Implications For Nursing Practice Research Articles

Teaching Sensitive Subjects Online: Lessons Learnt From the Pandemic and the Implications for Contemporary Nurse Education

BackgroundCovid 19 and the associated restrictions necessitated for an abrupt change to the way education was provided to nursing students . AimsThis study aims to explore the views/opinions of third year children's nursing students and nurse educators of an online learning approach regarding children's palliative care during a global pandemic. MethodsData were collected via an online questionnaire with nursing students and a reflective diary with nurse educators. FindingsCovid-19 and the associated restrictions had a significant impact on students and academics learning and teaching experiences. This small scale study gave insights into practices when teaching sensitive subjects to students on line. Whilst more blended teaching is likely to be used in the future, we highlight the range of support that can be offered to students which has implications for contemporary nursing practice. ConclusionWhilst students and academics prefer face-to-face delivery for sensitive topics such as children's palliative care, achieving a true ‘blend’ through asynchronous and synchronous learning can enable a quality learning experience. Consideration needs to be given to provision of emotional and practical support for students and academics.

The impact of cognitive fusion on stress among nurses: Exploring gender as a moderator controlling for depressive symptoms.

To investigate the influence of cognitive fusion on stress among nurses, with a focus on exploring gender as a moderator among Jordanian nurses controlling for depressive symptoms. Stress is a significant concern among healthcare workers, particularly nurses, given the escalating work demands and organizational constraints. Data were collected from 206 nurses using a cross-sectional design. Participants completed surveys that included measures for cognitive fusion, stress, and depressive symptoms. Statistical analysis included bivariate correlations, independent sample t-tests, and moderation analysis using Hayes PROCESS. The results were reported using The Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) guidelines. The findings revealed a moderate correlation among stress, cognitive fusion, and depressive symptoms. The regression model explained 42% of the variance in stress, with significant contributions from cognitive fusion, gender, depressive symptoms, and the interaction between cognitive fusion and gender. Gender moderated the relationship between cognitive fusion and stress, indicating differential effects for males and females. This study underscores the importance of cognitive fusion in understanding and managing stress among nurses. The moderating effect of gender highlights the need for tailored interventions. Reducing stress among nurses may benefit their mental health and potentially enhance patient care and treatment outcomes. IMPLICATIONS FORNURSING PRACTICE AND POLICY: The study highlights crucial implications for nursing policy. Addressing cognitive fusion is vital to reducing nurse stress, directly impacting patient care quality and healthcare outcomes. Policymakers should prioritize gender-aware strategies within nursing policies, fostering a less stressful and more supportive work environment. By doing so, healthcare institutions can enhance the well-being of nurses and ultimately improve patient care, aligning with broader healthcare policy objectives of patient safety and quality improvement.

The Effect of Gastrointestinal Mucositis Care Training Given to Pediatric Leukemic Patients and Caregivers on Mucosal Barrier Injury

Background Management of chemotherapy-induced mucosal barrier damage and oral/anal mucositis in leukemia is challenging. Objective The aim of this study was to investigate the effect of mucositis care training given to children receiving leukemia treatment and their caregivers on caregiver knowledge and skills, the development of gastrointestinal mucositis in children, the mean oral mucositis area in children, and the mucosal barrier injury laboratory-confirmed bloodstream infection in the clinic. Methods A stepped-wedge, quasi-experimental, unpaired control group design was used. The participants in the control group were given routine training, and the intervention group members were given mucositis care training in accordance with the guideline recommendations. Results No significant difference was found between groups in developing anal mucositis, but a significant difference in developing oral mucositis was documented, with the mean mucositis area of children being 8.36 ± 3.97 cm2 in the control group and 4.66 ± 2.90 cm2 in the intervention group. The mucosal barrier injury laboratory-confirmed bloodstream infection ratio was 4 per 1000 catheter days in the control group and 3 per 1000 catheter days in the intervention group. Conclusion Mucositis care training had a significant positive effect on caregivers’ knowledge and skills, the development of oral mucositis, and the mean oral mucositis area in children. However, the training had no effect on the development of anal mucositis or the infection rate in the clinic. Implications for Practice Nurses might increase the knowledge and skill levels of caregivers with training on mucositis care, prevent the development of mucositis, and reduce the mean mucositis area. Training might also contribute to the reduction in the infection rate of the clinic.

