Publications

Publications

Adaptation of the MISSCARE Survey to the Maternity Care Setting

Simpson, K. R., Lyndon, A., Spetz, J., Gay, C. L., & Landstrom, G. L. (2019). JOGNN - Journal of Obstetric, Gynecologic, and Neonatal Nursing, 48(4), 456-467. 10.1016/j.jogn.2019.05.005
Abstract
Missed nursing care is an important measure of nursing care quality that is sensitive to nurse staffing and is associated with patient outcomes in medical-surgical and pediatric inpatient settings. Missed nursing care during labor and birth has not been studied, yet childbirth represents the most common reason for hospitalization in the United States. The Missed Nursing Care (MISSCARE) Survey, a measure of medical-surgical nursing quality with substantial evidence for validity and reliability, was adapted to maternity nursing care using data from focus groups of labor nurses, physicians, and new mothers and an online survey of labor nurses. Content validity was evaluated via participant feedback, and exploratory factor analysis was performed to identify the factor structure of the instrument. The modified version, the Perinatal Missed Care Survey, appears to be a feasible and promising instrument with which to evaluate missed nursing care of women during labor and birth in hospitals.

Adherence connection for counseling, education, and support: Research protocol for a proof-of-concept study

Dunn-Navarra, A.-M., Gwadz, M., Bakken, S., Whittemore, R., Cleland, C. M., & D’Eramo Melkus, G. (2019). Journal of Medical Internet Research, 21(3). 10.2196/12543
Abstract
Background: The highest rates of new HIV infections are observed in African Americans and Hispanics/Latinos (ethnic minority) adolescents and young adults (youth). HIV-infected ethnic minority youth are less likely to initiate and maintain adherence to antiretroviral treatment (ART) and medical care, as compared with their adult counterparts. Objective: The objective of this research protocol was to describe our proposed methods for testing a peer-led mobile health cognitive behavioral intervention, delivered via remote videoconferencing and smartphones with HIV-infected ethnic minority youth, Adherence Connection for Counseling, Education, and Support (ACCESS). Our secondary aim was to obtain initial estimates of the biobehavioral impact of ACCESS on HIV virologic outcomes and self-reported ART adherence, beliefs and knowledge about ART treatment, adherence self-efficacy, and health care utilization (retention in care). Methods: An exploratory, sequential mixed-methods study design will be used with conceptual determinants of adherence behavior informed by the information-motivation-behavioral skills model. HIV-infected ethnic minority youth aged 16 to 29 years with a detectable HIV serum viral load of more than 200 copies/ml (N=25) will be recruited. Qualitative pretesting will be conducted, including semistructured, in-depth, individual interviews with a convenience sample meeting the study inclusion criteria. Preliminary analysis of qualitative data will be used to inform and tailor the ACCESS intervention. Testing and implementation will include a one-group pre-posttest pilot, delivered by a trained successful peer health coach who lives with HIV and is well-engaged in HIV care and taking ART. A total of 5 peer-led remote videoconferencing sessions will be delivered using study-funded smartphones and targeting adherence information (HIV knowledge), motivation (beliefs and perceptions), and behavioral skills (self-efficacy). Participant satisfaction will be assessed with poststudy focus groups and quantitative survey methodology. Bivariate analyses will be computed to compare pre- and postintervention changes in HIV biomarkers, self-reported ART adherence, beliefs and knowledge about ART, adherence self-efficacy, and retention in care. Results: As of December 2018, we are in the data analysis phase of this pilot and anticipate completion with dissemination of final study findings by spring/summer 2019. The major outcomes will include intervention feasibility, acceptability, and preliminary evidence of impact on serum HIV RNA quantitative viral load (primary adherence outcome variable). Self-reported ART adherence and retention in care will be assessed as secondary outcomes. Findings from the qualitative pretesting will contribute to an improved understanding of adherence behavior. Conclusions: Should the ACCESS intervention prove feasible and acceptable, this research protocol will contribute to a shift in existent HIV research paradigms by offering a blueprint for technology-enabled peer-led interventions and models.

