Journal Of Nursing Research Articles

Assessing Associations Between Health Information Technology Maturity and Nursing Home Survey Deficiencies.

One in three nursing home (NH) residents experience adverse events. One strategy for safer NH care is health information technology (HIT). Two national NH surveys measuring HIT maturity were administered in 2020 (N = 719) and 2021 (N = 312). Quarterly NH survey deficiencies from the same years were linked to HIT maturity surveys. Descriptive statistics and logistic regression were used in analysis. NHs were of similar size and location, with more for-profit facilities. Most (67.5% and 61.9%, respectively) NH administrators reported having capabilities to share data internally within their facility, and not externally. Mean HIT maturity scores increased from Year 1 to Year 2. Over 2 years, 5,406 deficiencies were reported, mostly (31.3%) for nutrition and dietary deficiencies. There were negative associations between HIT maturity and deficiency scope. With a 1-unit increase in HIT maturity, relative risk of widespread scope decreased by 14%. Among covariates, bed size, staffing, and year were significant factors associated with deficiency scope. [Journal of Gerontological Nursing, 50(1), 8-14.].

Social Support Networks Among Black Caregivers of Persons With Memory Problems.

Positive social support can predict health outcomes in populations that experience significant burdens, such as minority caregivers. The purpose of the current study was to detail the social network (SN) of 36 Black family caregivers (FCGs) for persons with memory problems (PWMP) and examine differences in SN support depending on FCG gender and relationship to the care recipient. Participants were recruited from the Alzheimer's family program at the University of Alabama at Birmingham and the local community. FCGs were categorized into adult children (ACH), grandchildren and in-law children, and friends and other relatives. FCGs described the amount of adequate support they receive for different types of support from their SN. Female FCGs reported higher levels of support overall, with the largest effect sizes including social (d = 0.63), emotional (d = 0.64), and financial (d = 0.38) support. The largest effect size comparison of caregiver relationship type was in social support, with the ACH group reporting the lowest levels of adequate social support compared to the other two groups (d = 0.48). Findings suggest that different types of Black FCGs face unique challenges depending on their gender and familial relationship to the care recipient. [Journal of Gerontological Nursing, 50(1), 22-29.].

Irreversible Damage: The Transgender Craze Seducing Our Daughters

Journal of Pediatric Surgical Nursing ():10.1097/JPS.0000000000000375, March 7, 2023. | DOI: 10.1097/JPS.0000000000000375

Development of the Dardashna Checklist for Identifying Triggers of Behavioral Change in Individuals With Dementia: A Qualitative Study.

The purpose of the current qualitative study was to describe the development of the Dardashna Checklist to clinically identify behavior change triggers in individuals with dementia. Semi-structured, in-depth, face-to-face interviews were conducted with four physicians and four experienced caregivers involved in the care of individuals with dementia. From analysis of participants' interviews, themes extracted included Triggers of Behavioral Change in Individuals With Dementia and Types of Behavioral Changes, using the checklist structure as a guide. The information gathered by this checklist conveys important messages to experienced physicians or caregivers who want to help less experienced caregivers or individuals with dementia. In this case, physicians' prescriptions and the responses of other experienced caregivers will be more targeted and useful. This checklist will help facilitate clinical care decisions, improve quality of life, reduce expenses and side effects of medications, and improve communication among persons with dementia, their caregivers, and health care providers. [Journal of Gerontological Nursing, 50(1), 37-46.].

Reducing Risk in the Treatment of Attention-Deficit/Hyperactivity Disorder Among Adults With Comorbidities.

