Journal Of Nursing Research Articles

Associations Between Components of Self-Management Theory and Falls Among Older Adults.

To examine the relationship of key individual and family self-management theory (IFSMT) components, including self-management process variables on proximal (self-management behaviors) and distal (falls) outcomes in older adults. A secondary data analysis was conducted using data of 99 older adults living in continuing care retirement communities in the U.S. Midwest. Descriptive statistics, multiple regression, and logistic regression were performed to analyze the data. The multiple regression model demonstrated a positive association between self-efficacy for physical activity and steps per day. The logistic regression model showed that high expectations regarding aging are associated with reduced likelihood of meeting daily protein intake. Key components of the IFSMT, such as self-efficacy, steps per day, and expectations regarding aging, are important when designing self-management interventions to prevent falls. [Journal of Gerontological Nursing, 50(8), 19-28.].

Psychosocial Factors and Quality of Life in Older Adults Discharged After Isolation Due to COVID-19 Infection.

To identify the impact of psychosocial factors on quality of life (QoL) of older adults hospitalized and isolated after contracting coronavirus disease 2019 (COVID-19). Data were collected between April 30 and June 18, 2022, from 117 discharged older adults who were in isolation for COVID-19 treatment in a tertiary hospital in South Korea. Of participants, 33.3% were at high risk for posttraumatic stress symptoms (PTSS), and 21.4% of participants were identified as having severe depressive symptoms. Participants' QoL negatively correlated with PTSS, depressive symptoms, and fear of social stigma. Depressive symptoms were the primary psychosocial factor identified as significantly affecting QoL (β = -0.682, p < 0.001), and the explanatory power of the regression model was 41.2%. To enhance QoL of older adults who have experienced hospitalization and isolation due to COVID-19, identifying pertinent psychosocial factors, especially depressive symptoms, is necessary. [Journal of Gerontological Nursing, 50(8), 29-36.].

Walking Interventions and Sleep Quality of Persons Living With Dementia and Their Family Caregivers: Effects of Different Walking Companions.

To examine the effect of walking interventions on sleep quality of persons with dementia (PWD) and their caregivers (dyads), and how different companions affect results. Forty-five dyads were divided into three groups: a control group and two experimental groups (one with a care attendant, one with a family caregiver). The two experimental groups engaged in 120 minutes of walking per week for 24 weeks. A significant improvement in sleep quality was observed among PWD in the family caregiver group (Wald χ2 = 4.55, p = 0.033), whereas there was no improvement in the care attendant group. A slight improvement in sleep quality of family caregivers was also found. Findings suggest the importance of creating individualized walking activity plans for dyads, incorporating trust and rapport-building strategies to improve sleep quality. [Journal of Gerontological Nursing, 50(8), 46-56.].

Staff Perceptions of Implementing a Person-Centered Communication Tool in the Nursing Home Setting: PAL Cards.

To understand direct care workers' perceptions of the impact of implementing a person-centered communication tool, Preference for Activity and Leisure (PAL) Cards, into care. PAL Cards provide at-a-glance information about a nursing home (NH) resident's background and important preferences for activities and leisure. As a quality improvement project, 11 NHs implemented use of PAL Cards in their communities and provided feedback (N = 91 feedback forms received) on their perceptions of impact of PAL Cards on care communication and delivery. A variety of NH staff members, across disciplines, were a part of PAL Card implementation. The majority of staff (84%) perceived that PAL Cards helped them start a conversation with a resident and 64% indicated that PAL Cards helped them provide care for a resident. PAL Cards are an effective tool for communicating information about NH residents' preferences to staff. [Journal of Gerontological Nursing, 50(8), 5-10.].

Impact of Dialectical Behavioral Therapy on Anxiety Levels Among African American Adolescents.

Anxiety and depression among adolescents in the United States has steadily increased. In addition, significant disparities in access to mental health care exist for African Americans. The purpose of the current project was to support the mental health of African American adolescents involved in faith-based youth groups through implementation of dialectical behavioral therapy (DBT). The community partner was an African American church in Southwest Georgia. Mindfulness training modules are offered in monthly sessions. Pre- and post-intervention surveys and the Generalized Anxiety Disorder-7 (GAD-7) were analyzed, comparing mean GAD-7 scores before and after participation. Nurse-led quality improvement initiatives support adolescent mental health and provide sustainable resources for mental health in rural areas. Results of the quality improvement project reveal improvement in self-reported anxiety symptoms among participants after the 4-month DBT intervention. [Journal of Psychosocial Nursing and Mental Health Services, 62(8), 7-10.].