Adherence to the AWHONN Staffing Guidelines as Perceived by Labor Nurses

Simpson, K. R., Lyndon, A., Spetz, J., Gay, C. L., & Landstrom, G. L. (2019). Nursing for Women’s Health, 23(3), 217-223. 10.1016/j.nwh.2019.03.003
Abstract
Objective: To evaluate the degree to which registered nurses perceive their labor and delivery units to be adhering to Association of Women's Health, Obstetric and Neonatal Nurses (AWHONN) staffing guidelines. Design: Prospective, cross-sectional study via an online survey of labor nurses recruited from hospitals in three states. Setting/Local Problem: In late 2016 and early 2017, labor nurses in selected hospitals in California, Michigan, and New Jersey were contacted via e-mail invitation to participate in a study about nursing care during labor and birth. Nurse leaders in each hospital facilitated the invitations. Participants: A total of 615 labor nurses from 67 hospitals. Intervention/Measurements: Descriptive statistics and linear regression models were used for data analysis. Results: Most nurses reported that the AWHONN nurse staffing guidelines were frequently or always followed in all aspects of care surveyed. Hospitals with annual birth volumes of 500 to 999 range were significantly more likely than hospitals with 2,500 or more annual births to be perceived as compliant with AWHONN staffing guidelines. Conclusion: When the AWHONN staffing guidelines were first published in 2010, there was concern among some nurse leaders that they would not be adopted into clinical practice, yet nurses in our sample overwhelmingly perceived their hospitals to be guideline compliant. There remains much more work to be done to determine nurse-sensitive outcomes for maternity care and to ensure that all women in labor in the United States are cared for by nurses who are not overburdened or distracted by being assigned more women than can be safely handled. In our survey of 615 labor nurses, most reported that the AWHONN nurse staffing guidelines were frequently or always followed in all aspects of care surveyed.

Advancing Long-Term Care Science Through Using Common Data Elements: Candidate Measures for Care Outcomes of Personhood, Well-Being, and Quality of Life

Edvardsson, D., Rebecca, B., Corneliusson, L., Anderson, R. A., Anna, B., Boas, P. V., Corazzini, K., Gordon, A. L., Hanratty, B., Jacinto, A., Lepore, M. J., Leung, A. Y., McGilton, K. S., Meyer, J. E., Schols, J. M., Schwartz, L., Shepherd, V., Skoldunger, A., Thompson, R., Toles, M., Wachholz, P., Wang, J., Wu, B., & Zuniga, F. (2019). Gerontology and Geriatric Medicine. 10.1177/2333721419842672

Age and regional disparity in HIV education among migrants in China: Migrants population dynamic monitoring survey, 2014-2015

Zhu, Z., Guo, M., Petrovsky, D. V., Dong, T., Hu, Y., & Wu, B. (2019). International Journal for Equity in Health, 18(1). 10.1186/s12939-019-0999-x
Abstract
Objective: A lack of education among migrants remains an important but overlooked issue that indirectly contributes to HIV transmission. It is necessary to know who has received HIV education and who has a lower probability of being educated among migrants across different regions and age groups in China. Methods: We used pooled data from the 2014 and 2015 Migrants Population Dynamic Monitoring Survey. The study population included 406,937 Chinese migrants. Participants were asked whether they had received any HIV education after migrating to the destination city. Regions were categorized into east-coast, central, northwest, southwest, west-Tibet, west-Uyghur, and northeast regions. Hierarchical logistic regression modeling was conducted to investigate the relationships between the independent variables and HIV education. Results: Of 406,937 participants, half (50.6%) had reported receiving HIV education. Individuals in the west-Uyghur region had the highest proportion of receiving HIV education (73.0%), followed by the southwest region (67.9%) and the west-Tibet region (54.8%). Methods of receiving HIV education varied among different age groups. Individuals who were in a region with a higher prevalence of HIV, a lower density of medical professionals, and a higher density of migrants were more likely to receive HIV education. Conclusions: The study showed significant regional disparities among migrants in China. More HIV resources need to be allocated to regions with large-scale floating populations, such as the east-coast region. Providing multiple options, including both new and traditional media, for both young and elderly migrants is essential. HIV education should be tailored to the age of migrants with low educational and income levels.

