Nursing Outlook最新文献

{"title":"Health equity and e-cigarette use among young adults in rural areas: A social determinants of health framework","authors":"Jovan Gwon ,&nbsp;Vipavee Thongpriwan ,&nbsp;Devon Noonan","doi":"10.1016/j.outlook.2025.102357","DOIUrl":"10.1016/j.outlook.2025.102357","url":null,"abstract":"<div><div>Young adults (YAs) aged 18 to 24 in rural areas are increasingly using Electronic Nicotine Delivery Systems (ENDS), commonly known as e-cigarettes, in the United States. Rural communities already face significant health disparities due to higher tobacco use, contributing to worse health outcomes, including increased mortality from heart disease, cancer, and respiratory diseases. Using the adapted World Health Organization’s Social Determinants of Health framework, this paper examines how structural and intermediary determinants shape ENDS use among rural YAs. Special attention is given to how policy and societal contexts, sociocultural norms, and rurality influence rural ENDS use. The paper also highlights intermediary factors like the availability of cessation resources and the role of psychosocial stressors in ENDS use behaviors. Nurses can play a vital role in addressing ENDS-related health inequities by providing culturally congruent and environmentally relevant care and advocating for intersectoral policies that promote health equity. This framework informs targeted public health interventions and nursing efforts to reduce the health disparities associated with ENDS use in rural communities.</div></div>","PeriodicalId":54705,"journal":{"name":"Nursing Outlook","volume":"73 2","pages":"Article 102357"},"PeriodicalIF":4.1,"publicationDate":"2025-02-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143387414","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Fractured FRAX: Nurses’ role in reckoning with racism in international osteoporosis fracture risk calculations","authors":"Melanie Agnes Mariano MSN, RN, FNP-BC ,&nbsp;Cecília Tomori PhD, MA","doi":"10.1016/j.outlook.2025.102353","DOIUrl":"10.1016/j.outlook.2025.102353","url":null,"abstract":"<div><h3>Aim</h3><div>This paper will examine racism’s role in calculating fracture risk via the use of race- and ethnicity-based calculations and offer guidance for nurses to mitigate the risk of further exacerbating race-based inequities in fracture care.</div></div><div><h3>Background</h3><div>Using race adjustments in fracture risk calculation, such as in the FRAX, reflects the history of systemic racism in nursing and medicine, particularly in screening for and treating osteoporosis. Osteoporosis-related fractures, which result in increased costs, disability, and death, are a public health problem.</div></div><div><h3>Sources of Evidence</h3><div>The critique examines genetic and sociohistorical evidence to illuminate the fallacy that race has biological underpinnings and outline the implications of using race in fracture risk assessment.</div></div><div><h3>Discussion</h3><div>Race-based risk calculation, including assessing fracture risk, is one of the mechanisms by which the medical and healthcare sectors perpetuate systemic racism.</div></div><div><h3>Implications for Nursing Practice and Policy</h3><div>Nurses are called to action to address the contributing role of race-based algorithms, such as the FRAX, to unequal treatment. Nurses should advocate for the removal of race in these clinical decision-making tools and case studies. Additionally, nurses should advocate for their replacement with better tools that do not use race but rather measures of structural racism to calculate risk. Policy guidance should be issued so that race, a sociohistorical tool of categorization to preserve power structures, should no longer be used as an approximation of other more relevant and precise risk factors for fractures or other diseases.</div></div><div><h3>Conclusion</h3><div>Nurses are critical in cultivating and implementing antiracist approaches to remediate health inequities in screening and treatment of osteoporosis and other preventable diseases.</div></div>","PeriodicalId":54705,"journal":{"name":"Nursing Outlook","volume":"73 2","pages":"Article 102353"},"PeriodicalIF":4.1,"publicationDate":"2025-02-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143378936","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The roles of nurses in preventing and managing excess weight among adults: A systematic scoping review","authors":"Adika Sen ,&nbsp;Ka Ying Annie Ho ,&nbsp;Wei Kian Frederick Goh ,&nbsp;Han Shi Jocelyn Chew","doi":"10.1016/j.outlook.2025.102377","DOIUrl":"10.1016/j.outlook.2025.102377","url":null,"abstract":"<div><h3>Background</h3><div>Nurses are well-positioned to tackle obesity but literature on their roles remains unclear.</div></div><div><h3>Purpose</h3><div>To present an overview of nurses’ roles in preventing and managing excess weight among adults.