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Purpose: This mixed-methods study assesses an innovative course design model that integrates community site visits and service-learning at the introductory level for Undergraduate Rehabilitation Education (URE) students (n = 44). Method: The authors used a survey design to analyze service-learning outcomes and civic attitudes to evaluate the course design. A panel of three independent raters analyzed student weekly papers based on research rubrics of the course objectives created by the authors. Results: The results demonstrate that the model is effective in altering student cognitive schemes about human service populations and encouraging students to synthesize academic knowledge and immersive experiences. Conclusions: The study provides evidence for the design of integrating service-learning and site visits throughout the entire semester of an introductory course. This design is what we theorize specifically allowed for the two outcomes of primary importance, altered cognitive schemes about human services populations and synthesis of academic and experiential knowledge. [ABSTRACT FROM AUTHOR]

Background and Purpose: In two previous studies, the Certified Registered Nurse Anesthetist (CRNA) Workload Perception Scale (CWPS) was developed. The purpose of this paper is to report the final psychometric validation of the CWPS. Methods: An 11-item CWPS was tested in a population of CRNAs. Classical psychometrics were performed on the 11-item instrument piloted in a sample of 393 CRNAs. Results: Parametric and non-parametric analysis indicated 7 of 11 items were a good fit to measure perception of workload. Conclusions: A revised 7-item final CWPS was developed. [ABSTRACT FROM AUTHOR]

Background and Purpose: Few studies have critically appraised Perceived Stress Scale (PSS) in immigrants. The purpose of the article is to determine if PSS is adequately developed and properly used with U.S. immigrants. Methods: Searching via PubMed and PsycINFO databases resulted in 10 research papers published between 2009 and 2019 that met the selection criteria and were integrated for this review. Results: Most of the studies do not have adequate theoretical models and do not have proper consideration of socio-cultural factors. Five studies used the PSS translated into different languages but only one study validated the translated version. Six studies reported the reliability of the PSS. The PSS-14 and PSS-10 may be appropriately used in immigrants to measure psychological stress. Conclusions: Some issues, such as the PSS's reliability and validity, need to be addressed in future use in immigrants. [ABSTRACT FROM AUTHOR]

Background and Purpose: No scales measure self-efficacy in women with Type 2 diabetes. A scale was developed and tested. Methods: Items generated, content validity index (CVI) assessed by experts, the 2-part Diabetes Self-Efficacy Scale (DSLF-I and DSLF-II) was piloted with 62 women, administered to 208 women, and then readministered to 30 women to determine initial reliability. Factor analysis was conducted for construct validity. Discriminant, convergent, and predictive validity was examined. Results: The CVI index was 98%. Cronbach's alphas were 0.88 (DSLF-I) and 0.82 (DSLF-II; pilot) and 0.87 and 0.86, respectively (main study); test-retest correlation was .60 (DSLF-I) and .69 (DSLF-II). There were 3 factors that emerged: diabetes knowledge of self-care activity, diabetes diet self-care, and diabetes medication self-care. Conclusions: The Diabetes Self-Efficacy Scale demonstrates good initial reliability and validity. [ABSTRACT FROM AUTHOR]

The purpose of this study is (a) to identify research terms and clusters of knowledge areas in articles published by the Rehabilitation Counseling Bulletin (RCB) and (b) to explore the quantity and networks of the publications. The current study used bibliometric analysis. Metadata of RCB publications included in the Web of Science database between October 25, 2012, and October 25, 2022, were elicited through database search and analyzed by the "VOSwiever" program. The results indicated that the total number of documents published between 2012 and 2022 was 259. There were publication collaborations between the countries of England, China, Taiwan, South Korea, Turkey, Norway, and the United States. Additionally, the results provided three different clusters for the co-occurrences of the terms in abstracts and titles. The first cluster was related to psychosocial factors; the second cluster was related to vocational rehabilitation and employment; and the third cluster was related to psychometric validation terms. The current study supported exploring and determining hot spots and research gaps in the field of RC. Although the RCB publications were in line with the journal's aim and policy, the RCB may benefit from publishing a greater number of review articles, theoretical concepts papers, and also, assistive technology, policy development, and demand side employment research. [ABSTRACT FROM AUTHOR]

Background: This paper aimed to describe the modification, translation, and psychometric testing of the Arabic version of the Belongingness Scale-Clinical Placement Experience (BES-CPE). Methods: This study included the following phases: modification of the original BES-CPE based on the qualitative findings from a previous study; translation and back-translation of the scale; evaluation of the content validity by experts from Saudi Arabia; evaluation of the internal consistency reliability; and other psychometric properties of the Arabic BES-CPE. Result: The results demonstrated acceptable psychometric properties. The Cronbach' s alpha ranged from 0.68 to 0.92. Conclusion: The Arabic BES-CPE is a promising tool that can be used to assess Saudi nursing students' sense of belonging. However, testing the tool with other undergraduate nursing students in a different context is recommended. [ABSTRACT FROM AUTHOR]

The main purpose of this review article was to collect and summarize all available papers that reported empirical data related to men's and women's motivations for IPV. To facilitate direct gender comparisons, the motives reported in each obtained study were coded by the current authors into seven broad categories: (a) power/control, (b) self-defense, (c) expression of negative emotion (i.e., anger), (d) communication difficulties, (e) retaliation, (f) jealousy, and (g) other. Across the 75 samples (located in 74 articles) that were reviewed and coded for this study, 24 contained samples of only women (32%), 6 samples consisted of only men (8%), and 46 samples used both women and men (62%). Power/control and self-defense were commonly measured motivations (76% and 61%, respectively). However, using violence as an expression of negative emotion (63%), communication difficulties (48%), retaliation (60%), or because of jealousy (49%) were also commonly assessed motives. In 62% of the samples, at least one other type of motive was also measured. Only 18 of the located study samples (24%) included data that allowed for a direct gender comparison of men's and women's reported motivations. Many of these studies did not subject their data to statistical analyses. Among those that did, very few gender-specific motives for perpetration emerged. These results should be viewed with caution, however, because many methodological and measurement challenges exist in this field. There was also considerable heterogeneity across papers making direct gender comparisons problematic. [ABSTRACT FROM AUTHOR]

