Applied Nursing Research - Articles in Press

Case study methodology in nurse migration research: An integrative review - Corrected Proof

2012-05-04

Abstract: The migration of nurses combined with a global nursing shortage affects the supply of nurses and access to health services in many countries. The purpose of this article was to conduct an integrative review of case study methodology (CSM) in nurse migration research. Findings identify where studies using CSM have been conducted, by whom, and the themes explored. More studies using CSM are required to answer the important “how” and “why” questions related to nurse migration. Nurses should take a leadership role in this research.

Variations of nursing teamwork by hospital, patient unit, and staff characteristics - Corrected Proof

Beatrice J. Kalisch, Kyung Hee Lee — 2012-03-02

Abstract: The aim of this cross-sectional study was to examine the relationship among hospital, patient units, and staff characteristics and nursing teamwork. Using multiple linear regression analysis, we found that nursing role, shift, absenteeism, perceived adequacy of staffing, and unit type were significant predictors of teamwork.

Human papillomavirus distribution in vulvar intraepithelial neoplasia - Corrected Proof

Wendy Likes, Leonard Bloom — 2012-02-10

Summary: This pilot study investigated the prevalence and distribution of human papillomavirus (HPV) type in vulvar lesions in women with a history of vulvar intraepithelial neoplasia. Fifty-two specimens were collected. Uncommon HPV subtypes were found among the specimens, which may have implications for HPV vaccination coverage.

“Reading between the lines” of flow sheet data: nurses' optional documentation associated with cardiac arrest outcomes - Corrected Proof

Sarah A. Collins, David K. Vawdrey — 2011-11-14

Abstract: Historically, short “comments” on paper-based flow sheets conveyed the patient's overall clinical state. We analyzed the content and documentation patterns of electronic health record flow sheets for 201 cardiac arrest patients. Free-text comments were associated with the abnormality of clinical measurements (p < .05). The documentation of 3 or more comments for acute care patients was associated with a greater likelihood of dying by discharge (p < .01). Documentation of intensive care unit vital signs greater than the minimum hourly requirement was associated with increased survival of a cardiac arrest (p < .05). Further analysis of such patterns may be useful for the measurement of nursing knowledge and surveillance activities, interdisciplinary communication tools, and clinical decision making.

Part 2: Enhancing heart failure home management: integrated evidence for a new family caregiver educational plan - Corrected Proof

Ubolrat Piamjariyakul, Carol E. Smith, Marilyn Werkowitch, Andrea Elyachar — 2011-11-14

Abstract: This article describes how the qualitative data integrated from patients, health care professionals, and family caregivers have been developed into a new heart failure (HF) educational plan for family caregivers to manage the complexities of HF self-management at home. In addition, the educational plan describes potential strategies and teaching materials based on these integrated data.

Health-related quality of life among participants in the SMART weight loss trial - Corrected Proof

2011-11-14

Abstract: Obesity has been associated with a decreased health-related quality of life (HRQoL); however, the association between weight change and HRQoL is unclear. This secondary analysis of the SMART (Self Monitoring And Recording using Technology) trial, a clinical trial of behavioral weight loss treatment, provides evidence that quality of life improves with weight loss.

“It's a touchy subject”: Latino adolescent sexual risk behaviors in the school context - Corrected Proof

Kim Larson, Margarete Sandelowski, Chris McQuiston — 2011-07-11

Abstract: Adverse sexual health outcomes remain disproportionately high for Latino adolescents. To examine sexual risk behaviors in Latino adolescents, we conducted in-depth interviews with 18 Latino parents and 13 school staff members and carried out 1 year of fieldwork in the school and community. “It's a touchy subject [sex] here” exemplified the reluctance of addressing sexual risk behaviors. Community- and systems-level strategies are recommended.

Triangulation as a method to create a preliminary model to identify and intervene in intimate partner violence - Corrected Proof

Tuija Leppäkoski, Eija Paavilainen — 2011-07-08

Abstract: This article examines the possibilities offered by the triangulative approach and the challenges using it related to intimate partner violence (IPV) research. The purpose of this descriptive, cross-sectional, multicenter study was to create a preliminary model for identifying women exposed to acute physical IPV seeking care at emergency departments (EDs) and for intervening in the violence. The model is based on the results of previous research and the example study. A multiple approach was chosen to describe and understand better the factors that have an influence on the identification of IPV and its intervention from the women's (n = 35) and the ED professional's (n = 480) perspectives. Research material was collected from 28 EDs with questionnaires. Secondly, semistructured interviews were carried out with 7 women and 20 ED professionals. The data were analyzed using quantitative and qualitative methods. The advantage of the triangulative approach is that it provides a view of the phenomenon in a variety of ways, completing and confirming the results. The problem of this method is that it is laborious for the researcher.