</div></div><div><h3>Methods</h3><div>Following the Arksey and O’Malley methodology, 11 databases were searched from inception to September 2023. Eligibility screening showed good inter-rater reliability (κ<!--> <!-->=<!--> <!-->0.84). Articles were appraised using the Mixed Methods Appraisal Tool and relevant data were charted.</div></div><div><h3>Discussion</h3><div>In total, 86 studies were included with 41.9% published in America and 3.5% and 26.7% of the studies addressing overweight and obesity management, respectively. Nurses acted as health advocates (100%), offered psychological support (54.7%), fostered collaboration and networks (48.8%), and facilitated interventions (9.3%) addressing intrapersonal, organizational, and community-level factors of the socioecological model.</div></div><div><h3>Conclusion</h3><div>Further investigations into nurses’ roles in the exclusive management of overweight and obesity are warranted. Focus on their contributions at the interpersonal and policy levels is also necessary.</div></div>","PeriodicalId":54705,"journal":{"name":"Nursing Outlook","volume":"73 2","pages":"Article 102377"},"PeriodicalIF":4.1,"publicationDate":"2025-02-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143378937","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Reimagining policy visibility: Bibliometric analysis of core nursing journals","authors":"Ruth Ludwick PhD, RN-BC, APRN-CNS, FAAN ,&nbsp;Margarete L. Zalon PhD, RN, ACNS-BC, FAAN ,&nbsp;Rebecca M. Patton DNP, RN, CNOR, FAAN ,&nbsp;Micaela McSpadden MSN-Ed, RN, CNE, CNOR-PEDS ,&nbsp;Anita J. Slack MA, MLIS, AHIP ,&nbsp;Kristin Baughman PhD","doi":"10.1016/j.outlook.2025.102360","DOIUrl":"10.1016/j.outlook.2025.102360","url":null,"abstract":"<div><h3>Background</h3><div>Providing nurses with knowledge about policy enhances their involvement in policymaking. Policy inclusion in editorial guidelines has yet to be examined.</div></div><div><h3>Purpose</h3><div>Describe how peer-reviewed nurse journals' editorial information communicates policy expectations to readers and authors and then to describe policy in articles published in those journals.</div></div><div><h3>Methods</h3><div>Using a list of nursing journals indexed in CINAHL, we analyzed each journal's author guidelines and key attributes. Journals that addressed policy guidelines were examined for articles that denoted policy as the subject focus, and the research team descriptively analyzed those articles.</div></div><div><h3>Findings</h3><div>Only half the journals included policy as a focus (aim, scope, or description), author guidelines, or column. Within this subset of journals, only 267 articles published in 2022 out of 4,085 (5.6%) had policy as a subject focus.</div></div><div><h3>Discussion</h3><div>Consistently and regularly addressing policy in nursing journals may facilitate nurse authors’ dissemination and reader awareness about policy.</div></div>","PeriodicalId":54705,"journal":{"name":"Nursing Outlook","volume":"73 2","pages":"Article 102360"},"PeriodicalIF":4.1,"publicationDate":"2025-02-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143326268","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Unlocking the potential of primary healthcare nurse practitioners globally: A concept analysis of their added value","authors":"Isabelle Savard MSc, MPH, PhD(c) ,&nbsp;Gina Sophia Costanzo BscN, eMBA ,&nbsp;Colette Henderson MSc, BSc (Hons) NP, DHSCI (c) ,&nbsp;Deborah C. Gray MSc, DNP, FNP-C ,&nbsp;Melanie Rogers RN, MSc NP, PhD ,&nbsp;Kelley Kilpatrick PhD","doi":"10.1016/j.outlook.2025.102358","DOIUrl":"10.1016/j.outlook.2025.102358","url":null,"abstract":"<div><h3>Background</h3><div>Primary healthcare nurse practitioners (PHCNPs) are expanding globally to meet rising healthcare demands. Despite positive outcomes, their added value remains underexplored.</div></div><div><h3>Purpose</h3><div>To clarify and refine the added value PHCNPs bring.</div></div><div><h3>Methods</h3><div>Building on a previous concept analysis of the added value of nurse practitioners, we analyzed 37 systematic reviews focusing on PHCNPs’ roles across various settings, using Rodgers' evolutionary approach.</div></div><div><h3>Findings</h3><div>Attributes include PHCNPs’ skills and competencies, activities, positive outcomes, and professional autonomy. Antecedents involve PHCNP characteristics and structural and institutional factors, while consequences highlight improved patient outcomes, satisfaction, professional dynamics, and system efficiency.</div></div><div><h3>Discussion</h3><div>Understanding PHCNPs' added value is crucial for policy development, role implementation, and healthcare optimization. Clear regulatory frameworks and supportive policies are needed to maximize their impact.</div></div><div><h3>Conclusion</h3><div>This analysis provides and updates the conceptual definition of PHCNPs' added value, offering insights for policy, education, and research to support their critical role in healthcare.