BACKGROUND: This article describes the follow-up study to Simulation Learning Among Low Literacy Guatemalan Traditional Birth Attendants , published in the International Journal of Childbirth in 2017. This current study had two purposes: (a) to implement and evaluate the use of enhanced training modalities (active-learning strategies and use of technology in a remote area), and (b) to pilot training-of-trainer (ToT) methods. The current study builds upon the previous study in which we conducted and evaluated a simulation-based training among low-literacy Guatemala traditional birth attendants (TBAs). MATERIALS AND METHODS: In the current study, we conducted a focus group with experienced TBAs (n = 8) to elicit concepts and issues important to address in the training. The 60-hour training designed for low-resource settings, was enhanced with active-learning strategies, technology, and ToT modules. We assessed pre–posttest knowledge and attitudes by paper-pencil format, and pre–post skills by demonstration using simulation. RESULTS: Training participants (N = 31) included the eight experienced TBAs from the focus group. Knowledge, skills, and attitudes all improved, with statistical significance achieved in many parameters. Evaluation of the training was positive and enhancement strategies were noted as particularly helpful. Two participants participated in the additional ToT modules and are now collaborating to provide short educational programs to other TBAs in their regions. CONCLUSION: Training enhancement strategies have the potential to increase safe practice among TBAs where skilled birth attendants are lacking. Adding ToT modules enhances sustainability and exemplifies the importance of locally prepared trainers in a time when global interaction is severely limited. [ABSTRACT FROM AUTHOR]

Background and Purpose: Intracranial pressure (ICP) monitoring is crucial to decision making for neurologically injured patients, yet measurement of ICP varies greatly among practitioners. Methods: Unblinded, nonrandomized, observational pilot study comparing ICP values collected using pen and paper (P&P), electronic medical record (EMR), and video data with continuous data acquisition (CDA) technology. Results: ICP values did not significantly differ between EMR and P&P records, despite an average of 16 minutes difference in reporting times. ICP values varied significantly when comparing CDA data to EMR or paper. Conclusion: The results of this pilot study put in to question the validity of ICP values that are recorded in the medical record, which has implications for patient care and research. [ABSTRACT FROM AUTHOR]

While exposure therapy is the most effective psychological treatment for obsessive-compulsive disorder (OCD), anxiety, and traumatic stress-related disorders, it is not universally effective, indicating a need for further treatment optimization. This study investigated a shift in approach to exposure therapy with 29 treatment-refractory adults in an OCD clinic not responding to standard treatment, comprising habituation-based exposure therapy. Participants completed standard exposure as a continuation of standard clinic treatment, followed by an acceptance and commitment therapy (ACT) consultation session to assess psychological inflexibility processes interfering with treatment progress, and then an ACT-based exposure targeting behavior change through increasing psychological flexibility. After each exposure, participants and independent raters reported levels of psychological flexibility, rituals, distress, treatment engagement, and treatment perceptions. We observed that the shift to ACT-based exposure was associated with greater psychological flexibility, treatment engagement, treatment acceptability, and treatment preference. These findings suggest that there may be situations where ACT-based exposure has particular utility. [ABSTRACT FROM AUTHOR]

Increased emphasis has been placed on elucidating the contribution of client variables, such as treatment preference, to optimize evidence-based practice. This analog study sought to better understand variables associated with treatment preference using a convenience sample of college students (n = 54) who read brief descriptions of three interventions for negative thoughts—defusion, noticing, and restructuring. They rated each on acceptability and practicality and completed measures of cognitive fusion, emotional distress, and experiential avoidance as possible moderating variables. Restructuring was overwhelmingly preferred and rated as more acceptable than the two alternatives by both the overall sample and a distressed subsample. Preference for defusion or noticing was not predicted by ratings of acceptability or practicality but by elevated levels of cognitive fusion and emotional distress consistent with a compensation model. Limitations of the study and its implications for further research on psychotherapy preference and its integration within evidence-based practice are discussed. [ABSTRACT FROM AUTHOR]

Background and Purpose: The Acceptance and Action Diabetes Questionnaire (AADQ) is a tool for assessing the acceptance of thoughts and emotions related to diabetes in people living with the disease. This study aimed to examine the psychometric properties of the Swedish version of AADQ (Swe-AADQ) in a sample of adults with type 1 diabetes. Methods: To examine the psychometric properties of the Swe-AADQ, the Rasch model was used. Data for 120 individuals were included. Results: The Swe-AADQ showed an acceptable fit to the Rasch model. A sufficiently high value of the separation index indicated a capacity to distinguish between different levels of acceptance in the sample. The 7-point Likert scale was reduced to three categories suggesting an improvement in the ordering of the item thresholds. Conclusions: The Swe-AADQ possesses reasonable quality in terms of reliability and validity. However, there are some deficiencies regarding the categorization of the response rating that should be addressed. [ABSTRACT FROM AUTHOR]

Background and Purpose: Compassion is increasingly considered essential to quality nursing care and is a concept that is strongly embedded across cultures, including Chinese culture. The Patient Compassion Model (PCM) depicts the unique yet overlapping domains of compassion. The Sinclair Compassion Questionnaire (SCQ) was directly developed and validated from this empirical model. In this study, we sought to establish initial validation of a translated SCQ among Mandarin-speaking patients by assessing the transferability of the PCM and the clinical sensibility of the SCQ. Methods: Forward and back-translation of the PCM and SCQ were performed in accordance with World Health Organization guidelines. Qualitative interviews were used to assess the transferability of the PCM with conceptualizations of compassion within a Chinese context. Cognitive interviews were conducted to assess the clarity, readability, wording, questions, and response scales of the Mandarin translation of the SCQ. Qualitative data were analyzed using constant comparative analysis, and cognitive interviews were analyzed using framework analysis. Results: The original categories of the PCM were verified in this Mandarin-speaking patient population. Specifically, participants' understanding of compassion is described as consisting of healthcare provider virtues, emphasizing the importance of a virtuous response that sought to understand the individual and their unique needs, to relationally communicate from a place of shared humanity and to ameliorate suffering. Participants were able to answer, comprehend, and endorse all 15 Mandarin SCQ items, resulting in no modifications to the Mandarin SCQ. Conclusions: This study provides initial validation of the Mandarin SCQ and PCM. Future studies should consider further establishing the validity and reliability of the Mandarin SCQ among a larger Chinese patient population. [ABSTRACT FROM AUTHOR]

