Amy B Thomas, Catherine R Van Son, Lonnie A Nelson, Gerasimos Fergadiotis, Celestina Barbosa-Leiker
{"title":"A Principle-Based Concept Analysis of Supported Conversation for Adults With Aphasia.","authors":"Amy B Thomas, Catherine R Van Son, Lonnie A Nelson, Gerasimos Fergadiotis, Celestina Barbosa-Leiker","doi":"10.1891/RTNP-2024-0094","DOIUrl":"https://doi.org/10.1891/RTNP-2024-0094","url":null,"abstract":"<p><p><b>Background and Purpose:</b> <i>Supported Conversation for Adults with Aphasia</i> (<i>SCA<sup>™</sup></i> ), an evidence-based framework to improve communicative access, is a unique concept to nursing with theoretical and technical components. Effective communication is essential in all patient interactions, and SCA™ could aid health care professionals in meeting the needs of people with aphasia. <b>Methods:</b> A principle-based concept analysis was conducted using a systematic and conceptually driven literature search. A review of literature from 1998 to 2024 contained in CINAHL, PubMed, and PsycINFO databases was performed on the concept of SCA<sup>™</sup> The concept was explored for (a) definitional clarity (epistemological principle), (b) relevance to nursing (pragmatic principle), (c) consistency in meaning (linguistic principle), and (d) differentiation from related concepts (logical principle). <b>Results:</b> The final dataset consisted of 49 articles. Findings revealed that (a) SCA<sup>™</sup> is composed of theoretical and technical components used to acknowledge and reveal the competence of a person with aphasia, but there is a vague use and a lack of definitional clarity; (b) the philosophical framework and techniques outlined by the concept are relevant and useful for nursing; (c) there is variability in the use, nomenclature, and conceptualization of SCA<sup>™</sup>; and (d) the concept is poorly differentiated from other similar concepts. <b>Implications for Practice:</b> Nurses working with people diagnosed with aphasia and other communication disorders should consider SCA<sup>™</sup> and its application in nursing practice. Findings from this concept analysis stress the importance of an interdisciplinary approach to future SCA<sup>™</sup> studies, as nursing can lend its distinct viewpoint to integrate SCA<sup>™</sup> techniques into practice.</p>","PeriodicalId":51287,"journal":{"name":"Research and Theory for Nursing Practice","volume":" ","pages":""},"PeriodicalIF":0.8,"publicationDate":"2025-05-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144133374","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":"Compassionate Communities: Conceptual Evolution and Implications for Nursing Practice.","authors":"Marianne Sofronas, Kim McMillan","doi":"10.1891/RTNP-2024-0184","DOIUrl":"https://doi.org/10.1891/RTNP-2024-0184","url":null,"abstract":"<p><p><b>Background and Purpose:</b> Compassion is a well-known nursing principle with a rich literature on concept development and clarification. Despite being central to care and at risk of being compromised due to increasingly challenging working conditions, compassion continues to be described as a predominantly individual attribute, with the responsibility to demonstrate compassion (and address lack of compassion) placed squarely on the shoulders of individual nurses. There is scant literature holding health care institutions accountable for implementing policies and practices that demonstrate, support, and sustain compassion. Acknowledging the encouraging recent literature on the potential for compassionate leadership, we look to other models based on compassion as embedded in practices and communities to better examine how it can shape nursing work environments. <b>Methods:</b> This paper examines the Compassionate Communities movement, first developed at the intersection of public health and palliative care. We trace its development, highlight ongoing methodological and conceptual tensions, and showcase its applicability as a conceptual framework for research and policy in health care beyond the palliative care context, specifically in nursing. <b>Results:</b> Literature on Compassionate Communities aligns with the priorities and concerns of nursing care, policy, and research. It also has the potential to transform health care institutions, creating compassionate spaces for patients, families, and nurses themselves. <b>Implications for Practice:</b> Proposed definitions and principles for using Compassionate Communities as a conceptual framework are offered; considerations on how health care organizations can become more compassionate, using reflections from our program of research examining nurses' psychological safety.