</div></div>","PeriodicalId":54705,"journal":{"name":"Nursing Outlook","volume":"73 2","pages":"Article 102358"},"PeriodicalIF":4.1,"publicationDate":"2025-01-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143076488","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A brief response to McLemore et al. regarding “Abortion is Healthcare: In What Sense?”","authors":"Grant R. Martsolf PhD, MPH, RN, FAAN ,&nbsp;Christopher Tollefsen PhD ,&nbsp;Farr Curlin MD","doi":"10.1016/j.outlook.2025.102355","DOIUrl":"10.1016/j.outlook.2025.102355","url":null,"abstract":"","PeriodicalId":54705,"journal":{"name":"Nursing Outlook","volume":"73 2","pages":"Article 102355"},"PeriodicalIF":4.1,"publicationDate":"2025-01-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143076485","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A call to action for disrupting microaggressions, improving interprofessional collaboration, and optimizing outcomes: Nurse leaders have a role","authors":"Bimpe Z. Adenusi PhD, APRN, CRNA ,&nbsp;Laurel Daniels Abbruzzese PT, EdD, FNAP ,&nbsp;Olaide Oluwole-Sangoseni DPT, MSc, Ph.D., FNAP ,&nbsp;Kathy Lee Bishop PT, DPT, CCS, FNAP ,&nbsp;Lydia Ann Thurston PT, DSc. ATC, FNAP ,&nbsp;Barbara Maxwell Ph.D., DPT, MSc, Cert THE, FNAP ,&nbsp;Phyllis Simon OTD, OTR/L, FNAP ,&nbsp;Travis Threats Ph.D., CCC-SLP, FNAP ,&nbsp;Andrea L. Pfeifle EdD, PT, FNAP ,&nbsp;Rita K. Adeniran DrNP, RN, NEA-BC, FNAP, FAAN","doi":"10.1016/j.outlook.2025.102354","DOIUrl":"10.1016/j.outlook.2025.102354","url":null,"abstract":"<div><h3>Background</h3><div>Microaggressions are pervasive in clinical and academic environments, often unnoticed by those unaware of the privileges and power dynamics tied to socially constructed hierarchies. These subtle manifestations of bias and prejudice are typically directed toward historically marginalized individuals and groups (HMIGs), contributing to a toxic culture that undermines interprofessional communication, collaboration, and healthcare delivery.</div></div><div><h3>Purpose</h3><div>This article aims to explore the concept of microaggressions and their impact on healthcare environments. It provides strategies to address microaggressions through education, self-reflection, and interventions at both individual and organizational levels, emphasizing the role of nurse leaders in fostering inclusivity and optimizing outcomes.</div></div><div><h3>Methods</h3><div>A brief review of the literature was conducted to define microaggressions and their types—microassaults, insults, invalidations, and environmental microaggressions. Strategies and frameworks for addressing microaggressions were evaluated, focusing on the roles of victims, perpetrators, and bystanders in promoting inclusivity and dismantling hierarchies.</div></div><div><h3>Discussion</h3><div>Microaggressions negatively affect workplace culture, interprofessional collaboration, and healthcare outcomes, perpetuating inequities. Strategies to address these include fostering education and self-reflection, creating organizational policies for inclusivity, and empowering nurse leaders to take active roles in mitigating microaggressions. Frameworks encourage all stakeholders to act, supporting a culture of equity and effective communication.</div></div><div><h3>Conclusion</h3><div>Dismantling hierarchies and promoting inclusive communication are essential for reducing bias, improving healthcare outcomes, and ensuring equity. Nurse leaders play a pivotal role in addressing microaggressions and fostering collaboration, ultimately contributing to a more inclusive and equitable healthcare system.</div></div>","PeriodicalId":54705,"journal":{"name":"Nursing Outlook","volume":"73 2","pages":"Article 102354"},"PeriodicalIF":4.1,"publicationDate":"2025-01-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143069651","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A reproductive justice investigation of utilizing digital interventions among underserved populations with criminal legal system supervision: Policy brief","authors":"Allison D. Crawford PhD, RN ,&nbsp;Lindsey Linder Geramifar JD ,&nbsp;Kelly McGlothen-Bell PhD, RN, IBCLC ,&nbsp;Emily Salisbury PhD","doi":"10.1016/j.outlook.2025.102349","DOIUrl":"10.1016/j.outlook.2025.102349","url":null,"abstract":"<div><h3>Background</h3><div>Mobile health interventions that utilize artificial intelligence may provide way for underserved populations to engage with healthcare.</div></div><div><h3>Purpose</h3><div>Examine the policy considerations that must be deliberated when developing, regulating, implementing, and sustaining mHealth apps among historically underserved individuals.</div></div><div><h3>Methods</h3><div>Reproductive Justice was used to investigate policy considerations for those with criminal legal system supervision who engage with mHealth apps. Three policy considerations resulted: 1) improving the legislative and regulatory landscape of digital technology, 2) enhancing comprehensive data protection legislation, 3) heightening privacy protections.