Nursing Research最新文献

{"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":"https://doi.org/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":""},"PeriodicalIF":2.2,"publicationDate":"2024-11-28","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":"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":"https://doi.org/10.1097/NNR.0000000000000792","url":null,"abstract":"<p><strong>Background: </strong>Psychological birth trauma is common among women in labor and has severe implications for maternal and infant health. Although the prevalence and risk factors of psychological birth trauma have been widely reported, these findings have not been systematically synthesized, limiting screening and interventions.</p><p><strong>Objective: </strong>This study aimed to determine the pooled prevalence of and risk factors for psychological birth trauma.</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 psychological birth trauma was 19%. We performed subgroup analysis based on age, parity, region, and measurement tools. The results showed differences in the prevalence of psychological birth trauma 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 psychological birth trauma.</p><p><strong>Discussion: </strong>The study found that the pooled prevalence of psychological birth trauma was 19%. PBT risk factors are diverse, and understanding the prevalence and risk factors for psychological birth trauma has important implications for health care and social care systems.</p>","PeriodicalId":49723,"journal":{"name":"Nursing Research","volume":" ","pages":""},"PeriodicalIF":2.2,"publicationDate":"2024-11-28","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":"Integration in Mixed Methods Research With an Exemplar Explanatory Sequential Study.","authors":"Youri Hwang, M Tish Knobf, Lois S Sadler","doi":"10.1097/NNR.0000000000000796","DOIUrl":"https://doi.org/10.1097/NNR.0000000000000796","url":null,"abstract":"<p><strong>Background: </strong>Integration-a hallmark of mixed methods research (MMR)-is crucial throughout the entire research process. Despite its importance, integration remains an elusive concept often inadequately addressed by researchers, with many publications focusing solely on the final stages of data analysis and interpretation.</p><p><strong>Objectives: </strong>The authors aim to synthesize methodologic discussions of the mixed method research integration process and provide an illustration of integration across all phases of an exemplar explanatory sequential study.</p><p><strong>Methods: </strong>Integration in MMR includes four distinct dimensions encompassing philosophical assumptions and paradigms, methodological methods, and dissemination of integrated study findings. This paper presents our integrated study findings, illustrated by a research study conducted to investigate sleep health among women with breast cancer.</p><p><strong>Results: </strong>Integration of quantitative and qualitative data analyses is demonstrated through consistently matching the guiding paradigm with design choice, meta-inferences, and visual joint displays. The connecting displays linking quantitative and qualitative data, compare sleep characteristics scores, and the relationship between anxiety and vasomotor symptoms. The results highlight the significance of visual tools in enhancing the analytic processes and providing a comprehensive understanding of complex clinical phenomena.</p><p><strong>Discussion: </strong>Integrating across all stages of mixed method research studies presents many challenges. The proposed four-dimension model of integration contributes to understanding the unique value of fully integrated mixed methods results. The exemplary study findings confirm the value of integration in achieving a nuanced and comprehensive understanding of a significant clinical problem.</p>","PeriodicalId":49723,"journal":{"name":"Nursing Research","volume":" ","pages":""},"PeriodicalIF":2.2,"publicationDate":"2024-11-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142774217","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":"https://doi.org/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 analyze 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":""},"PeriodicalIF":2.2,"publicationDate":"2024-11-19","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":"Area Deprivation and Patient Complexity Predict Low-Value Health Care Utilization in Persons With Heart Failure.","authors":"Kathryn M Ledwin, Sabrina Casucci, Suzanne S Sullivan, Sharon Hewner","doi":"10.1097/NNR.0000000000000794","DOIUrl":"https://doi.org/10.1097/NNR.0000000000000794","url":null,"abstract":"<p><strong>Background: </strong>Heart failure 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 health care 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 heart failure population.