Nursing Research最新文献

{"title":"Longitudinal Fatigue Symptoms and Inflammatory Markers in African American Adults With Hypertension and Obstructive Sleep Apnea.","authors":"Nicholas A Giordano, Madelyn C Houser, Jordan Pelkman, Francisco J Pasquel, Victoria Pak, Ann E Rogers, Katherine A Yeager, Susan Mucha, Matthew Schmitt, Andrew H Miller","doi":"10.1097/NNR.0000000000000779","DOIUrl":"https://doi.org/10.1097/NNR.0000000000000779","url":null,"abstract":"<p><strong>Background: </strong>There is a dearth of research inclusive of African Americans living with obstructive sleep apnea (OSA) despite differences in symptom presentations compared to non-Hispanic White patient populations. Less is known regarding the potential effect of comorbidities, such as hypertension, on commonly reported symptoms, such as fatigue, and their association with inflammatory biomarkers.</p><p><strong>Objective: </strong>This longitudinal pilot study aimed to characterize fatigue symptom presentations among African Americans newly diagnosed with OSA and discern peripheral blood analytes linked to symptoms while accounting for co-occurring hypertension.</p><p><strong>Methods: </strong>Adult African Americans newly diagnosed with OSA with and without co-occurring hypertension were approached by study staff and recruited following their diagnostic visit with sleep medicine clinicians at two health systems and followed over 6 months after commencing continuous positive airway pressure treatment. Patient-Reported Outcomes Measurement Information System Fatigue surveys and plasma were collected every 3 months from 29 participants. Mixed effects models examined changes in fatigue symptom presentations over time while accounting for plasma-based analytes and hypertension status.</p><p><strong>Results: </strong>Despite higher fatigue symptom severity upon diagnosis, participants with co-occurring hypertension reported greater improvements in fatigue scores after commencing continuous positive airway pressure treatment for up to 6 months than those without hypertension. Inverse correlations were observed between fatigue scores, C-reactive protein, matrix-metalloproteinase-8, and osteoprotegerin analyte levels among participants with/without hypertension. Across all participants, changes in interleukin-6 were associated with changes in fatigue scores in the first three months after diagnosis.</p><p><strong>Discussion: </strong>Findings indicate that hypertension is linked to increased fatigue upon diagnosis of OSA in this sample of African Americans. Fatigue in persons with hypertension improved after treatment. These hypothesis-generating findings can inform future interventional studies aimed at improving fatigue among persons with OSA while leveraging markers linked to fatigue symptom severity as potential objective markers of improvements. Further research on the role of inflammatory markers, such as IL-6, on fatigue symptom presentations is warranted in those with OSA regardless of hypertension status.</p>","PeriodicalId":49723,"journal":{"name":"Nursing Research","volume":null,"pages":null},"PeriodicalIF":2.2,"publicationDate":"2024-09-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142331088","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":"Racial and Ethnic Disparities in Emergency Department Use Among Older Adults With Asthma and Primary Care Nurse Practitioner Work Environments.","authors":"Lusine Poghosyan, Jianfang Liu, Eleanor Turi, Kathleen Flandrick, Marcia R Robinson, Maureen George, Grant R Martsolf, J Margo Brooks Carthon, Monica O'Reilly-Jacob","doi":"10.1097/NNR.0000000000000780","DOIUrl":"https://doi.org/10.1097/NNR.0000000000000780","url":null,"abstract":"<p><strong>Background: </strong>Older adults from specific racial and ethnic minoritized groups experience disproportionately higher asthma prevalence, morbidity, and mortality. They also often use emergency departments (EDs) to manage their asthma. High-quality primary care can improve asthma control and prevent ED use. Nurse practitioners (NPs) provide an increasing proportion of primary care to minoritized patients, yet often, they work in poor work environments that strain NP care.</p><p><strong>Objectives: </strong>We examined whether racial and ethnic health disparities in ED visits among older adults with asthma are moderated by the NP work environment in primary care practices.</p><p><strong>Methods: </strong>In 2018-2019, we used a cross-sectional design to collect survey data on NP work environments from 1,244 NPs in six geographically diverse states (i.e., Arizona, California, New Jersey, Pennsylvania, Texas, and Washington). We merged the survey data with 2018 Medicare claims data from 46,658 patients with asthma to assess the associations of all-cause and ambulatory care-sensitive conditions, ED visits with NPs' work environment, and race and ethnicity using logistic regression.