</p>","PeriodicalId":51287,"journal":{"name":"Research and Theory for Nursing Practice","volume":" ","pages":""},"PeriodicalIF":0.8,"publicationDate":"2025-05-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144133376","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":"Impacts of Neoliberalism and Disciplinary Power on Beauty and Thinness Ideals Among Adolescents in Western Societies.","authors":"Émilie Beauchemin, Dave Holmes","doi":"10.1891/RTNP-2024-0148","DOIUrl":"https://doi.org/10.1891/RTNP-2024-0148","url":null,"abstract":"<p><p><b>Background and Purpose:</b> The body has undergone significant aesthetic transformations throughout the centuries. A normalization has gradually taken place in contemporary Western society regarding the criteria attributed to a healthy and attractive body. The image of a thin body is omnipresent in how we conceptualize aesthetic norms in Western societies. This dominance of bodily beauty, this idealization of thinness, generates and reinforces a \"cult of the body\" that is already prevalent in our current societies. <b>Methods:</b> We believe our understanding of the \"cult of the body\" could be enlightened by the writings of Michel Foucault and Nikolas Rose. <b>Results:</b> The forthcoming article will initially delve into how immanent power operates within normative disciplinary practices, technologies of the self, and neoliberal practices. It will then seek to comprehend the extent and influence of the normative regime on the social construction of societal ideals of beauty and thinness to which adolescents in contemporary societies may be exposed. <b>Implications for Practice:</b> Foucault's and Rose's works allow us to expose power relations and interrogate the patient's body as constructed through technical and medical discourse. Their work allows for questioning, reevaluation, and deconstruction of certain paradigms in mental health nursing and raises awareness of not unquestionably accepting a single psychiatric and mental health nursing epistemology. Finally, they provide important insights for nursing practice, especially when it comes to comprehending how societal standards around beauty and health influence the behaviors and body image of adolescents.</p>","PeriodicalId":51287,"journal":{"name":"Research and Theory for Nursing Practice","volume":" ","pages":""},"PeriodicalIF":0.8,"publicationDate":"2025-05-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144007859","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}
Christian M Noval, Craig R Rackley, Donald E Bailey
{"title":"Adaptive Challenges and Adaptive Work of Family Members in a Long-Term Acute Care Hospital.","authors":"Christian M Noval, Craig R Rackley, Donald E Bailey","doi":"10.1891/RTNP-2024-0161","DOIUrl":"https://doi.org/10.1891/RTNP-2024-0161","url":null,"abstract":"<p><p><b>Background:</b> Family members provide emotional and psychosocial support and are an integral component of patient care for older patients with chronic critical illness (CCI). <b>Purpose:</b> This study aimed to describe how family members work with health care providers (HCPs) to support their loved ones by identifying their adaptive challenges, adaptive work, and technical work. <b>Methods:</b> This was an exploratory mixed-method study. Study participants were family members and HCPs of patients admitted to a long-term acute care hospital (LTACH). Surveys and semistructured interviews were completed between February and March 2023. Interviews were coded using <i>a priori</i> codes developed from the Adaptive Leadership Framework for Chronic Illness (ALFCI). <b>Results:</b> Nine participants (five family members and four with HCPs) were enrolled. Family members rated their HCPs' communication skills as very good. Similarly, HCPs' assessment of their communication skills was very good. Four themes were identified: family members' adaptive challenges, adaptive work, HCP-described family adaptive challenges, and HCPs' technical work. Family members' adaptive challenges included communication, care expectations, and individual challenges. Adaptive work included voicing concerns, advocating for their loved one, setting expectations, and coordinating with other family members. HCPs' technical work focused on communication strategies and collaboration with family members and other team members. <b>Implications for practice:</b> Family members play a crucial role in patient care. They experience adaptive challenges supporting their loved ones and managing their everyday activities. Collaborative work between family and HCPs addresses these challenges.