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Accessible Summary: What is known on the subject?: At the outset of the COVID‐19 pandemic, little was known about ways of delivering registered nurse practice within CMHTs under restrictions associated with a global pandemic.Emerging research focused on broad healthcare staff wellbeing during the pandemic. Qualitative research explored the overall response of COVID‐19 on people with existing health needs or remote working more specifically.Over the past 2 years studies have emerged detailing experiences but no studies have used qualitative research to understand community mental health nurses and service users experience of services. What the paper adds to existing knowledge?: This co‐produced qualitative study is the first to explore the changes to CMHT care from the experience of service users and nurses later in the COVID‐19 pandemic.The study questions whether recovery‐based approaches are possible in a hybrid way of working.The findings identify challenges for nurses' well‐being and work–life boundaries when working from home.The study adds to historical professional narratives of mental health nursing. What are the implications for practice: While hybrid approaches developed in response to COVID‐19 restrictions may offer more choice these approaches need further co‐produced evaluation on the impact of recovery‐focused care and therapeutic relationships.Mental health nurses need to review how future hybrid working continues to impact nurses' mental health and emotional safety.Nurses and service users need to raise awareness within society and policy on the impact that COVID‐19 had on people with existing mental health conditions. Introduction: Community Mental Health Team responses to COVID‐19 included fundamental service delivery adaptations. Aim/Question: Our co‐produced study sought to understand which service delivery changes experienced by service users and registered nurses were helpful or unhelpful to caregiving and receiving. Method: Qualitative semi‐structured interviews were undertaken with 10 service users and 13 registered nurses from 3 NHS England sites. Co‐produced throughout, people with lived experience of mental health services and nurses wishing to improve their research experience undertook interviews following training. Data were analysed thematically. Findings: Care radically changed from in‐person to large phone or video contact. This reportedly altered therapeutic relationship building and raised questions about whether recovery‐focused care was possible. Hybrid working was viewed as helpful but raised challenges for nurse wellbeing. Discussion: Changes to care delivery challenged the fundamentals of recovery‐focused interventions and therapeutic relationships. Service users and nurses well‐being consequently suffered. The impact of the pandemic on people with existing mental health conditions was poorly acknowledged in the media. Implications for Practice: Recovery‐focused interventions and relationship building need evaluating in the light of ongoing hybrid working. Teams need to consider the well‐being of nurses engaged in complex service‐user interactions from home. [ABSTRACT FROM AUTHOR]

Aims: To elicit experiences of patients, family caregivers, and healthcare professionals in intermediate care units (IMCUs) in an academic medical centre in Baltimore, MD related to the challenges and intricacies of multimorbidity management to inform development of a multimorbidity symptom management toolkit. Design: Experience‐based co‐design. Methods: Between July and October 2021, patients aged 55 years and older with multimorbidity admitted to IMCUs at an academic medical centre in Baltimore, Maryland, USA were recruited and interviewed in person. Interdisciplinary healthcare professionals working in the IMCU were interviewed virtually. Participants were asked questions about their role in recognizing and treating symptoms, factors affecting the quality of life, symptom burden and trajectory over time, and strategies that have and have not worked for managing symptoms. An inductive thematic analysis approach was used for analysis. Results: Twenty‐three interviews were conducted: 9 patients, 2 family caregivers, and 12 healthcare professionals. Patients' mean age was 67.5 (±6.5) years, over half (n = 5) were Black or Hispanic, and the average number of comorbidities was 3.67. Five major themes that affect symptom management emerged: (1) the patient–provider relationship; (2) open and honest communication; (3) accessibility of resources during hospitalization and at discharge; (4) caregiver support, training, and education; and (5) care coordination and follow‐up care. Conclusion: Patients, caregivers, and healthcare professionals often have similar goals but different priorities for multimorbidity management. It is imperative to identify shared priorities and target holistic interventions that consider patient and caregiver experiences to improve outcomes. Implications for the Profession and/or Patient Care and Impact: This paper addresses the paucity of research related to the shared experience of disease trajectory and symptom management for people living with multimorbidity. We found that patients, caregivers, and healthcare professionals often have similar goals but different care and communication priorities. Understanding differing priorities will help better design interventions to support symptom management so people with multimorbidity can have the best possible quality of life. Reporting Method: We have adhered to the Consolidated Criteria for Reporting Qualitative Studies (COREQ) guidelines in our reporting. Patient or Public Contribution: This study has been designed and implemented with patient and public involvement throughout the process, including community advisory board engagement in the project proposal phase and interview guide development, and member checking in the data collection and analysis phases. The method we chose, experience‐based co‐design, emphasizes the importance of engaging members of a community to act as experts in their own life challenges. In the coming phases of the study, the public will be involved in developing and testing a new intervention, informed by these qualitative interviews and co‐design events, to support symptom management for people with multimorbidity. [ABSTRACT FROM AUTHOR]

Aim: To examine the diagnostic reasoning skills of two nurse practitioner student cohorts. Introduction: Nurse practitioners continue to play a pivotal role in health care provision. Diagnostic reasoning is a core skill of advanced practice. A comparative diagnostic reasoning study between two student cohorts was undertaken between 2018 and 2019. Methods: A validated diagnostic reasoning scale was completed by nurse practitioner students in the United Kingdom and the United States of America at the beginning and end of their clinical placements. The study utilized descriptive quantitative statistics from the data submitted by 22 survey respondents from an online survey. Results: Analysis of the diagnostic reasoning skills suggested there was a difference in the structural memory scores when compared with the beginning of their clinical placements and the final semester of their clinical placements. Conclusion: Diagnostic reasoning skills are a core skill of advanced practice. As students progress through their training, these skills improve. Despite the statistical difference in diagnostic reasoning scores, caution should be made in determining any larger implications due to the small number of participants in this study. Further study is needed in this area. Summary statement: What is already known about this topic? Diagnostic reasoning is a core skill for nurse practitioners.There is minimal research in this area.Diagnostic accuracy is vital for ensuring patient safety. What this paper adds? Structural memory scores improved at the end of nurse practitioner clinical placements. What are the implications of this paper for policy/practice/research/education? Further global research in the field of diagnostic reasoning for nurse practitioners and nurse practitioner students is needed to validate these findings.It is important to ensure nurse practitioners have competency in diagnostic reasoning to reduce diagnostic error.Curricula could be designed to incorporate the use of the DTI to evaluate a student's progress throughout the clinical portion of the nurse practitioner programme. [ABSTRACT FROM AUTHOR]

Aim: The purpose of the study was to examine the influence of parenting stress, self‐efficacy and COVID‐19 health risks on general stress among nurses in the Midwest, United States, during the pandemic. Background: As frontline workers amidst the coronavirus disease 2019 (COVID‐19) pandemic, nurses have been subject to stressors at home and at work. Method: This quantitative, cross‐sectional study included 896 nurses with at least one child below 18 years of age. Using purposive sampling, participants answered an online survey composed of demographic questions, perception of COVID‐19 health risks, measures of self‐efficacy, general stress and parenting stress. Bivariate correlation and multiple regression were conducted. Data were collected from July 13 to August 13, 2020. Results: The four predictors, along with eight demographic covariates, accounted for 40% of the variance in general stress. Parenting stress and COVID‐19 health risks were positively related to general stress, while self‐efficacy was negatively associated with general stress. Conclusions: Results highlight the negative influence of parenting stress on nurses' general stress and the importance of self‐efficacy in reducing stress. Findings suggest that support services for nurses should focus not only on work‐related stressors but also consider parenting stressors, work‐home imbalances and self‐efficacy. Summary Statement: What is already known about this topic? Nurses are experiencing acute stress during the COVID‐19 pandemic because of the close proximity in dealing with infected and dying patients.Healthcare workers who have childcare obligations are facing more responsibilities at home and are less willing to report to work during a pandemic.High self‐efficacy among nurses has been found to significantly relate to willingness to work during a pandemic and that lower self‐efficacy is related to increased fear in caring for infected patients. What is already known about this topic? This paper adds to the limited research on the effects of parenting stress on nurses. This paper shows that parenting stress does contribute to nurses' overall perceived stress.Concerns about the potential risks if nurses themselves were to become infected and worries about the potential risks to family due to the nurses' clinical roles are significantly related to their general stress.In the context of the COVID‐19 pandemic, self‐efficacy can serve as a protective factor against stress for nurses working in the frontlines. The implications of this paper: The COVID‐19 pandemic has increased work stress for nurses and contributed to challenges in finding the balance between the increased demands at home and work. To help mitigate stress and support wellbeing of nurses, health care institutions and nurse managers might consider arranging educational parenting support groups, allowing more flexible work hours or self‐scheduling, extended rest days, providing free or subsidized childcare and offering professional development opportunities that enhance self‐efficacy among nurses.Challenges experienced by nurses must be addressed as sustained levels of work‐life imbalance may contribute to nursing shortages as nurses succumb to the strain of the stress created by the COVID‐19 pandemic. [ABSTRACT FROM AUTHOR]