Public School Nurses in the United States: National School Nurse Workforce Study 2.0.

The National School Nurse Workforce Study 2.0 describes the demographic characteristics and distribution patterns, school nursing models and activities, and practice environment among self-reported public school nurses in the United States. A random sample of U.S. public schools was surveyed, stratified by region, school level, and urban/rural locale. A total of 2,827 schools responded, yielding a 38.1% response rate. Using these data, we estimate 78,869 full-time equivalents of school nurses, with 65,052 registered nurses (RN) and 13,817 licensed practical/vocational nurses (LPN/LVN). Findings indicate school nurse distribution differences by region, locale, and income. The predominant model of school nursing practice was the RN only, followed by the RN and LPN model. In general, school nurse respondents felt supported by school staff and parents. Less than half of survey respondents stated they were supervised by an RN. Research, policy, and school nursing practice implications are discussed.

Academic-practice partnerships in evidence-based nursing practice: A theory-guided scoping review.

Academic-practice partnerships have the potential to solve many challenges in evidence-based nursing practice which is crucial for high-quality care. To identify the existing knowledge on academic-practice partnerships in evidence-based nursing practice. We conducted this review following the Joanna Briggs Institute scoping review methodology. We performed a comprehensive literature search of nine databases as well as five websites for gray literature. Two researchers independently conducted literature screening and data extraction and analysis. A third researcher was involved when needed. Dedicated time, dedicated resources, and compatible goals were found to be the top three inputs in academic-practice partnerships for evidence-based nursing practice. Meeting and discussion were the most popular forms of activities. Sufficient resources were the most important facilitators. Insufficient resources, insufficient time, and communication issues were the top three barriers. The assumption proposed in the practice-academic partnership logic model (i.e., inputs plus activities can lead to outputs and outcomes) was preliminarily verified by the results of this review in the context of evidence-based nursing practice. Academic-practice partnerships can leverage the advantages of both sides to overcome barriers and promote evidence-based nursing practice. However, it is essential to conduct a broader range of high-quality studies. Such endeavors could offer more comprehensive evidence for refining the framework of academic-practice partnerships in evidence-based nursing practice. IMPLICATIONS FOR NURSING EDUCATION, PRACTICE, POLICY AND RESEARCH: The "theoretical framework of academic-practice partnerships in evidence-based nursing practice" could theoretically guide academic and clinical nursing staff to collaborate on evidence-based nursing practice and related research and education programs. The academic-practice partnerships in evidence-based nursing practice could lead to a win-win situation for both the academic and the clinical sides. Furthermore, the results of this study provide an evidence-based foundation for policymakers to develop supportive policies for academic-practice partnerships in evidence-based nursing practice.

Problematic Sexualized Behavior in Children: Essentials for the Pediatric Forensic Nurse.

Problematic sexual behavior (PSB) in children and adolescents is a significant public health problem. PSB is defined as harmful or developmentally inappropriate behaviors involving sexual organs or regions of the body exhibited by children or adolescents. PSB may be harmful to self or others or be abusive toward another child, adolescent, or adult. Adolescents, typically defined as children 12 years old or older, engaging in PSB can be vulnerable to formal court adjudication as their behaviors may be considered a sexual offense. PSB can result in significant negative consequences for all children and adolescents involved as well as their families. This article will describe sexual behavior in children, normative and problematic, and explore implications for forensic nursing practice.

The Mediating Effect of Hope Level Between Social Support and Benefit Finding in Patients With Advanced Lung Cancer

Background As a protective factor, social support can influence benefit finding (BF) in patients with advanced lung cancer. However, the mechanism through which social support affects BF is controversial. Objective To investigate the factors influencing BF in patients with advanced lung cancer and the role of hope level in mediating the relationship between social support and BF. Methods This was a cross-sectional study. From September 2022 to March 2023, 286 participants completed the Social Support Rating Scale, Herth Hope Index, and Benefit Finding Scale. Data analysis included correlation analyses and multiple stepwise regression analysis; the SPSS PROCESS program was used to determine the significance of mediating effects. Results Social support and hope level were positively associated with BF. Monthly per-capita household income, social support and hope level entered the final regression model and explained 50.7% of BF variance. Social support’s direct and indirect effects on BF were significant (P < .05), suggesting that hope level partially mediated the relationship between social support and BF. Conclusion Our findings validate a positive association between social support and BF in patients with advanced lung cancer. The hope level as a mediating variable provided the impetus for their BF. Implications for practice Nurses should implement necessary interventions to help patients with advanced lung cancer carry out protective resources and coping strategies to facilitate their BF.