</p><p><strong>Objective: </strong>The purpose of this research was to assess the influence of complexity and social risk on low-value utilization in persons with heart failure 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 heart failure 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, Matthew's 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, while 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":""},"PeriodicalIF":2.2,"publicationDate":"2024-11-15","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":"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":"https://doi.org/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 (PET) 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 PET 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":""},"PeriodicalIF":2.2,"publicationDate":"2024-11-15","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":"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":"https://doi.org/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>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 school 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":""},"PeriodicalIF":2.2,"publicationDate":"2024-11-06","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":"Intervention Fidelity in a Virtual Community Participatory Research Trial.","authors":"Holly J Jones, Tamilyn Bakas, Patricia Bacchus, Vedat O Yildiz, Melinda Butsch Kovacic","doi":"10.1097/NNR.0000000000000765","DOIUrl":"10.1097/NNR.0000000000000765","url":null,"abstract":"<p><strong>Objective: </strong>The objective of this report is to describe approaches used to ensure fidelity in the B-SWELL feasibility trial.</p><p><strong>Methods: </strong>A virtual randomized feasibility trial was conducted. Intervention fidelity was evaluated in accordance with Borrelli's five principles of fidelity: design, training, delivery, receipt, and enactment. In addition to the rigorous oversight by the research team, tools were developed or adapted for the virtual trial. Tools used in the trial included a Visual Analog Attendee Engagement Tool, weekly feedback surveys, audio recordings, a facilitator's checklist, an overall satisfaction survey, and a technology survey.</p><p><strong>Results: </strong>Using Borrelli's framework for treatment fidelity, the researchers noted high ratings from the overall satisfaction survey, designed to assess ongoing participant satisfaction with the intervention materials and continued enactment. The tools successfully guided the intervention process from design to enactment.</p><p><strong>Discussion: </strong>Adherence to Borrelli's principles of fidelity enables rigorous oversight of an intervention and its delivery. The growing use of technology to deliver programmed interventions requires that tools be adapted and created to monitor fidelity. Validation of the research-developed and -adapted tools is recommended in a larger trial.</p>","PeriodicalId":49723,"journal":{"name":"Nursing Research","volume":" ","pages":"474-483"},"PeriodicalIF":2.2,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141894765","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":"Internalized Phobia, Community Connectedness, Outness, and Mental Health Risk and Protection in LGBTQ Persons.","authors":"Teresa A Graziano, Holly N Fitzgerald, José Ortiz, Christopher K Owen, Natalie J Shook","doi":"10.1097/NNR.0000000000000759","DOIUrl":"10.1097/NNR.0000000000000759","url":null,"abstract":"<p><strong>Background: </strong>Community connectedness, outness, and internalized phobia are potential protective and risk factors for mental health in lesbian, gay, bisexual, transgender, and queer (LGBTQ) individuals. However, these interrelated factors have generally been examined in isolation and for the LGBTQ community in aggregate. As such, there may be undetected effects of factors on mental health for each LGBTQ group.</p><p><strong>Objectives: </strong>We examined the associations between mental health (i.e., depression and anxiety) and risk/protective factors (i.e., internalized phobia, community connectedness, outness) in each LGBTQ subgroup separately.</p><p><strong>Method: </strong>A large national U.S. sample ( N = 1,030) of individuals who identified as LGBTQ completed an anonymous Internet survey during fall 2019. Participants answered questionnaires about community connectedness, outness, internalized homophobia or transphobia, anxiety, and depression.</p><p><strong>Results: </strong>On average, most subgroups reported symptoms of depression and anxiety above clinical cutoffs. Less outness and greater internalized phobia were associated with more severe depression and anxiety, but this pattern was not consistent across LGBTQ subgroups. Greater community connectedness was generally associated with more severe anxiety and depression.</p><p><strong>Discussion: </strong>LGBTQ subgroups vary in how risk and protective factors relate to mental health outcomes. Our findings highlight the importance of examining LGBTQ subgroups separately and examining risk/protective factors simultaneously to identify the unique contribution of each factor. More research is needed to understand potential LGBTQ mental health risks and protective factors, and future researchers should examine the unique roles of risk and protective factors in separate LGBTQ subgroups.</p>","PeriodicalId":49723,"journal":{"name":"Nursing Research","volume":" ","pages":"434-441"},"PeriodicalIF":2.2,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141894764","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":"In Search of Nursing Science.","authors":"Eunice Adu-Gyamfi, Rachel Robins, Sean James Ryan, Farley A Villarente","doi":"10.1097/NNR.0000000000000778","DOIUrl":"10.1097/NNR.0000000000000778","url":null,"abstract":"","PeriodicalId":49723,"journal":{"name":"Nursing Research","volume":"73 6","pages":"424-425"},"PeriodicalIF":2.2,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142523491","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}