Aims: To explore the relationship between nurse practitioner work environment and nurse practitioner outcomes (job satisfaction and intent to leave) in the United States. Design The study used a cross‐sectional survey design to collect survey data from primary care nurse practitioners in six states in the United States. Methods: We sent mail surveys to 5689 eligible nurse practitioners in Arizona, New Jersey, Washington, Pennsylvania, California and Texas. The mail also contained an online link. Participants could complete either the paper or online questionnaire. In total, 1244 participants completed the survey in 2018–2019. The work environment was measured using the Nurse Practitioner‐Primary Care Organizational Climate Questionnaire comprised of four subscales: Nurse Practitioner‐Administration Relations, Nurse Practitioner‐Physician Relations, Independent Practice and Support and Professional Visibility. Global items measured job satisfaction and intent to leave. We used mixed‐effect proportional‐odds cumulative logit models to assess the association between work environment and job satisfaction and intent to leave. Results: Overall, 90% of participants were either very satisfied or somewhat satisfied with their job and 22% reported intent to leave their job in 1 year. With a one‐unit increase in the organizational‐level Nurse Practitioner‐Administration Relations score, the odds of having a higher job satisfaction level increased by about four times and the odds of intent to leave job decreased by about 60%. A higher organizational‐level Nurse Practitioner‐Physician Relations score was significantly associated with higher job satisfaction and lower odds of intent to leave. Conclusion: Improvements in work environments may improve nurse practitioner job satisfaction and retention. Impact This study examined the relationship between work environment, job satisfaction and turnover intention of nurse practitioners. Better work environment is associated with higher job satisfaction and lower turnover intention. Findings have implications for clinical leadership who can take actions to create better work environments to increase the nurse practitioner workforce capacity. [ABSTRACT FROM AUTHOR]

Accessible Summary: What is already known about this topic?: Individuals with severe mental illness (SMI) have elevated risks for physical health problems and low screening rates.No previous studies have compared the physical health promotion needs of people with SMI using the same screening tool across different international settings. What this paper adds to existing knowledge?: It appears feasible to use the HIP to profile and compare physical health‐related risks in people with SMI across different international settings.The HIP tool identified significant differences in areas of risk across the four countries. What are the implications for practice?: The HIP could be used to identify unique clusters of health promotion needs in different countries.Use of HIP health checks may support implementation of individualized interventions. Introduction: To date, no studies have contrasted physical health profiles of people with severe mental illness (SMI) in different countries. Aim: To evaluate feasibility of using the Health Improvement Profile (HIP) to compare and contrast physical health and health behaviours of people with SMI from four countries. Method: An observational feasibility study using secondary analysis of pooled health state and lifestyle data. Physical health checks using modified versions of HIP were administered in four countries. Results: Findings suggest feasibility of HIP screening to profile and compare physical health and health behaviours of people with SMI across international settings. High overall numbers of risk items (red flags) were identified in all but the Thailand sample. Despite some commonalities, there were important differences in health profiles across countries. Discussion: This is the first study to demonstrate feasibility of the HIP to compare health risks in individuals with SMI across countries. Future multi‐national HIP studies should recruit a fully powered stratified random sample of people with SMI that is representative of each setting. Implications for practice: It appears feasible to utilize the HIP to identify specific areas of health risk in different countries, which may help to better focus nursing interventions and use of resources. [ABSTRACT FROM AUTHOR]

An evidence-based e-health program, e Care We Care, was developed to disseminate information on diabetes management through web-based interactive tutorials. This study examined the effect of the e Care We Care program on diabetes knowledge development in African American adults with low diabetes literacy. Forty-six African American adults with type 1 or type 2 diabetes and low diabetes literacy were recruited from two health-care centres in eastern Winston Salem, North Carolina. The e Care We Care program included four weekly sessions: introduction to diabetes; eye complications; foot care; and meal planning. Significant differences in scores on the diabetes knowledge survey were demonstrated between the e Care We Care program participants and the comparison group. Study findings indicate the e Care We Care program is more effective in improving diabetes knowledge of African American adults with low diabetes literacy than paper-based, text-only tutorials. The e Care We Care program can be an effective educational strategy for improving diabetes knowledge and decreasing diabetes disparities among African American adults. [ABSTRACT FROM AUTHOR]

Aims and objectives: This study aimed to measure the frequency of spiritual needs, identify the factors associated with these needs among Korean and American persons living with an advance chronic illness and compare them from a cross‐cultural perspective. Background: Persons with serious or life‐limiting illnesses often have spiritual needs. Unmet spiritual needs are associated with poor well‐being and threaten psychological health. Little is known about how specific spiritual needs vary across cultures. Design: A quantitative, cross‐sectional, observational cross‐cultural comparison was undertaken. Methods: The study has been prepared in accordance with the STROBE guidelines. Convenience sampling was used to recruit participants from outpatient clinics in South Korea and Southern California (N = 202). Spiritual needs were measured using the Spiritual Interests Related to Illness Tool (SpIRIT); demographic and illness‐related variables were also assessed using paper‐and‐pencil questionnaires. Data were analysed using various parametric statistical tests, including multiple regression analysis. Results: The findings quantify the intensity and types of spiritual needs that persons living with an advanced chronic illness experience. Furthermore, they show how the spiritual needs of religiously diverse samples of South Koreans and Americans differ. The findings also indicate that self‐reported spirituality and religiosity independently explain a substantial amount of the variance in spiritual needs. Conclusions: In both the samples, spiritual needs were reported and associated with spirituality and religiosity. Although all the eight domains of spiritual needs assessed by the SpIRIT were pertinent to the Korean and American samples, they were prioritised differently. Relevance to clinical practice: Screening patients to ascertain how important spirituality or religiosity is to them may help clinicians focus their in‐depth assessments on those who report high levels of spirituality or religiosity because these patients may experience the strongest spiritual needs. The SpIRIT shows promise as a measure of diverse spiritual needs. [ABSTRACT FROM AUTHOR]

Aim: To investigate the feasibility and acceptability of the training process, procedures, measures and recruitment strategies necessary for a future investigation to test the reliability and validity of using positivity resonance measures in health care encounters. Background: Although the measurement of positivity resonance is promising, and non‐participant observation is considered effective, their approaches to studying nurse–patient relationships have not been fully explored. Design: A mixed‐methods observational study. Methods: Video recordings of 30 nurse–patient dyads completing telehealth video visit encounters were edited and coded using behavioural indicators of positivity resonance. A post‐visit survey gathered data on the participants' perceptions of positivity resonance and the study procedures. The research team completed memos and procedural logs to provide narrative data on the study's training, coding, recruitment and operational procedures. The study included 33 persons with cancer and 13 oncology nurses engaging in telehealth video visit encounters at an academic oncology ambulatory care center located in the southeastern United States. Results: Study procedures were found to be feasible and acceptable to participants. An adequate sample of participants (N = 46) were enrolled and retained in the study. Interrater reliability, as evidenced by Cohen's weighted kappa, ranged from.575 to.752 and interclass correlation coefficients >.8 were attainable within a reasonable amount of time and with adequate training. Behavioural indicators of positivity resonance were observed in all telehealth visits and reported by the participants in the perceived positivity resonance survey. The Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) checklist guided reporting. Conclusions: Designing research around the concept of positivity resonance is an innovative and feasible approach to exploring how rapport is cultivated within nurse–patient relationships. Relevance to Professional Practice: Measuring positivity resonance may hold promise for exploring patient and nurse outcomes including trust, responsiveness, health‐related behaviours, well‐being, resilience and satisfaction. Reporting Method: The Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) checklist guided the reporting of results to ensure that adequate details of the study were provided to ensure an accurate and complete report. Patient or Public Contribution: Planning of the research design and study procedures was done in consultation with nurse clinicians with experience with telehealth and managers responsible within the practice setting where the study was conducted. This ensured the study procedures were ethical, safe, secure and did not create unnecessary burden to the study participants. The study included collecting data from nurse and patient participants about the acceptability of the study procedures. [ABSTRACT FROM AUTHOR]

Aim: To determine the association between nurse and institutional characteristics and perceived professional nurse knowledge and self‐efficacy of reporting child abuse and neglect. Design: A sample of N = 166 nurses were recruited to respond to the Reporting of Suspected Child Abuse and Neglect (RSCAN) survey. Methods: A multiple linear regression examined whether nurse characteristics and institutional characteristics were associated with the two RSCAN survey domain scores. Results: Perceived knowledge of a workplace child abuse and neglect protocol was associated with the knowledge subscale. Education and child abuse and neglect expertise were significant predictors of the self‐efficacy subscale. Nurses with a master's or higher degree and those who identified as being either forensic, paediatric or Emergency Department nurses, had less perceived institutional barriers to self‐efficacy of reporting child abuse and neglect. Conclusion: This study provides a preliminary insight into the institutional barriers and facilitators of nurses as child abuse and neglect mandated reporters. Implications for the profession and/or patient care: To encourage innovative education and collaborations to support nurses as fully informed child abuse and neglect mandated reporters. Impact: This research identifies the gaps and facilitators of nurses as child abuse and neglect mandated reporters to inform healthcare professionals and academic institutions on the importance of nurse education and experience in nurse knowledge and self‐efficacy in reporting suspected child abuse and neglect. Reporting methods: The authors of this study have adhered to relevant EQUATOR guidelines: STROBE. Patient or public contribution: There is no patient or public contribution as the study only looked at nurses. [ABSTRACT FROM AUTHOR]

