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The purpose of this scoping review was to survey the most recent (5 years) acute care, community health, and mental health nursing workload literature to understand themes and research avenues that may be applicable to school nursing workload research. The search for empirical and nonempirical literature was conducted using search engines such as Google Scholar, PubMed, CINAHL, and Medline. Twenty-nine empirical studies and nine nonempirical articles were selected for inclusion. Themes that emerged consistent with school nurse practice include patient classification systems, environmental factors, assistive personnel, missed nursing care, and nurse satisfaction. School nursing is a public health discipline and population studies are an inherent research priority but may overlook workload variables at the clinical level. School nurses need a consistent method of population assessment, as well as evaluation of appropriate use of assistive personnel and school environment factors. Assessment of tasks not directly related to student care and professional development must also be considered in total workload.

Introduction: African American (AA) high school-age girls are more likely to have had sex before age 13 years and have higher rates of all sexually transmitted infections. Cognition and religion/spirituality are associated with adolescent sexuality, therefore, the purpose of this study was to identify cognitive and religious substrates of AA girls’ risky sexual behaviors. Method: A descriptive study was conducted with 65 AA girls aged 15 to 20 years using computerized questionnaires and cognitive function tasks. Results: Average age was 17.8 ± 1.9 years and average sexual initiation age was 15.5 ± 2.6 years. Overall, 57.6% reported a history of vaginal sex. Girls who reported low/moderate religious importance were significantly younger at vaginal sex initiation than girls for whom religion was very/extremely important. Girls who attended church infrequently reported significantly more sexual partners. Implications: Health care providers can use these findings to deliver culturally congruent health care by assessing and addressing these psychosocial factors in this population.

The purpose of this article is to provide an overview of latent class analysis (LCA) and examples from symptom cluster research that includes biomarkers and genetics. A review of LCA with genetics and biomarkers was conducted using Medline, Embase, PubMed, and Google Scholar. LCA is a robust latent variable model used to cluster categorical data and allows for the determination of empirically determined symptom clusters. Researchers should consider using LCA to link empirically determined symptom clusters to biomarkers and genetics to better understand the underlying etiology of symptom clusters. The full potential of LCA in symptom cluster research has not yet been realized because it has been used in limited populations, and researchers have explored limited biologic pathways.

A lack of knowledge and skills in pediatric palliative care may create hesitation in caring for children with serious life-threatening conditions and their families. Our research examined the effectiveness of pediatric palliative care training for pediatric clinicians. A pretest–posttest study provided educational training in pediatric palliative care to pediatric clinicians and used a pretest and a posttest to assess outcomes. Fifty pediatric clinicians attended this research with 83.3% response rate. After training, participants reported significantly increased confidence in a variety of areas, including providing emotional support to clinicians, personal knowledge, skills, and communication; ethical and legal concerns; and providing emotional support to dying children and their families. Results showed a significant main effect of training on confidence levels (p < .000). This suggests that education can effectively boost pediatric clinicians’ confidence regarding providing pediatric palliative care and therefore should regularly be provided to clinicians.

The purpose of this systemic literature review is to unveil a greater understanding of Physical Activity in Latinas. We used PubMed and PsycInfo databases to search for articles published between 1991 and August 2016, examining physical activity and its correlates exclusively in adult Latinas. Only 21 primary studies met the inclusion criteria. Although physical activity derives from body movements in various domains, the leisure domain led the focus of research interest. The use of self-reports, cross-sectional design, and the ecological framework predominated. Only one study included examining the occupational domain, albeit as disaggregate in studies with a general physical activity approach. Occupational physical activity showed negative associations with education and acculturation. Positive associations were found between leisure-time physical activity, education, acculturation, and perceived health status. Despite the limited evidence to reach overall conclusions, this review uncovered methodological challenges and opportunities to advance knowledge about physical activity in Latinas.

Workplace bullying has been experienced by 27% to 80% of nurses who have participated in studies. Bullying behaviors negatively impact the health of nurses. This study examined whether nurses’ resilience had an impact on the effects of bullying on the nurse’s health. This cross-sectional descriptive study surveyed licensed registered nurses in one state. The sample (N = 345) was predominately female (89%) and Caucasian (84%), with an average age of 46.6 years. In this sample, 40% of nurses were bullied. Higher incidence of bullying was associated with lower physical health scores (p = .002) and lower mental health scores (p = .036). Nurses who are bullied at work experience lower physical and mental health, which can decrease the nurses’ quality of life and impede their ability to deliver safe, effective patient care.