Recent widely publicized shortages in the U.S. supply of first-line medications for treatment of attention-deficit/hyperactivity disorder (ADHD) are thought to reflect increases in public awareness, help seeking, and treatment. ADHD is one of the most common neurodevelopmental disorders and is typically identified in childhood. In adulthood, ADHD symptoms are less likely to include hyperactivity, but inattention, impulsivity, and emotional dysregulation are common. Clinical evaluation of symptomatic adults who were not diagnosed as children requires corroboration of ADHD diagnostic symptoms in childhood and careful differentiation of ADHD from frequently co-occurring psychiatric and substance use disorders. Treatment of adult ADHD can result in improved functioning across multiple dimensions and comorbid disorders. Existing guidelines and consensus statements recommend an integrated approach to treating ADHD and all existing comorbid disorders, prioritizing the disorder that is creating the most difficulty for the individual. [Journal of Psychosocial Nursing and Mental Health Services, 62(1), 8-11.].

Acupressure Intervention Program for Older Adults in Australian Residential Aged Care Facilities: A Qualitative Evaluation.

The current study explored participants' experiences and perceptions of receiving acupressure within an Australian aged care context. Participants were older adults living in three residential aged care facilities who had received an acupressure intervention. Data were collected using semi-structured interviews and analyzed using a thematic approach. Twelve participants (10 females and two males) were interviewed. Four major themes emerged: Having Better Sleep, Feeling Calm and Relaxed, Promoting Well-Being and Functional Status, and Acceptability of Acupressure. Participants' perception of the acupressure was positive, as participants found acupressure to be beneficial for the improvement of sleep, mood, and general well-being. Participants' overall perception supports the acceptability of acupressure and suggests acupressure may be beneficial for improving sleep, relaxation, and well-being in older adults. [Journal of Gerontological Nursing, 50(1), 30-36.].

Nursing Leaders to Address Workplace Bullying

The letter centers around a recent study published in the Malaysian Journal of Nursing, titled "Workplace bullying among nurses in Singapore: Aquantitative survey,” which sheds light on nurses' experiences regarding workplace bullying. The study deserves praise for its insightful look at nurse workplace bullying. This study calls for serious reflection because it undermines our caring professionals. This study also shows that nursing leaders can improve the workplace. What can nurse leaders do to help? This commentary will focus on two salient strategies that could assist nurse leaders in mitigating bullying: having the knowledge, skills, and confidence to identify bullying and prioritizing targeted support.

Passport to Freedom: A Trauma-Informed Mindfulness Program for Previously Incarcerated Women.

Poly-victimization is often reported by formerly incarcerated women and leads to physical and mental health problems that interfere with daily functioning, sustained employment, and housing stability. Although reentry programs exist, few focus on the physical and emotional impact of multiple traumas. Passport to Freedom (P2F), a woman-centered, trauma-informed reentry program, was developed to support formerly incarcerated women. The pilot intervention, performed in 2017, focused on the connections between trauma and health, coping with symptoms, and managing one's own health. To examine the effectiveness and feasibility of the intervention, we performed the current mixed methods study with two phases: (1) focus groups, and (2) sessions combining mindfulness and health promotion activities with follow-up evaluations. Participants (N = 24) showed decreased symptoms of depression and concerns of everyday stressors after the intervention. Of participants, 84% (n = 16) reported practicing mindfulness and 63% (n = 8) stated that mindfulness exercises helped with daily stress management. The P2F program offers a promising approach to support formerly incarcerated women with health self-management. [Journal of Psychosocial Nursing and Mental Health Services, 62(6), 18-26.].

Effects of Parental Psychological Control on Attitudes Toward Seeking Professional Psychological Help in Senior High School Students: Serial Mediating Effects of Rejection Sensitivity and Social Withdrawal.

The purpose of the current study was to examine the serial mediating effects of rejection sensitivity and social withdrawal on parental psychological control and attitudes toward seeking professional psychological help among senior high school students. In November 2022, 648 students completed a self-report questionnaire. The parental psychological control scale, senior high school students' rejection sensitivity scale, social withdrawal scale, and attitudes toward seeking professional psychological help scale were used for measurement. Correlation analysis showed parental psychological control and rejection sensitivity were positively correlated with social withdrawal (r = 0.387, 0.466, 0.495, all p < 0.001). Parental psychological control and rejection sensitivity were significantly negatively correlated with social withdrawal and attitudes toward seeking professional psychological help (r = -0.325, -0.324, -0.397, all p < 0.001). Mediating effect analysis indicated that parental psychological control had a significant direct effect on attitude toward seeking professional psychological help, and rejection sensitivity and social withdrawal had significant serial mediating effects among parental psychological control and attitudes toward seeking professional psychological help in senior high school students. These aspects warrant attention as they play significant roles in influencing students' willingness to seek psychological assistance. [Journal of Psychosocial Nursing and Mental Health Services, 62(7), 47-55.].