Accessible summary: What is known on the subject?: Many nursing students have inadequate preparation for practice in mental health nursing in the United States and China. The concept of mental illness has different connotations in different cultures. Studies differ from country to country concerning the influence of nursing education on students’ knowledge about and attitudes towards mental disorders. There is a lack of cross‐cultural research that takes a broad perspective to explore how nursing students’ knowledge and beliefs about mental disorders are influenced by the culture within education and healthcare systems. What this paper adds to existing knowledge?: Nursing students in the United States and China shared similar views on a broad range of intervention options including professional help, psychotropic medications and activity interventions for managing depression and schizophrenia. The major difference between the two nursing student groups was that the Chinese students showed more preference to occasional alcohol consumption and specialized therapies including cognitive‐behavioural therapy and electroconvulsive therapy and the US students held less skepticism towards traditional and religious practices as possible treatment options for depression and schizophrenia. What are the implications for practice?: The Chinese nursing students need to be educated about safe alcohol consumption guidelines adopted by the National Health and Family Planning Commission. The US nursing students need to increase their awareness of national practice guidelines for managing mental disorders, particularly with respect to the use of specialized therapies such as cognitive‐behavioural therapy and electroconvulsive therapy. We support professional and psychosocial interventions in caring for patients with mental disorders. Abstract: INTRODUCTION: Nursing students in the United States and China have reported inadequate preparedness for practice in mental health nursing. It is important to investigate nursing students’ mental health literacy levels for a better understanding of their practice readiness in mental health field upon completion of their education. Aim: This study was aimed at developing an understanding of American and Chinese nursing students’ mental health literacy regarding the effectiveness of specific interventions for managing depression and schizophrenia. Method: The “Australian National Mental Health Literacy Survey” was completed by a group of 310 nursing students including 152 Americans and 158 Chinese between April 2016 and April 2017 to compare students’ rated intervention options on two provided vignettes. Results: The two student groups reached consensus on many intervention options. However, the Chinese students showed more preference to occasional alcohol consumption and specialized therapies and the US students held less skepticism towards traditional practices as treatment options for depression and schizophrenia. Discussion and implications for practice: The findings support professional and psychosocial interventions in caring for patients with mental disorders. There is a significant need for specific education on safe alcohol consumption guidelines for Chinese nursing students and clinical practice guidelines for managing mental disorders for American nursing students. [ABSTRACT FROM AUTHOR]

brewer c.s., kovner c.t., greene w., tukov-shuser m. & djukic m. (2012) Predictors of actual turnover in a national sample of newly licensed registered nurses employed in hospitals. Journal of Advanced Nursing 68(3), 521-538. Abstract Aim. This paper is a report of a study of factors that affect turnover of newly licensed registered nurses in United States hospitals. Background. There is a large body of research related to nursing retention; however, there is little information specific to newly licensed registered nurse turnover. Incidence rates of turnover among new nurses are unknown because most turnover data are not from nationally representative samples of nurses. Method. This study used a longitudinal panel design to obtain data from 1653 registered nurses who were recently licensed by examination for the first time. We mailed surveys to a nationally representative sample of hospital registered nurses 1 year apart. The analytic sample consisted of 1653 nurses who responded to both survey mailings in January of 2006 and 2007. Results. Full-time employment and more sprains and strains (including back injuries) result in more turnover. Higher intent to stay and hours of voluntary overtime and more than one job for pay reduces turnover. When we omitted intent to stay from the probit model, less job satisfaction and organizational commitment led to more turnover, confirming their importance to turnover. Magnet Recognition Award® hospitals and several other work attributes had no effect on turnover. Conclusion. Turnover problems are complex, which means that there is no one solution to decreasing turnover. Multiple points of intervention exist. One specific approach that may improve turnover rates is hospital policies that reduce strains and sprains. [ABSTRACT FROM AUTHOR]

suhonen r., papastavrou e., efstathiou g., lemonidou c., kalafati m., da luz m.d.a., idvall e., berg a., acaroglu r., sendir m., kanan n., sousa v.d., katajisto j., välimäki m. & leino-kilpi h. (2011) Nurses' perceptions of individualized care: an international comparison. Journal of Advanced Nursing 67(9), 1895-1907. Abstract Aim. This paper is a report of a study of internationally-based differences in nurses' perceptions of individualized care in orthopaedic surgical in-patient wards. Background. Individualized care is valued in healthcare policy, practice and ethical statements as an indicator of care quality. However, nurses' assessments of individualized care are limited and comparative cross-cultural studies on individualized nursing care are lacking. Methods. A descriptive comparative survey was used to sample orthopaedic surgical nurses ( n = 1163) working in 91 inpatient wards in 34 acute hospitals in Finland, Cyprus, Greece, Portugal, Sweden, Turkey and the United States of America. Data were collected between March and November 2009 using the Individualized Care Scale-Nurse and analysed using descriptive and inferential statistics. Results. Nurses in different countries perceived that they supported patients' individuality generally and provided individualized care during nursing activities. Although the highest scores were in support of patients' individuality in the clinical situation both through nursing provision and nurses' perceptions of individuality, there were between-country differences within these scores. Generally, the Greek and American nurses gave the highest scores and the Turkish, Cypriot and Portuguese nurses the lowest. Conclusions. Between-country differences found may be attributed to differing roles of nurses, care processes, healthcare systems and/or the ways nursing care is defined and organized. As this was the first time the Individualized Care Scale-Nurse was used in an international context, the results are formative and indicate the need to continue studies in this area. [ABSTRACT FROM AUTHOR]

Aims. This paper is a report of a study of perceived levels of mental, physical and total fatigue, and also acute and chronic fatigue states, among registered nurses. Relationships between dimensions of fatigue and performance were investigated, as were differences in fatigue across levels of several demographic and work environment variables. Background. Fatigue is a factor that has been linked to performance decrements in healthcare workers. As a result of the nature of their work, nurses may be particularly susceptible to multiple dimensions of fatigue, and their performance is closely linked to patient safety. Methods. An online survey was used to measure mental, physical, and total fatigue dimensions, acute and chronic fatigue states, and performance. Participants were recruited via convenience sampling in cooperation with professional nursing organizations; 745 registered nurses completed the survey between February 2008 and April 2009. Results. Reported mental fatigue levels were higher than physical fatigue levels, and acute fatigue levels were higher than chronic fatigue levels. All fatigue dimensions and states were negatively correlated with perceived performance. Longer shift lengths and hours worked per week were associated with increases in physical and total fatigue levels. Mental, physical and total fatigue levels also differed with shift schedule. Conclusions. Fatigue levels were negatively correlated with performance, further supporting the role of fatigue in nurse performance. Work environment variables were strongly associated with differences in perceived levels of fatigue. By altering the work environment, it may thus be possible to reduce fatigue levels and the rates of medical errors. [ABSTRACT FROM AUTHOR]

This paper investigates whether private information from lending activities improves the forecast accuracy of bank-affiliated analysts. Using a matched sample design, matching by affiliated bank or borrower, we demonstrate that the forecast accuracy of bank-affiliated analysts increases after the followed firm borrows from the affiliated bank. We also find that the increase in forecast accuracy is more pronounced for borrowers with greater information asymmetry and bad news, and for deals with financial covenants. Last, we find that the informational advantage of bank-affiliated analysts exists only when the affiliated banks serve as lead arrangers, not merely as participating lenders. Overall, our evidence suggests that information flows from commercial banking to equity research divisions within financial conglomerates. [ABSTRACT FROM AUTHOR]

