Nursing Research最新文献

{"title":"Area Deprivation and Patient Complexity Predict Low-Value Healthcare Utilization in Persons With Heart Failure.","authors":"Kathryn M Ledwin, Sabrina Casucci, Suzanne S Sullivan, Sharon Hewner","doi":"10.1097/NNR.0000000000000794","DOIUrl":"10.1097/NNR.0000000000000794","url":null,"abstract":"<p><strong>Background: </strong>Heart failure (HF) is a debilitating condition affecting over 6.7 million adults in the United States. Social risks and complexity, or personal, social, and clinical aspects of persons' experiences, have been found to influence healthcare utilization and hospitalizations in persons with HF. Low-value utilization, or irregular outpatient visits with frequent emergency room use, or hospitalization is common among persons with complex conditions and social risk and requires further investigation in the HF population.</p><p><strong>Objectives: </strong>The purpose of this research was to assess the influence of complexity and social risk on low-value utilization in persons with HF using machine learning approaches.</p><p><strong>Methods: </strong>Supervised machine learning, tree-based predictive modeling was conducted on an existing data set of adults with HF in the eight-county region of Western New York for the year 2022. Decision tree and random forest models were validated using a 70/30 training/testing data set and k -fold cross-validation. The models were compared for accuracy and interpretability using the area under the curve, Matthews correlation coefficient, sensitivity, specificity, precision, and negative predictive value.</p><p><strong>Results: </strong>Area deprivation index, a proxy for social risk, number of chronic conditions, age, and substance use disorders were predictors of low-value utilization in both the decision tree and random forest models. The decision tree model performed moderately, whereas the random forest model performed excellently and added hardship as an additional important variable.</p><p><strong>Discussion: </strong>This is the first known study to look at the outcome of low-value utilization, targeting individuals who are underutilizing outpatient services. The random forest model performed better than the decision tree; however, features were similar in both models, with area deprivation index as the key variable in predicting low-value utilization. The decision tree was able to produce specific cutoff points, making it more interpretable and useful for clinical application. Both models can be used to create clinical tools for identifying and targeting individuals for intervention and follow-up.</p>","PeriodicalId":49723,"journal":{"name":"Nursing Research","volume":" ","pages":"136-143"},"PeriodicalIF":2.2,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142774214","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":"Preparing PhD Students for Tenure-Track Faculty Positions.","authors":"Mary K Killela, Harry Adynski, Gillian Adynski, Elizabeth Allen Myer, Cassandra Dictus, Leah Morgan, Hayden Hmiel, Jessica Williams","doi":"10.1097/NNR.0000000000000791","DOIUrl":"10.1097/NNR.0000000000000791","url":null,"abstract":"<p><strong>Background: </strong>With an increasing number of nursing faculty approaching retirement, it is critical to prepare PhD students to take on tenure-track faculty roles. There are a multitude of competing time demands for nursing faculty, and one way that PhD students can prepare for faculty roles is leading team-based science with their peers during their predoctoral program.</p><p><strong>Objectives: </strong>The aim of this study was to describe the process of PhD students leading an independent research project, in addition to their dissertation work, which aimed to incorporate the tripartite mission-scholarship, teaching, and service.</p><p><strong>Methods: </strong>This paper outlines the components of the PhD-student-led project as well as provides recommendations for leadership and schools of nursing as well as sponsors interested in funding this type of work.</p><p><strong>Results: </strong>Students were able to conduct independent research using diverse research approaches, practice mentoring skills, and provide service and helpful information about the nursing workforce to their academic clinical partner. A key component of this relationship building was incorporating a clinical fellowship during the PhD program for students that directly aided the transition from BSN to PhD programs.</p><p><strong>Discussion: </strong>PhD students learned valuable lessons about time management and collaborating in a team setting with peers. We recommend schools of nursing seek funding opportunities for PhD students to conduct independent team science, encourage academic partnerships with affiliated medical centers and public health settings, and facilitate peer mentorship across cohorts.