the adapted intervention. Feasibility of recruitment, engagement, and retention of minoritized adolescents and their caregivers were also demonstrated. Findings warrant larger scale implementation trials of STRIVE+ among minoritized youth at highest risk for CSE. [Journal of Psychosocial Nursing and Mental Health Services, 62(1), 27-35.].

Factors Influencing Professional Identity of Psychiatric Nurses as Second Victims: A Cross-Sectional Study.

The current study aimed to explore the status and influencing factors of professional identity among psychiatric nurses as second victims in China by using a cross-sectional design. We investigated 291 psychiatric nurses from two psychiatric hospitals. Participants were asked to complete a demographic questionnaire, Second Victim Experience and Support Scale, Multidimensional Health Locus of Control Scale, and Professional Identity Scale for Nurses. Scores of professional identity of psychiatric nurses as second victims were moderate. Regression analysis showed that the second victim experience and support and internal control were significant predictors, explaining 34.2% of the variance in professional identity. Identifying risk factors related to the professional identity of psychiatric nurses as second victims will help managers take timely preventive measures to improve the awareness of the self-health responsibility of psychiatric nurses and reduce the adverse effects of patient safety incidents to enhance their professional identity. [Journal of Psychosocial Nursing and Mental Health Services, 61(12), 47-54.].