Aim. This paper is a report of a comparison of advice on lifestyle given by healthcare providers and subsequent action by recipients between Korean Americans and native Koreans with hypertension. Background. High blood pressure is controllable by having a healthy lifestyle, such as weight control, dietary change, exercise, low-sodium diet, alcohol restriction and ' smoking cessation, and by taking medication. Healthcare providers play an important role in teaching individuals with hypertension on healthy lifestyles. Method. This descriptive comparative study was conducted with a convenience sample of 100 Korean Americans and 100 native Koreans with hypertension. They were interviewed between May 2003 and June 2004 on the advice they received from healthcare providers on lifestyle and their subsequent action in terms of taking medication, weight control, dietary change, exercise, low-sodium diet, smoking cessation, alcohol restriction and tension reduction. Nutrient profiles were examined using the 24-hour dietary recall method. Findings. Korean Americans received advice on lifestyle less than did native Koreans, but more Korean Americans followed healthy lifestyle advice on dietary change and exercise than did native Koreans (P < 0.001). Weight control was the least adhered to behaviour among the Korean Americans, although almost two-thirds of them were overweight or obese. Both groups exceeded the Dietary Reference Intakes of sodium, but perceived their sodium consumption as low. Conclusion. Native Korean participants need to pay closer attention to carrying out the advice, whereas healthcare providers to Korean Americans need to give more advice on culturally acceptable healthy lifestyles, particularly on dietary changes and weight control. Both groups need to monitor their sodium intake more realistically. It is not only advice from healthcare providers that is integral to control of hypertension, but also that patients should follow that advice. [ABSTRACT FROM AUTHOR]

li w.-w., wallhagen m.i. & froelicher e.s. (2010) Factors predicting blood pressure control in older Chinese immigrants to the United States of America. Journal of Advanced Nursing 66(10), 2202–2212. Aim. This paper is a report of a study of the extent to which demographic characteristics, medication-related factors, hypertension-related knowledge and medication adherence predict systolic and diastolic blood pressure. Background. Little is known about predictors of hypertension control in Chinese elders. Methods. A longitudinal study with a 3-month follow-up was conducted with 90 Chinese immigrants to the United States of America aged ≥65 years and recruited from 2006 to 2007. The independent variables were measured at baseline. Blood pressure was measured at 3 months. Multiple linear regression analysis was used to evaluate the independent effects of seven variables on change in blood pressure at 3 months. Results. Participants ranged in age from 66 to 92 years (Mean 76·7,sd 6·6). The overall regression model for systolic blood pressure was statistically significant ( R2 = 0·32, F = 4·37, P < 0·01). A higher number of prescribed oral medications (sr2 = 0·06, t = 2·42, P = 0·02) and lower medication adherence (sr2 = 0·07, t = −2·60, P = 0·01) were statistically significant determinants of an increased systolic blood pressure. The overall regression model for diastolic blood pressure was statistically significant ( R2 = 0·21, F = 2·39, P = 0·03). Male gender (sr2 = 0·06, t = 2·26, P = 0·03) and lower medication adherence (sr2 = 0·11, t = −3·03, P < 0·01) were statistically significant determinants of an increased diastolic blood pressure. Conclusion. A greater number of prescribed medications and lower adherence predicted higher level of systolic blood pressure. Male gender and lower adherence were significantly associated with higher level of diastolic blood pressure. These predictors should be considered when designing interventions to help Chinese elders achieve better hypertension management. [ABSTRACT FROM AUTHOR]

Aims and objectives: To describe the levels of insomnia, fatigue and intershift recovery, and psychological well‐being (burnout, post‐traumatic stress and psychological distress), and to examine differences in these measures based on work‐related characteristics among nursing staff during COVID‐19 pandemic in the United States. Background: The COVID‐19 pandemic has created a major physical and psychological burden on nursing staff in the United States and worldwide. A better understanding of these conditions will lead to tailored support and resources for nursing staff during and after the pandemic. Design: Cross‐sectional study. Methods: Hospital nurses and nursing assistants (N = 587) were recruited online between May–June 2020. The survey included measures on insomnia (Insomnia Severity Index) fatigue and intershift recovery (Occupational Fatigue and Exhaustion Recovery‐15), burnout (Maslach Burnout Inventory‐Human Services Survey), post‐traumatic stress (Short Post‐Traumatic Stress Disorder Rating Interview) and psychological distress (Patient Health Questionnaire‐4), and questions on work and demographics. The STROBE checklist was followed for reporting. Results: The sample had subthreshold insomnia, moderate‐to‐high chronic fatigue, high acute fatigue and low‐to‐moderate intershift recovery. The sample experienced increased emotional exhaustion and depersonalisation, increased personal accomplishment, moderate psychological distress and high post‐traumatic stress. Nurses who cared for COVID‐19 patients had significantly scored worse on almost all measures than their co‐workers. Certain factors such as working hours per week and the frequency of 30‐min breaks were significant. Conclusion: Nursing staff experienced poor sleep, fatigue and multiple psychological problems during the COVID‐19 pandemic. Moreover, staff who were involved in the care of COVID‐19 patients, worked more than 40 h per week and skipped 30‐min breaks showed generally worse self‐reported outcomes. Relevance to clinical practice: Nursing administration is recommended to monitor for fatigue and distress on nursing units, re‐visit current scheduling practices, reinforce rest breaks and provide access to mental health and sleep wellness resources with additional support for their front‐line nursing groups. [ABSTRACT FROM AUTHOR]

Aim: We tested key hypotheses derived from the Cultural Determinants of Trauma Recovery Theory (CDTR) with an American sample. Design: A cross‐sectional study using anonymous online surveys. Methods: This study was conducted with 225 American survivors of gender‐based violence (GBV) between August to November 2019. Demographics, distress (depression: PHQ8; PTSD: PCL‐5), mental health service utilization (counselling and medication), sense of coherence (SOC), internal barriers to help‐seeking (shame, frozen and problem management subscales: BHS‐TR Internal) and the GBV healing (GBV‐Heal) were used. Structural equation modelling (SEM) was conducted to test the hypotheses. Results: The final SEM model showed that the relationship between distress and mental health service utilization was not mediated by internal help‐seeking barriers; the relationship between distress and trauma healing was partially mediated by internal help‐seeking barriers; the relationship between internal help‐seeking barriers and trauma healing was partially mediated by SOC; mental health service utilization was not significantly associated with trauma healing. Overall, the relationship between distress and trauma healing was partially mediated by internal help‐seeking barriers and SOC. Conclusions: This study confirmed some hypothetical pathways between distress and trauma healing. Further research with larger and international samples should be necessary to test the overall CDTR and compare groups. Impact: This study can help us focus on psychological interventions that enhance meaning and mitigate internal help‐seeking barriers to promote holistic trauma recovery. Public and public contribution: The sample was gathered from a clinical population registry that alerts patients of potential research opportunities. [ABSTRACT FROM AUTHOR]

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Among women, cardiovascular disease is the leading cause of mortality worldwide. After experiencing an acute cardiovascular event, a woman's physical health, the prevalence of morbidities, likelihood of being treated with coronary artery bypass graft surgery, likelihood for referral for cardiac rehabilitation are less favourable than men. The social support resources of marginality and religiousness are associated with physical and mental health outcomes following cardiovascular crises. This study aimed to evaluate the reliability and validity of the translated versions (Japanese, Ukrainian, Tagalog, Hispanic and Arabic) of the Koci Marginality Index and the Duke University Religion Index among 282 women (aged 35-92 years) representing seven cultures. Results showed that reliability and validity were strong (coefficient alpha of 0.79 and 0.84). Understanding a woman's social isolation and whether she has a connection to religious groups assists health-care professionals to identify a woman's social support resources during recovery following acute cardiovascular episodes. [ABSTRACT FROM AUTHOR]

Aims and objectives: The purpose of this study was to report the psychometric properties, including validity and reliability, of the decision fatigue scale (DFS). Background: Decision fatigue may impair nurses' ability to make sound clinical decisions and negatively impact patient care. Given the negative impact of the COVID‐19 pandemic on psychological well‐being and the workplace environment, decision fatigue may be even more apparent among clinical nurses. Valid assessment of this condition among clinical nurses may inform supportive interventions to mitigate the negative sequelae associated with states of decision fatigue. Design: This study was a secondary analysis of a parent study using a cross‐sectional descriptive design. Methods: A convenience sample of 160 staff nurses was recruited online from across the United States. Participants completed a demographic questionnaire and subjective measures of decision fatigue, nursing practice environment scale and traumatic stress. Exploratory factor analysis (EFA), correlation coefficients and internal consistency reliability coefficients were computed to examine the DFS's validity and reliability within this sample. Results: The EFA yielded a single factor, 9‐item version of the DFS. The DFS scores were strongly correlated with traumatic stress and moderately correlated with the nursing practice environment, and the scale displayed appropriate internal consistency. Conclusions: This is the first known study to provide evidence of the DFS's validity and reliability in a sample of registered nurses working during the COVID‐19 pandemic. The results of this study provide evidence of a reliable and valid assessment instrument for decision fatigue that can be used to measure the burden of decision‐making among registered nurses. Relevance to clinical practice: Given the relationship between traumatic stress and the nursing work environment, decision fatigue may be a modifiable target for interventions that can enhance the quality of decision‐making among clinical nurses. [ABSTRACT FROM AUTHOR]