Analgesic prescribing trends in a national sample of older veterans with osteoarthritis: 2012-2017

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Abstract
Few investigations examine patterns of opioid and nonopioid analgesic prescribing and concurrent pain intensity ratings before and after institution of safer prescribing programs such as the October 2013 Veterans Health Administration system-wide Opioid Safety Initiative (OSI) implementation. We conducted a quasi-experimental pre-post observational study of all older U.S. veterans (≥50 years old) with osteoarthritis of the knee or hip. All associated outpatient analgesic prescriptions and outpatient pain intensity ratings from January 1, 2012 to December 31, 2016, were analyzed with segmented regression of interrupted time series. Standardized monthly rates for each analgesic class (total, opioid, nonsteroidal anti-inflammatory drug, acetaminophen, and other study analgesics) were analyzed with segmented negative binomial regression models with overall slope, step, and slope change. Similarly, segmented linear regression was used to analyze pain intensity ratings and percentage of those reporting pain. All models were additionally adjusted for age, sex, and race. Before OSI implementation, total analgesic prescriptions showed a steady rise, abruptly decreasing to a flat trajectory after OSI implementation. This trend was primarily due to a decrease in opioid prescribing after OSI. Total prescribing after OSI implementation was partially compensated by continuing increased prescribing of other study analgesics as well as a significant rise in acetaminophen prescriptions (post-OSI). No changes in nonsteroidal anti-inflammatory drug prescribing were seen. A small rise in the percentage of those reporting pain but not mean pain intensity ratings continued over the study period with no changes associated with OSI. Changes in analgesic prescribing trends were not paralleled by changes in reported pain intensity for older veterans with osteoarthritis.

Assessing geriatric capacity building needs in public hospitals in Mexico

Squires, A., Caceres, B., Bub, L., & Negrete Redondo, M. I. (2019). International Journal of Older People Nursing. 10.1111/opn.12262
Abstract
AIMS To conduct a needs assessment of public hospitals in Mexico to determine workforce specific capacity building needs in the care of older people. BACKGROUND The older population in Mexico is growing rapidly. The healthcare system and workforce may not be prepared to handle the needs of older people, especially those with chronic illnesses who are also disadvantaged socioeconomically. Determining workforce and system needs is important to strategically develop capacity. METHODS A needs assessment using a pragmatic qualitative approach structured this study. Semi-structured interviews and focus groups were conducted with healthcare professionals at five public hospitals in Mexico. Directed content analysis techniques analysed the data. RESULTS Ninety-two healthcare professionals participated in the study. Three themes emerged, including geriatric service delivery, social changes and human resources for health. Participants reported a lack of gerontology knowledge and related clinical skills deficits to provide care for hospitalised elders and expressed emotional distress related to the lack of resources in their institutions. All healthcare professionals expressed strong concern at the social toll the ageing population had on families. The support of government organisations emerged as a facilitator for adoption of geriatric care principles. CONCLUSIONS This qualitative study uncovered important data to inform the implementation of quality improvement and capacity building models for older people care in Mexico. There appears to be strong potential for a culturally appropriate translation of high-income country older people care models within the Mexican healthcare context. IMPLICATIONS FOR PRACTICE Findings suggests there is a need to increase geriatric capacity building among helathcare professionals in Mexico. This will be an important step in improving care for hospitalised older people.

Association between dying experience and place of death: Urban-rural differences among older Chinese adults

Dong, T., Zhu, Z., Guo, M., Du, P., & Wu, B. (2019). Journal of Palliative Medicine. 10.1089/jpm.2018.0583

Association Between Health Literacy and Medication Adherence Among Hispanics with Hypertension

