Nursing Research最新文献

{"title":"Illness Perception Mediation and Disease Characteristics Moderation of the Relationship Between Health Literacy and Self-Care Behaviors in Chronic Kidney Disease.","authors":"Chia Chu Chang, Ruey Hsia Wang, Yueh Ying Lo, Kuan Pin Lin","doi":"10.1097/NNR.0000000000000953","DOIUrl":"https://doi.org/10.1097/NNR.0000000000000953","url":null,"abstract":"<p><strong>Background: </strong>Health literacy (HL) is widely recognized as a determinant of self-care behaviors in chronic kidney disease (CKD). Grounded in the Common-Sense Model of Self-Regulation, illness perception may serve as a cognitive intermediary in this relationship, yet which specific dimensions carry this role in CKD remains unclear.</p><p><strong>Objective: </strong>This study examined the mediating roles of illness perception dimensions in the relationship between CKD-specific HL and self-care behaviors and explored how demographic and disease characteristics moderated this pathway.</p><p><strong>Methods: </strong>We conducted a cross-sectional study among 235 adults with CKD stage 3 or higher, recruited from the nephrology outpatient department of a regional hospital in central Taiwan. Participants completed validated measures of CKD-specific HL, illness perception across seven dimensions, and self-care behaviors. We performed mediation and moderated mediation analyses with 5,000 bootstrap samples.</p><p><strong>Results: </strong>HL was linked to three of the seven illness perception dimensions, namely timeline acute/chronic, personal control, and treatment control, while four dimensions-timeline cyclical, personal control, treatment control, and illness coherence-were related to self-care behaviors. Treatment control was the only dimension that mediated the relationship between HL and self-care behaviors; the other three dimensions did not. CKD duration moderated this mediating pathway. The indirect association between HL and self-care behaviors through treatment control was present among patients with shorter CKD duration but weakened and became non-significant as CKD duration increased.</p><p><strong>Discussion: </strong>Treatment control may be an important cognitive pathway linking HL to self-care in CKD. This pathway appeared more evident among patients with shorter disease duration, suggesting that HL-based support may be particularly useful when patients are still developing their understanding of CKD and confidence in treatment. For patients with a longer illness history, self-care support may need to move beyond information provision and address treatment confidence and the challenges of long-term disease management.</p>","PeriodicalId":49723,"journal":{"name":"Nursing Research","volume":" ","pages":""},"PeriodicalIF":2.5,"publicationDate":"2026-10-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149128825","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Demonstration of Conceptual and Statistical Assumptions of Causal Mediation.","authors":"Heather L Smyth, Angela D Bryan, Sarah J Schmiege","doi":"10.1097/NNR.0000000000000950","DOIUrl":"https://doi.org/10.1097/NNR.0000000000000950","url":null,"abstract":"<p><strong>Background: </strong>Mediation analysis has a long history, with numerous examples of mediation being tested in clinical trials and observational studies. Mediation analysis focuses on outcome mechanisms, providing a lens for understanding the why behind clinical outcomes. While mediation is a statistical method, it is as much, if not more, about study design, assumptions, and conceptual underpinnings. Several authors have already provided excellent summaries of the state of the science of mediation in nursing research and statistical tutorials; however, barriers remain to adopting robust mediation methods.</p><p><strong>Objectives: </strong>Provide an accessible introduction to causal mediation, encourage research designs that incorporate principles of causal inference, and provide a straightforward explanation of the assumptions inherent in study design and statistical modeling in causal mediation.</p><p><strong>Methods: </strong>We first review causal mediation assumptions, including practical examples relevant to nursing. Then we walk through an example demonstration of assumptions in the context of one of our own studies. We conclude with a pragmatic discussion of common considerations when incorporating mediation into a study design.</p><p><strong>Results: </strong>Through the illustrative example, we demonstrate how to evaluate core assumptions of causal mediation in practice and how design decisions influence the plausibility of meeting them. The example serves as a practical template for applying causal mediation concepts in nursing research.</p><p><strong>Discussion: </strong>The quality of causal inference in mediation analysis depends on research design as much as it does on statistical sophistication. Mediation analysis is most powerful when researchers treat its causal assumptions as design principles rather than technical add-ons. No amount of post-hoc statistical adjustment can fully compensate for weaknesses in measurement, temporality, or study conceptualization.