Aims: Explore the knowledge, experiences, preferences, and concerns related to fertility preservation as an option for building a biological family among women with cystic fibrosis. Design: Convergent mixed methods study design. Methods: We recruited women with cystic fibrosis of childbearing age in the United States through cystic fibrosis centres, snowball sampling, and social media. Participants completed an anonymous survey about fertility and fertility preservation (n = 50). We also conducted audio‐recorded, semi‐structured interviews with a subset of women to gain a better understanding of their perspectives (n = 20). We transcribed the interviews verbatim and analysed them using thematic analysis. Results: For the quantitative arm, 78% of women indicated that they would like to have a child in the future; however, 74% reported never having had conversations about fertility preservation with their providers. For the qualitative arm, four major themes emerged: (1) Women with cystic fibrosis have inadequate knowledge about fertility and fertility preservation; (2) fertility is a low priority area for the cystic fibrosis care team; (3) women with cystic fibrosis recommend that the cystic fibrosis care team provide specific fertility resources; and (4) providers and literature lack information on fertility and cystic fibrosis. Integrated findings identified that while the majority of women with cystic fibrosis want to become mothers in the future, including post‐lung transplantation, they have not received education on fertility preservation, and there is a general lack of knowledge on the topic of fertility in cystic fibrosis. Conclusion: Women with cystic fibrosis desire to have children but have little knowledge about fertility preservation, and cystic fibrosis providers do not initiate family planning discussions. Impact: Findings from the study support that additional education is needed for women with cystic fibrosis who are considering parenthood. Clinical care models should include early, regular, and thoughtful discussions about reproductive health issues, including fertility preservation. [ABSTRACT FROM AUTHOR]

Aims: To describe beginning nursing student learning styles and to determine whether there are relationships between learning style and sociodemographic or educational background. We also aim to compare these data with the normative values of the 3.1 version of the Kolb learning style inventory and verify its reliability. Background/Literature: Learning style is related to the way in which an individual interacts with learning conditions, involving cognitive, affective, physical and environmental aspects. In nursing education, few studies have focused on knowing the learning styles of beginning nursing students, despite the need for students to develop critical thinking skills required of nurses. Design: Descriptive, cross‐sectional, correlational, multi‐site study. Method: The study took place at five universities in Brazil and one university in the United States. Data were collected from a sample of beginning nursing students (n = 176) in 2019, using the Portuguese and English 3.1 versions of Kolb's learning style inventory. Results: Most students' learning styles were classified as divergers (34.10%), while 28.41% were assimilators, 23.86% were accommodators and 13.63% were convergers. Kolb describes learning as a four‐stage cyclical process grounded in experience. The mean score of one learning stage, the concrete experience, showed those who attended public high schools compared with private high schools was higher (mean = 26.22; p =.0019), and there were different results between Brazilian state universities, Brazilian federal universities and the American university (p =.0149). Conclusion: The diverger style was the most common among beginning nursing students in Brazil and the United States. There was a significant relationship between learning style, the educational background of students, the type of institution they attend and their previous experience with some active learning methodologies. Relevance to clinical practice: Aligned with Kolb's experiential learning theory, nurse educators must be aware of student learning styles so they may use teaching strategies to meet their students' needs. [ABSTRACT FROM AUTHOR]

Aims and Objectives: To examine the feasibility of a culturally tailored education programme for Haitian immigrants diagnosed with hypertension. Background: Hypertension is a major public health problem, impacting more than 26% of the global population. The overall prevalence of hypertension is 45.4% in the United States with nearly 80,000 deaths due to hypertension in 2015. African Americans and other Black populations living in the U.S. are disproportionally affected by hypertension. Design: Pre‐test and post‐test feasibility study. Methods: A convenience sample of forty‐four participants who identified as Haitian immigrants was enrolled in this evidence‐based education programme. The intervention included culturally tailored education focused on improving knowledge, medication adherence and blood pressure. Outcomes were measured using the Hill‐Bone Medication Adherence Scale and Hypertension Knowledge Test. The SQUIRE 2.0 guidelines were used for reporting outcomes. Results: Of the participants that completed the study (N=42), the mean age was 61.95 (± 9.75) years and 59% were female. Baseline systolic and diastolic blood pressures were 143 (±18.15) and 85 (±7.23), respectively. Six weeks after the intervention, there was a significant decrease in mean systolic, 126 (±12.07) and diastolic 78.50 (± 7.23) blood pressures. An increase in medication adherence and hypertension knowledge was also noted at the six‐week follow‐up period. Conclusion: The feasibility of healthcare provider implementation of a culturally tailored intervention to manage hypertension has been demonstrated. However, future research is warranted to gain a more in‐depth understanding of how to approach hypertension management among Haitians and other Black immigrant communities. Relevance to clinical practice: Advanced practice nurses are uniquely qualified to implement evidence‐based programmes that improve patient knowledge and adherence to hypertension management. Through tailoring and adopting an evidence‐based methods for educating patients about medication adherence and adequate blood pressure management, there is a potential to see improvements in patient outcomes. [ABSTRACT FROM AUTHOR]

Aims and objectives: To understand how pain affects physical and mental health‐related quality of life during the third trimester of pregnancy. Background: Poor health‐related quality of life during pregnancy is associated with adverse maternal foetal health outcomes such as increased risk of low‐birth‐weight neonates. Poor health‐related quality of life is linked to pain, pain interference and anxiety in the general adult population. However, we do not know how pain, pain interference (i.e., interference of pain with patient function), and anxiety are interrelated during the third trimester of pregnancy. Methods: This exploratory cross‐sectional study followed STROBE guidelines. A mobile educational and tracking pregnancy application was used to obtain a racially/ethnically diverse convenience sample of 141 third trimester pregnant women from the U. S. In this sample, 58.2% of women had commercial health insurance, 68.8% were Caucasian, 86.5% were younger than 35 years, and 85.1% had a partner. Women completed demographics, Edinburgh Postnatal Depression Scale and the Brief Pain Inventory on REDCap. Path analysis was used to investigate a model for the relationships among pain intensity, pain interference, anxiety and physical and mental health‐related quality of life. Results: Pain intensity affected health‐related quality of life indirectly by increasing pain interference, which in turn, decreased both physical and mental health‐related quality of life. In addition, pain interference also increased anxiety, which in turn worsened mental health‐related quality of life, but not physical health‐related quality of life. Conclusions: Treating perinatal pain may improve health‐related quality of life by decreasing pain interference and anxiety. Relevance to clinical practice: Nurses should assess for pain interference and anxiety in women experiencing moderate to severe pain during the third trimester of pregnancy. With this knowledge, nurses may advocate for women in receiving effective treatment for their conditions and improvements in their physical and mental health‐related quality of life. [ABSTRACT FROM AUTHOR]

Aims and objectives: The current study surveyed nurse practice patterns for performing swallowing screens in an academic cardiac intensive care unit (ICU). It aimed to index: training and levels of confidence in conducting dysphagia screens; screening methods employed; timing and frequency of implement; and subsequent plan of care in identified high‐risk patients. Background: Swallowing impairment (dysphagia) is common following cardiac surgery and associated with significant morbidity and mortality. Early and accurate detection of dysphagia is therefore critical to afford implementation of interventions to optimise patient care. Currently, no validated instruments or guidelines exist for nursing screening of dysphagia in this setting. Methods: An anonymous and voluntary 10‐item mixed‐methods online survey was conducted using Qualtrics software. Nonprobability purposive sampling was utilised to recruit nurses working in an academic 24‐bed cardiac ICU. Thematic analysis using operationally defined coding, SRQR checklist and descriptive statistics were employed. Results: Sixty‐nine nurses completed the survey during a 1‐month period, representing an 84% response rate. Formal training in performing swallowing screens was reported in 18.6% of nurses. In rank order, reported level of confidence was the following: "moderately" (49%); "somewhat" (35%); "not" (13%); and "very" (3%). The majority of nurses performed screens within 1 hr (40.6%) or between 1–4 hr (43.8%) of extubation. Fifteen different methods were utilised to screen swallowing function by nurses who reported a total of 31 different clinical signs indicative of dysphagia. Conclusions: Survey data of practicing nurses in an academic cardiac ICU revealed limited formal training in swallowing screening methodology, a high degree of variability in screening methods employed and low levels of agreement for dysphagia signs. Relevance to clinical practice: Data highlight a knowledge gap and need for the development of formal education and validated rapid nursing dysphagia screening tools for standardised implementation in the cardiac surgery ICU setting. [ABSTRACT FROM AUTHOR]

