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Objectives Custodial grandparents are grandparents who raise grandchildren on a full-time basis in absence of the grandchild's birth parents. Compared to noncaregiving grandparents, custodial grandparents report poorer mental and physical health and stronger changes in daily well-being when experiencing negative and positive events. We examine whether an online social intelligence training (SIT) program improves custodial grandmothers' (CGM) daily well-being, socioemotional skills, and changes in well-being when confronted with daily negative and positive events. Methods Multilevel models were applied to 200 CGM who were recruited from across the United States and completed a daily survey for 14 consecutive days prior to and following participation in a randomized clinical trial. Participants were randomized into the SIT program or an attention control condition focusing on healthy living habits. The outcomes of interest were daily well-being, social connectedness, emotional awareness, and perspective-taking. Results Multilevel analyses revealed that participants who participated in the SIT program, compared to the attention control condition, exhibited stronger emotional responsiveness (i.e. improvements) to daily positive events in the outcomes of positive affect, social engagement, and perspective-taking. Discussion Our findings illustrate that SIT improves key components of daily functioning in CGM, which may serve as a pathway linking the demands of custodial grandparenting to poorer mental and physical health. Our discussion focuses on the utility and accessibility of the SIT program for helping improve outcomes for this disadvantaged population. Clinical Trials Registration Number: NCT03239977 [ABSTRACT FROM AUTHOR]

Background and Objectives In this study, we investigated the efficacy of a self-administered, online Social Intelligence Training (SIT) program aimed at enhancing psychological and relational well-being among a nationwide U.S. sample of custodial grandmothers. Research Design and Methods A two-arm randomized clinical trial (RCT) was conducted, where 349 grandmothers raising grandchildren aged 11–18 years were assigned to either SIT or an attention control condition (ACC). Participants self-completed online surveys at baseline and immediately postintervention, in addition to follow-ups at 3-, 6-, and 9-month postintervention. First-order latent difference score models were used to compare SIT to ACC, across all times of measurement, along key indicators of psychological and relational well-being on an intent-to-treat basis. Results Although SIT was largely superior to ACC at yielding positive results, it appears that it attenuated longitudinal declines that occurred among ACC participants. SIT also exerted stronger effects on relational than psychological outcomes, with perceived relations with grandchildren being the most positively affected. Discussion and Implications Given that the historical time of this RCT unpredictably corresponded with the coronavirus disease 2019 pandemic, we suspect that SIT helped offset declines in psychological and relational well-being that are widely documented to have resulted from the pandemic. Our overall positive findings support future use of the inexpensive and easily delivered SIT program under normal environmental conditions, with the vulnerable and geographically disperse population of custodial grandmothers. Clinical Trials Registration Number NCT03239977 [ABSTRACT FROM AUTHOR]

Mindfulness, resilience, and resourcefulness are theoretically distinct but related constructs critical for improving psychosocial well-being outcomes for informal caregivers and others. Our aims were to evaluate the theoretical and operational distinctions among these constructs. Measures of mindfulness (Decentering Scale), resilience (Connor-Davidson Scale) and resourcefulness (Resourcefulness Scale) were collected from a national sample of 348 grandmother caregivers. We conducted exploratory factor analysis and examined correlation patterns. Inter-correlations ranged from r=.26 (resourcefulness and resilience) to r=.73 (resilience and mindfulness). Factor analyses and scree plots indicated unidimensional factors for resilience and for mindfulness, and two factors for resourcefulness (personal and social). When items from all measures were analyzed together, the four factors remained. Distinct relationships were found between mindfulness, resilience, and resourcefulness with relevant external variables. Our results support the conceptual distinctions among the constructs, providing support for interventions targeting these constructs to improve psychosocial outcomes in caregivers. [ABSTRACT FROM AUTHOR]