Lor, M., Koleck, T. A., Bakken, S., Yoon, S., & Dunn-Navarra, A.-M. (2019). Journal of Racial and Ethnic Health Disparities, 6(3), 517-524. 10.1007/s40615-018-00550-z
Abstract
Background: Poor adherence to prescribed antihypertensive medication is a major contributor to disparities in effective blood pressure control among Hispanics. The purpose of this study was to investigate the association between health literacy level and adherence to antihypertensive medications among Hispanic adults, who self-reported hypertension, controlling for potential covariates of adherence and/or health literacy. Methods: We conducted a cross-sectional survey of 1355 Hispanic adults, primarily Dominicans, who self-reported hypertension. Antihypertensive medication adherence and health literacy were evaluated along with covariates, including sociodemographic characteristics, depression, anxiety, and sleep disturbance. Linear regression models were created for health literacy, each covariate, and adherence. Factors found to be significantly associated with adherence in the individual regression models at a p value of < 0.20 were included in a hierarchical multiple linear regression model. Results: Overall, the majority of participants had low adherence levels to antihypertensive medications (88.4%; n = 1026) and inadequate health literacy (84.9%; n = 1151). When controlling for age, sex, birth country, education level, recruitment location, depression, anxiety, and sleep disturbance, having adequate as compared to inadequate health literacy was associated with a higher adherence score (b = 0.378, p = 0.043). The full model explained 13.6% of the variance in medication adherence (p value < 0.001), but the unique contribution of health literacy to the model was minimal (R 2 change = 0.003). Conclusions: Tailored interventions considering health literacy are needed to support medication adherence in order to improve hypertension outcomes of Hispanics. Additional studies are needed to identify and prioritize factors in the development of targeted and effective adherence interventions for Hispanics with hypertension.

Association of Obesity with DNA Methylation Age Acceleration in African American Mothers from the InterGEN Study

Li, C., Wang, Z., Hardy, T., Huang, Y., Hui, Q., Crusto, C. A., Wright, M. L., Taylor, J., & Sun, Y. V. (2019). International Journal of Molecular Sciences, 20(17). 10.3390/ijms20174273
Abstract
African American women are affected by earlier onset of age-associated health deteriorations and obesity disproportionally, but little is known about the mechanism linking body mass index (BMI) and biological aging among this population. DNA methylation age acceleration (DNAm AA), measuring the difference between DNA methylation age and chronological age, is a novel biomarker of the biological aging process, and predicts aging-related disease outcomes. The present study estimated cross-tissue DNA methylation age acceleration using saliva samples from 232 African American mothers. Cross-sectional regression analyses were performed to assess the association of BMI with DNAm AA. The average chronological age and DNA methylation age were 31.67 years, and 28.79 years, respectively. After adjusting for smoking, hypertension diagnosis history, and socioeconomic factors (education, marital status, household income), a 1 kg/m2 increase in BMI is associated with 0.14 years increment of DNAm AA (95% CI: (0.08, 0.21)). The conclusion: in African American women, high BMI is independently associated with saliva-based DNA methylation age acceleration, after adjusting for smoking, hypertension, and socioeconomic status. This finding supports that high BMI accelerates biological aging, and plays a key role in age-related disease outcomes among African American women.

Building Interprofessional Teams Through Partnerships to Address Quality

Cortes, T. (2019). Nursing Science Quarterly, 32(4), 288-290. 10.1177/0894318419864343
Abstract
Interprofessional collaborative education and practice is essential in the current complex healthcare climate. Barriers to interprofessional education include difficulty scheduling joint activities amid the silos of discipline-specific curricula and the lack of urgency by faculty to find innovative ways to commit to interprofessional training. Barriers in practice include poor understanding of the roles of different professionals and lack of awareness of the concept because the people in the workforce were mostly educated before interprofessional practice and education were prioritized by national bodies representing academic professions. The author of this paper describes opportunities for interprofessional education and practice and describes a way to create an educational-practice partnership to drive quality in healthcare settings.

Cardioprotective medication adherence among patients with coronary heart disease in China: a systematic review.

Ni, Z., Dardas, L., Wu, B., & Shaw, R. J. (2019). Heart Asia, 11(2). 10.1136/heartasia-2018-011173
Abstract
In China, poor cardioprotective medication adherence is a key reason for the high mortality rate of coronary heart disease (CHD). The aims of this systematic review are to (1) describe and synthesise factors that influence medication adherence among Chinese people with CHD, (2) evaluate the current status of intervention studies, and (3) discuss directions of future research to improve medication adherence. A comprehensive search using PubMed, Cumulative Index to Nursing and Allied Health Literature, Embase, Scopus, Global Health and PsycINFO was undertaken to describe poor adherence in China. Thirty-three eligible articles were included in the study. The review shows that there are multiple contributing factors to poor medication adherence, including patients' sociodemographic characteristics, health status and medication characteristics. In addition, from patients' perspective, lack of medication-related knowledge, such as the name, function, dosage and frequency, contributes to poor adherence. From physicians' perspective, a gap exists between CHD secondary prevention guidelines and clinical practice in China. Follow-up phone calls, educational lectures, booklets and reminder cards were common methods found to be effective in improving medication adherence. This systematic review indicates that cardioprotective medications were commonly prescribed as secondary prevention medication to patients with CHD in China, but adherence to these medications gradually decreased during a follow-up period. Therefore, more research should be conducted on how to establish high-quality health educational programmes aimed at increasing patients' medication adherence.