</p><p><strong>Results: </strong>More than one third of patients with asthma visited the ED in 1 year, and a quarter of them had an ambulatory care sensitive condition ED visit. Black and Hispanic patients were more likely than White patients to have all-cause and ambulatory care sensitive condition ED visits. NP work environment moderated the association of race with all-cause and ambulatory care sensitive condition ED visits among patients with asthma. Greater standardized NP work environment scores were associated with lower odds of all-cause and ambulatory care sensitive condition ED visits between Black and White patients.</p><p><strong>Discussion: </strong>Disparities in ED visits between Black and White patients with asthma decrease when these patients receive care in care clinics with more favorable NP work environments. Preventing unnecessary ED visits among older adults with asthma is a likely benefit of favorable NP work environments. As the NP workforce grows, creating favorable work environments for NPs in primary care is vital for narrowing the health disparity gap.</p>","PeriodicalId":49723,"journal":{"name":"Nursing Research","volume":null,"pages":null},"PeriodicalIF":2.2,"publicationDate":"2024-09-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142331089","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":"Experiences and Health Outcomes of Emerging Adults with Type 1 Diabetes: A Mixed Methods Study.","authors":"Amani Al Bayrakdar, Houry Puzantian, Samar Noureddine, Huda Abu-Saad Huijer, Mona Nasrallah, Kevin L Joiner, Pamela Martyn-Nemeth, Hala Tfayli","doi":"10.1097/NNR.0000000000000781","DOIUrl":"https://doi.org/10.1097/NNR.0000000000000781","url":null,"abstract":"<p><strong>Background: </strong>Emerging adults with type 1 diabetes are at risk of poorer diabetes-related health outcomes than other age groups. Several factors affecting the health and experiences of the emerging adults are culture and healthcare specific.</p><p><strong>Objectives: </strong>The aim of this study was to explore the experience of emerging adults living with type 1 diabetes in Lebanon, describe their diabetes self-care and diabetes-related health outcomes (HbA1c and diabetes distress), and identify the predictors of these outcomes.</p><p><strong>Methods: </strong>A convergent mixed methods design was used with 90 participants aged 18-29 years. Sociodemographic, clinical data, and measures of diabetes distress, social support, and self-care were collected. Fifteen emerging adults participated in individual semi-structured interviews. Multiple linear regression was used to determine predictors of diabetes outcomes. Thematic analysis was used to analyze qualitative data. Data integration was used to present the mixed methods findings.</p><p><strong>Results: </strong>The study sample had a mean HbA1c of 7.7% (SD = 1.36) and 81.1 % reported moderate to severe diabetes distress levels. The participants had good levels of diabetes self-care and high levels of social support. HbA1c was predicted by insulin treatment type, age at diagnosis, and diabetes self-care; while diabetes distress was predicted by diabetes knowledge, blood glucose monitoring approach, and diabetes self-care. \"Living with type 1 diabetes during emerging adulthood: the complex balance of a chemical reaction\" was the overarching theme of the qualitative data, with three underlying themes: \"Breaking of bonds: changes and taking ownership of their diabetes\", \"The reactants: factors affecting the diabetes experience\", and \"Aiming for equilibrium\". The integrated mixed methods results revealed one divergence between the qualitative and quantitative findings related to the complexity of the effect of received social support.</p><p><strong>Discussion: </strong>The suboptimal health of the emerging adults despite good self-care highlights the importance of addressing cultural and healthcare specific factors such as diabetes knowledge and public awareness, social support, and availability of technology to improve diabetes health. Findings of this study can guide future research, practice, and policy development.</p>","PeriodicalId":49723,"journal":{"name":"Nursing Research","volume":null,"pages":null},"PeriodicalIF":2.2,"publicationDate":"2024-09-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142331087","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":"Designing a Website to Support a Multisite, International Clinical Trial.","authors":"Tracy Ann Pasek, Natalie Napolitano, Amy Cassidy, Laura Beth Kalvas, Martha A Q Curley","doi":"10.1097/NNR.0000000000000775","DOIUrl":"https://doi.org/10.1097/NNR.0000000000000775","url":null,"abstract":"<p><strong>Background: </strong>Safe and reliable implementation of complex study protocols in multisite clinical trials requires that all study personnel have 24/7 access to up-to-date study materials. Study websites can serve as an electronic manual of operations (eMOO) to support trial conduct.