</p>","PeriodicalId":49723,"journal":{"name":"Nursing Research","volume":" ","pages":""},"PeriodicalIF":2.5,"publicationDate":"2026-09-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149031708","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Sample Size Justification in Quantitative Research.","authors":"Alicja Rogusz","doi":"10.1097/NNR.0000000000000949","DOIUrl":"https://doi.org/10.1097/NNR.0000000000000949","url":null,"abstract":"<p><strong>Background: </strong>Sample-size justification remains a central element of quantitative research, yet classical a priori power analysis is frequently applied to designs for which it is neither required nor conceptually appropriate. When power calculations are used indiscriminately, they may misalign with the aims of studies that do not need them. This poses challenges for researchers and student nurses, particularly those without specialist training in statistics, and can lead to methodological inconsistencies across the published nursing literature.</p><p><strong>Objectives: </strong>In this paper, I aim to clarify how sample-size justification can be aligned with study purpose and to describe design-appropriate alternatives to traditional hypothesis-testing power analysis in common, non-inferential nursing studies.</p><p><strong>Methods: </strong>This conceptual discussion of the methodological and statistical literature examines the assumptions underlying classical power analysis and identifies study designs in which these assumptions may not hold. The discussion groups commonly use quantitative designs by primary purpose and presents alternative justification frameworks.</p><p><strong>Results: </strong>Part A illustrates common research contexts in which traditional power analysis may not be appropriate and presents the methodological rationale for alternative approaches to sample-size justification. In Part B, alternative approaches are presented, such as confidence-interval precision planning and detectable-effect reporting that offer more coherent and transparent approaches to sample-size reasoning. A summary table provides practical sample-size calculation guide with examples. Part C contains a practice experience reflection.</p><p><strong>Discussion: </strong>Aligning sample-size justification with the methodological purpose of the study strengthens transparency, improves conceptual coherence, and enhances ethical accountability. Misapplication of power analysis can lead to unstable effect-size estimates, misinterpretation, and inefficient use of research resources. A design-specific approach can therefore help maintain methodological rigor across quantitative nursing research.</p>","PeriodicalId":49723,"journal":{"name":"Nursing Research","volume":" ","pages":""},"PeriodicalIF":2.5,"publicationDate":"2026-09-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149041791","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Collaborative Biostatistics as Methodological Leadership in Nursing Team Science.","authors":"Sarah J Schmiege, Todd A Schwartz, Deanna J Marriott, Matthew J Hayat","doi":"10.1097/NNR.0000000000000947","DOIUrl":"https://doi.org/10.1097/NNR.0000000000000947","url":null,"abstract":"","PeriodicalId":49723,"journal":{"name":"Nursing Research","volume":" ","pages":""},"PeriodicalIF":2.5,"publicationDate":"2026-09-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149018462","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Building Capacity for Statistical Rigor in a College of Nursing.","authors":"Ruofei Du, Matthew J Hayat, Jing Jin, Nikolas Berardi, Hannah Aston, Judith L Weber","doi":"10.1097/NNR.0000000000000948","DOIUrl":"https://doi.org/10.1097/NNR.0000000000000948","url":null,"abstract":"<p><strong>Background: </strong>Nursing research faces persistent challenges in selecting and implementing methodological approaches that adequately address the complexity of research questions in nursing science, underscoring the need for structured biostatistical collaboration to enhance rigor and reproducibility.</p><p><strong>Objective: </strong>This article describes a collaboration model designed to build biostatistical capacity within a College of Nursing.</p><p><strong>Methods: </strong>Developed under the leadership of the Associate Dean for Research, the model incorporates coordinated access to external biostatistical expertise alongside an integrated research management team. The committee's structure, operational systems, and core activities were described on how they effectively support and sustain collaboration across the research lifecycle.</p><p><strong>Results: </strong>Outcomes from the first five years of experience were summarized, including grant activity and scholarly productivity. In addition, survey feedback collected from faculty and PhD students indicated strong engagement at various of research stages and high perceived value of the biostatistical resource.</p><p><strong>Discussion: </strong>The collaboration model offers a feasible, mission-aligned alternative to centralized university cores, or biostatistics cores housed within a college of nursing, commonly found in many U.S institutions. By combining strategic leadership with coordinated external expertise and operational infrastructure, the model strengthens statistical rigor while remaining adaptable to the needs of a college of nursing. Key areas for future development include expanding funding support for educational efforts, strengthening research culture, and exploring the committee's role in supporting practice and education scholarship.