Background and Purpose: Cultural competence is significant in addressing the health needs of vulnerable populations. This study conducted psychometric testing of a cultural competency instrument in the Philippines. Methods: Brislin's translation and a cross-sectional online design were used. Exploratory factor analysis (EFA) with varimax rotation examined construct validity of the 23-item scale among 157 adult LGBTQ+ residents. The scale revealed overall reliability (α =.85) including two subscales (α =.87, α =.81, and α =.61). The EFA yielded three theoretical factorial solutions. Conclusion: The Filipino version of the instrument demonstrated reliability and validity. Measuring clients' perceptions of provider and organizational cultural competency can improve the utilization of healthcare in Filipino LGBTQ+ communities. Future research will examine the dimensional structures of the instrument among expanded LGBTQ+ communities. [ABSTRACT FROM AUTHOR]

Background and Purpose: This study aimed to develop and examine the psychometric properties of the "Preparedness for Transition to Survivorship Care Instrument" (PTSCI) for cancer survivors. Methods: A cross-sectional study of cancer survivors in Korea was conducted to test the reliability and validity of the PTSCI. Exploratory factor analysis (EFA), confirmatory factor analysis (CFA), and concurrent validity tests were conducted. Results: The EFA showed that the 7-factor structure of a 34-item PTSCI accounted for 61.5% of the total observed variance. In CFA, three competing models were created and compared to a 7-factor solution model. A 6-factor 31-item model showed the best fit and was chosen as the final PTSCI model. PTSCI is significantly associated with quality of life, psychological distress, and health promotion. Conclusions: PTSCI can be helpful in preparing for diverse psychosocial and behavioral issues faced by cancer survivors in the survivorship phase. [ABSTRACT FROM AUTHOR]

Background and Purpose: Clinical reasoning for nurses is considered a valuable component of clinical nursing competencies, but there are few tools to ascertain this. This study tested the Italian Nurses Clinical Reasoning Scale (I-NCRS) psychometric properties based on Levett-Jones' theoretical clinical reasoning model. Methods: Content, face, and construct characteristics were ascertained for their validity. The study had a two-phase design: (a) content and face validity and (b) construct validity. Results: Three factors emerged from the factorial analysis of our reference sample: nursing problems of health, nursing information of health, and nursing assessment of health. Conclusions: The scale represents a valuable tool for the self-assessment of the clinical reasoning skills of nurses. I-NCRS showed evidence of validity and reliability, being also useful for assessing clinical reasoning for educational and research purposes among Italian nurses. [ABSTRACT FROM AUTHOR]

Background and Purpose: Electronic health record systems (EHRSs) are widely used to record patients' data and should be compatible with nurses' workflow. The purpose of this study was to adapt the Workflow Integration Survey (WIS) to the Turkish language and examine the reliability and validity measures of the Turkish version of the scale. Methods: In this methodological study, data were collected between December 2019 and February 2020 from 120 nurses. This study included the following phases: translation and evaluation of the content validity; explanatory factor analysis and confirmatory factor analysis (CFA) and reliability analysis. The intraclass correlation coefficient (ICC) was used for the test–retest reliability with 30 nurses. Results: The results of CFA revealed a two factors' structure, and these two factors explained 50.57% of the total variance. This was confirmed (χ2/ df = 1.673, goodness-of-fit index = 0.948, incremental fit index = 0.923, comparative fit index = 0.918, root mean square error of approximation = 0.075, and standardized root mean square residual = 0.0604) using structural equation modeling. The total Cronbach's alpha value was found to be.702,.636, and.649 for the subscales. The ICC was calculated for test–retest reliability and was found to be 0.871. Conclusions: The validity and reliability of the WIS have been found to be sufficient. It is recommended that the validity and reliability studies on the WIS be conducted in different hospitals with a larger number of participants. Furthermore, the use of the scale in cross-cultural studies to evaluate the compatibility of EHRSs with nurses' workflow in different cultures is also suggested. [ABSTRACT FROM AUTHOR]

Background and Purpose: It is essential to address sexual health to ensure quality of life and sexual well-being; however, studies to measure sexual attitudes remain scarce. This study aimed to find reliability and validity evidence of the Brief Sexual Attitudes Scale (BSAS) using confirmatory factor analysis (CFA) among Filipino men. Methods: A cross-sectional study was conducted. Results: BSAS shows coefficient alpha of 0.90. CFA demonstrates goodness of fit (adjusted goodness-of-fit index =.82; goodness-of-fit index =.86; comparative fit index =.91; incremental fit index =.91; expected cross-validation index = 2.27; root mean square error of approximation =.08; [χ2 (213) = 927.45, p ≤.001], χ2/ df ratio = 4.35). Conclusions: BSAS is a valid and reliable questionnaire to assess sexual attitudes among Filipino men. Further research is needed to evaluate sexual attitudes in the promotion of sexual health across cultures. [ABSTRACT FROM AUTHOR]

Background and Purpose: An instrument to measure wellness behaviors in adolescent females did not appear in the literature. The purpose of this article is to describe the development and evaluation of the Self-Rated Abilities for Health and Practices Scale–Adolescent Version (SRAHP-A). Methods: Initial psychometric testing was conducted with a sample of 265 adolescents and young adults aged 13–24 years. Data collection occurred through paper and pencil surveys. Results: Exploratory factor analysis using maximum likelihood factor extraction method and oblique ration was conducted. A four-factor structure consisting of Exercise, Nutrition, Health Practices, and Well-Being emerged. Conclusions: Initial psychometric testing suggested that it is a valid and reliable measure of wellness behaviors in adolescent females. Further testing is necessary; however, it appears this instrument has the potential to move wellness care for adolescents and young adults forward. [ABSTRACT FROM AUTHOR]