</p><p><strong>Objective: </strong>We describe the development, organization, and maintenance of a study website and eMOO to facilitate quick and efficient communication during conduct of a complex, multisite, international clinical trial.</p><p><strong>Methods: </strong>We worked closely with our information technology (IT) department to develop and maintain our study website, which includes a public home page, a section for parents and families, and three password-protected portals that serve as an eMOO for (a) study sites, (b) study site investigators, and (c) the operations team (e.g., clinical coordination center, data coordination center).</p><p><strong>Results: </strong>The public home page is helpful for families contemplating study participation and for nonparticipating sites considering joining our trial. The patient and family education section supports family participation in the study. The study site portal contains all information needed for local study teams to safely manage a study patient. The investigator portal provides access to research-specific materials needed to lead the study at each site. The operations team portal supports overall study management. For other scientists considering use of a study website for their multisite research, we recommend close collaboration with IT for development and maintenance, limited and clearly defined roles for version control, and use of unmodifiable file formats to prevent unapproved alterations of study materials.</p><p><strong>Discussion: </strong>While investment in development and maintenance has been significant, we have appreciated marked value to our operations team and study sites. Our study website development process is relevant to other scientists conducting multisite clinical research.</p>","PeriodicalId":49723,"journal":{"name":"Nursing Research","volume":null,"pages":null},"PeriodicalIF":2.2,"publicationDate":"2024-09-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142331085","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":"Influence of Preterm Birth and Environmental Context on Academic Performance and Neurodevelopmental Outcomes.","authors":"Michelle M Kelly, Margaret Brace","doi":"10.1097/NNR.0000000000000751","DOIUrl":"10.1097/NNR.0000000000000751","url":null,"abstract":"<p><strong>Background: </strong>Preterm birth affects 10% of all births annually in the United States. Outcomes of people born preterm are challenging to predict because of multiple influences, including gestational age, birth weight, and social and environmental contexts, that contribute to an individual's growth and developmental trajectory. The influence of toxic stress is underrepresented in the literature assessing preterm birth outcomes.</p><p><strong>Objectives: </strong>The current analyses use the eco-bio-developmental model of poverty and preterm birth as a framework to model the pathways among toxic stress, preterm birth, and neurodevelopmental outcomes. Poverty and toxic stress were hypothesized to increase the risk for impaired neurodevelopmental and academic outcomes-both directly and indirectly.</p><p><strong>Methods: </strong>The analytic sample of 55,873 children aged 6-17 years was derived from the National Survey of Children's Health 2020-2021. Structural equation models with combined measurement and path models for each dependent variable were constructed using latent toxic stress variables. The structural path equations included direct paths from the latent measure of prenatal toxic stress, preterm birth status, and the latent measure of childhood toxic stress to the neurodevelopmental outcome, as well as an indirect, mediated path from prenatal toxic stress through preterm birth status to the outcome.</p><p><strong>Results: </strong>Across models, higher levels of prenatal toxic stress were significantly associated with preterm birth and lower birth weight ranges. Preterm low birth weight status was associated with a greater likelihood of neurodevelopmental impairment, repeating a grade, and special education plans. The predicted probabilities of neurodevelopmental impairment, repeating grades, and special education plans are significantly higher with above-average levels of exposure to prenatal and childhood toxic stress.</p><p><strong>Discussion: </strong>There is a need for prospective studies that assess predictors and outcomes of preterm birth that are stratified by gestational age and consider the timing, chronicity, and influence of toxic stress and environmental exposures. There is an imperative for public health programs and policies designed to support families, caregivers, and children to address the individual and structural social determinants of health that contribute to toxic stress, thereby increasing preterm birth rates and negatively affecting the outcomes of children born preterm.