Methodologic and Data-Analysis Triangulation in Case Studies: A Scoping Review.

We sought to explore the processes of methodologic and data-analysis triangulation in case studies using the example of research on nurse practitioners in primary health care. We conducted a scoping review within Arksey and O'Malley's methodological framework, considering studies that defined a case study design and used 2 or more data sources, published in English or German before August 2023. The databases searched were MEDLINE and CINAHL, supplemented with hand searching of relevant nursing journals. We also examined the reference list of all the included studies. In total, 63 reports were assessed for eligibility. Ultimately, we included 8 articles. Five studies described within-method triangulation, whereas 3 provided information on between/across-method triangulation. No study reported within-method triangulation of 2 or more quantitative data-collection procedures. The data-collection procedures were interviews, observation, documentation/documents, service records, and questionnaires/assessments. The data-analysis triangulation involved various qualitative and quantitative methods of analysis. Details about comparing or contrasting results from different qualitative and mixed-methods data were lacking. Various processes for methodologic and data-analysis triangulation are described in this scoping review but lack detail, thus hampering standardization in case study research, potentially affecting research traceability. Triangulation is complicated by terminological confusion. To advance case study research in nursing, authors should reflect critically on the processes of triangulation and employ existing tools, like a protocol or mixed-methods matrix, for transparent reporting. The only existing reporting guideline should be complemented with directions on methodologic and data-analysis triangulation.

Examining Factors Associated With Intention to Seek Professional Mental Health Support Among First-Generation Iranian Americans.

Research suggests immigrants are at a greater risk of mental health disorders compared to native-born populations. Thus, the current study investigated factors associated with professional mental help-seeking intention among American immigrants. A cross-sectional study was conducted with 207 first-generation Iranian Americans, and data were collected using survey questionnaires. Younger Iranians living in western states in the United States and those with positive attitudes toward professional mental health services had greater intention to seek these services. Unexpectedly, those with better mental health literacy (MHL) held more mental health stigma (MHS). Findings elucidated valuable insights into the complex dynamics among sociodemographic factors, acculturation, MHL, MHS, attitudes, and intentions toward professional mental health help-seeking. We also highlighted the intricate relationship between MHL and MHS, suggesting that strategies to improve MHL may not necessarily mitigate MHS within this community. Therefore, integrating anti-stigma, contact-based approaches to MHL programs could effectively reduce stigma while facilitating mental health help-seeking. [Journal of Psychosocial Nursing and Mental Health Services, xx(xx), xx-xx.].

Self-Esteem Among U.S. African American and Latinx Adolescents With Depressive Symptoms and Overweight and/or Obesity.

To examine the concept of self-esteem among African American and Latinx adolescents with overweight and/or obesity and depressive symptoms in the United States. Using key terms in CINAHL, PubMed, and PsycINFO databases, an initial search yielded 371 articles; after examining title, abstract, and full text, 33 articles remained. The concept of adolescent self-esteem was analyzed using Rodger's evolutionary method. Several antecedents of self-esteem in this context were identified, including bullying, negative portrayal in the media, stressors and hassles, low socioeconomic status, dieting, and family dietary influences. Attributes identified were body image and misperception, body image dissatisfaction, diminished social status, and isolation. Consequences included stigma, somatic complaints, decreased earnings over a lifetime, decreased quality of life, lower educational attainment over a lifetime, and increased substance use. Increased self-esteem, increased number of friends, and in-depth friendships were associated with a lower risk of being overweight or obese. Adolescent self-esteem varied based on gender, racial and ethnic group, and changed over time in the African American population but remained static in the Latinx population. [Journal of Psychosocial Nursing and Mental Health Services, xx(xx), xx-xx.].

Parental Substance Use Disorder and the Rise in Children Being Raised by Grandparents: Focusing on Children's Needs and Improving Outcomes.