</p>","PeriodicalId":49723,"journal":{"name":"Nursing Research","volume":" ","pages":"E11-E14"},"PeriodicalIF":2.2,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142631596","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":"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 semistructured 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":" ","pages":"98-107"},"PeriodicalIF":2.2,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11895817/pdf/","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":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Reducing Stigma in Chinese Women Living With HIV/AIDS: Mixed Methods Cluster Randomized Controlled Trial Protocol.","authors":"Zhongfang Yang, Lin Zhang, Zheng Zhu, Yanfen Fu, Shuyu Han, Meiyan Sun, Yue Zhang, Hongli Yang, Beibei Gong, Yirong Shi, Yan Hu","doi":"10.1097/NNR.0000000000000797","DOIUrl":"10.1097/NNR.0000000000000797","url":null,"abstract":"<p><strong>Background: </strong>Perceived stigma significantly impedes access to public health resources for women living with HIV/AIDS, highlighting the crucial need for interventions to empower individuals to overcome such barriers.</p><p><strong>Objectives: </strong>This paper outlines the protocol for a pilot study aimed at evaluating the efficacy of the Helping Overcome PErceived Stigma (HOPES) intervention employing the mixed methods-grounded in narrative transportation-theory in reducing perceived stigma among women living with HIV/AIDS.</p><p><strong>Methods: </strong>A total of 100 women living with HIV/AIDS will be randomized into two groups: the HOPES group and the control group. Participants in the HOPES group will watch the narrative transportation videos about perceived stigma experiences and coping strategies recorded by peer volunteers and write notes.</p><p><strong>Results: </strong>The study commenced in September 2023 and concluded data collection in May 2024.</p><p><strong>Discussion: </strong>Findings from this study will inform effectiveness trials of HOPES, advancing the evidence base for reducing stigma and improving mental health in women living with HIV/AIDS.</p>","PeriodicalId":49723,"journal":{"name":"Nursing Research","volume":" ","pages":"155-158"},"PeriodicalIF":2.2,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142774236","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":"Frailty and Self-Care Maintenance Mediated by Social Support and Depression in Older Adults With Heart Failure.","authors":"Na Bu, Min Leng, Guorong Cao, Chao Dou, Rongchun Hou, Xiaohong Lu, Hong Xu","doi":"10.1097/NNR.0000000000000795","DOIUrl":"10.1097/NNR.0000000000000795","url":null,"abstract":"<p><strong>Background: </strong>Older adults with heart failure often exhibit poor self-care maintenance. Frailty could exacerbate self-care, leading to deteriorating health. Social support and depression may play a role in self-care maintenance in older adults with heart failure combined with frailty. Confirming this potential mechanistic relationship could provide valuable reference for nurses to formulate and improve the targeted intervention strategies and health education programs for older adults with heart failure.</p><p><strong>Objectives: </strong>This study analyzed the relationship between frailty and self-care maintenance in older adults with heart failure and determined the sequential mediation effect of social support and depression. Its goal was to provide valuable theoretical insights for formulating targeted clinical nursing interventions for older adults with heart failure.</p><p><strong>Methods: </strong>A cross-sectional study was conducted from July 2023 to February 2024, during which older adults with heart failure were recruited using a convenience sampling method from the cardiovascular department of a tertiary Class A hospital in Qingdao, China. A total of 241 completed the Tilburg Frailty Indicator, the Self-Care of Heart Failure Index, the Social Support Rating Scale, and the Patient Health Questionnaire-9. t -Tests and one-way analysis of variance were used to examine differences in self-care maintenance among participants with distinct characteristics; correlation analysis was used to identify variable relationships within the study. The mediation model was tested using the SPSS PROCESS macro and the bootstrap method.</p><p><strong>Results: </strong>Frailty was negatively correlated with self-care maintenance, and both social support and depression were significantly related to frailty and self-care maintenance. Social support and depression not only independently mediated the relationship between frailty and self-care maintenance but also exhibited a significant sequential mediation effect.</p><p><strong>Discussion: </strong>The frailty of older adults with heart failure and its correlation with self-care maintenance is a complex and multidimensional phenomenon. Frailty not only directly influenced self-care maintenance in participants but also indirectly affected it through the mediating factors of social support and depression. Future research should emphasize innovative, targeted interventions to enhance social support quality and accessibility and alleviate depression, ultimately boosting patients' self-care capabilities and elevating their quality of life.