Aims and objectives: This study sought to understand the experience of living with cystic fibrosis (CF) as an adult. Background: Cystic fibrosis is one of the most difficult chronic diseases to manage long term because of numerous challenges faced on a day‐to‐day basis. The majority of studies focus on improving symptom response to new treatment regimens with the hope of prolonging life. Yet few qualitative studies explore the experience of adults with CF. What is missing from the current literature are the voices of people living with CF, especially as they age. Design: This study follows a hermeneutic phenomenology design guided by Martin Heidegger's philosophy. Methods: Semi‐structured interviews were conducted with nine adults living with CF. Hermeneutic phenomenology guided the data interpretation. This manuscript follows COREQ reporting guidelines. Results: Hermeneutic analysis revealed the overarching theme The Dance of Cystic Fibrosis which is supported by five themes: (a) the paradox of control, (b) living deaths, (c) dancing with death, (d) relearning to dance, and (e) role of the dance partner. Conclusions: The experience of living with CF as an adult is multidimensional and unique to each person. Despite the uniqueness, there is a shared experience that manifested as The Dance of Cystic Fibrosis. As life expectancy continues to increase for persons with CF, it is essential that researchers and healthcare professionals intentionally consider the life‐prolonging effects of the treatment regimen alongside the persons' experience with those effects. Relevance to clinical practice: Nurses at all levels of practice should be prepared to address the multifaceted experience of living with CF through thoughtful incorporation of open‐ended questions. This allows patients to share their experience with nurses, augmenting their practice of delivering holistic care. [ABSTRACT FROM AUTHOR]

Copyright of Journal of Advanced Nursing (John Wiley & Sons, Inc.) is the property of John Wiley & Sons, Inc. and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Journal of Advanced Nursing (John Wiley & Sons, Inc.) is the property of John Wiley & Sons, Inc. and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Journal of Advanced Nursing (John Wiley & Sons, Inc.) is the property of John Wiley & Sons, Inc. and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Aim and objective: To describe factors associated with father involvement in the neonatal intensive care unit using the Heuristic model of the dynamic of parental behaviour and influence on children over time. Background: Research shows that infants with involved fathers have better cognitive development, fewer crying episodes after caesarean birth, improved breastfeeding exclusivity and duration, and more regular sleep patterns. Preterm infants with involved fathers have improved cognitive development. Design: This cross‐sectional exploratory study used survey methodology to explore factors associated with father involvement in the neonatal intensive care unit. Methods: The STROBE checklist for cross‐sectional studies was used (see Appendix S2). Biological fathers of infants in a 97‐bed neonatal intensive care unit in the southern USA completed a survey which asked about their involvement with their hospitalised infants and factors which affected that involvement. Eighty fathers completed the survey. Results: Age ranged between 20–53 with 43% first‐time fathers. Compared to less involved fathers, fathers who were more involved were younger, married or living with the mother, performed kangaroo care or fathers of multiple gestation. Fathers who had attended the delivery were more likely to bathe their infants than those who had not attended the delivery and fathers who performed kangaroo care felt more confident than those who did not. Compared to fathers who visited less often, fathers who visited more often were younger, had infants with a shorter hospitalisation time and lower acuity, and had fewer children in the family. Conclusions: Fathers are involved with their neonatal intensive care unit infants in many ways. Factors were identified that affect involvement in the neonatal intensive care unit. Relevance to clinical practice: Results can help nurses in neonatal intensive care units worldwide facilitate father–infant interaction, identify fathers at risk for decreased involvement and advocate for institutional policy development for supporting neonatal intensive care unit father involvement. [ABSTRACT FROM AUTHOR]

Aims and objectives: To explore staff nurses' discourses of workplace bullying, to critically examine how these discourses affect their responses to bullying. Background: Workplace bullying has been identified as a pervasive problem within the nursing profession. Efforts to eradicate workplace bullying need to involve staff—targets as well as bystanders. By understanding how this population conceptualises workplace bullying, more effective and targeted solutions to the problem can be devised. Design: This qualitative study used a critical discourse analysis method which was based on the work of Foucault. Methods: Thirteen staff nurses who worked in a variety of settings in the USA were interviewed. COREQ checklist was used for this article. Results: Three interrelated discursive strands were identified: "biased behaviour manifested as workplace bullying, workplace bullying disguised as performance review and workplace bullying as entrenched behaviour in nursing". Actions in response to bullying varied according to which discursive strand was invoked. Conclusions: The central theme at the intersection of the discursive strands was that workplace bullying is a mechanism for driving out nurses who are different. Relevance to clinical practice: Efforts to address workplace bullying among nurses need to include training on legitimate methods of performance review, workshops on how to interact with diverse co‐workers, and examination of how practices with nursing education contribute to the perpetuation of bullying in clinical settings. [ABSTRACT FROM AUTHOR]

Copyright of Journal of Advanced Nursing (John Wiley & Sons, Inc.) is the property of John Wiley & Sons, Inc. and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Aims and objectives: To explore Somali Bantu refugee women's reproductive health decision‐making, as influenced by their resettlement in the USA. Background: Available literature on reproductive health of refugee women is mostly from the healthcare provider perspective, neglecting the lived experience of the population. Design: Qualitative descriptive. Methods: A purposive sample of 30 women was recruited for five focus groups. Data were collected via demographic survey and semi‐structured focus group discussion. Content analysis was used to analyse the data. Results: Our study revealed that Somali Bantu women considered children as wealth. Reproductive health decision‐making was influenced by three main factors: family influence, cultural/religious ideas and experience with various hormonal birth control methods. Conclusions: Nurses and other healthcare providers would better serve refugee women if equipped with a more nuanced understanding of factors in their reproductive healthcare decision‐making. This study can inform tailored and cultural relevant interventions to improve reproductive health among those at greatest need. Relevance to clinical practice: Our findings can serve to guide nurses and other healthcare providers' clinical approach to a subset of the population whose cultural beliefs and practices regarding reproductive health may be unfamiliar. Incorporating the perspective of the Somali Bantu women will facilitate the provision of person‐centred care and ensure women receive appropriate, efficient and quality care that meets their needs, which may potentially reduce financial costs to the healthcare system. [ABSTRACT FROM AUTHOR]

Aims: The aim of this study was to examine relationships among subjective cognitive complaints, psychosocial factors and nursing work function in nurses providing direct patient care. Background: Cognitive functioning is a critical component for nurses in the assurance of error prevention, identification and correction when caring for patients. Negative changes in nurses' cognitive and psychosocial functioning can adversely affect nursing care and patient outcomes. Design: A descriptive correlational design with stratified random sampling. Method: The sample included 96 nurses from the major geographic regions of the United States. Over 9 months in 2016-2017, data were collected using a webbased survey. Stepwise multiple linear regression analyses were used to examine relationships among subjective cognitive complaints, psychosocial factors and nursing work function. Results: Overall, participants reported minimal work function impairment and low levels of subjective cognitive complaints, depression and stress. In multivariate analyses, depression was not associated with nurses' work function. However, perceived stress and subjective concerns about cognitive function were associated with greater impairment of work function. Conclusion: Nurses experiencing subjective cognitive complaints should be encouraged to address personal and environmental factors that are associated with their cognitive status. Additionally, stress reduction in nurses should be a high priority as a potential intervention to promote optimal functioning of nurses providing direct patient care. Healthcare institutions should integrate individual and institutional strategies to reduce factors contributing to workplace stress. [ABSTRACT FROM AUTHOR]

Aim To examine the relative effects of interpersonal conflict and workload on job outcomes (turnover intentions, burnout, injuries) and examine if resilience moderates the indirect effects of conflict and workload on job outcomes via job-related negative effect. Background There is interest in understanding resilience in the nursing profession. Placing resilience in the context of the Emotion-Centred Model of Occupational Stress (Spector, ) is a novel approach to understanding how resilience ameliorates the negative effects of workplace stressors. Design This study used a two-wave survey design to collect data from 97 nurses across medical units. Methods Nurses working in the US were recruited in June 2014 using Qualtrics Panels, an online survey platform service that secures participants for research. Nurses were contacted via email at two time points, two weeks apart and provided a link to an online survey. SPSS v. 23 and PROCESS v2.15 were used to analyse regressions and moderated mediation. Results/Findings Interpersonal conflict predicted turnover intentions and burnout; workload predicted injuries. Job-related negative affect mediated the relationships between stressors and job outcomes except for the direct effect of workload on injuries. Low resilience increased the magnitude of the indirect effects of conflict on job outcomes. Conclusion Job characteristics like workload predicted unique variability in self-reported physical injuries. Conflict at work, a social stressor, predicted well-being and job attitudes. Highly resilient nurses bounced back after experiencing conflict in the workplace. Resilience should be explored for its potential as a method to reduce the negative effects of social stressors. [ABSTRACT FROM AUTHOR]