Cardiovascular Risk in Middle-Aged and Older Immigrants: Exploring Residency Period and Health Insurance Coverage

Sadarangani, T., Trinh-Shevrin, C., Chyun, D., Yu, G., & Kovner, C. (2019). Journal of Nursing Scholarship. 10.1111/jnu.12465
Abstract
Purpose: It is reported that while immigrants are, initially, healthier than the native-born upon resettlement, this advantage erodes over time. In the United States, uninsured aging immigrants are increasingly experiencing severe complications of cardiovascular disease (CVD). The purpose of this study was to compare overall CVD risk and explore the importance of health insurance coverage on CVD risk relative to other health access barriers, from 2007 to 2012, in recent and long-term immigrants >50 years of age. Methods: This study was based on secondary cross-sectional analysis of the National Health and Nutrition Examination Survey (N = 1,920). The primary outcome, CVD risk category (high or low), was determined using the American College of Cardiology and American Heart Association Pooled Cohort equation. Differences between immigrant groups were examined using independent-samples t tests and chi-square analysis. The association between insurance and CVD risk was explored using a hierarchical block logistic regression model, in which variables were entered in a predetermined order. Changes in pseudo R 2 measured whether health insurance explained variance in cardiac risk beyond other variables. Results: Recent immigrants had lower overall CVD risk than long-term immigrants but were twice as likely to be uninsured and had higher serum glucose and lipid levels. Based on regression models, being uninsured contributed to CVD risk beyond other health access determinants, and CVD risk was pronounced among recent immigrants who were uninsured. Conclusions: Health insurance coverage plays an essential part in a comprehensive approach to mitigating CVD risk for aging immigrants, particularly recent immigrants whose cardiovascular health is susceptible to deterioration. Clinical Relevance: Nurses are tasked with recognizing the unique social and physical vulnerabilities of aging immigrants and accounting for these in care plans. In addition to helping them access healthcare coverage and affordable medication, nurses and clinicians should prioritize low-cost lifestyle interventions that reduce CVD risk, especially diet and exercise programs.

Caregiver Contribution to Self-care in Patients With Heart Failure: A Qualitative Descriptive Study

Durante, A., Paturzo, M., Mottola, A., Alvaro, R., Vaughan Dickson, V., & Vellone, E. (2019). The Journal of Cardiovascular Nursing, 34(2), E28-E35. 10.1097/JCN.0000000000000560
Abstract
BACKGROUND: Caregiver contribution to heart failure (HF) self-care maintenance and management is important in HF care. Literature remains unclear regarding which practices caregivers perform to contribute to self-care for patients with HF, especially in Southern Europe. OBJECTIVE: The objective of this study was to describe caregiver contributions to HF self-care maintenance (ie, treatment adherence and symptom monitoring) and management (ie, managing HF symptoms when they occur). METHODS: Forty HF caregivers were enrolled from 3 outpatient clinics in Italy for a qualitative descriptive study. Data were collected with a semistructured interview and analyzed using content analysis. RESULTS: Caregivers were 53.6 years old on average and mostly female (63.5%). Caregiver contributions to self-care maintenance included practices related to (1) monitoring medication adherence, (2) educating patients about HF symptom monitoring, (3) motivating patients to perform physical activity, and (4) reinforcing dietary restrictions. However, some of these practices were incorrect (eg, weighing the patient only once a week). Caregiver contributions to self-care management included practices related to (1) symptom recognition and (2) treatment implementation. Caregivers were able to recognize symptoms of HF exacerbation (eg, breathlessness) but lacked confidence regarding treatment implementation (eg, administering an extra diuretic). CONCLUSIONS: Although caregivers described contributing to patients' HF self-care maintenance and management, some of their practices were incorrect. Because the caregiver contributions to HF self-care can improve patient outcomes, clinicians should routinely assess caregiver HF self-care practices and provide education and reinforcement regarding evidence-based practices.