Part I: Heart failure home management: Patients, multidisciplinary health care professionals and family caregivers' perspectives - Corrected Proof

Ubolrat Piamjariyakul, Carol E. Smith, Marilyn Werkowitch, Andrea Elyachar — 2011-07-08

Abstract: Using qualitative research study methods, this study identified the key factors that patients, health care professionals, and family caregivers perceived as most helpful in effectively managing heart failure (HF) at home. These key factors were the following: (a) family caregiver involvement, (b) continuous learning about HF, (c) acceptance of and coping with HF diagnosis, (d) learning from other patients with HF, (e) guidance for daily problem solving, (f) lifestyle changes, and (g) financial resources.

Conducting research with end-of-life populations: Overcoming recruitment challenges when working with clinical agencies - Corrected Proof

Dena J. Fischer, Sandy C. Burgener, Karen Kavanaugh, Catherine Ryan, Gail Keenan — 2011-06-23

Abstract: Conducting end-of-life (EOL) research can present numerous challenges associated with recruitment and retention of research subjects. Such issues may result from working with a variety of clinical settings or the uniqueness of the patient population. The purposes of this article were to describe recruitment challenges in EOL research when collaborating with different types of clinical agencies and to discuss strategies that are being used to overcome these recruitment issues.

Psychometric testing of the Depressive Cognition Scale in Korean adults - Corrected Proof

Eun Ja Yeun, Young Mi Kwon, Jung A Kim — 2011-06-23

Abstract: This study translated the Depressive Cognition Scale (DCS) from English into Korean and tested the reliability and validity of the scale. Data were from a convenient sample of 795 community-dwelling Korean adults with a self-administered questionnaire. With regard to the reliability estimate, the internal consistency of the Korean version of the DCS (K-DCS) was acceptable, where the Chronbach's alpha is .93 and the average item-to-total correlation r = .760. With regard to the validity estimate, the mean scores of the K-DCS were significantly different according to gender, age, and marital status. A single factor was extracted that accounted for 67.37% of the total variance. The average score of the K-DCS also correlated significantly with the subscales of the Korean version of the Profile of the Mood States Brief Form. These findings suggest that the K-DCS can be used as a reliable and valid measure of depressive cognition among Korean adults.

Balancing interests of hospitals and nurse researchers: Lessons learned - Corrected Proof

June Marshall, Cole Edmonson, Gretchen Gemeinhardt, Patti Hamilton — 2011-06-09

Abstract: While nurse researchers and administrators in health care organizations need to collaborate to understand the variables that affect nursing practice environments and patient care outcomes, there are inherent risks associated with these collaborations that require careful consideration. A team of academic and hospital researchers found that in studying the off-peak (nights and weekends) nursing environment using institutional ethnography, which involved interviews of nurses and administrators, the subject of the research was frequently the hospitals where these individuals worked. Although the individuals who participated in the research consented to be interviewed about their work, it was less clear how and to what extent the anonymity of their organizations could be maintained. The risks and benefits encountered suggest the need for a decision-making process to be undertaken by collaborative research teams. This decision process and analysis can help ensure a fruitful research relationship that protects sensitive concerns of hospital entities while advancing our understanding of nursing practice environments and patient care outcomes. Important strategies include having all leaders and research team members discuss the agendas of all entities and individuals involved, including clearly delineating the roles, responsibilities, and contributions of all parties. In addition, any constraints or expectations of first right of review of publications needs to be negotiated from the outset. Collaborators need to review their agreements throughout the research process to avoid pitfalls that could adversely impact the relationships as well as the dissemination of knowledge gained.