</p>","PeriodicalId":49723,"journal":{"name":"Nursing Research","volume":null,"pages":null},"PeriodicalIF":2.2,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141307275","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":"Comparison of Weighting Methods to Understand Improved Outcomes Attributable to Public Health Nursing Interventions.","authors":"Jared D Huling, Robin R Austin, Sheng-Chieh Lu, Michelle A Mathiason, Anna M Pirsch, Karen A Monsen","doi":"10.1097/NNR.0000000000000750","DOIUrl":"10.1097/NNR.0000000000000750","url":null,"abstract":"<p><strong>Background: </strong>The complex work of public health nurses (PHNs) specifically related to mental health assessment, intervention, and outcomes makes it difficult to quantify and evaluate the improvement in client outcomes attributable to their interventions.</p><p><strong>Objectives: </strong>We examined heterogeneity across parents of infants served by PHNs receiving different interventions, compared the ability of traditional propensity scoring methods versus energy-balancing weight (EBW) techniques to adjust for the complex and stark differences in baseline characteristics among those receiving different interventions, and evaluated the causal effects of the quantity and variety of PHN interventions on client health and social outcomes.</p><p><strong>Methods: </strong>This retrospective study of 4,109 clients used existing Omaha System data generated during the routine documentation of PHN home visit data. We estimated the effects of intervention by computing and comparing weighted averages of the outcomes within the different treatment groups using two weighting methods: (a) inverse probability of treatment (propensity score) weighting and (b) EBWs.</p><p><strong>Results: </strong>Clients served by PHNs differed in baseline characteristics with clients with more signs/symptoms. Both weighting methods reduced heterogeneity in the sample. EBWs were more effective than inverse probability of treatment weighting in adjusting for multifaceted confounding and resulted in close balance of 105 baseline characteristics. Weighting the sample changed outcome patterns, especially when using EBWs. Clients who received more PHN interventions and a wider variety of them had improved knowledge, behavior, and status outcomes with no plateau over time, whereas the unweighted sample showed plateaus in outcomes over the course of home-visiting services.</p><p><strong>Discussion: </strong>Causal analysis of PHN-generated data demonstrated PHN intervention effectiveness for clients with mental health signs/symptoms. EBWs are a promising tool for evaluating the true causal effect of PHN home-visiting interventions.</p>","PeriodicalId":49723,"journal":{"name":"Nursing Research","volume":null,"pages":null},"PeriodicalIF":2.2,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141447403","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":"COVID-19 Vaccination Uptake, Infection Rates, and Seropositivity Among Youth Experiencing Homelessness in the United States.","authors":"Diane M Santa Maria, Nikhil Padhye, Luis Ostrosky-Zeichner, Carolyn Z Grimes, Adeline Nyamathi, Marguerita Lightfoot, Yasmeen Quadri, Mary E Paul, Jennifer Torres Jones","doi":"10.1097/NNR.0000000000000747","DOIUrl":"10.1097/NNR.0000000000000747","url":null,"abstract":"<p><strong>Background: </strong>People experiencing homelessness are at greater risk of exposure and poor health outcomes from COVID-19. However, little data exist on the prevalence and correlates of COVID-19 among homeless populations. To mitigate the spread and severity, uptake of the COVID-19 vaccine is needed. This can be challenging among youth experiencing homelessness who are more likely to be unvaccinated when compared to stably housed youth.</p><p><strong>Objective: </strong>We conducted this study to determine the prevalence and correlates of COVID-19 among youth experiencing homelessness.</p><p><strong>Methods: </strong>We examined experiences of COVID-19 symptoms, self-report of infection, and rates of COVID-19 antibodies and distinguished between natural and vaccinated immunity among youth experiencing homelessness ( N = 265) recruited in one large metropolitan area in the south.</p><p><strong>Results: </strong>Based on self-report, very few participants experienced any symptoms, and 80% had never been diagnosed with COVID-19. Of those with COVID-19 antibodies (68%), the proportion with antibodies resulting from natural infection was 44%. The vaccination rate was 42%. Younger and vaccinated participants and those in shelters were likelier to have COVID-19 antibodies. Black and Hispanic youth were more likely than White youth to have had COVID-19. Those who adopted only one or two prevention behaviors were more likely to acquire a natural infection than those who adopted three or more prevention behaviors.