</div></div><div><h3>Discussion</h3><div>The need to bring awareness to policy protections on the local, institutional, state, federal, and global levels specific to mHealth apps among underserved groups with criminal legal supervision is required.</div></div><div><h3>Conclusion</h3><div>These emerging advances in technology serve as an avenue for direct healthcare services to collaborate with other professions and organizations to implement ethical interventions that respect human rights and improve reproductive health equity.</div></div>","PeriodicalId":54705,"journal":{"name":"Nursing Outlook","volume":"73 2","pages":"Article 102349"},"PeriodicalIF":4.1,"publicationDate":"2025-01-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143069658","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Relationship between nurse staffing during labor and cesarean birth rates in U.S. hospitals","authors":"Audrey Lyndon PhD, RN, FAAN ,&nbsp;Kathleen Rice Simpson PhD, RN, FAAN ,&nbsp;Gay L. Landstrom PhD, RN, FAAN ,&nbsp;Caryl L. Gay PhD ,&nbsp;Jason Fletcher PhD ,&nbsp;Joanne Spetz PhD","doi":"10.1016/j.outlook.2024.102346","DOIUrl":"10.1016/j.outlook.2024.102346","url":null,"abstract":"<div><h3>Background</h3><div>Cesarean birth increases risk of maternal morbidity and mortality.</div></div><div><h3>Purpose</h3><div>Examine the relationship between labor and delivery staffing and hospital cesarean and vaginal birth after cesarean (VBAC) rates.</div></div><div><h3>Methods</h3><div>Survey of U.S. labor nurses in 2018 and 2019 on adherence to AWHONN nurse staffing standards with data linked to American Hospital Association Survey data, patient discharge data, and cesarean birth and VBAC rates.</div></div><div><h3>Findings</h3><div>In total, 2,786 nurses from 193 hospitals in 23 states were included. Mean cesarean rate was 27.3% (SD 5.9, range 11.7%–47.2%); median VBAC rate 11.1% (IQR 1.78%–20.2%; range 0%–40.1%). There was relatively high adherence to staffing standards (mean, 3.12 of possible 1–4 score). After adjusting for hospital characteristics, nurse staffing was an independent predictor of hospital-level cesarean and VBAC rates (IRR 0.89, 95% CI 0.84–0.95 and IRR 1.58, 95% CI 1.25–1.99, respectively).</div></div><div><h3>Discussion</h3><div>Better nurse staffing predicted lower cesarean birth rates and higher VBAC rates.</div></div><div><h3>Conclusion</h3><div>Hospitals should be accountable for providing adequate nurse staffing during childbirth.</div></div>","PeriodicalId":54705,"journal":{"name":"Nursing Outlook","volume":"73 2","pages":"Article 102346"},"PeriodicalIF":4.1,"publicationDate":"2025-01-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143069614","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"An examination of factors contributing to different anesthesia models in underserved areas","authors":"Ashley Palmer PhD ,&nbsp;Jared Sawyer MPH ,&nbsp;Alexa Beeson MPP ,&nbsp;Samantha Rosner MPH ,&nbsp;Isha Padhye BA ,&nbsp;Holly A. Andrilla MS","doi":"10.1016/j.outlook.2025.102352","DOIUrl":"10.1016/j.outlook.2025.102352","url":null,"abstract":"<div><h3>Background</h3><div>Maternity care access is worsening across the United States, driven in part by difficulties staffing obstetric units in some hospitals. Certified registered nurse anesthetists (CRNAs) provide obstetric anesthesia services in underserved areas, including rural areas (<span><span>Cohen et al., 2021</span></span>, <span><span>Martsolf et al., 2019</span></span>), areas with low delivery volumes (<span><span>Kohzimannil et al., 2015</span></span>) and areas with more vulnerable populations (<span><span>Liao et al., 2015</span></span>).</div></div><div><h3>Purpose</h3><div>This study examines the characteristics of hospitals that rely on CRNAs to provide anesthesia services in their obstetric departments, including hospital-level characteristics and state-level policy decisions.</div></div><div><h3>Methods</h3><div>We use an exploratory and explanatory sequential mixed-method design that relies on two series of key informant interviews and a survey of CRNAs practicing obstetric anesthesia.</div></div><div><h3>Discussion</h3><div>We find that CRNAs practice without medical direction more frequently in areas where fewer maternity care services are available, indicating that CRNAs may be filling an important vacancy in access to care.</div></div><div><h3>Conclusion</h3><div>Findings support the idea that CRNAs are vital in areas which would otherwise lack anesthesia providers and obstetric services. Policies that support hospitals in allowing CRNAs to practice without medical direction may increase access to hospital obstetric anesthesia services in underserved areas.</div></div>","PeriodicalId":54705,"journal":{"name":"Nursing Outlook","volume":"73 2","pages":"Article 102352"},"PeriodicalIF":4.1,"publicationDate":"2025-01-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143061328","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}