The occurrence of children being raised solely by their grandparents has steadily risen in the past decade prompted by parental substance use disorder (SUD) and associated incarceration and death. These families, especially children, are a vulnerable population with unique needs. Nurses should be cognizant of the needs, risk factors, and protective factors often associated with this population. Meanwhile, the literature to date mostly focuses on grandparents. School and pediatric nurses, specifically, are in an advantageous position to help support these families and help foster better child outcomes. The purpose of the current article is to explore the experiences, needs, and resources for supporting children being raised by grandparents due to parental SUD. Best practices for health care professionals, especially nurses, are discussed as well as future directions for research with this vulnerable population. [Journal of Psychosocial Nursing and Mental Health Services, xx(x), xx-xx.].

Nutrition Care Practices in Mental Health Nursing Services: Insights from a Preliminary Study from Pune, Maharashtra, India.

To assess nutrition care practices in selected mental health care facilities in Pune, Maharashtra, India. A preliminary cross-sectional study was conducted in individuals (N = 100) residing in five private mental health care facilities. Data were collected on diet quality, nutritional status, and health status of adult patients with mild to moderate mental health disorders. Food safety practices of the care facilities were also investigated. Of 100 recruited participants, 68% were over-nourished (body mass index >23 kg/m2), 32% were given vitamin B complex supplements, 81% used antipsychotic drugs, and 72% reported drug-induced gastric issues. Most participants (n = 71; 71%) consumed medium-quality diets (four to five food groups per day). Food sanitation and hygiene scores indicated fair standards (range = 46% to 51%) at these facilities. Further, partial compliance with World Health Organization guidelines was observed. Findings underscore the need for induction of nutritionists or, in their absence, additional nutrition training for mental health nurses to enhance diet quality, nutritional and health status of patients, and food safety. [Journal of Psychosocial Nursing and Mental Health Services, xx(x), xx-xx.].

Effectiveness of Acupuncture and Brief Telehealth Intervention for Individuals With Posttraumatic Stress Disorder.

This open-trial pilot study evaluated the feasibility and effectiveness of acupuncture with brief therapy (ABT) for individuals with posttraumatic stress disorder (PTSD). Participants included 27 individuals with PTSD diagnoses confirmed using the Clinician-Administered PTSD Scale for DSM-5. Before ABT, 22 participants completed eight acupuncture sessions and three telehealth sessions of a brief treatment program for PTSD (Brief Relaxation, Education, and Trauma Healing [BREATHE]). ABT significantly reduced PTSD symptoms, depression symptoms, anxiety, and improved trauma-related cognition. Acupuncture can play an important role in mental health recovery, and combining acupuncture with a brief, telehealth-based treatment (BREATHE) may assist recovery among individuals with PTSD. [Journal of Psychosocial Nursing and Mental Health Services, xx(xx), xx-xx.].

Experiences and Cognitive Characteristics of Non-Suicidal Self-Injury in Adolescents With Depression: A Qualitative Study.

To elucidate the underlying motivations, experiential dimensions, and cognitive perceptions in adolescents with depression and non-suicidal self-injury (NSSI). A descriptive qualitative design was used. Participants were 18 Chinese adolescents with depression and NSSI. Conventional content analysis was used for data analysis. Three primary themes and 11 subthemes were identified: Triggers of NSSI (personal, family, school, and social factors); Experiencing Emotional Complexity in NSSI Implementation (mitigating psychological distress, awakening a sense of existential life, generating secondary negative emotions, stimulating reflections on life and death); and Perceptions and Understandings of NSSI are Diverse (NSSI as a form of seeking validation or approval, an addictive behavior, a means to attain a sense of control, and unacceptable behavior). Although nursing staff should provide comprehensive treatment and psychological support, efforts should also be made to strengthen caregiving skills of family members, thereby promoting overall physical and mental health of adolescents. [Journal of Psychosocial Nursing and Mental Health Services, xx(x), xx-xx.].

Emotion Regulation Can Effectively Improve Decision-Making Behaviors of Individuals Who Use Methamphetamine.