The effect of structured health promotion education given to adolescents on health literacy and health-promoting behaviors

PurposeThis study was conducted to determine the effect of structured health promotion education given to adolescents on health literacy and health promotion level. Design and methodsThe research was designed according to the pretest-posttest control group model and conducted using the quasi-experimental method. The population of the study consisted of students studying in the 6th, 7th, and 8th grades of a secondary school. A total of 191 students were assigned to the intervention group and the control group. The data were collected using the Sociodemographic Characteristics Form, the Adolescent Health Promotion Scale, and the School Age Health Literacy Scale. Structured Health Promotion Education consisting of six modules was given to the intervention group. The control group did not receive any intervention. ResultsOf the students, 33.9% were in the 8th grade, 76.6% were born in Turkey, 31.6% had a father and mother who were secondary school graduates, 72.5% were from moderate-income families, and 83% had no chronic health problems. The groups' health literacy and adolescent health-promoting behaviors pretest mean scores before the intervention were homogeneous (p > 0.05). There was a significant difference between the groups' health literacy and adolescent health-promoting behaviors posttest mean scores after the intervention (p < 0.05). ConclusionsWhile structured health promotion education was found to increase health literacy and health-promoting behaviors, nutrition, stress management, life satisfaction, and health responsibility behaviors in adolescents, it did not affect social support and exercise behaviors. Implications for practiceNurses should provide training to increase students' health literacy and health-promoting behaviors.

Identification of Core Symptom Cluster in Patients With Digestive Cancer: A Network Analysis.

A lack of identified core symptom clusters in digestive cancer patients hinders achieving precision symptom intervention. There are few studies on identifying digestive cancer symptom clusters based on network analysis. The aims of this study were to construct the symptom network of digestive cancer patients and identify the core symptom cluster. A cross-sectional study was conducted among 202 digestive cancer patients. The Chinese version of the MD Anderson Symptom Inventory for gastrointestinal cancer scale was used to assess the symptoms by convenience sampling. R software was used to construct a symptom network and identify core symptom clusters. Edge weight and centrality difference tests were used to test the accuracy of core symptom cluster identification. The most common symptoms were distress, poor appetite, and sadness. The most serious symptoms were poor appetite, disturbed sleep, and fatigue. The core symptom cluster of the psychoemotional symptom group was distress, sadness, and numbness. The centrality index showed that the top 3 in strength were distress (Rs = 1.11), fatigue (Rs = 1.09), and sadness (Rs = 1.04). The edge weight difference test showed that the psychoemotional symptom group had high stability. The psychoemotional symptoms of digestive cancer patients should be given priority for intervention. Network analysis must be extended to the symptom research of cancer patients as soon as possible to provide a scientific basis for symptom management. Nurses must perform comprehensive psychological and emotional assessments, initiate referrals for psychoemotional symptom management and psychological services, and administer pharmacologic and nonpharmacologic interventions to improve appetite loss in digestive cancer patients.

Experiences and Perceptions of Patients with Oxaliplatin-Induced Cold Sensitivity in Turkey: A Qualitative Study

This study aimed to explore and describe the impact on patients with oxaliplatin-induced cold sensitivity in the early stages. An inductive design was used for this qualitative study, which included open-ended, and in-depth interviews with 18 cancer patients. Throughout the study, the authors followed the COREQ checklist. The interviews were audiorecorded and listened to multiple times. Observation notes were also recorded following each interview. Thematic analysis developed six main themes and 13 subthemes. The first theme concerns changing habits, including changes in fluid intake and clothing choice, changes in bathing and eating habits, and changes in caregiver roles. The second theme includes changes in daily routine behaviors that are perceived as difficulties with changing routines. The third theme is avoiding triggers; the fourth theme is anxiety about self-care. The fifth theme includes a subtheme of difficulty in contact. The final theme includes adaptation to life, caring responsibilities, changes in sexual functions, the performance of religious activities, and social activities IMPLICATIONS FOR NURSING PRACTICE: This study provides an overview of the lived experiences of oxaliplatin-induced cold sensitivity among cancer patients. Patients faced fewer adverse events by avoiding initiators from the first treatment. They changed their eating and drinking habits owing to difficulties. The findings of this study can be used to better understand oxaliplatin-induced cold sensitivity, identify patients needs based on their experience, and develop interventions to improve patient outcomes.