Provision of anticipatory guidance to parents during well-child visits is a defining component of pediatric primary care. Using nationally representative data from the 2000 U.S. National Survey of Early Childhood Health, this study addressed the questions of whether, how, and what mothers of children below age 3 with different ethnic/racial background could benefit from anticipatory guidance. Structural equation modeling results showed that across ethnic/racial groups, guidance was directly associated with decreased maternal stress and directly and indirectly associated with effective parenting practices in child development, discipline, and safety. Moreover, guidance was consistently associated with decreased stress (effect size = .159/.123/.252) and increased effective parenting practices in child development (total effect = .090/.179/.296), discipline (total effect = .079/.138/.111), and safety (total effect = .186/.204/.229) in White/Black/Latino groups, respectively. Finally, whereas guidance was directly associated with child safety in all groups, it was indirectly contributed to child development and discipline via maternal stress in the Latino group only.

New software that performs Classical and Bayesian Instrument Development (CBID) is reported that seamlessly integrates expert (content validity) and participant data (construct validity) to produce entire reliability estimates with smaller sample requirements. The free CBID software can be accessed through a website and used by clinical investigators in new instrument development. Demonstrations are presented of the three approaches using the CBID software: (a) traditional confirmatory factor analysis (CFA), (b) Bayesian CFA using flat uninformative prior, and (c) Bayesian CFA using content expert data (informative prior). Outcomes of usability testing demonstrate the need to make the user-friendly, free CBID software available to interdisciplinary researchers. CBID has the potential to be a new and expeditious method for instrument development, adding to our current measurement toolbox. This allows for the development of new instruments for measuring determinants of health in smaller diverse populations or populations of rare diseases.

The current study examines whether person–job fit moderates the relationship between transformational leadership and work engagement. Data were collected using cross-sectional design from 224 (15 male and 209 female) hospital nurses. Participants completed measures of transformational leadership, person–job fit, and work engagement. Moderated multiple regression results showed that transformational leadership had a significant positive predictive relationship with work engagement, and person–job fit had a significant positive predictive relationship with work engagement. Simple slope analysis showed that person–job fit moderated the relationship between transformational leadership and work engagement such that transformational leadership was more positively related to work engagement for nurses with high person–job fit compared with those with low person–job fit. Thus, all the hypotheses were confirmed. The findings were discussed, and suggestions for future research were offered.

Many individuals, including dementia caregivers, use blogs to share their experiences. These blogs contain rich narratives representing an untapped resource for understanding the psychosocial impact of caring for a person with dementia at the family level. The present study used blogs written by caregivers of persons with dementia to explore how these individuals leveraged this medium as part of the caregiving experience. Blogs written by self-identified informal caregivers of persons with dementia were identified using a systematic search method, and data were analyzed using a qualitative thematic analysis. Four themes emerged from the narratives: social support through communication and engagement, information gathering and seeking, reminiscing and legacy building, and altruism. By understanding the ways in which individuals providing care for persons with dementia use social media as part of the caregiving experience, family nurses can develop interventions and services aimed at improving caregiver burden and quality of life.

Providing timely palliative and end-of-life care (PC/EOL) information to parents of children with a serious illness is a national health care priority. The goals of this study were to determine feasibility, acceptability, and parent responses related to a PC/EOL communication intervention, titled "Communication Plan: Early through End of Life (COMPLETE)" to parents of children with a brain tumor. The study was a 2-site prospective, single-group pilot study targeting parents’ stress and coping outcomes. The sample included 13 parents of 11 children (ie, 11 families). During the first 6 months postdiagnosis, we evaluated parent outcomes at 4 time points (baseline and 3 post-sessions). Our findings included significant decline in decision regret (P = .0089); strong, significantly increased hope (P ≤ .0001); and significantly decreased uncertainty (P = .04). Over time, more than half of the parents (61.5%) preferred to receive information about their child’s current condition and PC/EOL options. Our findings provide evidence to suggest that the COMPLETE intervention is feasible and acceptable and produces promising effects on 3 parent outcomes (ie, decision regret, hope, and uncertainty) in parents of children with a brain tumor. Further research is indicated to evaluate COMPLETE with a larger sample of parents of children with cancer and with a control group.