Decisional conflict and regret: Consequences of surrogate decision making for the chronically critically ill - Corrected Proof

Ronald L. Hickman, Barbara J. Daly, Eunsuk Lee — 2011-06-09

Abstract: Decisional conflict may predispose surrogate decision makers (SDMs) of the chronically critically ill (CCI) to making health care decisions that are not aligned with the patient's health care preferences and increase the SDM's likelihood of experiencing decision regret. This study establishes the relationship between decisional conflict and decision regret and offers insight on tailoring decision support interventions to the preferences of SDMs of CCI patients.

Examining barriers to emergency contraception use - Corrected Proof

Sezer Kısa, Simge Zeyneloğlu, Duygu Yılmaz, Esra Verim — 2011-04-20

Abstract: Using a cross-sectional survey research design, this study examined barriers to emergency contraception (EC) use among a sample of 318 Turkish women. Only 34% of the respondents reported being aware of EC methods, and about 20% had actually used EC. More than 90% of the participant women considered use of EC methods as a sin. The results of the study showed that the major barriers to EC use are lack of awareness and common misconceptions about EC methods. This study highlights the need of education for Turkish women regarding EC to increase awareness and dispel misconceptions related to EC.

Longitudinal study of symptom control and quality of life indicators with patients receiving community-based case management services - Corrected Proof

Jane M. Brokel, Marie Cole, Linda Upmeyer — 2011-04-20

Abstract: A longitudinal study examined seven outcomes of chronically ill patients receiving community-based case management services. A repeated-measures analysis showed that these patients reported greater satisfaction with quality of life and personal well-being and controlled their symptoms better, but declined in self-care activities of daily living and in self-care instrumental activities of daily living.

Are cognitive–behavioral interventions effective in reducing occupational stress among nurses? - Corrected Proof

Sarid Orly, Berger Rivka, Eckshtein Rivka, Segal-Engelchin Dorit — 2011-03-31

Abstract: Despite the growing evidence regarding the effectiveness of cognitive–behavioral interventions in reducing occupational stress, very few studies have examined its effectiveness among nurses. This study investigated the impact of a cognitive–behavioral (CB) course on the nurses' well-being. The study compared the sense of coherence (SOC), perceived stress (PSS), and mood states of 20 nurses who had participated in the CB course to that of 16 control participants using a pre–post test design. At baseline (t1), no significant differences were found between the two groups in SOC, PSS, and mood states. The effects within each group controlling for t1 were examined by analysis of covariance. At t2, a significant increase in SOC and the mood state of vigor and a significant decrease in PSS and fatigue were found only among participants in the CB course. The results are discussed in relation to the conceptual framework of stress and coping theory.

Oral care practices among critical care nurses in Singapore: a questionnaire survey - Corrected Proof

Ee-Yuee Chan, Isabel Hui-Ling Ng — 2011-03-25

Abstract: Background: Oral hygiene has an important role in maintaining the health and well-being of critically ill patients. Although a number of studies have examined nurses' oral hygiene practices, few were conducted among nurses caring for critically ill patients or involved Asian nurses.Objectives: The study aims to assess local nurses' knowledge, attitudes, and practices regarding oral care for critically ill patients.Methods: A descriptive cross-sectional design was used. We developed a 31-item questionnaire based on the literature, existing questionnaires, and focus group discussion. The tool covers three domains: beliefs and attitudes, prevailing practices, and knowledge. We sampled all nurses who worked in five intensive care units and high dependency during a 2-week period. We summarized data using descriptive statistics and explored the association between the nurses' knowledge of oral practices and ward specialty, job function, nurses' education level, and work shift. We used exploratory factor analysis to investigate factorial validity of the beliefs and attitudes domain.Results: A total of 244 nurses (97%) returned the surveys. More than 80% of the respondents believed that good oral care has a significant impact on the patients' clinical outcomes. However, practices varied with regard to the frequency, requisites, and methods used for oral care. Only 66.3% perceived that they have adequate oral care training. Nurses' oral health knowledge varied with education level (p = .019). Nurses' knowledge did not differ statistically across different specialities, job functions, and type of shift work. Factor analysis on the beliefs and attitudes domain revealed three factors, which we labeled as task efficacy, knowledge need, and task salience.Conclusions: The survey provided useful insights on the oral hygiene knowledge and practices of nurses caring for critically ill patients. The findings indicated that local nurses lacked adequate knowledge related to oral health and generally were ill equipped to deliver proper oral hygiene for critically ill patients. The large majority of the nurses' oral care knowledge was learned during their basic nursing education. This knowledge is inadequate to prepare them for the challenge of caring for the oral hygiene needs of critically ill patients. The results emphasized the need for continuing training in this area.