Objectives: The International Board of Lactation Consultant Examiners (IBLCE) sets strict criteria for the IBCLC credential. While all IBCLCs meet rigorous criteria, including specified health sciences background requirements, employers may require an IBCLC to have an additional credential. This practice may limit the availability of IBCLCs. The aim of this study was to determine what qualifications employers prefer or require for lactation care professionals. Methods: Three job posting websites in the United States were reviewed throughout the summer of 2022 for lactation consultant postings. During the study period, 448 unique lactation consultant job postings were identified. Results: Overall, 76% of job postings required an additional credential beyond the IBCLC, and there was a statistically significant preference for registered nurses (RNs; p <.005). This trend held true for inpatient hospital jobs specifically (p <.005). Public health jobs had a statistically significant preference for no additional credential (p <.005). Conclusions: According to the IBLCE, all IBCLCs are equally prepared to provide clinical lactation care. Employers, especially those with inpatient facilities, who require an IBCLC to be an RN are placing an additional barrier on the availability of qualified lactation professionals. Further research should explore the reasons behind these additional qualifications and the impact on the quality of lactation care provided. [ABSTRACT FROM AUTHOR]

Background and Purpose: The purpose of this article is to document the development and validation process of an instrument adapted for French-speaking nurses and to measure the occurrence of omitted nursing care (ONC) in the intensive care unit (ICU). Methods: An electronic Delphi panel, involving ICU nursing experts from the province of Quebec (Canada), was used to develop the intensive care unit omitted nursing care (ICU-ONC) instrument. For the validation process, an electronic cross-sectional survey was conducted. Results: A total of 564 nurses participated in the validation study. Exploratory factor analysis performed on 478 complete observations supports the presence of a single-factor structure for the 22-item ICU-ONC instrument. Coefficient alpha for the scale was.93, 95% confidence interval (CI) was [0.92, 0.94], item–partial total correlations ranged from.49 and.68, and the mean/median interitem correlations were.38 and.37, respectively. Moderate negative correlations were found between the ICU-ONC instrument overall score and two related constructs: nurses' perception of the quality as well as the safety of care. Conclusions: Our current understanding of ONC in the ICU is based on the results drawn from the administration of generic instruments to ICU nurses. The novel 22-item ICU-ONC instrument can help better estimate the occurrence of the phenomena in the ICU. [ABSTRACT FROM AUTHOR]

Background and Purpose: This study aimed to translate and validate a Japanese version of the Paternal Antenatal Attachment Scale (PAAS-J). Methods: The PAAS-J was translated through a pilot study and a survey of fathers with pregnant partners. Results: The survey involved 189 fathers. A confirmatory factor analysis was performed, but the model fit was poor. Therefore, an exploratory factor analysis (EFA) was performed. Based on the results of the EFA, three items with low interitem correlations and factor loadings were deleted, and a 13-item scale consisting of 2 domains was created. Coefficient alpha was.80. The intraclass correlation coefficient of the retest method was.80, confirming its reliability. Conclusions: The PAAS-J was found to be reliable and valid. [ABSTRACT FROM AUTHOR]

Background: HIV is a chronic infection that can lead to acquired immunodeficiency syndrome, a life-threatening condition. The highest number of new HIV diagnoses occurs in males, particularly Black men living in the southern region of the United States. Black men tend to test less frequently than other races. Objective: This pilot project was a quality improvement (QI) initiative to increase HIV screening rates among Black men who received healthcare at a Federally Qualified Healthcare Center (FQHC). Methods: The 8-week QI initiative was implemented during clinic hours. A retrospective chart review was performed to compare baseline with post-initiative HIV screening rates for eligible patients who received care in Birmingham, Alabama, which was shown to be low. Then, a risk assessment questionnaire was administered before providing educational materials to improve screening rates among Black men at an urban multisite FQHC. Results: HIV screening rates among Black men increased after the two-part initiative (20% and 21%, respectively). Conclusions: This QI initiative demonstrated that HIV screening rates could increase with tailored provider-initiated interventions, including risk assessment and educational materials. Implications for Nursing: A DNP or other healthcare providers could use this project to inform the development of a larger-scale QI initiative at an FQHC to improve HIV screening rates for under-resourced populations. [ABSTRACT FROM AUTHOR]

Heeding calls to examine multiple protective factors within single studies, this study tested whether resilience uniquely predicted higher life satisfaction and lower depression over the predictive ability of generalized self-efficacy (GSE) and mindfulness among 332 university students. A second purpose was to test whether resilience uniquely buffered the relationship between two forms of stress—cumulative stress from particular negative life events and general perceived stress—and both life satisfaction and depression over the buffering ability of GSE and mindfulness. In hierarchical multiple regressions, resilience uniquely predicted 3% of the variance in satisfaction with life and 1% of the variance in depression. GSE and mindfulness buffered the relationship between cumulative negative life event stress and depression. At higher levels of GSE and mindfulness, the relationship between cumulative negative life event stress and depression was weaker. [ABSTRACT FROM AUTHOR]

In social cognitive theory, belief in the ability to manage emotions renders these emotions less aversive. Reduced emotional reactions to stress and greater self-regulation have been linked to lower neuroticism. The purpose of this study was to ascertain whether self-efficacy for regulation of distress/despondency (SEDes) and anger (SEAng) and self-efficacy for experiencing and expressing positive emotions (SEPos) predicted lower subsequent neuroticism. A second purpose was to determine whether these forms of self-efficacy buffered the relationship between perceived stress and subsequent neuroticism. Among 251 university students in the United States, perceived stress predicted 8% of the variance, and SEAng negatively predicted 2% of the variance, in time 2 neuroticism over 3–4 weeks. Contrary to hypotheses, high SEDes and SEPos did not protect against higher time 2 neuroticism when stress was high, but low levels of these forms of self-efficacy were risk factors for modestly higher time 2 neuroticism when stress was low. [ABSTRACT FROM AUTHOR]

Objective: Immigrant Muslim Arab women are a fast-growing and underserved minority group in the United States. Immigrant Muslim Arab women face breastfeeding challenges in accessing and seeking healthcare. Little is known about breastfeeding challenges that immigrant Muslim Arab women face to establish successful breastfeeding. This study aimed to identify the barriers and facilitators to adequate breastfeeding among immigrant Muslim Arab women who reside in a metropolitan area of the Southwestern United States and inform recommendations for practice. Methods: A cross-sectional, descriptive study was used to identify facilitators and barriers to adequate breastfeeding using the social–ecological model of health promotion. A survey was carried out with a convenience sample of 116 immigrant Muslim Arab women with at least one child, 5 years or younger, from a large metropolitan area between September and November 2016. Results: Facilitators of breastfeeding within the sample were high intentions to breastfeed, positive breastfeeding attitudes related to the benefits of breastfeeding, religious teachings promoting breastfeeding, and encouragement to breastfeed from the mothers' social support system. Several barriers to successful breastfeeding were related to lacking the specific knowledge of the benefits of breastfeeding and discomfort with breastfeeding in public and in front of strangers. Conclusions: Nurses and healthcare providers need to apply ecological breastfeeding interventions to promote optimal breastfeeding in this population. [ABSTRACT FROM AUTHOR]