The purpose of this descriptive comparative study is to compare the levels of decisional involvement of staff nurses between one Midwestern health care system in the United States with a nongovernmental University hospital in Turkey. The Decisional Involvement Scale was used for data collection. U.S. (n = 163) and Turkey (n = 50) staff nurses were included in the study. Both samples preferred more decisional involvement than they currently experienced. However, Turkish nurses experienced and preferred lower levels of decisional involvement than the U.S. sample. Shared governance structures may be a strategy used to enhance staff nurse decisional involvement.

The purpose was to examine the effects of auricular acupressure to relieve constipation in patients with breast cancer who were undergoing chemotherapy. Participants were 52 patients with breast cancer receiving chemotherapy at E University Hospital, Seoul, Korea, randomized into two groups of equal size. For the experimental group, auricular acupressure was applied to seven auricular acupoints for 6 weeks using vaccaria seeds, whereas the control group received the usual care. Constipation-assessment scores of the experimental group were significantly lower compared with the control group (p < .001). Stool-form scores of the experimental group were significantly higher compared with the control group (p = .003). Patient Assessment of Constipation–Quality of Life scores of the experimental group were significantly lower compared with the control group (p < .001). Auricular acupressure was effective at relieving constipation in patients with breast cancer receiving chemotherapy. Auricular acupressure was also a safe and acceptable nursing intervention.

Although following a low-sodium diet (LSD) for heart failure (HF) has been recommended for decades, little is known about factors related to long-term patient adherence. The purposes of this study were to (a) compare sodium intake and factors affecting adherence in a long-term adherent group and in a non-adherent group and (b) examine predictors of membership in the long-term adherent group. Patients with HF (N = 74) collected 24-hr urine samples and completed the Dietary Sodium Restriction Questionnaire and the Patient Health Questionnaire-9. Long-term adherence was determined using the Stage of Dietary Behavior Change Scale. The long-term adherent group had lower sodium intake (3,086 mg vs. 4,135 mg, p = .01) and perceived more benefits from LSD than the non-adherent group. Only positive attitudes toward LSD predicted membership in the long-term adherence group (odds ratio [OR] = 1.18, p = .005). Interventions focused on enhancing positive perceptions of the benefits of an LSD may improve long-term dietary adherence in patients with HF.

Purpose: To improve health and reduce health disparities, research partnerships with American Indian and Alaska Native communities should build on existing traditions and strengths. The overall goal of this pilot project was to clarify the needs of tribal community members and determine strengths and resources available to the community. Design: Community-based participatory research was the approach used to obtain community input. Data collection methods included, Photovoice (n = 16), digital storytelling (n = 4), and community capacity surveys (n = 128). Results: Quantitative and qualitative findings supported the need to (1) address youth suicide and substance abuse on the reservation and (2) use preexisting resources available in the community. The results led to the development of a strengths-based intervention incorporating the Gathering of Native American’s curriculum. Conclusion: Integral to the development, implementation, and sustainability of the intervention was the truly reciprocal relationship developed between community and university partners.

Purpose: This exploratory qualitative study examines Chinese adolescents’ health information sharing habits on social network sites. Method: Ten focus group meetings with 76 adolescents, ages 12 to 17 years, were conducted at community-based organizations in Chicago’s Chinatown. The research team transcribed the recording and analyzed the transcripts using ATLAS.ti. Results: Chinese adolescents are using different social network sites for various topics of health information including food, physical activity, and so on. Adolescents would share useful and/or interesting health information. Many adolescents raised credibility concerns regarding health information and suggested evaluating the information based on self-experience or intuition, word-of-mouth, or information online. Conclusion: The findings shed lights on future intervention using social network sites to promote health among Chinese adolescents in the United States. Implications for Practice: Future interventions should provide adolescents with interesting and culturally sensitive health information and educate them to critically evaluate health information on social network sites.

Many survivors of childhood acute lymphoblastic leukemia (ALL) develop neurocognitive deficits that compromise academic functioning, especially in the presence of sociodemographic risk factors. The extent to which these risk factors coexist for Latino ALL survivors is not well described, but with shifts in U.S. demographics and improved survival in ALL, culturally competent interventions are needed. The Achieving Best Cognitive Successes after Cancer service was designed and implemented by a team representing nursing, medicine, psychology, and social work. Service components include neurocognitve assessment and individualized intervention for treatment-related risks and improving academic success for school-aged ALL survivors. Interventions are child-focused and parent-directed, recognizing that parents are major sources of support and advocates for their children within school systems. The service was designed to be culturally appropriate for the predominantly Latino patient population at our center, based on (1) linguistic competency of children and parents; (2) multicultural and ecological considerations for urban, low socioeconomic status, and migrant populations; (3) literacy barriers; and (4) contextual factors. This report describes methodological considerations and practice implications relevant to the design and implementation of similar culturally competent services for Latino pediatric cancer survivors.