Aims and objectives Explore different methods by which intimate partner violence screening practices are implemented in clinic and emergency settings and better understand barriers and facilitators. Background Healthcare visits provide an opportunity for providers to identify and provide assistance to victims of intimate partner violence. However, wide variation exists in the implementation of screening and response protocols. In addition, providers experience barriers and facilitators to intimate partner violence screening and response. A comprehensive understanding of these factors is necessary to improve the role that providers play in detection and intervention of intimate partner violence. Design Qualitative descriptive research design. Methods Sixteen healthcare facilities were recruited from a large metropolitan area in the USA. Data were collected through semi-structured, in-depth interviews with individuals knowledgeable about intimate partner violence screening and response within their facility. Data were analysed using directive content analysis. Results Major themes and patterns concerning intimate partner violence screening and response were identified within the following areas: procedural characteristics, barriers, facilitators and additional needs. Patient-provider communication and operational/facility characteristics emerged as critical aspects that impact the successful implementation of intimate partner violence screening and response programmes. Differences were found between clinic and emergency settings stemming from variations in health delivery models. Conclusions Results provide important information on how healthcare facilities implement intimate partner violence screening and response, suggestions for practice improvement and directions for future interventions. Additional guidance is needed to ensure intimate partner violence identification, and response procedures are effective and tailored to needs of patients, providers and the facility. Relevance to clinical practice Nurses are in a strategic position to play a pivotal role in identification of and response to intimate partner violence. It is essential that nurses are cognizant of this, and understand the actions they can take to assist patients who have been victims of intimate partner violence. Recommendations on how to do this are provided. [ABSTRACT FROM AUTHOR]

Aims and objectives To examine and describe the transition process of military nurses from military nursing practice to civilian nursing practice. A second aim was to identify challenges and facilitators to this transition. Background Serving in the military, and embodying its values, can have a major impact on a person's worldview. These individuals serve not only as nurses but also as part of a larger military culture with a mission to protect. The decision to separate from the military and transition into the civilian workforce carries many challenges capable of influencing nurses' personal and professional identities. Design Qualitative descriptive. Methods Semi-structured interviews of 10 nurse veterans were conducted in 2015-2016. Data were collected until saturation was reached. Results The transition includes four major phases from military to civilian nurse: Separating from Military Life, Conflict and Chaos, Shifting Sands and Personal and Professional Reconstruction. Duration and progress through each phase varied slightly for individual nurses. Conclusions Both work-role and personal identity transition occur when a nurse leaves the military and enters civilian practice. Military and civilian organisations, in both the USA and other countries, can implement supports to aid these nurses during this personal and professional change. Recommendations from the study group are provided. Relevance to clinical practice The global nursing profession, as well as healthcare organisations that employ nurse veterans, has a commitment and obligation to understand the transition process of nurses who practise within the scope of military nursing and later in civilian nursing environments so that they may be supported and used to the extent of their prior experience. Lessons learned and advice from this group of nurses may positively aid others in their transition experience. [ABSTRACT FROM AUTHOR]

Aim The aim of this study was to achieve profession-wide consensus on an Australian nurse practitioner specialty framework. Background Since its introduction in 1998, the Australian nurse practitioner profession has grown to over 1300 endorsed practitioners, representing over 50 different specialties. To complement better a generalist learning and teaching framework with specialist clinical education, prior research proposed a broad framework of Australian nurse practitioner specialty areas termed metaspecialties. Design This study employed an online three-round modified Delphi method. Method Recruitment using purposive sampling and snowballing techniques identified an eligible sample from a population of nurse practitioners with at least 12 months' postendorsement experience ( n = 966). Data were collected using online survey software from September 2014-January 2015 and analysed using descriptive statistics and content analysis. The Content Validity Index and McNemar's Test for Change were used to determine consensus on the nurse practitioner metaspecialties. Results One-fifth of the total eligible population completed the study. Participants achieved high consensus on four metaspecialties, including: Emergency and acute care, primary health care, child and family health care and mental health care. Two metaspecialties did not achieve consensus and require further investigation. Conclusion A large sample of nurse practitioners achieved consensus on an Australian metaspecialty framework, increasing the likelihood of widespread acceptance across the profession. This technique may be appropriate for use in jurisdictions with smaller populations of nurse practitioners. Ongoing research is needed to re-evaluate the metaspecialties as the profession grows. [ABSTRACT FROM AUTHOR]

Aims To empirically validate a conceptual model of Clinical Nurse Leader integrated care delivery. Background There is limited evidence of frontline care delivery models that consistently achieve quality patient outcomes. Clinical Nurse Leader integrated care delivery is a promising nursing model with a growing record of success. However, theoretical clarity is necessary to generate causal evidence of effectiveness. Design Sequential mixed methods. Methods A preliminary Clinical Nurse Leader practice model was refined and survey items developed to correspond with model domains, using focus groups and a Delphi process with a multi-professional expert panel. The survey was administered in 2015 to clinicians and administrators involved in Clinical Nurse Leader initiatives. Confirmatory factor analysis and structural equation modelling were used to validate the measurement and model structure. Results Final sample n = 518. The model incorporates 13 components organized into five conceptual domains: 'Readiness for Clinical Nurse Leader integrated care delivery'; 'Structuring Clinical Nurse Leader integrated care delivery'; 'Clinical Nurse Leader Practice: Continuous Clinical Leadership'; 'Outcomes of Clinical Nurse Leader integrated care delivery'; and 'Value'. Sample data had good fit with specified model and two-level measurement structure. All hypothesized pathways were significant, with strong coefficients suggesting good fit between theorized and observed path relationships. Conclusions The validated model articulates an explanatory pathway of Clinical Nurse Leader integrated care delivery, including Clinical Nurse Leader practices that result in improved care dynamics and patient outcomes. The validated model provides a basis for testing in practice to generate evidence that can be deployed across the healthcare spectrum. [ABSTRACT FROM AUTHOR]

Aim Sexual risk behaviour was explored and described using Social Action Theory. Background The sexual transmission of HIV is complex and multi-factorial. Social Action Theory provides a framework for viewing self-regulation of modifiable behaviour such as condom use. Condom use is viewed within the context of social interaction and interdependence. Design Cross-sectional survey. Methods Self-report questionnaire administered to adults living with HIV/ AIDS, recruited from clinics, service organizations and by active outreach, between 2010 - 2011. Findings Having multiple sex partners with inconsistent condom use during a 3-month recall period was associated with being male, younger age, having more years of education,substance use frequency and men having sex with men being a mode of acquiring HIV. In addition, lower self-efficacy for condom use scores were associated with having multiple sex partners and inconsistent condom use. Conclusion Social Action Theory provided a framework for organizing data from an international sample of seropositive persons. Interventions for sexually active, younger, HIV positive men who have sex with men, that strengthen perceived efficacy for condom use, and reduce the frequency of substance use, may contribute to reducing HIV-transmission risk. [ABSTRACT FROM AUTHOR]

Aims and objectives The purposes of this study were to measure the prevalence of, and identify factors associated with, cervical cancer screening among a sample of lesbian, bisexual and queer women, and transgender men. Background Past research has found that lesbian, bisexual and queer women underuse cervical screening service. Because deficient screening remains the most significant risk factor for cervical cancer, it is essential to understand the differences between routine and nonroutine screeners. Design A convergent-parallel mixed methods design. Methods A convenience sample of 21- to 65-year-old lesbian and bisexual women and transgender men were recruited in the USA from August-December 2014. Quantitative data were collected via a 48-item Internet questionnaire ( N = 226), and qualitative data were collected through in-depth telephone interviews ( N = 20) and open-ended questions on the Internet questionnaire. Results Seventy-three per cent of the sample was routine cervical screeners. The results showed that a constellation of factors influence the use of cervical cancer screening among lesbian, bisexual and queer women. Some of those factors overlap with the general female population, whereas others are specific to the lesbian, bisexual or queer identity. Routine screeners reported feeling more welcome in the health care setting, while nonroutine screeners reported more discrimination related to their sexual orientation and gender expression. Routine screeners were also more likely to 'out' to their provider. The quantitative and qualitative factors were also compared and contrasted. Conclusions Many of the factors identified in this study to influence cervical cancer screening relate to the health care environment and to interactions between the patient and provider. Relevance to clinical practice Nurses should be involved with creating welcoming environments for lesbian, bisexual and queer women and their partners. Moreover, nurses play a large role in patient education and should promote self-care behaviours among lesbian women and transgender men. [ABSTRACT FROM AUTHOR]

Aims To conduct a qualitative needs assessment of Directors of Nursing regarding challenges and recommendations for addressing sexual expression and consent. Background Sexual expression management among long-term care residents is a complex issue for nursing home staff. Little guidance is available for those wanting to follow a person-centred approach. Policies and procedures are needed, and must be usable across long-term care settings. Design Qualitative design for in-depth exploration. Methods Semi-structured interviews were conducted with 20 Directors of Nursing in the spring and summer of 2013, representing a range of regions, facility sizes and resident populations. Interview questions prompted them to identify recommendations that address challenges to improving sexual expression management in long-term care settings. Results Comparative thematic analysis resulted in several codes, which were grouped into eight overall categories. Recommendation categories that addressed key challenges included: address the issue, make environmental changes, identify staff expertise, provide education and training, assess sexuality initially and recurrently, establish policies/procedures for sexual expression management, develop assessment tools for sexual expression and consent, and clarify legal issues. The recommendation to develop national guidelines was observed across categories. Discussion Directors of Nursing report several challenges to sexual expression management in their facilities, and perceive their current methods to be ad hoc. A proactive approach to policy and procedure development is needed. [ABSTRACT FROM AUTHOR]