Obesity-related hypertension: Implications for advanced nursing practice.

Obesity-related hypertension: Implications for advanced nursing practice.

Obesity-related hypertension: Implications for advanced nursing practice.

Obesity increases the risk of hypertension and other cardiometabolic comorbidities. Lifestyle modifications are usually recommended, though lasting effects on weight and BP reduction are limited. Weight-loss medications, especially incretin mimetics, are effective for short- and long-term treatment. Metabolic surgery provides cure of obesity-related hypertension in some patients. NPs are well positioned to manage obesity-related hypertension to improve clinical outcomes of affected individuals.

Prescription psychostimulants as a harm reduction and treatment intervention for methamphetamine use disorder and the implications for nursing clinical practice: A scoping review of the literature.

The global rise in methamphetamine use and its negative effects warrants the need for research exploring harm reduction and treatment interventions for individuals with methamphetamine use disorder. Agonist medications have been utilized for years for the treatment of heroin and opioid addiction, but have yet to be incorporated into mainstream Canadian practice for methamphetamine dependence. This review aims to provide an overview of the current trends of prescription psychostimulant usage for individuals with methamphetamine use disorder from a Canadian perspective, identifies the barriers to accessing prescription psychostimulants for methamphetamine use disorder and highlights the nursing clinical practice implications in caring for individuals with the disorder. Discourse on the sustained abstinence and harm reduction debate is presented from the perspective of methamphetamine abuse is provided along with the neuropsychiatric complications of chronic methamphetamine use. The impacts of specific prescription psychostimulants on cognition are discussed as is the use of neuroimaging techniques to assess neuronal damage in methamphetamine users. Sign of toxicity, overdose and the contraindications for use of these prescription psychostimulants is also presented. The implications to nursing clinical practice in caring for this population is provided, touching on the clinical presentation of methamphetamine use, completing thorough assessment and screening and patient education. The findings of this review indicate the need for further research in this area exploring the benefits of prescription psychostimulants as a harm reduction and treatment intervention for the global problem of methamphetamine dependence.

Posttraumatic Growth in Women Who Have Experienced Intimate Partner Abuse.

The purpose of the current qualitative descriptive study was to describe the experiences of women who have endured intimate partner abuse using the theoretical framework of posttraumatic growth (PTG). Women (N = 14) who reported emotional and/or physical abuse by their male partners were interviewed. Five themes were identified: Acknowledging the Abusive Relationship; Fear of Him: Threats, Control, Pain, and Isolation; Accepting Support: Grabbing the Life Preserver; Rediscovering Myself: Digging Deep; and Appreciating Life and Helping Others. Findings have practical implications for nurses who are in pivotal positions to educate and influence others about the possibility of PTG following partner abuse. Nurses can help women find their way through this trauma and teach others about coping, healing, and recovery. [Journal of Psychosocial Nursing and Mental Health Services, 61(8), 34-41.].

Breast Cancer Survivors' Experiences of Acceptance Following Recurrence: A Qualitative Content Analysis.