Challenges to Diabetes Self-Management in Emerging Adults With Type 1 Diabetes

Ramchandani, N., Way, N., D’Eramo Melkus, G., & Sullivan-Bolyai, S. (2019). Diabetes Educator. 10.1177/0145721719861349
Abstract
Purpose: The purpose of this qualitative descriptive study undergirded by Meleis’s Transition Framework was to explore developmental, situational, and organizational challenges experienced by a diverse group of emerging adults (18-29 years old) with type 1 diabetes (T1DM). Their perspectives on creating a developmentally informed diabetes self-management (DSM) program that supports transitional care were also explored. Methods: A purposive sample of emerging adults with T1DM was recruited from the pediatric and adult diabetes clinics of an urban academic medical center. Those who consented participated in either a single focus group or a single interview. Self-reported demographic and clinical information was also collected. Results: The sample was comprised of 21 emerging adults, with an average age of 23.6 ± 2.6 years, diabetes duration of 14.7 ± 5.0 years, and 71% female. Four main themes emerged: (1) finding a balance between diabetes and life, (2) the desire to be in control of their diabetes, (3) the hidden burden of diabetes, and (4) the desire to have a connection with their diabetes provider. Use of insulin pumps and continuous glucose monitors and attendance at diabetes camp decreased some of the DSM challenges. Different groups of individuals had different perspectives on living with diabetes and different approaches to DSM. Conclusions: The emerging adults in this study had a strong desire to be in good glycemic control. However, all participants described having a hard time balancing DSM with other competing life priorities. They also desired personalized patient-provider interactions with their diabetes care provider in clinical follow-up services. Even though the study sample was small, important themes emerged that warrant further exploration.

Chinese Dementia Caregiver Intervention Research and its Future Development

Wu, B., Zhu, Z., Wang, J., & Xu, H. (2019). Chinese Nursing Management, 172-177.

Chinese Physicians’ Perspectives on the 2017 American College of Cardiology/American Heart Association Hypertension Guideline: A Mobile App-Based Survey

Ni, Z., He, J., Wang, J. G., Cao, J., Yang, Q., Wu, B., & Shaw, R. J. (2019). High Blood Pressure and Cardiovascular Prevention. 10.1007/s40292-019-00321-9
Abstract
Introduction: Hypertension is a leading global risk factor for death and disability. Seeking new ways to prevent and treat hypertension is a priority for scientists and healthcare professionals worldwide. In November 2017, the American College of Cardiology (ACC) and the American Heart Association (AHA) issued a new hypertension guideline shifting the definition of hypertension from 140/90 mm Hg to 130/80 mm Hg for systolic/diastolic blood pressure. This new diagnostic threshold of hypertension has sparked a lively discussion worldwide over whether it should be applied in clinical settings to diagnose and treat hypertension. China, the world’s most populous country, is facing a hypertension crisis. According to the 140/90 mm Hg guideline, China has an estimated 244.5 million population aged ≥ 18 years with hypertension, and another 435.3 million with pre-hypertension. If the new guideline is adopted, the prevalence of hypertension in China would double. This change would significantly impact patients, healthcare professionals, scientists, and policy makers in terms of the delivery of care and needed resources. Aim: This study aims to investigate whether Chinese physicians will use the 130/80 mm Hg threshold to diagnose hypertension in clinical practice. Methods: In March 2018, we launched a mobile app-based survey to study 253 Chinese physicians’ perspectives on the ACC/AHA Guideline. Results: A total of 253 physicians from 21 Chinese provinces completed the survey. Nearly 80% of the participants had already noticed the ACC/AHA guideline change. The proportion of participants who said they would use the new threshold to diagnoses hypertension was 41%, while 59% said they would not use the new threshold. The primary reason for those who said “yes” was that they believed early diagnosis of hypertension can trigger early actions to prevent the increasing blood pressure. For those who said “no”, they argued that their decision was based on the fact that the Chinese Hypertension Prevention Guideline had not yet changed the diagnostic threshold from 140/90 to 130/80 mm Hg. Conclusions: Different understanding of hypertension prevention and treatment exists among Chinese physicians. It is an emergent need to form an evidence-based authoritative answer to guide Chinese physicians’ future clinical practice.