Negative emotions can cause people to make irrational decisions, and decision-making disorders may lead individuals who use methamphetamine (meth) to relapse. Therefore, the current study was performed to investigate whether emotion regulation (ER) can improve negative emotions and thus improve decision-making behavior of individuals who use meth. Based on the Iowa Gambling Task, a three-factor mixed experimental design was used to examine the effects of cognitive reappraisal and expressive suppression strategies on negative emotions and decision-making behaviors of 157 individuals who use meth. Cognitive reappraisal and expressive suppression were effective in reducing participants' negative emotions and improving decision-making behaviors. Specifically, two types of ER strategies were effective in improving decision-making abilities of participants with negative emotional distress, and cognitive reappraisal was more effective than expressive suppression. Regarding cognitive reappraisal, female participants showed better decision-making behavior than males, which predicts that females who use meth might be more adept at using cognitive reappraisal. This finding suggests that mental health providers should aid substance users in managing their negative emotions and also pay attention to gender differences during the nursing process. [Journal of Psychosocial Nursing and Mental Health Services, xx(xx), xx-xx.].

Factors Related to Postpartum Depression in People Living With HIV: A Systematic Review.

Postpartum depression (PPD) affects one in eight women in the United States. Women with HIV may be at higher risk for PPD. This systematic review examined factors related to PPD in those with HIV. Using three databases, articles published between 2017 and 2022 were screened for eligibility, with 19 full texts reviewed and critically appraised. Ten studies from eight countries were ultimately included in the analysis. Using Engel's biopsychosocial model, common themes emerged within the theoretical framework: (a) biological (e.g., HIV diagnosis in pregnancy, impact on HIV adherence); (b) psychological (e.g., pregnancy intention, intimate partner violence, fear of HIV transmission, infant illness, behavior); and (c) social (e.g., socioeconomic status, lack of social support, disclosure, stigma). Living with HIV carries additional stressors for new parents that may impact mental health in the postpartum period. Nurses are in a unique position to screen for PPD early using established screening tools while paying particular attention to associated factors impacting those with HIV. [Journal of Psychosocial Nursing and Mental Health Services, xx(xx), xx-xx.].

Assessing the Potential of Technology to Describe Resident and Staff Interactions in Assisted Living Facilities.

Falls are a significant financial burden and health hazard for residents in assisted living facilities (ALFs). However, limited capacity to observe residents has hindered understanding of resident-staff interactions within rooms. The current study aimed to describe nurse-resident interactions using data from a remote technology combining computer vision and staff location tracking. Eighty-three staff working at an urban ALF with 215 residents were trained at the initiation of the study. Remote surveillance devices were installed in 32 residences and staff and resident interactions were tracked over 170 days. Staff visited residents an average of 20.7 times per day for short durations (mean = 1.08 minutes). Urgent alert response times averaged 3.0 minutes, with faster response times through the mobile application (mean = 2.7 minutes) compared to in-person (mean = 3.3 minutes) response. By better understanding staff activity patterns in ALFs, this study has the potential to improve fall prevention and care for residents in ALFs. [Journal of Gerontological Nursing, 50(7), 7-11.].

Workplace Resilience and Stress Among Certified Nursing Assistants in Long-Term Care Institutions During the COVID-19 Pandemic.

To explore the relationship among resilience, stress, and demographic factors in certified nursing assistants (CNAs) who worked in long-term care institutions during the coronavirus disease 2019 pandemic. A cross-sectional correlation-based research design was used. Data were collected using a demographic questionnaire, Connor-Davidson Resilience Scale, and Occupational Stress Scale. CNAs from 21 long-term care institutions in Taiwan were recruited. This study included 118 female and 26 male CNAs (response rate = 80%). Mean age was 46.8 years. A moderately negative correlation was found between workplace resilience and stress. Overall, being a woman and parent were found to be significantly correlated with CNAs' resilience. Furthermore, resilience and shift work were important predictors of stress. We suggest that leadership and management pay more attention to CNAs' basic demographic background information. Furthermore, timely, relevant strategies can be provided to enhance resilience and reduce workplace stress. [Journal of Gerontological Nursing, 50(7), 19-26.].

Psychosocial Characteristics by Pain Presence and Limitations Among Older Adults.