Breast cancer recurrence is a traumatic event for patients, and its treatment depends on the patient's ability to accept the circumstances. The aim of this study was to explore how patients experience breast cancer recurrence and go through a process of negotiating acceptance. This study explored the experiences of 16 patients with breast cancer recurrence regarding the acceptance of recurrence in a hospital in Tehran, Iran. Purposive sampling with maximum diversity was used. Data were collected through semistructured telephone interviews from November 2020 to November 2021 and analyzed using the qualitative content analysis. Four themes emerged that described the process of accepting cancer recurrence: (1) response to recurrence (emotional reactions and loss of trust); (2) psychological preparedness (confirmation of medical diagnosis and acceptance of fate); (3) mobilizing supports (using spiritual capacities, utilizing supportive resources, and seeking relationships to promote knowledge); and (4) return to the path of treatment (rebuilding trust and continuation of treatment). The acceptance of breast cancer recurrence is a process that begins with emotional reactions and ends with returning to the treatment path. The patient's psychological preparation, support systems, behavior of healthcare providers, and rebuilding trust are the determining factors in acceptance of recurrence. Nurses can compensate for the failures created in the primary treatment of breast cancer by spending time with patients and paying attention to their concerns, providing effective education, strengthening communication between patients with similar conditions and using the spiritual capacities of patients, and mobilizing the support of family and relatives.

Work stress among physicians, dubai health authority, in the year 2018-2019

Background: Work stress is a significant problem that affects physicians. Multiple sources can contribute to this problem. High-stress rates among physicians can manifest in various expressions, including cognitive, behavioral, and somatic expressions. Work performance and quality of medical care administered to patients can be undermined by over-stressed physicians. The study aimed to assess the prevalence of stress among physicians working in governmental health facilities in Dubai (2018-2019) and their relationship with socio-demographic and job factors. Methods: It is a cross-sectional study. This study population includes all physicians practicing in Dubai Health Authority hospitals and primary health care centers in the Year 2018-2019. Target Number is 1337 taken from the registry of Dubai health authority administration, but only 668 questionnaires were included with a RR of 49.9%. The data tool used in this study is a modified self-administered questionnaire from both validated health and safety executive (Barbaranelli et al., 2018) occupational stress and stress questionnaire by International Stress Management Association UK 2013. It consists of 22 items which were divided into demographic, stress indicators, factors, and other domains. They were distributed as hard copies by hand. Findings: The study concluded that 40.2% were more likely to experience stress, while 59.8% were most prone to stress. Furthermore, the study showed a strong association with different factors such as the role of managers, shift duty, and multi-task work. Conclusion: Work stress is a prevalent problem among physicians working at Dubai health authority. The stress is associated with factors: such as multi-task work, shift hours’ duties, time pressure, and the role of line manager. Implications for Occupational Health Nursing Practice or Implications for Occupational Health Practice: Healthier working environment will promote the well-being of its staff and ensure the proper delivery of care to the community.

Cultural Adaptation of the Younger Women's Wellness After Cancer Program for Younger Chinese Women With Breast Cancer: A Pilot Randomized Controlled Trial.

The incidence of breast cancer in younger women, that is, aged 50 years or younger, in Hong Kong is increasing. The Internet-based Younger Women's Wellness After Cancer Program (YWWACP) is a whole-lifestyle intervention that can help young women to manage their health and risks of chronic diseases. The study aimed to test the acceptability and feasibility of the culturally adapted YWWACP in Hong Kong (YWWACPHK) and to evaluate its preliminary effects in improving health-related quality of life, distress, sexual function, menopausal symptoms, dietary intake, physical activity, and sleep among younger Chinese women with breast cancer. Women aged 18 to 50 years with breast cancer were recruited from an oncology outpatient department. The participants in the intervention group received the 12-week YWWACPHK, whereas the control group received standard care. Sixty women consented to participate. At 12 weeks after intervention completion, the intervention group showed a significant increase in the pain subscale scores of sexual function and more improvement in the level of physical activity than the control group, with Hedge g effect sizes 0.66 and 0.65, respectively. Nineteen intervention group participants reported that they were satisfied with the program and suggestions for improvement were provided. The implementation of YWWACPHK is feasible. The preliminary findings suggest that YWWACPHK could increase the level of physical activity among the participants. Nurses could utilize YWWACPHK to support younger Chinese patients with breast cancer to maintain a healthy lifestyle, subject to wider confirmation of these results through a larger study.

The impact of a web-based mind map learning technique on students' nursing knowledge of the nursing process.