</p>","PeriodicalId":49723,"journal":{"name":"Nursing Research","volume":" ","pages":"115-122"},"PeriodicalIF":2.2,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142774216","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":"Predictors of Decisional Capacity in Alzheimer's Disease Biomarker Test Candidates.","authors":"Jeong Eun Kim, Susan M Sereika, Lisa K Tamres, Jennifer H Lingler","doi":"10.1097/NNR.0000000000000793","DOIUrl":"10.1097/NNR.0000000000000793","url":null,"abstract":"<p><strong>Background: </strong>Deciding to learn one's Alzheimer's disease (AD) biomarker status is a high-stakes endeavor that requires comprehending and deliberating about complex and nuanced information. Assessing capacity to consent to AD biomarker testing and disclosure is further complicated when candidates have cognitive impairment and present with family care partners.</p><p><strong>Objective: </strong>The objective of this analysis was to identify predictors of decisional capacity for an amyloid positron emission tomography disclosure study among persons with mild cognitive impairment (MCI) and their family care partners.</p><p><strong>Methods: </strong>This analysis used an analytical correlational design, using baseline data from a randomized controlled trial of amyloid positron emission tomography results disclosure. Simple linear regression was used to examine predictors of decisional capacity. Focusing on persons with MCI, the predictor variables of interest were sociodemographic characteristics, level of knowledge of MCI/AD, global cognition, and neuropsychological tests of language and executive functioning. Dyadic analyses were conducted with data from 82 dyads of persons with MCI and care providers using the Actor-Partner Interdependence Model to assess for presence of actor and partner effects among key variables.</p><p><strong>Results: </strong>Capacity-to-consent scores demonstrated sufficient capacity for all participants to consent to the study. For persons with MCI, lower age, higher mental status scores, MCI/AD knowledge scores, and better performance on measures of language and executive functioning were predictors of decisional capacity. The model revealed positive actor relations for MCI/AD knowledge with decisional capacity for both persons with MCI and family care partners and negative partner relationships for family care partners' MCI/AD knowledge with the decisional capacity of persons with MCI.</p><p><strong>Discussion: </strong>Assessment of decisional capacity is imperative when considering participation in AD research, including studies with high-stakes procedures like biomarker results disclosure. Our findings highlight that not only do individual characteristics put persons with MCI at risk for lower decisional capacity, but dyadic effects from family care partners may also be present.</p>","PeriodicalId":49723,"journal":{"name":"Nursing Research","volume":" ","pages":"108-114"},"PeriodicalIF":2.2,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142774234","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":"Systematic Review and Meta-Analysis of Prevalence and Risk Factors for Psychological Birth Trauma.","authors":"Yaxuan Xu, Wenjuan Wang, Lihua Zhou, Wenli Xu, Hui Wang, Fengying Zhang, Xiaoqin Wang, Hanmei Zhang","doi":"10.1097/NNR.0000000000000792","DOIUrl":"10.1097/NNR.0000000000000792","url":null,"abstract":"<p><strong>Objective: </strong>The aim of this study was to determine the pooled prevalence of and risk factors for PBT.</p><p><strong>Methods: </strong>The Cochrane Library, Web of Science, PubMed, Embase, and Scopus databases were systematically searched between their inception and October 1, 2023. Pooled prevalence, odds ratio, and 95% confidence intervals were calculated using fixed- or random-effects models using Stata 15.0.</p><p><strong>Result: </strong>The pooled prevalence rate of PBT was 19%. We performed subgroup analysis based on age, parity, region, and measurement tools. The results showed differences in the prevalence of PBT between these subgroups, suggesting the need for clinical personalization in different populations. The pooled odds ratio showed that fear of childbirth, cesarean section, operative vaginal birth, pain during labor, and dissatisfaction with support from midwives were significantly associated with PBT.</p><p><strong>Discussion: </strong>The study found that the pooled prevalence of PBT was 19%. PBT risk factors are diverse, and understanding the prevalence and risk factors for PBT has important implications for healthcare and social care systems.</p>","PeriodicalId":49723,"journal":{"name":"Nursing Research","volume":" ","pages":"123-129"},"PeriodicalIF":2.2,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142774238","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":"Study Protocol Evaluating Breastfeeding for Mother-Infant Dyads Experiencing Infant Ankyloglossia.","authors":"Rebecca R Hill, Jonathan M Carnino, Jessica R Levi","doi":"10.1097/NNR.0000000000000801","DOIUrl":"10.1097/NNR.0000000000000801","url":null,"abstract":"<p><strong>Background: </strong>Tongue-tie is associated with nipple pain and early breastfeeding cessation. To date, research has been limited by small sample sizes and a dearth of evidence on the effects of tongue-tie on infant feeding symptoms and physiologic breastfeeding mechanics.