</p><p><strong>Discussion: </strong>Youth experiencing homelessness report low vaccination rates, disrupted access to healthcare and social supports, and underlying chronic conditions, which may explain why they face poorer outcomes when infected with COVID-19. Vaccination and risk mitigation strategies to combat the high prevalence of COVID-19 are especially needed for sheltered youth who are at high risk yet are often asymptomatic.</p>","PeriodicalId":49723,"journal":{"name":"Nursing Research","volume":null,"pages":null},"PeriodicalIF":2.2,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11344680/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141162751","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":"Musical Activity Engagement, Depressive Symptoms, Physical Activity, and Cognitive Function in People With Type 2 Diabetes.","authors":"Jeeyeon Kim, Heather Cuevas","doi":"10.1097/NNR.0000000000000749","DOIUrl":"10.1097/NNR.0000000000000749","url":null,"abstract":"<p><strong>Background: </strong>Music interventions have beneficial effects on cognitive function and related risk factors, such as depressive symptoms and behavior of exercise participation. However, little research has been conducted on music's effects on people with type 2 diabetes, and evidence of the effect remains inconclusive in this population.</p><p><strong>Objectives: </strong>Guided by the theory of music, mood, and movement (MMM), this exploratory study aimed to examine the direct and indirect effects of musical activity engagement, depressive symptoms, and physical activity on cognitive function in people with type 2 diabetes.</p><p><strong>Methods: </strong>The present study is a secondary data analysis using the cross-sectional data collected from the Memory, Attention, and Problem-Solving Skills for Persons With Diabetes trial conducted between 2021 and 2023. Data were collected using self-reported questionnaires and a computerized cognitive assessment tool. A total of 189 people with type 2 diabetes and subjective cognitive decline were included in the study. Path analysis was conducted using IBM SPSS AMOS to examine the pathways of the proposed conceptual framework.</p><p><strong>Results: </strong>The study results partially support the MMM model for subjective cognitive function but not objective cognitive function. The path model demonstrated the significant direct effects of musical activity engagement on physical activity, physical activity on subjective cognitive function, and depressive symptoms on physical activity as well as on subjective cognitive function. There was a significant indirect effect of musical activity engagement on subjective cognitive function through physical activity-which fully mediated this relationship. However, no significant direct effect of musical activity engagement on depressive symptoms and subjective cognitive function was found.</p><p><strong>Discussion: </strong>The findings suggest that regular assessment of the presence of depressive symptoms and physical activity participation should be done in people with type 2 diabetes to identify potential modifiable factors and develop targeted interventions for cognitive health promotion. Also, our findings provide insights into the potential use of music to facilitate physical activity and manage cognitive health in people with type 2 diabetes. This study partially supports the MMM model; however, more research with a rigorous study design and larger sample size is needed to better understand the relationships among musical activity engagement, depressive symptoms, physical activity, and cognitive function.</p>","PeriodicalId":49723,"journal":{"name":"Nursing Research","volume":null,"pages":null},"PeriodicalIF":2.2,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11344666/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141260338","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":"Reliability and Validity of Measures Commonly Utilized to Assess Nurse Well-Being.","authors":"Nicholas A Giordano, Omid Razmpour, Jennifer S Mascaro, Deanna M Kaplan, Apryl S Lewis, Marianne Baird, Polly H Willis, Lisa Reif, Rajitha Bommakanti, Alexa Lisenby, Tim Cunningham, Jeannie P Cimiotti","doi":"10.1097/NNR.0000000000000752","DOIUrl":"10.1097/NNR.0000000000000752","url":null,"abstract":"<p><strong>Background: </strong>A healthy nursing workforce is vital to ensuring that patients are provided quality care. Assessing nurses' well-being and related factors requires routine evaluations from health system leaders that leverage brief psychometrically sound measures. To date, measures used to assess nurses' well-being have primarily been psychometrically tested among other clinicians or nurses working in specific clinical practice settings rather than in large, representative, heterogeneous samples of nurses.