Healing Trauma While Staying at Home: Using Telehealth to Conduct a Brief Treatment Program for Posttraumatic Stress Disorder.

Studies suggest that a three-session brief treatment program (Brief Relaxation, Education, and Trauma Healing [BREATHE]) can help treat posttraumatic stress disorder (PTSD) and symptoms of trauma; however, the program has not been examined via telehealth. Thus, the current study evaluated the feasibility of BREATHE delivered via telehealth. The intervention included breathing retraining and psychoeducation about PTSD and trauma. Thirty participants from the community with confirmed PTSD diagnoses participated in this telehealth program. Treatment retention was high, and participants showed decreased PTSD symptoms, posttraumatic cognitions, depression, anxiety, overall psychiatric symptoms, and internalized stigma and increased resiliency at posttreatment and 3-month follow up. Results suggest that a telehealth brief treatment program for PTSD is feasible and effective for individuals with PTSD. [Journal of Psychosocial Nursing and Mental Health Services, 62(7), 36-46.].

Positive PTSD Screening and Its Health Correlates in Patients With HIV in Urban Primary Care Settings.

Posttraumatic stress disorder (PTSD) is underdiagnosed and undertreated in primary care, especially among African American individuals. The current study assessed documentation rates of PTSD and clinical health correlates among 135 predominantly African American patients with HIV and positive PTSD screens in a primary care unit. The Primary Care PTSD Screen for DSM-5 (PC-PTSD-5) and a retrospective chart review of 135 patients with HIV were conducted. On the PCPTSD-5 (cut point of 3), approximately one half of patients (49.6%; n = 67) had probable PTSD; however, only 11.9% of patients (n = 16) had a chart diagnosis of PTSD. A positive PTSD screen was associated with higher rates of depression and insomnia, but not anxiety, alcohol use, drug use, or pain in patients with HIV. Multi-morbidity of HIV, major depression, and positive PTSD screens was associated with increased risk for asthma, number of medical diagnoses, depression, insomnia, and anxiety. Findings highlight the need for trauma-informed care in primary care settings for people with PTSD and HIV. Larger samples are warranted to further explore health correlates of PTSD. [Journal of Psychosocial Nursing and Mental Health Services, 62(8), 25-36.].

Relationships Among Demographic Factors, Stigma, Social Support, and Self-Management in Individuals With Bipolar Disorder in Remission.

The current cross-sectional study aimed to investigate the extent to which demographic characteristics, stigma, and social support impact the self-management abilities of individuals with bipolar disorder in remission. Participants (N = 114) completed a demographic questionnaire, Self-Stigma Scale-Short Form, Social Support Rating Scale, and Self-Management Scale for Patients With Bipolar Disorder. Mean scores were 60.65 (SD = 10.42) for self-management, 35.76 (SD = 7.14) for social support, and 21.38 (SD = 5.06) for stigma. In the univariate analysis, age, educational level, method of payment for care, illness duration, and number of hospitalizations demonstrated significant associations with self-management (p < 0.05). Correlation analysis revealed a positive correlation between self-management and social support (r = 0.574, p < 0.01) and negative correlations between self-management and stigma (r = -0.489, p < 0.01) and stigma and social support (r = -0.476, p < 0.01). Multiple linear regression analysis included number of hospitalizations (β = -3.818), social support (β = 0.436), literacy (β = 2.132), and stigma (β = -0.397). Individuals in remission from bipolar disorder exhibit moderate levels of self-management. Follow-up interventions should prioritize enhancing social support and addressing stigma to promote improved self-management and overall well-being. [Journal of Psychosocial Nursing and Mental Health Services, 62(7), 26-35.].