A clinical exemplar: Assessment of knowledge regarding obesity preventative methods among african american children ages 9 to 11.

Gilles, S. (2019). DEStech Publications.

Cognitive function and oral health among ageing adults

Kang, J., Wu, B., Bunce, D., Ide, M., Pavitt, S., & Wu, J. (2019). Community Dentistry and Oral Epidemiology, 47(3), 259-266. 10.1111/cdoe.12452
Abstract
Objectives: There is inconclusive evidence that cognitive function is associated with oral health in older adults. This study investigated the association between cognitive function and oral health among older adults in England. Methods: This longitudinal cohort study included 4416 dentate participants aged 50 years or older in the English Longitudinal Study of Ageing during 2002-2014. Cognitive function was assessed at baseline in 2002/2003 using a battery of cognitive function tests. The self-reported number of teeth remaining and self-rated general oral health status was reported in 2014/2015. Ordinal logistic regression was applied to model the association between cognitive function at baseline and tooth loss or self-rated oral health. Results: Cognitive function at baseline was negatively associated with the risk of tooth loss (per each 1 standard deviation lower in cognitive function score, OR: 1.13, 95% CI: 1.05-1.21). When cognitive function score was categorized into quintiles, there was a clear gradient association between cognitive function and tooth loss (P-trend = 0.003); people in the lowest quintile of cognitive function had higher risk of tooth loss than those in the highest quintile (OR: 1.39, 95% CI: 1.12-1.74). A similar magnitude and direction of association were evident between cognitive function and self-rated oral health. Conclusion: This longitudinal study in an English ageing population has demonstrated that poor cognitive function at early stage was associated with poorer oral health and higher risk of tooth loss in later life. The gradient relationship suggests that an improvement in cognitive function could potentially improve oral health and reduce the risk of tooth loss in the ageing population.

Commercial Sexual Exploitation of Children: An Update for the Forensic Nurse

Hornor, G., Quinones, S., Bretl, D., Courtney, A. B., Herendeen, P. A., Lewin, L., Loyke, J. A., Morris, K., Schapiro, N. A., & Williams, S. (2019). Journal of Forensic Nursing, 15(2), 93-102. 10.1097/JFN.0000000000000243
Abstract
Commercial sexual exploitation of children (CSEC) is the sexual abuse of children through buying, selling, or trading their sexual services. This may involve engaging a child under the age of 18 years in prostitution, pornography, stripping, exotic dancing, escort services, or other sexual services. CSEC is a problem of epidemic proportions throughout the world including the United States; however, the actual number of CSEC victims in the United States is unknown. Studies indicate that most child victims are seen by a healthcare provider while being trafficked and that many victims receive care at a pediatric hospital within 1 year of their identification as a victim. CSEC is a significant pediatric healthcare problem. It is vital that forensic nurses possess a thorough understanding of the problem and be poised to better identify, intervene, and prevent CSEC. In this article, we focus on risk factors commonly experienced by victims, recruitment strategies used by traffickers, indicators to identify child victims, and intervention and educational strategies of relevance to forensic nurses.

A comparison of scheduling, work hours, overtime, and work preferences across four cohorts of newly licensed Registered Nurses

Stimpfel, A., Fletcher, J., & Kovner, C. (2019). Journal of Advanced Nursing. 10.1111/jan.13972
Abstract
Aims: To conduct a comparative analysis of four cohorts of newly licensed Registered Nurses and their work schedule, daily shift length, weekly work hours, second job, and weekly overtime hours. Nurses also reported their preferences regarding work schedule and daily shift length. Design: We used a retrospective, comparative design analysing four cross-sectional surveys from new nurses first licensed between 2004–2015. Methods: Using state licensure lists, nurses who were first licensed between 1 August 2004 and 31 July 2005 were randomly sampled using a nested design in 23 geographical areas in 13 states and Washington, DC. The same sampling strategy was conducted for subsequent cohorts in January 2009, 2012, and 2016. We sent a mailed survey measuring demographics, education, work attributes, and attitudes to participants with a $5 incentive, following methods by Dillman. Results: There were no statistically significant differences in average weekly work hours (39.4 hrs) or holding more than one job for pay (11.6–14.6% across all cohorts). There were statistically significant differences in overtime across cohorts and shift length by unit type. The preferred shift length was 12 hrs and day shift was the preferred work schedule. Conclusion: New nurses are predominantly scheduled for 12-hrs shifts and nearly half work weekly overtime, trends that have remained relatively stable over the past 10 years. Nurse managers, policy-makers, and researchers should pay attention to new nurses’ schedule and shift preferences and guard against mandatory overtime hours.