Asthma severity in children and the quality of life of their parents - Corrected Proof

Noelle S. Cerdan, Patricia T. Alpert, Sheniz Moonie, Dianne Cyrkiel, Shona Rue — 2011-03-25

Abstract: This study examines the effect of asthma severity of children aged 7–17 years and sociodemographic characteristics on the caregiver's quality of life. For parents of asthmatic children, there was a negative correlation between overall asthma severity and quality-of-life score. Measuring parental quality of life enables the development of effective asthma programs.

Influence of coping strategies on somatic symptoms in pregnant Spanish women: differences between women with and without a previous miscarriage - Corrected Proof

2011-03-25

Abstract: The aim of this research was to analyze the relation between coping strategies and somatic symptomatology in pregnant Spanish women and the influence of a previous miscarriage on these variables. We used a correlational retrospective design, which included 207 expectant mothers (44 with a previous miscarriage). The instruments included a questionnaire on coping with stress and questions about first-trimester symptoms. Regression analysis showed a significant positive relationship between sleep disturbances and overt emotional expression coping, between tiredness/fatigue and avoidance coping, and between nausea and religious coping. The influence of coping strategies on somatic symptomatology did not differ significantly between women who had had or had not had a previous miscarriage, although women with a previous miscarriage scored higher on the use of religious coping and positive reappraisal and reported more nausea.

“The system is beginning to shut down”: Utilizing caregivers' metaphors for dementia, persons with dementia, and caregiving - Corrected Proof

Mindi Ann Golden, Bryan B. Whaley, Anne M. Stone — 2011-03-25

Abstract: Family caregivers reflect understandings of dementia, persons with dementia, and their changing role through metaphors. Analyzing transcripts from a support group for spouses of persons with dementia, 14 core metaphors for dementia, caregiving/caregiver, and persons with dementia were identified. By using these metaphors, nurses can aid familial caregiver understanding and well-being.

Symptom cluster among hemodialysis patients in Taiwan - Corrected Proof

I-Chen Yu, Jeng-Yi Huang, Yun-Fang Tsai — 2011-01-27

Abstract: This cross-sectional study aimed to investigate the prevalence and severity of symptom disturbance and to identify symptom clusters among hemodialysis patients. A convenience sample of 117 Taiwanese dialysis patients completed the Somatic Symptoms Disturbance Index, the Taiwanese Depression Scale, and a demographic questionnaire. Findings indicated that four symptom clusters emerged from the factor analysis. Relationships within symptom clusters were offered and explored.

A pilot study of QT interval analysis in overweight and obese youth - Corrected Proof

Shirleatha Lee, Patricia Ann Cowan, Pedro Velasquez-Mieyer — 2011-01-21

Abstract: This descriptive pilot study examined if manual corrected QT (QTc) interval measures obtained from a standard 12-lead electrocardiogram (ECG) correlated with automated 24-hour ambulatory Holter QTc measures in 30 overweight and obese youth aged 12–17 years. In addition, we sought to determine if a significant difference existed between the means of manual 12-lead ECG versus automated 24-hour ambulatory Holter measures. Spearman's rho correlation coefficient revealed there was little if any correlation between manual 12-lead ECG and automated 24-hour ambulatory Holter QTc measures (r = .179, p = .345). In addition, a significant difference existed between QTc measures obtained from the manual 12-lead ECG in comparison to the automated 24-hour ambulatory Holter measures (p = .01). The manual 12-lead ECG and automated 24-hour ambulatory Holter analysis methods should not be used for comparison of QTc measures in overweight and obese youth.

The effectiveness of an aquarobic exercise program for patients with osteoarthritis - Corrected Proof

In-Sook Kim, Seung-Hee Chung, Yeun-Ju Park, Hee-Young Kang — 2010-12-30

Abstract: Aquarobics, a combination of the words aqua and aerobics, is based on the idea that much more energy is consumed during exercise when resisting water rather than air. The aquarobic exercise program is composed of patient education and aquarobic exercise. The program was effective in enhancing self-efficacy, decreasing pain, and improving depression levels, body weight, and blood lipid levels in patients with osteoarthritis. Therefore, this program can be widely used in a community setting for the management of osteoarthritis.