</p>","PeriodicalId":49723,"journal":{"name":"Nursing Research","volume":" ","pages":""},"PeriodicalIF":2.5,"publicationDate":"2026-09-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149018516","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Review of Protection Against Bots and Fraudulent Survey Submissions in Nursing Researchs.","authors":"John R Blakeman, Sandra Nielsen, Ann L Eckhardt, Caitlin M McCarthy, MyoungJin Kim","doi":"10.1097/NNR.0000000000000909","DOIUrl":"10.1097/NNR.0000000000000909","url":null,"abstract":"<p><strong>Background: </strong>Online survey-based research is common in nursing, but potentially fraudulent responses (e.g., bots or bad actors) threaten the validity of the data obtained from these studies.</p><p><strong>Objectives: </strong>The purpose of this methods paper was to quantify and describe the extent to which nursing investigators have protected against fraudulent submissions in online, survey-based research studies.</p><p><strong>Methods: </strong>A random sample of articles published in nursing journals and reporting the results of online, survey-based research was obtained from PubMed in June 2024. Each article was audited using a standardized audit matrix.</p><p><strong>Results: </strong>The included articles ( n = 132) were published in 51 unique journals and involved 56,159 participants. Studies were primarily cross-sectional and conducted worldwide, with most originating in the United States, multiple nations, or China. Investigators mentioned screening for response validity in only 21 articles; fewer explicitly described the screening processes used. Screening strategies included reviewing open-ended responses, checking for response-set biases, reviewing completion times, using computer-assisted tools, and examining responses for implausible values. In all cases where a potentially fraudulent response was identified, investigators excluded the response from analysis. There was no significant difference in the frequency of fraud screening across journal impact factor tertiles.</p><p><strong>Discussion: </strong>Fraudulent responses are an ever-present problem in survey research. The articles examined did not routinely report strategies for detecting potentially fraudulent responses or protecting data quality. Published online, survey-based studies that include methods for detecting fraudulent responses enhance reader confidence. Investigators are encouraged to develop an a priori data analysis plan that includes multiple means to identify and eliminate, or otherwise, process fraudulent responses. We suggest that investigators transparently detail the use of a standard checklist for online survey research, in addition to the Fraud detection strategies, Recruitment, Incentive, Excluded responses, Data collection (FRIED) checklist we propose in this article.</p>","PeriodicalId":49723,"journal":{"name":"Nursing Research","volume":" ","pages":"388-394"},"PeriodicalIF":2.5,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147534134","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Moderating Effects of Dementia on Health Outcomes in Dyads of Older Adults and Family Caregivers.","authors":"Cristina B de Rosa, Tania T Von Visger, Christopher Barrick, Weijun Wang, Yu-Ping Chang","doi":"10.1097/NNR.0000000000000920","DOIUrl":"10.1097/NNR.0000000000000920","url":null,"abstract":"<p><strong>Background: </strong>While both older adults receiving assistance with daily living tasks for health or functioning reasons and the family members or kin-like friends who help them are affected by the context of caregiving, little is known about how their interactions might simultaneously affect each other's well-being.</p><p><strong>Objective: </strong>This study aimed to determine the influence of intrapersonal factors on health outcomes for dyads of older adults and their family caregivers and to examine the moderating effect of dementia status on these associations.</p><p><strong>Methods: </strong>Cross-sectional dyadic data were obtained from the National Health and Aging Trends Study (NHATS; Round 12, 2022) linked to the National Study of Caregiving (NSOC; IV, 2022), yielding a sample of 1,560 older adults paired with their respective primary family caregiver, defined as the person providing the greatest number of hours of care. A series of actor-partner interdependence models (APIMs), which statistically account for nonindependent observations, examined associations between older adults' and caregivers' positive affect, negative affect, and self-realization on both their own and each other's mental health (depression and anxiety) and perceived general health. A second series of APIMs explored interactions between predictors and the dementia status of the care recipient. All models controlled for dyad members' own age, gender, race/ethnicity, and dementia status.</p><p><strong>Results: </strong>Dyad members' positive affect, negative affect, and self-realization were significantly associated with their own depression, anxiety, and perceived general health. In addition, caregivers' negative mood was associated with their care recipients' symptoms of depression, and older adults' self-realization was associated with their caregivers' perceived general health. Dementia status of the older adult was also found to moderate the relationship between older adults' positive affect and their own depression. Probing revealed that this relationship was stronger for older adults with dementia than for those without dementia.</p><p><strong>Discussion: </strong>Considering caregiving dyads together provides a more holistic perspective. Intrapersonal factors are potentially modifiable aspects of caregiving contexts, and addressing older adults and their family caregivers simultaneously could be synergistically beneficial.