Objectives: Physicians may be asked to prescribe, recommend, or discuss foods, herbs, and medications for low milk supply. It is unclear how factors such as education, experience, and regulations influence clinical practice. The objective was to document physicians' clinical practice surrounding pharmacologic, nutritional, and herbal products for the management of low milk supply. Methods: Physicians from two Facebook groups completed an anonymous, online survey about their clinical use of pharmaceutical, supplemental, and nutritional substances perceived to increase milk production. The association between practice patterns and lactation medicine expertise or country for different perceived galactagogues was determined. Results: A total of 307 physicians completed the primary portion of the survey. There was no difference in the proportion of physicians in Canada or the United States (U.S.) who were defined as lactation medicine experts. Canadian physicians were more likely to prescribe metformin, levothyroxine, and domperidone for low milk supply compared with U.S.-based physicians. Canadians and experts were more likely than U.S.-based and nonexpert physicians, respectively, to include herbs in their practice. Patient request, personal and clinical experience, and lack of education, research, or access were frequently selected as reasons for or against using a specific substance. Conclusions: The U.S. Food and Drug Administration ban on domperidone affects low milk supply management in North America. Though Canadian physicians prescribed domperidone without limitations, U.S. physicians were less likely to incorporate it into clinical practice. Despite a lack of evidence, physicians in North America frequently used herbs and foods to increase milk production. [ABSTRACT FROM AUTHOR]

Background: Diabetes is a chronic illness and increasing among older populations. Self-care is a critical element in managing diabetes. Orem's Self-Care Deficit Nursing Theory (SCDNT) has been used and applied in nursing to explain significant self-care concepts. Although older Korean immigrants are marginalized in maintaining optimal health status and accessing adequate health services, related studies are still lacking. Utilization of Orem's SCDNT allows nurses to better understand associated factors in self-care among older Korean immigrants with diabetes. Purpose: The first aim is to explain the significant concepts of SCDNT. The second aim is to examine basic conditioning factors on self-care among older Korean immigrants with diabetes based on Orem's SCDNT. Methods: Each concept and structure of Orem's SCDNT was described with a table and figure. The 10 basic conditioning factors in self-care among older Korean immigrants with diabetes were investigated based on the previous literature and discussed in terms of Orem's SCDNT. Results: By exploring the 10 basic conditioning factors among older Korean immigrants, nurses can identify related factors in the self-care of this minority immigrant group and initiate the development of culturally tailored and age-specific nursing interventions. Implications for Nursing Practice: This study provides an understanding of related self-care factors among older Korean immigrants with diabetes. Additionally, the findings will help nurses to develop customized effective interventions and implement appropriate diabetes care for this minority group. [ABSTRACT FROM AUTHOR]

Background and Purpose: Cultural competence in clinical nurses can lead to comprehensive care for patients from different cultures. Currently, an appropriate instrument to assess cultural competence in clinical nurses is limited. This study aimed to design and determine the psychometric properties of the clinical nursing cultural competence scale (CNCCS). Methods: This methodological study was conducted in 2018–2019 in two phases. In the first phase, a literature review and semistructured interviews with 18 clinical nurses from Isfahan and Ahvaz were conducted, and the results were used for item generation. In the second phase, the face, content, construct validity, and reliability of the questionnaire were assessed. For construct validity assessment through exploratory factor analysis (EFA), 200 clinical nurses were purposefully recruited to fill out CNCCS. Results: In the first phase, 140 items were produced. In the second phase, the item number was reduced to 40 after the face and content validity assessment. In EFA for construct validity assessment, 13 more items were deleted, and the remaining 27 items were loaded on six factors. The Cronbach's alpha and the test–retest intraclass correlation coefficient were CNCCS 0.86 and 0.93, respectively. Conclusions: The CNCCS had acceptable psychometric characteristics in Iranian nurses and can be used for assessing cultural competence among clinical nurses. The use of this scale can help nursing policymakers and managers develop their understanding of nursing cultural competence and develop strategies for its improvement. [ABSTRACT FROM AUTHOR]

Background and Purpose: The main aim of this study has been the psychometric validation of an Italian translation of the Nurse Professional Competence Scale-Short Form (I-NPCS-SF), testing its validity and reliability. Methods: A multiphase design was used for the I-NPCS-SF translation and psychometric validation: (a) cultural and linguistic validation, (b) content and face validity, and (c) construct validity. Results: The I-NPCS-SF showed adequate linguistic translation, cultural adaptation, and content validity. Confirmatory factor analysis supported a four-factor structure of the I-NPCS-SF, in explaining data obtained from nurses and nursing students. Conclusions: The I-NPCS-SF demonstrated evidence of validity and reliability in measuring four professional competencies. Having an appropriate tool to be applied in the Italian context for professional competence self-assessment constitutes an essential step in measuring professional competencies. [ABSTRACT FROM AUTHOR]

Domestic violence and abuse (DVA) within relationships is a worldwide problem, which has detrimental direct and indirect consequences. Indeed, the negative health effects of DVA have been evidenced both nationally and internationally. It is also increasingly acknowledged that men experience DVA, and the gendered experience of DVA by those who identify as men has been explored in recent studies and reviews. However, there is still little known about how male victims of DVA utilize support services, particularly in countries like Ireland where masculinity stereotypes may be particularly powerful. In the present study, an exploratory statistical analysis of 10 months of retrospective contact data from a DVA support service based in Ireland was conducted, which included 3,181 contacts made by 1,093 individuals. Of this, 2,507 contacts were made by 715 men. Analyses provided evidence as to who contacts the service, what kinds of DVA are reported, how these behaviors are reported, and what kinds of outcomes result from this contact. Of the 715 men who made contact, they were most likely to be married, living apart from their partner, between the ages of 35 and 54, with an average of 2.1 children. All types of DVA were reported but psychological abuse was the most common, with 69.5% of the 2,507 contacts from male victims containing a report of psychological abuse. Contact was made by telephone in most cases (80%) and information was the most common outcome, being provided on 55.2% of contacts. Results provide important information about the utilization and characteristics of calls received by an Irish DVA support service, which will inform the enhancement of services provided to vulnerable men and their families. [ABSTRACT FROM AUTHOR]