Buprenorphine and Opioid Use Disorder Training: Graduate Nursing Curricula Recommendations.

Opioid use disorder (OUD) is a public health emergency, with a shortage of providers trained to prescribe buprenorphine for OUD treatment. We conducted a systematic review to examine advanced practice RN (APRN) and medical school programs that included OUD content or Drug Addiction Treatment Act waiver training and evaluate the outcomes of those curricular modifications. APRN and medical school programs that provided OUD content or waiver training saw improvements in students' knowledge and self-efficacy for managing buprenorphine treatment and reduced stigma toward individuals with OUD. Students' perceptions of training were largely positive, and the programs' results indicated improved practice outcomes related to the use of buprenorphine. Further inclusion of OUD content and training in APRN curricula will increase the number of capable buprenorphine prescribers, which will increase access to buprenorphine for individuals with OUD. [Journal of Psychosocial Nursing and Mental Health Services, 62(7), 17-24.].

Quality of Life Health Outcomes Among People Who Lived in a Nursing Home Prior to and During the COVID-19 Pandemic.

The purpose of the current study was to compare quality of life health outcomes during the year prior to and first year of the coronavirus disease 2019 (COVID-19) pandemic among people who lived in a nursing home. This study used quarterly cross-sectional data from Minimum Data Sets between March 2019 and March 2021 among 96 people who resided in a nursing home. Health outcomes were cognitive function, transfer ability, depression, rejecting care, falls, urinary tract infections, physical conflict, and verbal conflict. Data were analyzed using Stuart-Maxwell test to compare differences in health outcomes in the year prior to and first year of the COVID-19 pandemic. There were statistically significant differences between the two time periods for the worsening of health outcomes related to transfer ability, rejecting care, physical conflict, and verbal conflict. Understanding the influence of the COVID-19 pandemic on health outcomes among people who live in nursing homes is critical for improving individual health and health system preparedness. [Journal of Gerontological Nursing, 49(12), 41-48.].

Outcomes of the Nurse-Led Interdisciplinary-Heart Failure Team Program (NLI-HFTP): A Pilot Study.

Information is lacking in long-term care regarding heart failure (HF) management, including in nursing homes. The current pilot project examined the Nurse-Led Interdisciplinary-Heart Failure Team Program (NLI-HFTP) intervention for nursing home residents with HF. This study used a pre-posttest one-group design with 46 nursing home residents who were primarily female, African American, of non-Hispanic ethnicity, and with an average age of 76 years. Post-intervention Nurse-Patient Interaction Scale scores were significantly higher than pre-intervention scores (mean pretest = 124.83, mean posttest score = 103.04; t [45] = 27.78, p < 0.001). Comparison of participants' medical records found a substantial decrease in the number of HF-exacerbated hospitalizations during the 3-month post-implementation period compared with rates during the 3-month pre-implementation period (16 vs. 7). The NLI-HFTP was feasible to implement in a nursing home, reduced referral rates to acute care hospitals, and could thus provide a better resident experience through increasing nurse-patient interactions. [Journal of Gerontological Nursing, 49(12), 18-23.].

Resilient Adaptation Strategies: Unveiling Older Adults' Coping Dynamics Amidst the COVID-19 Pandemic.

Older adults, who are particularly vulnerable to coronavirus disease 2019 (COVID-19), exhibit less stress and greater well-being than their younger peers. However, there have been no in-depth explorations of adaptive coping strategies among this population, nor has the role of frailty status been addressed. The current study examined stress and coping in 30 U.S. older adults (mean age = 81 years, range = 68 to 95 years) amidst the COVID-19 pandemic, uncovering themes of: (1) Pandemic Stresses: stresses experienced during the pandemic centered around social isolation and concern for others' well-being; (2) Resilience: older adults proved highly adaptable, with lifetime experience as a stress buffer; and (3) Silver Linings: older adults reported positive by-products, such as reconnecting with and a renewed appreciation for life and nature. Motivation for change and change itself centered around creating value and meaning in the present, especially around social isolation. Findings challenge existing ageist stereotypes, give insight into interventional design, and highlight the importance of ensuring infrastructural and societal support. [Journal of Gerontological Nursing, 49(12), 32-39.].