Compassionate care of the patient who uses substances: Implications for the infusion nurse.

Knapp, M., & Gilles, S. (2019). Journal of Infusion Nursing.

Content Validation of the Arabic Translation of the Practice Environment Scale of the Nursing Work Index-Revised

Ambani, Z., Al-Hamdan, Z., Al-Touby, S., Ghanim, A., Al Jarameez, F., & Squires, A. (2019). Journal of Nursing Measurement, 27(2), 234-246. 10.1891/1061-3749.27.2.234
Abstract
BACKGROUND AND PURPOSE: There is no reliable and valid version of the Practice Environment Scale of the Nursing Work Index-Revised (PES-NWI-R) in Arabic. The purpose of this study was to describe the systematic instrument translation and validation of the PES-NWI-R. METHODS: Using the Content Validity Indexing-based approach, 32 expert nurses from four countries in the Eastern Mediterranean Region (Jordan, Oman, Saudi Arabia, and United Arab Emirates) participated in the validation of this translation. RESULTS: The content validity index score of the overall scale was excellent (0.87 for the relevancy, and 0.95 for the quality of Arabic translation). CONCLUSION: Our study supported the content validity of the Arabic version of the instrument which provided the first valid Arabic translation of the instrument.

Correlational research between the status health literacy and health behavior of the inpatients with stroke

Li, J., Wu, B., Tian, F., Liu, J., Zhao, X., & Zhou, Y. (2019). Journal of Nursing Science (Chinese), 34(11), 13-15. 10.3870/j.issn.1001-4152.2019.11.00
Abstract
Objective: To explore the correlation between health literacy and healthy behaviors in patients with stroke, and provide corresponding reference for patients' rehabilitation intervention. Methods: A convenient sampling method was used to select 508 stroke patients from the neurology department and physiatry department of fore third-grade hospitals in Guiyang from November 2017 to March 2018. A total of 508 stroke patients were investigated and analyzed using the Chronic Diseases Health Literacy Survey Scale, the Health Promotion Lifestyle Scale II, and the General Survey Form. Results: The overall score of healthy behavior of stroke patients was (31.26±7.74) points, the overall score of healthy behavior of stroke patients was (123.26±23.74) points; Pearson correlation analysis: health literacy level and healthy behavior level were positively correlated (r=0.625,P<0.01); the relationship between the level of healthy behavior and the improvement of health will which is from the health literacy is the strongest (r=0.621,P<0.01); the correlation between the health literacy and the self-actualization level which is from healthy behaviors is the highest (r=0.562,P<0.01). Conclusion: The level of health literacy is positively correlated with the level of health behavior, and there is a positive correlation between each dimension. Medical personnel should start from the correlation between health literacy and health behavior, to improve the rehabilitation treatment of patients.

Debriefing approaches for high-fidelity simulations and outcomes related to clinical judgment in baccalaureate nursing students

Lavoie, P., Pepin, J., Cossette, S., & Clarke, S. (2019). Collegian. 10.1016/j.colegn.2019.01.001
Abstract
Simulation followed by debriefing is increasingly common in clinical nursing education. Yet, limited studies have compared approaches to debriefing—the portion of simulations where participants re-examine and make sense of their experience. In this study, 120 baccalaureate nursing students in Quebec were randomized to receive one of two types of debriefing (self-assessment with Plus-Delta vs. guided reflection using a structured tool with REsPoND) after each of four simulations (a hemorrhage scenario, two sepsis scenarios, and a trauma simulation) during which their situation awareness was measured as a proxy for their clinical judgment. Unexpectedly, situation awareness scores showed little to no consistency across students or simulations and no clear improvements over time were noted, which rendered the comparison of the debriefing approaches across scenarios problematic. However, when comparing the two iterations of the sepsis scenario, students who participated in a reflective debriefing showed greater improvement in their recognition of abnormalities in patient vital signs and level of consciousness than students whose debriefing involved self-assessment.