Purpose The purpose of this article is to describe the outcomes of a collaborative initiative to share data across five schools of nursing in order to evaluate the feasibility of collecting common data elements (CDEs) and developing a common data repository to test hypotheses of interest to nursing scientists. This initiative extended work already completed by the National Institute of Nursing Research CDE Working Group that successfully identified CDEs related to symptoms and self-management, with the goal of supporting more complex, reproducible, and patient-focused research. Design Two exemplars describing the group's efforts are presented. The first highlights a pilot study wherein data sets from various studies by the represented schools were collected retrospectively, and merging of the CDEs was attempted. The second exemplar describes the methods and results of an initiative at one school that utilized a prospective design for the collection and merging of CDEs. Methods Methods for identifying a common symptom to be studied across schools and for collecting the data dictionaries for the related data elements are presented for the first exemplar. The processes for defining and comparing the concepts and acceptable values, and for evaluating the potential to combine and compare the data elements are also described. Presented next are the steps undertaken in the second exemplar to prospectively identify CDEs and establish the data dictionaries. Methods for common measurement and analysis strategies are included. Findings Findings from the first exemplar indicated that without plans in place a priori to ensure the ability to combine and compare data from disparate sources, doing so retrospectively may not be possible, and as a result hypothesis testing across studies may be prohibited. Findings from the second exemplar, however, indicated that a plan developed prospectively to combine and compare data sets is feasible and conducive to merged hypothesis testing. Conclusions Although challenges exist in combining CDEs across studies into a common data repository, a prospective, well-designed protocol for identifying, coding, and comparing CDEs is feasible and supports the development of a common data repository and the testing of important hypotheses to advance nursing science. Clinical Relevance Incorporating CDEs across studies will increase sample size and improve data validity, reliability, transparency, and reproducibility, all of which will increase the scientific rigor of the study and the likelihood of impacting clinical practice and patient care. [ABSTRACT FROM AUTHOR]

The purpose of this study was to investigate the use of ketamine to treat vaso-occlusive crisis (VOC) pain in patients with sickle cell disease (SCD). A descriptive, quantitative study was conducted to collect baseline data about the use of ketamine in SCD VOC across the United States using a brief, researcher-developed, Internet survey sent to advanced practice registered nurses (APRNs). A total of 128 surveys from APRNs were analyzed. Thirteen of those respondents reported use of ketamine in SCD VOC. The most common reason ketamine was not used by the others was lack of awareness of this treatment modality. Of those using ketamine, most reported that patients rated pain lower sometimes or almost always after ketamine administration. A strong need for education and more rigorous studies are suggested by these data. Providers indicated that many had never heard of ketamine being used in this population and that strong empirical evidence is lacking to guide its use. Failure of other pain management modalities was reported as a very important consideration by most of those who use or recommend the use of ketamine in SCD VOC. This promising treatment has the potential to benefit many of the thousands of patients who experience VOC. As the primary providers of care to many of these patients, APRNs should be actively involved in investigation and protocol development. [ABSTRACT FROM AUTHOR]

Examines whether older adults in Ohio who experience consistently recurring arthritis or cardiopulmonary symptoms report more depression and worse self-assessed health and show more symptoms management than those who report inconsistent symptoms. Comparison of self-cure, physician consultation and use of illness labels; Concept of chronicity.

Discusses the study concerning the factors that persuade an elderly person to interpret a bodily change as a symptom of illness. Measures of the illness interpretation; Application of a theoretical framework from the Common Sense Model; Assessment of bodily changes as illness through the past life experiences and health attitudes.

We assessed a subset of behavioral indicators from the American Heart Association Life's Essential 8 cardiovascular health (CVH) construct-diet, physical activity, sleep, and nicotine exposure-and quantified associations in scores between members of 12 grandparent-grandchild dyads (grandparents, 52-70 years old; children, 7-12 years old). We also assessed the number of adverse childhood experiences from the dyads. Using the Life's Essential 8 scoring algorithm (0-100, with 100 as optimal), we calculated averages and used Spearman's ρ correlation to quantify associations. Mean score was 67.5 (±12.4) for grandparents and 63.0 (±11.2) for grandchildren. Mean scores for the dyad members were significantly correlated ( r = 0.66, P < .05). The mean numbers of adverse childhood experiences were 7.0 and 5.8 for the grandparents and grandchildren, respectively. The results indicate that CVH in these dyads was suboptimal and interrelated. Adverse childhood experiences in this analysis surpass levels reported as high risk for poor CVH. Our findings suggest that dyadic-based interventions to improve CVH are warranted., Competing Interests: The authors have no conflicts of interest to disclose., (Copyright © 2023 Wolters Kluwer Health, Inc. All rights reserved.)