This study examined the effect of an intervention on coping knowledge among fifth- and sixth-grade elementary schoolchildren who received smartphone-delivered emergency preparedness education. This was a quasi-experimental study using a pre-/posttest design. Eighty-six children were recruited to participate. The children in the experimental group (n = 44) received smartphone-delivered emergency preparedness education while those in the control group (n = 42) received traditional lecture-centered education. Data were analyzed using a repeated-measured analysis of variance. Subsequently, the experimental group scored significantly higher than the control group on coping knowledge (F = 7.96, f = .31, p = .010). The use of technology such as smartphone-delivered emergency preparedness education may be effective to improve their coping knowledge of fifth- and sixth-grade elementary schoolchildren.

In 2012, 20% of high school students were bullied in the United States. Bullying is more prevalent among minority populations. Arab American adolescents receive little research attention and are described as the invisible population. This descriptive qualitative study was conducted with 10 Arab American adolescent bullying victims to describe their bullying experiences and related stress. In addition to being bullied because of health problems or social disadvantages, Arab American adolescents reported that they were bullied because of their ethnic/racial background and religious affiliation. Victims described high stress levels and anxiety which compromised their ability to function. They reported feeling sad, angry, overwhelmed, helpless, and hurt when they were bullied. They also lost control over their lives and self-confidence. Family and friends were sources of support but school administrators and teachers were not supportive. Implications for practice and future research were discussed.

Pender’s health promotion model guided this descriptive/correlational study exploring the relationship between religiosity and health-promoting behaviors of pregnant women at Pregnancy Resource Centers (PRCs). A consecutive sample included women who knew they were pregnant at least 2 months, could read/write English, and visited PRCs in eastern Pennsylvania. Participants completed self-report surveys that examined religiosity, demographics, pregnancy-related variables, services received at PRCs, and health-promoting behaviors. Women reported they "sometimes" or "often" engaged in health-promoting behaviors, Hispanic women reported fewer health-promoting behaviors than non-Hispanic women, and women who attended classes at the centers reported more frequent health-promoting behaviors than those who did not attend classes. In separate multiple linear regressions, organized, non-organized, and intrinsic religiosity and satisfaction with surrender to God explained additional variance in health-promoting behaviors above and beyond what Hispanic ethnicity and attending classes at the PRCs explained in pregnant women at PRCs.

New methods of care are required to meet the needs of people with dementia and their caregivers. The Namaste Care™ program provides a person-centered approach through meaningful activities and loving touch. The purpose of this qualitative study was to explore the experiences of residents, staff, and family involved in the Namaste Care™ program at a long-term care facility in the United States. A descriptive approach was used to interview 14 staff members. The findings revealed six themes: peaceful sanctuary, relating their way, transforming experiences, connections and community, positive moments, and awakened to the possibilities. Results suggest that Namaste Care™ may be useful for individuals no longer able to participate in traditional long-term care setting activities. Further studies are indicated to confirm the impact on hospital readmissions, therapy enhancement, and medication use in relationship to Namaste Care™ program participation.

The main objective is to study the effects of job crafting activities of elder care and nursing home employees on their perceived well-being and quality of care in two European countries, Spain and Sweden. The Job Crafting, the General Health, and the Quality of Care questionnaires were administered to 530 employees. Correlations and hierarchical regression analyses were performed. Results confirm the effects of job crafting on quality of care (r = .291, p < .01; β = .261, p < .01; R² = .065, p < .01) and employees’ well-being (r = .201, p < .01; β = .171, p < .01; R² = .028, p < .01). A positive linear relationship was found between job crafting and well-being in Spain and Sweden and with quality of care in Spain. On the contrary, in Sweden, the relationship between job crafting and well-being was not linear. Job crafting contributes significantly to employees’ and residents’ well-being. Management should promote job crafting to co-create meaningful and productive work. Cultural effects are proposed to explain the differences found.