Purpose: Pregnancy and birth is often a joyous period for a dyad. In the instance of fetal death, however, dyads are met with a devastating loss of their child, the hope for the future, and the new reality of becoming a bereaved parent. The purpose of this qualitative study was to investigate the lived experience of the dyad following a fetal death and capture the essence of the grief journey. Study design and methods: A hermeneutic phenomenological study was performed using van Manen's method for data collection and analysis. Semi-structured interviews were conducted via Zoom. Participants were recruited from national and local agencies providing education and resources about perinatal loss. Data analysis utilized the Dedoose software platform to track qualitative coding. Results: Ten dyads (20 individuals) from the United States and Canada participated. The data revealed four major themes with several subthemes. The major themes were as follows: "The child I'll never really know": Pregnancy loss grief; "You're on a rollercoaster, just hold on": The emotional journey; Climbing uphill: Barriers to healing ; and Resurfacing from grief: Healing after loss. Clinical implications: The death of a fetus over 20 weeks gestation provides a unique experience of grief. The findings support the need for additional resources needed beyond the hospital by nurses or other providers to facilitate healing and minimize complicated grief. Furthermore, the findings support the need for increasing awareness among healthcare providers and peers about how to communicate and care for dyads experiencing fetal death. [ABSTRACT FROM AUTHOR]

Doula care improves maternal care, yet barriers exist to incorporating doula care. The purpose of this study was to evaluate interest and barriers to doula care. Overall, 508 women, 26–35 years of age (54.5%), White/Caucasian (89.8%), and married (88.6%), completed this study. Most reported ≥1 previous birth (97.6%). Respondents would "feel comfortable" (73.2%) and "more confident" (54.9%) with doula care at birth, and 57.9% reported their provider would be supportive of doula care. Only 39.0% expressed benefits to doula care during pregnancy compared to 72.6% at birth and 68.1% during postpartum. Most would hire a doula if health insurance covered some of the costs. Despite the recognized benefits and support of doula care, cost-associated barriers exist to the incorporation of doula care. [ABSTRACT FROM AUTHOR]

Background and Purpose: Engagement in one's healthcare is paramount to improving health outcomes. As adolescents begin their journey into adulthood and increase involvement in their health-care decision-making, it is critical to understand their ability to be involved in their healthcare. The purpose of this instrumentation study was to develop and evaluate the psychometric properties and underlying factors of the Adolescent Capacity to Engage Index (ACEI) tool which measures the construct of an adolescent's capacity to engage in their healthcare. Methods: This study had a two-phase approach. Phase 1 consisted of the pilot and cognitive testing of the items developed based on the literature and content expertise. Phase 2 was the testing of the final 21 item revised instrument among 15- to 17-year-old online teen panel (n = 226). Results: Psychometric testing revealed a valid and reliable 21 item scale with a four-factor solution. The Cronbach's alpha for the total scale was.901. The four subscales and each subscale Cronbach's alpha were: (a) Active Participation In Healthcare with Psychosocial Support to Aid/Foster Good Healthcare Choices, (.826); (b) Transition Readiness to Self-Management with Family Support to Guide/Foster Health/Healthcare Decisions, (.825); (c) Proactivity and Empowerment to Have a Say in Health/Healthcare, (.747); and (d) Technology Use to Seek Health/Healthcare Information (.648). Conclusions: This study demonstrated the ACEI is a psychometrically sound instrument with good internal consistency for the overall scale and subscales. The ACEI can be implemented in clinical practice to measure adolescents' engagement capacity in their healthcare and identify appropriate interventions based on ACEI score. Further research to determine engagement capacity among teens of various populations is warranted. [ABSTRACT FROM AUTHOR]

Background and Purpose: It is critical to accurately measure and understand the nurse practitioner (NP) work environment in which individual NP information is gathered but decisions or inferences are made at an aggregated, group level. However, there is little research on preconditions of aggregating individual-level data into group level in nursing research. This study was conducted to assess the multilevel reliability and group interrater agreement (IRA) of the Nurse Practitioner Primary Care Organizational Climate Questionnaire. Methods: Secondary data analysis from a cross-sectional survey with 247 NPs in 112 practices across 6 U.S. states in 2018–2019 was used. Results: The generalizability coefficients and values of IRA were acceptable (>.70), and values of ICC(1) were significant (.18–.38). Conclusions: Aggregating individual NP data to a higher group-level work environment construct is acceptable. [ABSTRACT FROM AUTHOR]

Background and Purpose: Currently, there is no available Finnish version of the Genomic Nursing Concept Inventory tool (GNCI). This study tested the validity, reliability, and clinical usability of a Finnish translation. Methods: A decision tree algorithm was used to guide the translation, as per International Society for Pharmacoeconomics and Outcomes Research guidelines. Item-Content Validity Index (I-CVI), modified kappa (k*) statistics, and Cronbach's alpha were calculated. Results: The I-CVI and k* values were "good" to "excellent" (I-CVI = 0.63–1.00, k* = 0.52–1.00), and Cronbach's alpha value was "good" (α = 0.816; 95% confidence interval: 0.567–0.956). Conclusion: The Mandysova's decision tree algorithm provided clear and rigorous direction for the translation and validity of the Finnish GNCI [ABSTRACT FROM AUTHOR]

Background and Purpose: Limited culturally relevant condom self-efficacy measures have been adapted for use with Chilean college students. This study aims to culturally adapt and measure the psychometric properties of the Condom Use Self-Efficacy Scale (CUSES) by use in college students in Chile. Methods: This cross-sectional study was carried out in six stages: (a) authorization from original authors, (b) translation, (c) back translation, (d) analysis of equivalences, (e) content analysis, and (f) exploratory factor analysis and reliability assessment. Results: Of the 460 college students who completed the Chilean CUSES (Ch-CUSES), 73.9% were women and 99% were single with a mean age of 20.5. Total scale Cronbach's alpha was 0.845, and factor analysis demonstrated six dimensions with 59.1% of the total variance. The factor loading scores of 21 items ranged between 0.515 and 0.921. Conclusions: Ch-CUSES shows good psychometric properties for assessing self-efficacy for condom use in Chilean college students. [ABSTRACT FROM AUTHOR]