Objective: Guided by a life-course perspective, we examine the nature of daily life among custodial grandmothers (CGM) through documenting daily positive and negative affect, reporting daily negative and positive events, and emotional reactivity/responsiveness to daily negative and positive events. We also examine whether CGM age, adverse childhood experiences (ACEs), and social relationship quality with grandchild are associated with each indicator., Methods: We applied multilevel models to 200 CGM (Mage = 61, SD = 5.66) who were recruited from across the United States and completed a daily survey for 14 consecutive days prior to commencing a randomized clinical trial., Results: Older age and reporting fewer ACEs were associated with better overall and less variability in daily well-being. Positive events were reported on 83% of days and negative events were reported on 56% of days. Daily well-being was lower when a negative event was reported and higher when a positive event was reported. Reporting more ACEs was associated with greater exposure to daily negative events and stronger gains in daily well-being when a daily positive event was reported. Older age was associated with lesser declines in daily well-being on days when a negative event was reported., Discussion: In accordance with the life-course perspective, our findings illustrate how the timing of being a CGM (age) and the cumulative nature of development (ACEs) affect daily well-being and negative and positive events for CGM. Our discussion focuses on resources to consider when building resilience-focused interventions for promoting the health and well-being of CGM., (© The Author(s) 2022. Published by Oxford University Press on behalf of The Gerontological Society of America. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.)

Background: In 2004, the American Association of Colleges of Nursing (AACN) called for all nursing schools to phase out master's-level preparation for advanced practice registered nurses (APRNs) and transition to doctor of nursing practice (DNP) preparation only by 2015. Today, five years after the AACN's deadline, nursing has not yet adopted a universal DNP standard for APRN practice entry., Purpose: The purpose of this paper is to examine the factors influencing the ability of nursing schools to implement a universal DNP standard for APRNs., Methods: Deans from top-ranked nursing schools explore the current state of the DNP degree in the US. The authors draw upon their collective experience as national leaders in academic nursing, long-time influencers on this debate, and heads of DNP programs themselves. This insight is combined with a synthesis of the literature and analysis of previously unpublished data from the AACN on trends in nursing doctoral education., Findings: This paper highlights issues such as the long history of inconsistency (in messaging, curricula, etc.) surrounding the DNP, certification and accreditation challenges, cost barriers, and more. The authors apply COVID-19 as a case study to help place DNP graduates within a real-world context for health system stakeholders whose buy-in is essential for the success of this professional transition., Discussion: This paper describes the DNP's standing in today's professional environment and advances the conversation on key barriers to its adoption. Insights are shared regarding critical next steps to ensure national acceptance of the DNP as nursing's terminal practice degree., (Copyright © 2020 Elsevier Inc. All rights reserved.)

Background: Standards for interfacility transport in the United States recommend that each transport request be triaged to ensure that each patient is transported by an appropriate mechanism and by the appropriate clinicians in order to meet the patient's intratransport needs. No instrument currently exists to meet that need. The Transport Triage Tool, a novel instrument, has been designed to determine the clinician (paramedic, registered nurse, or advanced practice registered nurse) who will best meet the patient's needs during transport., Objective: To assess psychometric elements-that is, validity and reliability-of the Transport Triage Tool when used by health care professionals in determining which clinician is appropriate for interfacility transport., Methods: A 3-step process was used to initially evaluate the reliability and validity of this tool when assigning a lead clinician during transport. Content and predictive validity were evaluated. Both intrarater and interrater agreement were used to examine reliability., Results: Predictive validity was supported by an area under the receiver operating characteristic curve of 0.847 and a Youden index of 0.31. Percentage agreement and Cohen κ were reasonable across all periods of testing., Conclusions: The Transport Triage Tool has acceptable predictive validity and reliability; however, this preliminary evaluation indicates that further refinement is needed. Large tertiary centers that offer variations in transport team composition may be able to use the Tool in its present form to train and evaluate individuals who make decisions regarding interfacility transport, although additional testing and evaluation are recommended., (© 2019 American Association of Critical-Care Nurses.)