</p>","PeriodicalId":51287,"journal":{"name":"Research and Theory for Nursing Practice","volume":" ","pages":""},"PeriodicalIF":0.8,"publicationDate":"2025-04-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144052705","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":"Adolescent Shared Decision-Making: A Concept Analysis.","authors":"Alaina R Smelko, Cynthia L Russell Lippincott","doi":"10.1891/RTNP-2024-0113","DOIUrl":"https://doi.org/10.1891/RTNP-2024-0113","url":null,"abstract":"<p><p><b>Background and Purpose:</b> Adolescent involvement in decision-making processes is influenced by their developmental phase in life, the type of decision, the severity of the adolescent's condition or prognosis, and vulnerability. While developmental science does not support the exclusion of adolescents from decision-making, work to promote adolescent shared decision-making has been hampered by the uncertainty of what the concept means. This paper analyzes the concept of adolescent shared decision-making and brings light to a special population within pediatrics. <b>Methods:</b> Rodgers's evolutionary method was used for this concept analysis. Adolescent shared decision-making was defined along with surrogate and related terms, antecedents, attributes, and consequences. An exemplar was included to further describe the application and context of adolescent shared decision-making. <b>Results:</b> Adolescent shared decision-making is defined as an ongoing process with active participation of multiple parties through shared decision-making to reach an agreed medical decision with a goal to optimize the adolescent's future medical wishes; it may change with time and/or growth and development of the adolescent. <b>Implications for Practice:</b> Adolescent shared decision-making bridges the gap in the continuum of patient-centered, medical care participation. Since nurses often have more contact with patients than providers, the integration of adolescent shared decision-making into practice may help nurses better advocate for adolescents' wishes, especially if they are not able to speak for themselves. Adolescents will feel better prepared for future decision-making in adulthood by empowering them to use their voices to become active contributors within our global society.</p>","PeriodicalId":51287,"journal":{"name":"Research and Theory for Nursing Practice","volume":" ","pages":""},"PeriodicalIF":0.8,"publicationDate":"2025-04-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144016145","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":"Uncertainty as a Barrier to Self-Care and Quality of Life in Patients With Heart Failure With Reduced Ejection Fraction.","authors":"Seyma Demir Erbas, Ganime Esra Soysal","doi":"10.1891/RTNP-2024-0157","DOIUrl":"https://doi.org/10.1891/RTNP-2024-0157","url":null,"abstract":"<p><p><b>Background and Purpose:</b> Quality of life (QoL) and self-care behaviors (SCB) are crucial for patients with heart failure, yet the uncertainty surrounding health outcomes can severely undermine these aspects, particularly in patients with heart failure with reduced ejection fraction (HFrEF). This study aimed to determine the collective impact of perceived uncertainty on both QoL and SCB in HFrEF patients. <b>Methods:</b> A cross-sectional study was conducted among 118 HFrEF patients recruited from cardiology clinics. Data were collected using the Mishel Uncertainty in Illness Scale-Community Form, the Left Ventricular Dysfunction Scale, and the European Heart Failure Self-Care Behavior Scale. The primary analysis, a one-way multivariate analysis of variance (MANOVA), assessed the relationship between uncertainty and the combined outcomes of QoL and SCB. Additional analyses, including a two-way MANOVA and multiple regression, examined predictors such as age, gender, body mass index, and New York Heart Association (NYHA) class. <b>Results:</b> Of the participants, 62.7% reported low uncertainty. Higher levels of uncertainty significantly predicted lower QoL and SCB scores (<i>F</i> = 15.795, <i>p</i> < .001, η² = .216). Other significant predictors included age, gender, body mass index, duration since diagnosis, and NYHA class. <b>Implications for Practice:</b> These findings highlight the pressing need for health care professionals to address uncertainty in HFrEF patients through tailored interventions. Reducing uncertainty can enhance both QoL and SCB, empowering patients to manage their condition more effectively. Future research should develop and evaluate interventions that reduce uncertainty, thereby fostering improved patient engagement, resilience, and long-term well-being.