Leveraging Regulation and Legislation to Improve the Care of Older Adults Through Home- and Community-Based Services.

An increase in demand for health care services for older adults is being negatively impacted by lack of a sufficient nursing workforce with competence in home- and community-based services (HCBS). The current article examines the unique challenges and opportunities in caring for older adults in HCBS settings, outlines the core competencies nurses must possess to provide this care, and proposes strategies to leverage legislative and regulatory initiatives to incorporate these competencies into nursing education and practice. Examining the American Association of Colleges of Nursing's Essentials Competencies through the HCBS lens, it is an ideal time to create a roadmap for nurses in practice, policy, and education to shape the health care workforce to meet the needs of a diverse and vulnerable population: older adults who depend on home- and community-based care for maintaining or improving their health outcomes and overall quality of life. [Journal of Gerontological Nursing, 49(12), 11-16.].

Xylazine: The Drug Taking the World By Storm: What You Need to Know.

Xylazine has taken the world by storm and proactive strategies are urgently needed to combat its negative impacts on population health. Xylazine is an unscheduled non-opioid indicated as a veterinary tranquilizer, also known as "Tranq." This drug is commonly used in combination with other drugs, such as heroin, fentanyl, and cocaine. Xylazine can be used orally, intranasally, sniffed, smoked, and injected, but is mostly used intravenously. Adverse effects of xylazine are secondary to central nervous system (CNS), cardiovascular, and respiratory function depression. When alpha-2-receptors in the cardiovascular and respiratory systems are stimulated, physiological effects include bradycardia, hypotension, and respiratory and CNS depression. There are currently no U.S. Food and Drug Administration-approved medications for the treatment of xylazine withdrawal or reversal of its overdose. Therefore, it is imperative that health care providers are trained to recognize these signs and symptoms and intervene proactively. [Journal of Psychosocial Nursing and Mental Health Services, 61(12), 7-10.].

Dementia and Postoperative Delirium in Surgical Hip Fracture Patients: Unveiling Contrasting Risk Factors and Implications.

Postoperative delirium is a serious complication, particularly in older adults with hip fractures. Using the 2019 American College of Surgeons National Surgical Quality Improvement Program data file, we performed multiple regression analyses to compare risk factors for postoperative delirium in hip fracture patients with and without dementia. Preoperative delirium and mobility aid use were common risk factors in both groups. However, differential effects were observed for other factors. Pathological fracture increased delirium risk in patients with dementia but had a protective effect in those without dementia. In patients with dementia, American Society of Anesthesiology score IV/V was identified as a risk factor, whereas advanced age, severe chronic obstructive pulmonary disease, weight loss, sepsis, elevated international normalized ratio, and serum creatinine level were additional risk factors in patients without dementia. These findings enhance our understanding of the complex relationship among dementia, hip fractures, and postoperative delirium. Identifying specific risk factors for each group can inform tailored interventions and preventive strategies. Further research is needed to validate and expand these findings, ultimately improving care and outcomes. [Journal of Gerontological Nursing, 49(12), 25-30.].

Transitions of Care: Strategies for Medication Optimization and Deprescribing in Older Adults.

Older adults have an increased risk of adverse drug events related to polypharmacy and potentially inappropriate medication (PIM) use. These patients are even more vulnerable as they transition through different health care settings. In 2023, the American Geriatrics Society published an updated version of the Beers Criteria®, providing updated guidance on identifying and managing PIMs. Nurses and nurse practitioners play important roles in medication management across the continuum of care. The current article aims to illustrate key concepts regarding medication safety and deprescribing for older adult patients during transitions of care. [Journal of Gerontological Nursing, 49(12), 5-10.].