</p><p><strong>Objectives: </strong>In this article, we describe the protocol for our study exploring infant feeding, negative breastfeeding symptoms, maternal anatomy, and physiologic sucking data between infants with and without tongue-tie.</p><p><strong>Methods: </strong>A prospective cohort study design is being employed. Over 8 weeks, three visits will be conducted with a sample of mothers and their infants without tongue-tie and a sample of mothers and their infants diagnosed with tongue-tie undergoing treatment via frenotomy. The aims of the study were to compare breastfeeding symptoms, breast anatomy, infant feeding symptoms, feeding efficiency, and nutritive sucking parameters between infants with and without tongue-tie, further comparing these metrics pretreatment and posttreatment via frenotomy with the non-tongue-tied age-matched counterparts.</p><p><strong>Results: </strong>This study is currently ongoing.</p><p><strong>Discussion: </strong>Tongue-tie is an everyday problem; clear guidelines are needed to decide whether to treat it. This novel, innovative, and multidisciplinary research study aims to fill critical gaps in understanding the physiological and functional effects of tongue-tie on breastfeeding, offering evidence to inform better clinical decisions and support effective interventions.</p>","PeriodicalId":49723,"journal":{"name":"Nursing Research","volume":" ","pages":"159-164"},"PeriodicalIF":2.2,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142840123","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":"History and Science.","authors":"Rita H Pickler","doi":"10.1097/NNR.0000000000000805","DOIUrl":"https://doi.org/10.1097/NNR.0000000000000805","url":null,"abstract":"","PeriodicalId":49723,"journal":{"name":"Nursing Research","volume":"74 2","pages":"85-86"},"PeriodicalIF":2.2,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143574442","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":"Nurses' Perception of Firearm Safety.","authors":"Brigitte S Cypress, Meriam Caboral-Stevens, Maria Rosario-Sim, Priscilla Sagar","doi":"10.1097/NNR.0000000000000786","DOIUrl":"10.1097/NNR.0000000000000786","url":null,"abstract":"<p><strong>Background: </strong>Firearm or gun violence has become a significant and ongoing public health crisis in the United States. There is little evidence of the current practices of nurses in assessing, screening, and counseling patients and families on firearm ownership and safety.</p><p><strong>Objectives: </strong>The purpose of this exploratory qualitative study was to explore the attitudes, perceptions, and current practices in assessing, screening, and counseling gun ownership and safety among registered nurses, with a secondary aim of identifying the facilitators and barriers to implementing the practice.</p><p><strong>Method: </strong>An exploratory qualitative research study design was used. We recruited focus group participants via e-mail, social media blasts, referrals, and personal contact requests. Participants were interviewed using structured focus group questions via Zoom. Five focus groups included 32 registered and advanced practice nurses. The audio-recorded and transcribed data were analyzed using Braun and Clarke's approach to thematic analysis.</p><p><strong>Results: </strong>We identified four key themes. First, there was a significant need to educate and train nurses in the assessment, screening, and counseling about firearm safety. Second, there was a need to extend this education to patients, families, and the community. Third, there was a need to advocate for the creation and implementation of policies. Fourth, there was a need to implement mental health assessment as a standard practice before owning a gun, which emerged as a potential solution. Additionally, we found a need to address barriers to assessment and counseling on gun use. The creation of state laws and organizational policies, along with the provision of current data, emerged as other facilitators for assessment, screening, and counseling among nurses about firearms use and safety.</p><p><strong>Discussion: </strong>Ours is one of the first studies to explore attitudes and perceptions about gun ownership and current practices in gun safety assessment, screening, and counseling among registered nurses. The findings lay some foundation for a focused, multifaceted approach and interventions to address gun violence and safety concerns.</p>","PeriodicalId":49723,"journal":{"name":"Nursing Research","volume":" ","pages":"91-97"},"PeriodicalIF":2.2,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142957855","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}