</p>","PeriodicalId":51287,"journal":{"name":"Research and Theory for Nursing Practice","volume":" ","pages":""},"PeriodicalIF":0.8,"publicationDate":"2025-04-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144020560","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":"Analysis of the Impact of Interventions Based on Orem's Self-Care Model on the Balance and Motor Function of Patients with Parkinson's Disease.","authors":"Xiaoxia Zhang, Hongzhi Lu, Yanchao Dong","doi":"10.1891/RTNP-2024-0168","DOIUrl":"https://doi.org/10.1891/RTNP-2024-0168","url":null,"abstract":"<p><p><b>Background and Purpose:</b> The study investigates the effects of Orem's self-care model on balance and motor function in patients with Parkinson's disease (PD), aiming to enhance self-management abilities. <b>Methods:</b> Sixty-one PD patients were selected and divided into an experimental group (31 participants) receiving Orem's self-care interventions and a control group (30 participants) receiving standard care. The experimental group received Orem's self-care intervention, whereas the control group received standard care. The Berg Balance Scale (BBS) and the third part of the Unified Parkinson's Disease Rating Scale (UPDRS-III) scores were recorded and analyzed for both groups before and after the nursing intervention. Multiple linear regression was used to analyze the relationship between pre- and postintervention changes in BBS and UPDRS-III scores in the intervention group, considering factors, such as marital status, education level, place of residence, disease duration, and rehabilitation exercise participation. <b>Results:</b> After the intervention, the experimental group demonstrated significantly improved scores, with a BBS score of 34.81 ± 3.24 and a UPDRS-III score of 25.16 ± 5.49, compared with the control group, which had a BBS score of 29.54 ± 3.20 and a UPDRS-III score of 31.60 ± 7.69. The differences were statistically significant (<i>t</i> = 6.391, <i>p</i> < .001; <i>t</i> = 3.775, <i>p</i> < .001). Age and disease duration were negatively correlated with changes in BBS (ΔBBS) and UPDRS-III (ΔUPDRS-III), whereas education level showed a positive correlation with these changes. <b>Implications for Practice:</b> Incorporating Orem's self-care model into the nursing care of PD patients can lead to significant improvements in their balance and motor function.</p>","PeriodicalId":51287,"journal":{"name":"Research and Theory for Nursing Practice","volume":" ","pages":""},"PeriodicalIF":0.8,"publicationDate":"2025-04-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143812797","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":"Using Orem's Self-Care Model for a Continuing Care Program After Transurethral Prostate Resection.","authors":"Shuyan Wang, Feng Gao","doi":"10.1891/RTNP-2024-0159","DOIUrl":"https://doi.org/10.1891/RTNP-2024-0159","url":null,"abstract":"<p><p><b>Background:</b> Transurethral resection of the prostate (TURP) is a common surgical procedure for benign prostatic hyperplasia. However, postoperative care often lacks continuity after hospital discharge, potentially leading to complications and reduced quality of life. <b>Objective:</b> The aim of the study was to develop and evaluate the effectiveness of a continuing care program based on Orem's Self-Care Model for patients after TURP. <b>Methods:</b> A quasi-experimental study was conducted with 97 patients with post-TURP. Participants were assigned to either the intervention group receiving the Orem-based continuing care program or the control group receiving standard care. The program included educational interventions, self-care skills training, and follow-up support. Outcomes were measured using the Self-Care Agency Scale, International Prostate Symptom Score (IPSS), and Quality of Life (QoL) scale at baseline, 1 month, and 3 months postdischarge. <b>Results:</b> The intervention group showed significant improvements in Self-Care Agency, IPSS scores, and QoL (WHOQOL-BREF Physical Health domain increase) compared with the control group at the 3-month follow-up (<i>p</i> < .001). The incidence of postoperative complications was lower in the intervention group without statistically significant differences. <b>Conclusion:</b> The continuing care program based on Orem's Self-Care Model effectively improved self-care abilities and quality of life in patients after TURP.