Though the importance of the inclusion of multicultural and social justice competencies in rehabilitation counselor education has been attended to for years, we know little about the content, concepts, activities, and assignments included in multicultural counseling courses. This mixed-methods study analyzed 25 multicultural counseling syllabi from CACREP-accredited rehabilitation counseling programs. Results indicated that nearly half of the multicultural counseling syllabi analyzed took an essentialist approach to educate future rehabilitation counselors. Very few syllabi mentioned the immigrant and refugee experience, and no syllabi exploredsize diversity and/or anti-fat bias. Class assignments and activities assigned exercises focused largely on students' racial and ethnic identities. Additionally, results showed a common theme of ethnographic interviews, cultural site visits, and cultural immersion exercises. A call to action for counselor educators is included. [ABSTRACT FROM AUTHOR]

Demographic data projections for the United States indicate a significant increase in the population of older persons with disabilities. The Americans with Disabilities Act (ADA) mandates community access for individuals with disabilities, including older individuals who are aging with or aging into disabilities. However, there is limited research regarding the knowledge and the use of the ADA among this population specific to their perceptions and experiences regarding barriers and facilitators to community access and participation as mandated under the Act. The purpose of this qualitative focus group study was to explore the perceptions and experiences of a sample of older adults with disabilities regarding their community access, and their knowledge and utilization of the provisions of the ADA to facilitate community participation. Analysis of results identified three predominant themes within this sample of older adults: experiences with structural and attitudinal barriers to community access leading; fear of loss of autonomy and independence in the community, and how they deploy; coping and advocacy strategies to address barriers. Recommendations for improving ADA knowledge, access, and utilization among the population, as well as senior service providers, are also addressed. [ABSTRACT FROM AUTHOR]

Background and Purpose: To enhance critical care competency, it is necessary to develop and apply a clinical expertise-based competency training program. This study aimed to identify the perceived importance and performance of critical care nursing competency and the training priorities of competency-based training programs by nurses' clinical expertise. Methods: This was a cross-sectional descriptive survey with a convenience sample of 236 intensive care unit nurses. The critical care nursing competency of nurses was measured. Training needs were determined using an importance-performance analysis. Results: Competency areas with high training priority on the importance-performance matrix were skin assessment, emotional support, Code of Ethics, and collaboration for novice nurses, skin assessment and patient education for advanced beginner nurses, skin assessment and decision-making for competent nurses, and patient education and interprofessional collaboration for proficient nurses. Implications for Practice: Different training needs were identified according to the self-reported level of clinical expertise at four levels. Nursing administrators and educators should provide competency-based continuing education programs based on high-priority training areas according to the nurses' clinical expertise. [ABSTRACT FROM AUTHOR]

Background and Purpose: No valid and reliable instrument exists in Arabic to measure the spiritual perspectives of Arab Muslims and Christians. This study translated the Spiritual Perspective Scale (SPS; Reed, 1987) into Arabic and examined its psychometric properties. Methods: The Arabic SPS was tested in a convenience sample of 206 Jordanian Christians and 182 Jordanian Muslim undergraduate nurses. Correlational and exploratory factor analysis were used. Results: For both sample groups, the factor analysis supported a clear two-factor structure for the Arabic SPS. A significant moderate positive correlation between the spiritual perspectives and religiosity was in the expected direction. The internal consistency reliability of the Arabic SPS was high. This study revealed that the Arabic SPS is a valid and reliable instrument to measure spiritual perspectives among Jordanian Muslim student nurses and adult Christians. Implications for Practice: Developing an Arabic version of the SPS exhibited good evidence of validity and reliability is important because it contributes to the evaluation of the spiritual behaviors and spiritual values and beliefs of Arab nurses and their patients. It also opens the way for comparison and transcultural studies regarding individual's spiritual perspectives. [ABSTRACT FROM AUTHOR]

The current study examined the use of immersive technology as a way to improve access to high-quality interpersonal breastfeeding interactions in an undergraduate clinical lactation course. In particular, we investigated the impact of immersive consultation videos and related activities on student self-efficacy, motivational beliefs, and perceived skill level. Results indicate that usability was high, with participants rating videos, interactives, and activities positively. Students did report a significant increase in self-efficacy and their perceived ability to meet the course learning objectives; no significant changes in the level of interest or perceived skill were found. Our results demonstrate that high-quality immersive videos can be an important learning tool for teaching clinical skills when access to direct patient care is limited or absent. [ABSTRACT FROM AUTHOR]

Background & Purpose: This study aims to consolidate expert views and validated 371 items for developing spiritual intelligence instrument for Muslim nurses guided by the Spiritual Intelligence Model for Human Excellence (SIMHE). Methods: A Fuzzy Delphi Method (FDM) was used to validate these items and analyzed with Triangular Fuzzy Numbers and Defuzzification process. Views from 20 experts from three different backgrounds, namely, theology/Sufism, psychology and Islamic counseling, and evaluation and measurement, were also included in the validation process. Results: All items fulfilled the prerequisite of a threshold level of (d) ≤ 0.2, which obtained more than 75% of expert consensus and α -cut value ≥ of 0.5. Conclusion: The FDM analysis results indicated that all items could further validate the instrument using Rasch measurement analysis. [ABSTRACT FROM AUTHOR]

Background and Purpose: To report on the psychometric properties of the Acute Coronary Syndrome Response Index in adults without heart disease. Methods: Participants were enrolled online, using social media platforms and an email listserv. The sample of 1,040 was randomly split into two sub-samples for exploratory and confirmatory factor analysis. Results: Exploratory factor analysis yielded a four-factor solution for the knowledge subscale, a one-factor solution for the attitudes subscale, and a two-factor solution for the belief subscale. Subsequent confirmatory factor analysis demonstrated an excellent fit for the attitudes and beliefs subscales and an acceptable fit for the knowledge subscale. Conclusions: The Acute Coronary Syndrome Response Index can be used with individuals without diagnosed heart disease. However, researchers may wish to omit the incorrect items in the original version of this instrument. [ABSTRACT FROM AUTHOR]