Aims and objectives. To determine, from a systematic literature review, the experience of living with heart failure and to propose some practice guidelines and research questions. Background. Chronic heart failure has been one of the fastest growing illnesses in recent decades, with almost 23 million people affected worldwide. This complex syndrome has multiple causes and appears when underlying heart disease is advanced. Currently, heart failure has no cure and leads to a significant deterioration in patients' quality of life. Design. Qualitative meta-synthesis. Methods. A qualitative meta-synthesis was conducted to extract and analyse qualitative research from the Cochrane, PubMed, CINAHL, PsycINFO, Web of Science and Cuiden databases. Snowball sampling and a manual search were performed to identify other relevant studies. Results. Twenty-five qualitative studies were selected. The findings indicate that there are three main themes that describe the phenomenon. The first theme refers to the experiences related to the beginning of the process. The second theme is connected with the effects on the person: physical, emotional, social and spiritual changes. The third theme is linked with how to live with heart failure despite the illness, including the adjustment and coping process and how external resources can help them to manage. Conclusions. Heart failure has a major impact on the entire person, but some areas have not been addressed. By creating new tools to understand and evaluate the impact of this illness and interventions that prevent or improve some situations, we can promote the well-being and the quality of life of this population. Relevance to clinical practice. Nurses must have a personal knowledge of the experiences and needs of the patients. To do this, nurses should create care environments that promote an exchange of experiences and knowledge between the nurse and the patient and family. [ABSTRACT FROM AUTHOR]

Aims and objectives This study aims to provide insight into key factors from a clinician's perspective that influence uninterrupted early skin-to-skin contact after vaginal and caesarean delivery of healthy full-term infants. Background Early skin-to-skin contact of healthy full-term infants ideally begins immediately after birth and continues for the first hour or the first breastfeed as recommended by the Baby Friendly Hospital Initiative. However, adoption of early skin-to-skin contact is low in many settings and the barriers that hinder its universal use are not well understood. Design An exploratory qualitative research design using semi-structured interviews. Methods Eleven clinicians were interviewed, including five registered nurses and one medical doctor from the obstetrics and gynaecology unit as well as four registered nurses and one medical doctor from the neonatal intensive care unit. Core topics that were discussed included perceptions on early skin-to-skin contact and facilitating factors and barriers to early skin-to-skin contact after vaginal and caesarean delivery. Interview sessions were recorded, transcribed and analysed using a thematic analysis approach. A coding framework was developed from which subthemes emerged. The overall themes were adopted from Lee et al.'s thematic framework to categorise factors into institutional, familial-level and implementation factors. Findings Critical institutional factors included inadequate staffing and education of clinicians on early skin-to-skin contact. On a familial level, parental education and motivation were identified as important factors. Barriers to implementation included the absence of a clinical algorithm and unclear definitions for eligible mothers and infants. Conclusions Various facilitating factors and barriers to early skin-to-skin contact of healthy full-term infants born via vaginal and caesarean delivery were identified. Relevance to clinical practice Addressing these factors can help to provide a better understanding of clinician perspectives on early skin-to-skin contact and help guide its implementation as standard of care for healthy full-term infants. [ABSTRACT FROM AUTHOR]

Aims and objectives. The aim of this investigation was to evaluate, monitor and manage the quality of projects conducted and work produced as evidence of scholarship upon completion of Doctor of Nursing Practice education. Background. The Doctor of Nursing Practice is a relatively new degree which prepares nurses for high impact careers in diverse practice settings around the globe. Considerable variation characterises curricula across schools preparing Doctors of Nursing Practice. Accreditation assures curricula are focused on attainment of the Doctor of Nursing Practice essentials, yet outcomes have not been reported to help educators engage in programme improvement. This work has implications for nursing globally because translating strong evidence into practice is key to improving outcomes in direct care, leadership, management and education. The Doctor of Nursing Practice student learns to accomplish translation through the conduct of projects. Evaluating the rigour and results of these projects is essential to improving the quality, safety and efficacy of translation, improvements in care and overall system performance. Design. A descriptive study was conducted to evaluate the scholarly products of Doctor of Nursing Practice education in one programme across four graduating classes. Methods. A total of 80 projects, conducted across the USA and around the globe, are described using a modification of the Uncertainty, Pace, Complexity Model. Results. The per cent of students considered to have produced high quality work in relation to target expectations as well as the per cent that conducted means testing increased over the four study years. Conclusions. Evaluation of scope, complexity and rigour of scholarly work products has driven improvements in the curriculum and informed the work of faculty and advisors. Relevance to clinical practice. Methods, evaluation and outcomes conformed around a set of expectations for scholarship and rigour have resulted in measurable outcomes, and quality publications have increased over time. [ABSTRACT FROM AUTHOR]

Aim We explored how acculturation and self-actualization affect depression in the HIV-positive Asians and Pacific Islanders immigrant population. Background Asians and Pacific Islanders are among the fastest growing minority groups in the USA. Asians and Pacific Islanders are the only racial/ethnic group to show a significant increase in HIV diagnosis rate. Design A mixed-methods study was conducted. Methods Thirty in-depth interviews were conducted with HIV-positive Asians and Pacific Islanders in San Francisco and New York. Additionally, cross-sectional audio computer-assisted self-interviews were conducted with a sample of 50 HIV-positive Asians and Pacific Islanders. Content analysis was used to analyse the in-depth interviews. Also, descriptive, bivariate statistics and multivariable regression analysis was used to estimate the associations among depression, acculturation and self-actualization. The study took place from January-June 2013. Discussion Major themes were extracted from the interview data, including self-actualization, acculturation and depression. The participants were then divided into three acculturation levels correlating to their varying levels of self-actualization. For those with low acculturation, there was a large discrepancy in the Center for Epidemiologic Studies Depression Scale scores between those who had totally lost their self-actualization and those who believed they could still achieve their 'American dreams'. Among those who were less acculturated, there was a significant difference in depression scores between those who felt they had totally lost their ability to self-actualize and those who still believed they could 'make their dreams come true.' Conclusion Acculturation levels influence depression and self-actualization in the HIV-positive Asians and Pacific Islanders population. Lower acculturated Asian Americans achieved a lower degree of self-actualization and suffered from depression. Future interventions should focus on enhancing acculturation and reducing depression to achieve self-actualization. [ABSTRACT FROM AUTHOR]

Aim This article describes the rationale, design and methodology of the Building research initiative group: chronic illness management and ad herence in transplantation ( BRIGHT) study. This study of heart transplant patients will: (1) describe practice patterns relating to chronic illness management; (2) assess prevalence and variability of non-adherence to the treatment regimen; (3) determine the multi-level factors related to immunosuppressive medication non-adherence. Background The unaltered long-term prognosis after heart transplantation underscores an urgent need to identify and improve factors related to survival outcomes. The healthcare system (e.g. level of chronic illness management implemented) and patient self-management are major drivers of outcome improvement. Design The study uses a survey design in 40 heart transplant centres covering 11 countries in four continents. Methods Theoretical frameworks informed variable selection, which are measured by established and investigator-developed instruments. Heart transplant recipients, outpatient clinicians and programme's directors complete a survey. A staged convenience sampling strategy is implemented in heart transplant centres, countries and continents. Depending on the centre's size, a random sample of 25-60 patients is selected (N estimated 1680 heart transplant recipients). Five randomly selected clinicians and the medical director from each centre will be invited to participate. Conclusion This is the first multi-centre, multi-continental study examining healthcare system and heart transplant centres chronic illness management practice patterns and potential correlates of immunosuppressive medication non-adherence. The knowledge gained will inform clinicians, researchers and healthcare policy makers at which level(s) interventions need to be implemented to improve long-term outcomes for transplant recipients. [ABSTRACT FROM AUTHOR]

Aim The aim of this study was to describe factors that influence decisions of young African Americans to start smoking. Background Young adult African Americans have a high risk for becoming regular smokers, but little is understood about their smoking. This knowledge is needed because understanding young adults' smokers will help develop effective tobacco cessation and prevention strategies. Design Qualitative study. Method The study consisted of 22 in-depth interviews with African Americans between the ages of 19-25. Data were collected between 2009-2010. Smokers, former smokers and non-smokers were included. Results/findings Results indicated that smoking identity of young adults was influenced by their limited and discounted knowledge of health risks and the stigma associated with the type of tobacco smoked. The importance of cost was discussed as was the effect of smoking on relationships and vice versa. Marijuana was the primary reason they started smoking tobacco. Their transition into adulthood and views of smoking, adulthood and success all influenced smoking. Additionally, self-reflection on personal choices around smoking was important and may be useful in effective smoking cessation programmes for this group. Conclusion Nurses are in an ideal position to promote effective smoking cessation in young adults. Direct, culturally relevant messages are needed that fit into the context of the young adults' lives by addressing concurrent use of marijuana, self-esteem and success in life. [ABSTRACT FROM AUTHOR]