To compare psychosocial outcomes of older adults according to pain experience. Using cross-sectional 2021 data from the National Health and Aging Trends Study, we examined psychosocial characteristics in older adults (N = 3,376) divided into three groups: no pain, pain without activity limitations, and activity-limiting pain. In multiple regression models, older adults with activity-limiting pain compared to those without pain had significantly higher depression, anxiety, and fear of falling, as well as reduced positive affect, self-realization, self-efficacy, resilience, and social participation. Older adults with non-activity-limiting pain had significantly higher social participation than those without pain, but no differences in self-realization, self-efficacy, or resilience. Pain is strongly associated with all psychosocial outcomes, especially in older adults with activity-limiting pain. Future research should examine the impact of self-realization, self-efficacy, resilience, and social participation on activity limitations. [Journal of Gerontological Nursing, 50(7), 27-34.].

Function-Focused Care for Cognitive Impairment Training Among Formal Caregivers in Long-Term Care Facilities in Taiwan: A Cluster Randomized Controlled Trial.

To examine behavior changes among formal caregivers in Taiwanese long-term care facilities (LTCFs) after receiving training in function-focused care for cognitive impairment (FFC-CI). The current study was a clustered randomized controlled trial. Formal caregivers (i.e., RNs and nursing assistants) (N = 98) from four LTCFs were randomly assigned to experimental or control groups. Training was based on four components of FFC-CI. Data were collected four times within 9 months using five observational outcome measurements: Self-Efficacy for Restorative Care (SERCS), Outcome Expectations for Restorative Care Scale (OERCS), Restorative Care Knowledge Scale (RCKS), Restorative Care Behavior Checklist (RCBC), and Job Attitude Scale (JAS). Statistically significant changes were noted in each activity of restorative care behavior among the four observational measurements. Results also indicated that job satisfaction was a statistically significant main effect for the experimental group; however, SERCS, OERCS, and RCKS scores were not statistically significant. To eliminate gaps between translating research outcomes to clinical practice, this study applied a theory-based caring model for caregivers to improve knowledge and skills in caring for older adults with dementia. Caregivers who received training in FFC-CI not only had higher job satisfaction but could also provide specific FFC activities for residents during their daily care. [Journal of Gerontological Nursing, 50(7), 42-50.].

Comparing Sleep Quality, Duration, and Efficiency Among Low-Income Community-Dwelling Older Adults With and Without Physical Disabilities.

Physical disabilities may exacerbate the natural decline in sleep quality that occurs with aging. In the current study, we assessed sleep quality and medicinal sleep aid use among 87 community-dwelling older adults with (n = 24) and without (n = 63) physical disabilities. Sleep quality, duration, and efficiency were assessed subjectively with the Pittsburgh Sleep Quality Index. Sleep duration and efficiency were objectively measured with actigraphy. Participants self-reported medicinal sleep aid use. Significant group differences were observed in sleep duration measured objectively (p = 0.01) and subjectively (p = 0.04). No other group differences were observed for sleep factors (p > 0.05) or medicinal sleep aid use (p = 0.41). Findings show that physical disability may be a factor in sleep duration; however, physical disability was not found to be associated with worsened sleep perception or greater reliance on medicinal sleep aids. Future research should consider longer objective actigraphy assessment windows and explore potential subgroup differences in sex and race/ethnicity. [Journal of Gerontological Nursing, 50(7), 12-18.].

Mental Health Needs of Asian American Older Adults: Bridging the Inequity Gap.

The mental health needs of Asian American older adults are complex and multifaceted. Despite their rich diversity, Asian American older adults face significant challenges, including mental health stigma, cultural stress, limited English proficiency, and historical trauma. In addition, the coronavirus disease 2019 pandemic reignited preexisting anti-Asian attitudes of hostility, discrimination, blame, and scapegoating. The historical context of Asian immigration to the United States, impact of race-based discrimination, and recent resurgence of anti-Asian hate crimes impact mental health in Asian American older adults. Thus, there is a need for a culturally sensitive and competent mental health care workforce, culturally tailored interventions, and family involvement. In the context of research and policy, it is critical to prioritize increased funding and research focus on culturally tailored instrument development, interventions, and policy initiatives informed by recent findings to safeguard this population from hate crimes and discrimination. [Journal of Psychosocial Nursing and Mental Health Services, 62(7), 11-15.].