</p>","PeriodicalId":51287,"journal":{"name":"Research and Theory for Nursing Practice","volume":" ","pages":""},"PeriodicalIF":0.8,"publicationDate":"2025-03-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143694338","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":"The Ramifications and Ethical Considerations of Using Proxy Data to Measure Health-Related Quality of Life in Stroke Survivors.","authors":"Anas Okour, Elaine L Miller","doi":"10.1891/RTNP-2024-0150","DOIUrl":"https://doi.org/10.1891/RTNP-2024-0150","url":null,"abstract":"<p><p><b>Background:</b> Understanding ethics in health care research is necessary to solve moral conflicts that may arise during the research process. Guidelines have been proposed to ensure a standardized ethical approach. However, the use of proxy responses in research involving stroke survivors raises ethical debate due to the vulnerabilities of stroke survivors and the discrepancies observed between proxy and patient perspectives. <b>Aim:</b> This article aims to discuss the ramifications and ethical considerations associated with using proxy responses to examine the health-related quality of life of stroke survivors. <b>Discussion:</b> This article suggests a level of agreement on the ability to use proxy data with stroke survivors but with careful consideration of the nature of the data and how the result will be interpreted. The article also highlights the discrepancies between proxy and patient preferences. Strategies such as employing validated tools, integrating proxy data with patient observations, and providing proxy training are proposed to enhance data reliability. <b>Conclusion:</b> Proxy data serves as a feasible and ethical method to examine the health-related quality of life of stroke survivors when direct patient responses are unavailable. Addressing the discrepancies and ethical concerns through innovative approaches is essential to improve proxy-reported data in research and practice.</p>","PeriodicalId":51287,"journal":{"name":"Research and Theory for Nursing Practice","volume":" ","pages":""},"PeriodicalIF":0.8,"publicationDate":"2025-03-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143659718","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":"Utilizing the Social Ecological Model to Inform Nursing Practice for Improved Childhood Eating Behaviors.","authors":"Qutaibah Oudat, Anas Okour","doi":"10.1891/RTNP-2024-0169","DOIUrl":"https://doi.org/10.1891/RTNP-2024-0169","url":null,"abstract":"<p><p><b>Background:</b> Understanding and promoting healthy eating behaviors in young children is essential for their immediate and long-term health outcomes. However, these behaviors are influenced by an intricate network of factors that extend beyond individual choices, posing challenges for health practitioners seeking effective interventions. <b>Purpose:</b> This article aims to explore how the Social Ecological Model (SEM) can serve as a framework for understanding the multilevel determinants of young children's eating behaviors, and the seminal role that nursing plays in this dynamic. <b>Discussion:</b> The SEM encompasses five levels of influence: individual, interpersonal, community, organizational, and policy. At the individual level, factors include the child's biological predispositions and nutritional knowledge. The interpersonal level highlights the role of parents and caregivers in modeling and shaping dietary habits. Community influences focus on access to nutritious foods and social norms, while the organizational level emphasizes the importance of schools and health care settings in reinforcing healthy eating. The policy level addresses government regulations and public health initiatives that shape the food environment. Together, these interconnected layers provide a comprehensive understanding of the factors impacting children's eating behaviors. <b>Implications for Nursing:</b> By applying the SEM, nursing professionals can develop multilayered, culturally sensitive interventions that address these determinants, advocating for policies and practices that support healthy eating habits and promote holistic well-being in children.</p>","PeriodicalId":51287,"journal":{"name":"Research and Theory for Nursing Practice","volume":" ","pages":""},"PeriodicalIF":0.8,"publicationDate":"2025-03-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143617758","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}