</p><p><strong>Objectives: </strong>This study aimed to psychometrically test measures frequently used to evaluate factors linked to nurse well-being in a heterogeneous sample of nurses within a large academic health system.</p><p><strong>Methods: </strong>This cross-sectional, survey-based study used a convenience sample of nurses working across acute care practice settings. A total of 177 nurses completed measures, which included the Professional Quality of Life, the short form of the Professional Quality of Life measure, the two-item Connor-Davidson Resilience Scale, the five-item World Health Organization Well-Being Index, the Secondary Traumatic Stress Scale, and the single-item Mini-Z. Internal reliability and convergent validity were assessed for each measure.</p><p><strong>Results: </strong>All the measures were found to be reliable. Brief measures used to assess domains of well-being demonstrated validity with longer measures, as evident by significant correlation coefficients.</p><p><strong>Discussion: </strong>This study provides support for the reliability and validity of measures commonly used to assess well-being in a diverse sample of nurses working across acute care settings. Data from routine assessments of the nursing workforce hold the potential to guide the implementation and evaluation of interventions capable of promoting workplace well-being. Assessments should include psychometrically sound, low-burden measures, such as those evaluated in this study.</p>","PeriodicalId":49723,"journal":{"name":"Nursing Research","volume":null,"pages":null},"PeriodicalIF":2.2,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141260339","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":"Acute Care Use Among Patients With Multiple Chronic Conditions Receiving Care From Nurse Practitioner Practices in Health Professional Shortage Areas.","authors":"Amy McMenamin, Eleanor Turi, Justinna Dixon, Jianfang Liu, Grant Martsolf, Lusine Poghosyan","doi":"10.1097/NNR.0000000000000758","DOIUrl":"10.1097/NNR.0000000000000758","url":null,"abstract":"<p><strong>Background: </strong>Patients with multiple chronic conditions often have many care plans, polypharmacy, and unrelieved symptoms that contribute to high emergency department and hospital use. High-quality primary care delivered in practices that employ nurse practitioners can help prevent the need for such acute care services. However, such practices located in primary care health professional shortage areas face challenges caring for these patients because of higher workloads and fewer resources.</p><p><strong>Objective: </strong>We examined differences in hospitalization and emergency department use among patients with multiple chronic conditions who receive care from practices that employ nurse practitioners in health professional shortage areas compared to practices that employ nurse practitioners in non-health professional shortage areas.</p><p><strong>Methods: </strong>We performed an analysis of Medicare claims, merged with Health Resources and Services Administration data on health professional shortage area status in five states. Our sample included 394,424 community-dwelling Medicare beneficiaries aged ≥65 years, with at least two of 15 common chronic conditions who received care in 779 practices that employ nurse practitioners. We used logistic regression to assess the relationship between health professional shortage area status and emergency department visits or hospitalizations.</p><p><strong>Results: </strong>We found a higher likelihood of emergency department visits among patients in health professional shortage areas compared to those in non-health professional shortage areas and no difference in the likelihood of hospitalization.</p><p><strong>Discussion: </strong>Emergency department use differences exist among older adults with multiple chronic conditions receiving care in practices that employ nurse practitioners in health professional shortage areas, compared to those in non-health professional shortage areas. To address this disparity, the health professional shortage area program should invest in recruiting and retaining nurse practitioners to health professional shortage areas to ease workforce shortages.</p>","PeriodicalId":49723,"journal":{"name":"Nursing Research","volume":null,"pages":null},"PeriodicalIF":2.2,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11344658/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141581350","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}