Nursing Research最新文献

{"title":"Estimating the Relationship Between Nurse Staffing and Medication Pass Workload Using National Barcode Data.","authors":"Chase S Eck, Melissa K Knox, Paras D Mehta, Laura A Petersen","doi":"10.1097/NNR.0000000000000764","DOIUrl":"10.1097/NNR.0000000000000764","url":null,"abstract":"<p><strong>Background: </strong>Measuring and assessing the relationship between inpatient nurse staffing and workload across a national health system is difficult because of challenges in systematically observing inpatient workload at the unit level.</p><p><strong>Objective: </strong>The objective of this study was to apply a novel measure of inpatient nurse workload to estimate the relationship between inpatient nurse staffing and nurse workload at the unit level during a key nursing activity: the peak-time medication pass.</p><p><strong>Methods: </strong>A retrospective observational study was conducted in the Veterans Health Administration, the largest employer of nurses in the United States. The sample included all patients ( n = 1,578,399 patient days) admitted to 311 non-intensive care unit inpatient acute care units in 112 hospitals in 2019 (104,588 unit days). Staffing was measured as the unit-level, nurse-to-patient ratio, and workload was measured using average time (duration) for RNs to complete the peak-time medication pass.</p><p><strong>Results: </strong>We found a negative relationship between the RN-to-patient ratio and average peak-time medication pass duration after adjusting for unit-level patient volume and average patient severity of illness and other unit-level factors. This relationship was nonlinear: The marginal effect of staffing on workload decreased as staffing increased.</p><p><strong>Discussion: </strong>As unit-level nurse staffing increased, average RN workload decreased. This result suggests that interventions to improve nurse staffing may have larger nonlinear effects for units with lower staffing levels. Understanding the effect of differing staffing decisions on variations in nursing workload is critical for adopting models of care that effectively use scarce staffing resources and contribute to retaining nurses in the inpatient workforce. This work provides evidence that peak-time medication pass duration is a valid process-based measure of workload and highlights the potential diminishing returns to increasing staffing.</p>","PeriodicalId":49723,"journal":{"name":"Nursing Research","volume":" ","pages":"450-457"},"PeriodicalIF":2.2,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141894763","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 Pandemic Increases in Nursing-Sensitive Quality Indicators.","authors":"Eileen T Lake, Angela Pascale, Nora E Warshawsky, Jessica G Smith, Douglas Staiger, Jeannette A Rogowski","doi":"10.1097/NNR.0000000000000771","DOIUrl":"10.1097/NNR.0000000000000771","url":null,"abstract":"<p><strong>Background: </strong>The pandemic profoundly stressed practicing nurses and could have thereby affected trends in nursing-sensitive quality indicators (NSIs), measures that detect changes in patient health status directly affected by nursing care.</p><p><strong>Objectives: </strong>The aim of the study was to determine if NSIs have worsened in response to the pandemic and then returned to prepandemic levels using data from 2019 through 2022.</p><p><strong>Methods: </strong>We conducted a cross-sectional descriptive study of annual trends, examining unit data from the National Database of Nursing Quality Indicators (NDNQI) from 2019 through 2022 for five indicators: rates of falls, central line-associated bloodstream infections (CLABSI), catheter-associated urinary tract infections (CAUTI), hospital-acquired pressure injuries (HAPI), and ventilator-associated events (VAE). The NDNQI is the largest repository of nursing quality indicators, which are derived from patient-level events, reported at the nursing unit level, and submitted quarterly by over 2,000 member hospitals. Adult medical-surgical or critical care inpatient nursing units with complete data for the 4 years were included, with samples ranging from 456 to 5,818 nursing units in 2,346 hospitals. Analysis of variance was conducted by comparing the 2019 rates to each subsequent year.</p><p><strong>Results: </strong>In decreasing order of prevalence, the mean prepandemic rates were 6.58 VAE per 1,000 ventilator days (critical care only), 2.41 HAPI per 1,000 device days, 2.20 falls per 1,000 patient days, 0.96 CAUTI per 1,000 catheter days, and 0.68 CLABSI per 1,000 central line days for medical-surgical and critical care units combined. The rates for all five nurse-sensitive indicators increased significantly beginning in 2020 and have begun to decline but have not returned to baseline by 2022. The maximum rate was observed in 2020 for falls and 2021 for the remaining indicators. These increases to the maximum ranged from a 12% increase in CAUTI to 49% for CLABSI.</p><p><strong>Discussion: </strong>NSIs increased during the pandemic and are now returning to baseline. The pandemic underscored the importance of nursing practice. The pandemic's enduring negative effects on the nursing workforce must be addressed to preserve patient safety.</p>","PeriodicalId":49723,"journal":{"name":"Nursing Research","volume":" ","pages":"490-495"},"PeriodicalIF":2.2,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142005660","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":"Men's Perceptions and Expectations of Fertility Clinics.","authors":"Mehrdad Abdullahzadeh, Zohreh Vanaki, Eesa Mohammadi, Jamileh Mohtashami","doi":"10.1097/NNR.0000000000000767","DOIUrl":"10.1097/NNR.0000000000000767","url":null,"abstract":"<p><strong>Background: </strong>Most of the research and care in fertility focuses on women, whereas men's perspectives and expectations are often overlooked.</p><p><strong>Objectives: </strong>The aim of the study was to explore the experiences and expectations of men with primary infertility regarding fertility clinics and to provide implications for personalized and inclusive care.</p><p><strong>Methods: </strong>A qualitative study was conducted in Iran between November 2022 and October 2023. Thirteen men with primary infertility were interviewed in-depth using a semistructured approach. Data were analyzed using the inductive content analysis method.</p><p><strong>Results: </strong>The central theme, \"Therapy Environment: Private and Interactive,\" was identified. The theme comprises four categories: Effective Interaction-A Key to Therapy Success; Infertility Treatment-A Joint Effort; Personal and Stress-Free Environment-Essential for Treatment; and Treatment Plan-Vital for Successful Outcome.</p><p><strong>Discussions: </strong>Study findings underscore the importance of tailored approaches to male infertility care. Healthcare providers should prioritize personalized, stress-free environments for male infertility patients and encourage effective communication and joint participation with partners to achieve successful outcomes. Tailored approaches and therapeutic settings should be created to cater to male patients' unique needs.</p>","PeriodicalId":49723,"journal":{"name":"Nursing Research","volume":" ","pages":"467-473"},"PeriodicalIF":2.2,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142005623","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":"Health Implications of Black Identity Among Latinos: A Call for Afro-Latina Representation in Maternal Child Health Research.","authors":"Alexa Parra, Vanessa Morales, Cynthia N Lebron, Hudson P Santos","doi":"10.1097/NNR.0000000000000769","DOIUrl":"10.1097/NNR.0000000000000769","url":null,"abstract":"","PeriodicalId":49723,"journal":{"name":"Nursing Research","volume":"73 6","pages":"417-419"},"PeriodicalIF":2.2,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142523490","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 G Rosario-Sim, Priscilla L Sagar","doi":"10.1097/NNR.0000000000000786","DOIUrl":"https://doi.org/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":""},"PeriodicalIF":2.2,"publicationDate":"2024-10-11","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}

{"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":" ","pages":""},"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":"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":" ","pages":"390-398"},"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":"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":" ","pages":"342-353"},"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":"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":" ","pages":"373-380"},"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":" ","pages":"381-389"},"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}