Background and Purpose: To adapt, validate and assess the psychometric properties of the Readiness for Interprofessional Learning Scale (RIPLS-19 items), Interdisciplinary Education Perception Scale (IEPS-18 items) and Team Skills Scale (TSS-17 items) in 484 undergraduate students. Methods: Transcultural adaptation of the scales was performed. Internal consistency, test-retest reliability, factor analysis, and convergent and discriminant validity were determined. Results: The instruments showed good internal consistency and test-retest reliability for total score. However, factor analyses revealed differences in the subscales compared to the original validations. The RIPLS detected more differences, discriminating gender, race, course semester and course enrolled. The TSS and IEPS detected differences in age and course enrolled. Conclusions: These scales appear to have satisfactory psychometric properties and could be used in both research and education. The subscales, however, should be interpreted with caution. [ABSTRACT FROM AUTHOR]

Background: Persons living with disabilities have difficulty finding work, are discriminated against, and have high rates of unemployment. They face many barriers, including stereotyped perceptions that prevent employers from hiring people with disabilities. Objective: To promote equality in the employment market and to lower barriers, we at Gal College in cooperation with the School of Social Work at Tel-Aviv University developed an innovative multidimensional integrative program. Methods: The program offers a beneficial learning experience that integrates professional studies with a personal rehabilitation process as the students themselves cope and live with their disability. The program graduates then become rehabilitators who serve as employment placement workers and rehabilitation facilitators for others coping with disability. All the students completed at least 12 years of school, were between the ages of 25 and 55, and were out of work for a long period of time. Findings: The quantitative results reveal a high placement rate for program graduates. Over the years, this rate has increased from 79% to 100%, testifying to the program's success. Conclusions: Analyzes the dynamic learning model as well as the quantitative results and the successful transition from rehabilitee to rehabilitator. [ABSTRACT FROM AUTHOR]

Background: This study compared differences in work roles and functions, employment settings, job titles, and compensation received over a 12-year time period as reported by two different samples of undergraduate-trained personnel. Method: Using the same survey instrument from an earlier investigation conducted by Herbert et al. (2010), data from 166 respondents who graduated from 14 undergraduate rehabilitation programs across the country were asked to estimate the frequency and importance of each job task performed. Findings: Although there was a broad diversity in work tasks, as it relates to the ranking of job tasks performed on a daily basis and their relevance to client service outcome, there was a strong consistency between the current and earlier study, particularly among the highest ranked job tasks: providing emotional support, writing progress notes, obtaining client background information, and providing client training on problem-solving. It is also clear that undergraduate rehabilitation alumni continue working in diverse work settings and hold a wide variety of job titles earning an annual salary of $33,058, with half earning between $20,640–$35,000. Conclusions: Results from this study may be useful in terms of student recruitment information, program curriculum considerations, and accreditation requirements applicable to undergraduate rehabilitation education. [ABSTRACT FROM AUTHOR]

Background: This investigation examined what information is typically included in an undergraduate rehabilitation syllabus and how this information is presented in written form to students. Method: Syllabi (n = 117) from six undergraduate programs, each of which reflected a different program emphasis, were reviewed in terms of their framework (traditional, instructor-centered, student-centered, and enhanced) as well as categorical information contained in their narratives. Findings: An analysis of stylistic features indicate that undergraduate faculty tend to produce syllabi that are instructor-centered and support a pedagogical rather than an andragogical way of learning. The "typical" undergraduate course is a 3-credit offering with an enrollment of about 30 students that meets once or twice per week and is more likely taught by an adjunct faculty (nontenure track) member. While most faculty post information regarding instructor contact information, course description, learning objectives, grading system, and support services, greater variation was noted regarding posting office hours, expected student behavior (e.g., attendance, missing class, and participation), class policies (e.g., late/missing assignments and extra credit), and a description of teaching methods. Conclusion: Given the importance of how syllabi serve as an outline of course content and class policies, it is recommended that rehabilitation educators develop syllabi that are more student-centered and support adult learners. [ABSTRACT FROM AUTHOR]

Unplanned extubations (UEs) can have devastating effects on neonates. The purpose of this quality improvement project is to decrease the number of UEs in Lankenau Medical Center's 22-bed Level III NICU. The UE rate had risen to 4.6 UEs per 100 ventilator days in 2016. Transitioning to a standardized bundle for intubated infants has decreased the UE rate to less than 2 per 100 ventilator days since 2018. The UE rate continues to be monitored for ongoing accountability and further staff education when rates increase. [ABSTRACT FROM AUTHOR]

Background: Compassion fatigue is a negative consequence impacting caregivers of chronic illness, such as heart failure. Reliance on family caregivers is expected to rise, placing importance on recognizing family caregiver characteristics that contribute to compassion fatigue. Purpose: This study specifically examined the associations of characteristics of family caregivers caring for end-stage heart failure, compassion satisfaction, social desirability, and the family caregiver–nursing provider relationship on compassion fatigue. Methods: An adapted interaction model of client health behavior guided this cross-sectional survey, which comprised a demographic questionnaire, the Professional Quality-of-Life Scale, the caregiver–provider relationship assessment, the Marlowe–Crowne Social Desirability Scale Short Form (Form C), and the Bakas Caregiving Outcomes Scale. Results: There were 127 family caregivers (FCGs), primarily those who have been a caregiver for longer than 1 year (78.4%), who completed the entire survey. Increased compassion satisfaction and positive caregiving effects were associated with decreased compassion fatigue (p <.001), while increased social desirability was associated with increased compassion fatigue (p <.001). A positive family caregiver–nursing provider relationship was related to decreased compassion fatigue (p <.001). More compassion fatigue was seen with lower spiritual status (p <.001). Implications: The chronic progression of heart failure presents opportunities for nursing providers to assess caregivers and offer frequent interventions. Family caregivers may not ask for help. Nursing providers must foster relationships with family caregivers to prevent negative consequences and mitigate compassion fatigue. Future research on the nursing provider relationship and FCGs is needed. [ABSTRACT FROM AUTHOR]