This research aims to investigate the effects of web-based mind map learning techniques in the nursing process on students' ability to investigate the nursing diagnosis, descriptive characteristics, and the etiological and risk factors. In this experimental study, 91 nursing students enrolled in a state university in a city in Turkey in the 2020-2021 academic year were included. Data were collected using a test for determining the level of knowledge about the nursing diagnosis and the factors affecting the diagnosis, case sample, and care plan. In the teaching of the nursing process, the experimental group students (n = 42) experienced the web-based mind map learning technique, while the control group students (n = 49) experienced the lecture and question-answer teaching methods. The mean scores of the experimental group in terms of reaching the nursing diagnosis, descriptive characteristics, and the etiological and risk factors were significantly higher than the control group (p < 0.05). The findings showed that the experimental group scored significantly higher than the control group in making accurate diagnoses (p < 0.05). The web-based mind map learning technique used in teaching the nursing process favorably affected the students' ability to determine the nursing diagnosis, descriptive characteristics, and etiological and risk factors. The findings suggest that the web-based mind map learning technique should be used in teaching the nursing process. Active learning in nursing process teaching should be promoted using different teaching techniques. Teaching the nursing process with different teaching techniques has the potential to to increase the knowledge and skills of students and thus improve the quality of nursing care.

Adolescent Perspectives in Eastern Indonesia on Social Motivation in Alcohol Consumption: A Qualitative Study

Introduction: Alcohol consumption among teenagers is a significant public health issue on a global scale. However, the levels of alcohol consumption among teenagers and their understanding of its impact on human health are still relatively poorly documented in various regions of Indonesia, especially among teenagers in the eastern regions of Indonesia. Objective: This research aims to comprehend the social motivations driving alcohol consumption among teenagers in Eastern Indonesia, identify contributing motivations, and investigate their implications in clinical nursing practice. Method: This study employs a qualitative approach with a descriptive design. The study population consists of teenagers aged 16–17 in the eastern region of Indonesia. Sampling was conducted using the snowball sampling method based on predefined inclusion criteria. The data were gathered through in-depth interviews, recorded using audio recording devices, and supplemented with field notes. Data analysis was carried out using the Colaizzi method, continuing until data saturation was achieved. Result: The research findings reveal a variety of perspectives among East Indonesian teenagers regarding alcohol consumption, including cultural normalization of drinking and youth parties, factors associated with adolescent alcohol consumption, conflicting feelings about alcohol consumption, and alcohol consumption as a symbol of masculinity. Conclusion: This study underscores the importance of a more holistic approach to understanding and addressing alcohol consumption issues among teenagers in Eastern Indonesia. Clinical nursing practice implications involve intensifying health education efforts for adolescents and developing more effective interventions to reduce the risks associated with alcohol consumption among teenagers, particularly in Eastern Indonesia

Relationship between hospitalised older people’s fear of falling and adaptation to old age, quality of life, anxiety and depression

Fear of falling affects older people physically and psychosocially, causing a decrease in their daily activities. The aim of this study was to determine the relationship between fear of falling (FoF) in hospitalised older people and their difficulty in adapting to old age, quality of life, anxiety, depression and other associated factors. This descriptive correlational study was carried out in a university hospital. The sample consisted of 409hospitalised older patients. The data were collected using the Falls Efficacy Scale International, Hospital Anxiety and Depression Scale, Assessment Scale of Adaptation Difficulty for the Elderly (ASADE) and the Adaptation of Quality of LifeScalein Older People (CASP-19). It was found that 74.1% of the older people were found to have high FoF. Five models were created to determine the predictors of FoF, of which Model 5 explained 61% of the total variance (F=42.455, p=.000). Among the independent variables included in Model 5, being a woman (β=-086, 95%CI -3.5 to -0.52, p=.008), having a chronic disease (β=.293, 95% CI 6.3-10.01, p<.001), using a walking aid (β=.152, 95% CI 1.74-5.49, p<.001), CASP-19 autonomy-satisfaction perception (β=-.242, 95% CI 0.33-0.08, p<.001), CASP-19 disability perception (β=-.111, 95% CI 0.58-1.22, p<.001) and the ASADE role and self-actualisation mode (β=.361, 95% CI -0.50 to 0.08, p<.001) were found to be statistically significant predictors of FoF. A large proportion of hospitalised older people tend to have a fear of falling. Being a woman, having a chronic disease, using a walking aid as well as quality of life and difficulty in adapting to old age are the predictors of FoF. Nurses should evaluate the associated psychosocial components in order to reduce the fear of falling among hospitalised older people.