</p>","PeriodicalId":49723,"journal":{"name":"Nursing Research","volume":" ","pages":"346-354"},"PeriodicalIF":2.5,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148044444","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Onward: Giving Your Best to Manuscript Reviews.","authors":"Rita H Pickler","doi":"10.1097/NNR.0000000000000917","DOIUrl":"10.1097/NNR.0000000000000917","url":null,"abstract":"","PeriodicalId":49723,"journal":{"name":"Nursing Research","volume":" ","pages":"333-334"},"PeriodicalIF":2.5,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148521360","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Scoping Review of Adolescent Autonomy and Responsibility for Managing Chronic Physical Conditions.","authors":"Elif Isik, Brittany Haynes, Melanie Morton, Nina M Fredland, Safiye Sayma, Jean-Marie Bruzzese","doi":"10.1097/NNR.0000000000000921","DOIUrl":"10.1097/NNR.0000000000000921","url":null,"abstract":"<p><strong>Background: </strong>Adolescents' autonomy is a key developmental milestone. Adolescents rely on active support from parents, nurses, and peers as they transition toward self-managing their chronic health conditions. Gaining insight into how adolescents perceive and practice autonomy is essential for supporting the gradual transfer of disease self-management responsibilities.</p><p><strong>Objectives: </strong>To map and synthesize evidence on adolescents' perceived autonomy and responsibility for self-management of their chronic conditions, including decision-making, goal setting, and actions.</p><p><strong>Methods: </strong>This review followed the Joanna Briggs Institute methodology and was reported in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews guidelines. Searches were conducted in CINAHL, APA PsycARTICLES, PubMed, Nursing and Allied Health, Scopus, and Embase without publication date limits, yielding studies published between 2002 and 2024. A total of 4,738 studies were imported into Covidence for screening. Results were analyzed using inductive content analysis.</p><p><strong>Results: </strong>The review included 30 articles. Four main categories were identified related to how adolescents perceive autonomy and progressively assume, exercise, and sustain responsibility for their daily care and self-management: (a) navigating responsibility transfer and regression; (b) communication and support for readiness; (c) emotional turmoil and identity adaptation; and (d) emerging autonomy in action.</p><p><strong>Discussion: </strong>Acquiring self-management skills introduces a growing complexity of effectively monitoring symptoms, adhering to treatments and medication regimens, acquiring dexterity for interventions, and action planning. Nurses play a vital role in assessing adolescents' readiness for autonomy based on developmental maturity and health literacy rather than age alone, while actively involving them in care decisions to foster confidence and a gradual assumption of self-management responsibilities.</p>","PeriodicalId":49723,"journal":{"name":"Nursing Research","volume":" ","pages":"407-419"},"PeriodicalIF":2.5,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13329876/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148044431","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Perceived Family Support and Treatment Adherence in Older Adults With Type 2 Diabetes.","authors":"Simge Kalav, Arife Altin Çetin","doi":"10.1097/NNR.0000000000000914","DOIUrl":"10.1097/NNR.0000000000000914","url":null,"abstract":"<p><strong>Background: </strong>Evidence regarding the association between family support and treatment adherence among older adults with type 2 diabetes (T2D) remains limited.</p><p><strong>Objectives: </strong>The purpose of this study was to examine the association between perceived family support and treatment adherence among older adults with T2D.</p><p><strong>Methods: </strong>This cross-sectional study included 233 older adults with T2D from an endocrinology outpatient clinic in southern Turkey. Data were collected using a personal information form, Hensarling's Diabetes Family Support Scale (HDFSS), and the Type 2 Diabetes Mellitus Treatment Patient Compliance Scale.</p><p><strong>Results: </strong>Older adults with T2D reported moderate-to-high levels of perceived family support, alongside moderate overall patient compliance. Some participants reported T2D-related complications and a history of hospitalization. Regression analysis indicated that the model accounted for a substantial proportion of the variance in patient adherence. Although total HDFSS was not significantly associated with compliance, the encouragement subscale showed a positive association, whereas the facilitative support subscale showed a negative association with patient compliance.</p><p><strong>Discussion: </strong>The results highlighted that facilitative support was associated with better treatment adherence among older adults, suggesting the importance of considering patient-centered and family-centered approaches in diabetes care. Encouraging initiatives, when carried out entirely under family control, seemed to be linked to lower self-management skills among older adults.</p>","PeriodicalId":49723,"journal":{"name":"Nursing Research","volume":" ","pages":"E251-E259"},"PeriodicalIF":2.5,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147787330","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}