Mothers of infants in the neonatal intensive care unit (NICU) face stressors including turbulent emotions from their pregnancy/unexpected preterm delivery and their infant's unpredictable health status. The study purpose was to examine the psychological state of mothers prior to the discharge of their technology-dependent infants (eg, feeding tubes, supplemental oxygen) from the NICU to home. The study sample consisted of mothers (N = 19) of infants dependent on medical technology being discharged from a large Midwest NICU. A descriptive, correlational design using convenience sampling was employed to recruit mothers to examine associations of infant and maternal factors, resourcefulness, and stress with psychological state (depressive symptoms, posttraumatic stress symptoms). Forty-two percent of mothers were at high risk for clinical depression, with 37% in the clinical range for posttraumatic stress disorder. Increased maternal depressive symptoms were significantly associated with the increased frequency and perceived difficulty of their stress and posttraumatic stress symptoms. Increased posttraumatic stress symptoms were significantly associated solely with elevated depressive symptoms. This study identified factors associated with the mothers' increased psychological distress, providing beginning evidence for future interventions to employ prior to their technology-dependent infant's NICU discharge.

Objective: The purpose of this study was to describe relationships between structural empowerment, psychological empowerment, and engagement among clinical nurses., Background: Empowerment and engagement are key drivers of retention and quality in healthcare. Creating an empowering culture and an engaged staff supports initiatives that are essential for positive work environments., Methods: A survey of 280 nurses in a national conference was conducted using the Conditions of Work Effectiveness, Psychological Empowerment Instrument, and the Utrecht Work Engagement Scale. Pearson correlation coefficients and multiple regression analysis were used to determine relationships between demographic data and study variables., Results: Overall, nurses had high perceptions of structural empowerment and psychological empowerment and were moderately engaged. Also, significant positive relationships were found between the key study variables., Conclusions: Results show positive correlations between empowerment and perceived engagement among clinical nurses.

The population of children dependent on medical technology such as mechanical ventilation, feeding tubes, and supplemental oxygen continues to grow in the United States. These children are frequently cared for by their mothers at home following hospital discharge. Research indicates that these mothers are at high risk for negative mental health outcomes that affect both caregiver and care recipient. The purpose of this randomized controlled pilot trial was to determine the feasibility, acceptability, and efficacy of resourcefulness training (RT), a cognitive-behavioral intervention, among mothers of technology-dependent children. RT was found to be a feasible and acceptable intervention with this population during the 6 week study. The effect size in this pilot study demonstrates initial efficacy and indicates areas for strengthening the intervention protocol. RT is a promising intervention that can be employed by pediatric nurses to assist mothers in the home management of technology-dependent children., (Copyright © 2014 Elsevier Inc. All rights reserved.)

In this pilot study of 102 grandmothers raising grandchildren, we used a quasi-experimental, repeated measures design to examine effects of resourcefulness training reinforced by expressive writing (journaling) or verbal disclosure (digital voice recording) in reducing stress and depressive symptoms and enhancing quality of life. Resourcefulness training was compared with expressive writing, verbal disclosure, and attention control conditions. Both the expressive writing and verbal disclosure methods for reinforcing resourcefulness training were more effective than the other three conditions in reducing stress and depressive symptoms and improving quality of life. No difference was found between the two reinforcement methods. Grandmothers may benefit from learning resourcefulness skills and from practicing them in ways that best fit their needs and lifestyles., (© 2013 Wiley Periodicals, Inc.)

Grandmothers raising grandchildren may experience stress that adversely affects their health and, thus, they may benefit from interventions to promote resourcefulness. Before conducting definitive tests about the effectiveness of resourcefulness training (RT), it is essential to determine the need for the training. This study of 126 grandmothers examined baseline resourcefulness, attrition rates from the resourcefulness training, and perceived need for RT. Baseline resourcefulness scores indicated that 72% of the grandmothers had more than a moderate need for RT. Reasons for attrition were unrelated to perceived need. After receiving RT, 88% perceived that they needed it. The results support testing RT effectiveness as the next step.

This article describes issues to consider when planning and conducting international research projects. Key considerations include building collaboration, developing a comprehensive and feasible research plan, funding and budgets, addressing human subjects concerns, and analyzing and disseminating project findings. These considerations and related methodological issues are discussed in the context of a replication pilot project conducted outside Kampala, Uganda. Ongoing dialog, flexibility, and collaboration, in addition to good science, are critical to developing successful international research projects.