Adherence to recommended physical activity after a cardiac event is important to prevent cardiac recurrence. Social support from peers and family is known to improve self-care in chronic illnesses, including cardiovascular disease. However, the relationship between social support from health care providers and physical activity among patients with coronary artery disease remains unclear. This cross-sectional study aimed to identify the relationship between perceived social support from health care providers and physical activity among patients with stable coronary artery disease. The study included 237 patients with stable coronary artery disease attending an outpatient clinic. Hierarchical linear regression found that perceived social support explained 12% of variance in physical activity, F(14, 222) = 7.37, p < .001. In addition, self-efficacy partially mediated the relationships between perceived social support and physical activity. Abundant support from health care providers plays a key role in promoting physical activity among patients with stable coronary artery disease.

Housing instability threatens the health and well-being of millions of families across the United States, yet little is known about the characteristics or housing trajectories of at-risk families. To address this gap in our understanding of family risk for housing instability and homelessness, we undertook a qualitative descriptive study utilizing a convenience sample of 16 mothers recruited from a housing service agency living in Detroit and receiving emergency services to avoid homelessness. Participants completed the Brief Patient Health Questionnaire (PHQ), then narrated their life events and reasons for housing instability and disclosed desired interventions for homelessness prevention. Data analysis reveals that women experienced high rates of previously undisclosed trauma, broken family relationships, early parenting responsibilities, social isolation, and system failures that contributed to recurrent episodes of housing instability. We argue that housing instability is a symptom of multiple chronic underlying issues that need more than a temporary financial patch.

Children and adolescents in the United States spend many hours in school. Students with chronic health conditions (CHCs) may face lower academic achievement, increased disability, fewer job opportunities, and limited community interactions as they enter adulthood. School health services provide safe and effective management of CHCs, often for students with limited access to health care. A systematic review to assess the role of school health services in addressing CHCs among students in Grades K–12 was completed using primary, peer-reviewed literature published from 2000 to 2015, on selected conditions: asthma, food allergies, diabetes, seizure disorders, and poor oral health. Thirty-nine articles met the inclusion criteria and results were synthesized; however, 38 were on asthma. Direct access to school nursing and other health services, as well as disease-specific education, improved health and academic outcomes among students with CHCs. Future research needs to include standardized definitions and data collection methods for students with CHCs.

Bullying in schools is a major health concern throughout the world, contributing to poor educational and mental health outcomes. School nurses are well placed to facilitate the implementation and evaluation of bullying prevention strategies. To evaluate the effect of such strategies, it is necessary to measure children’s behavior over time. This scoping review of instruments that measure the self-report of aggressive behavior and bullying by children will inform the evaluation of bullying interventions. This review aimed to identify validated instruments that measure aggression and bullying among preadolescent children (age 8–12). The review was part of a larger study that sought to differentiate bullying from aggressive behavior by measuring the self-report of power imbalance between the aggressor and the child being bullied. The measurement of power imbalance was therefore a key aspect of the scoping review.

Children with cancer are a subset of patients with central lines with distinct risk factors for infection including periods of prolonged neutropenia and compromised mucous membrane integrity. This article relates the implementation of principles of practice-based evidence to identify interventions in addition to best practice maintenance care bundles to reduce central line–associated bloodstream infections involving viridans group streptococci and coagulase-negative staphylococci on an inpatient pediatric oncology unit. Review of individual events combined with review of current clinical practice guided the development of structured protocols emphasizing routine oral care and general supportive cares. Key principles of the protocols emphasized a 1-2-3 mnemonic and included daily bathing, twice daily oral care, and out-of-bed activity 3 times daily. Poisson regression identified a significant main effect for time period for central line–associated bloodstream infection rates involving both viridans group streptococci and coagulase-negative staphylococci. Significant differences were present between the preintervention baseline and implementation of the supportive care protocols. Project outcomes demonstrate the added value of using principles of practice-based evidence to guide the development of interventions to improve clinical care when evidence-based sources are limited.

The purpose of this study was to identify family caregivers’ experiences in managing the behavioral and psychological symptoms of dementia (BPSD) with particular focus on their interpersonal interactions with patient with dementia. Data were collected through focus-group interviews with 15 family caregivers from three local dementia-support centers located in Seoul. Data were analyzed using content analysis. Three main themes were identified through data analysis: triggers of BPSD, family caregiver’s actions in response to BPSD and patient’s reactions, and the effect of BPSD on family caregivers. Findings demonstrated that BPSD depended on the complex interplay of family caregivers and patients, including their interaction style. This information could help nurses when counseling and educating family caregivers to improve or modify their attitudes and approaches to behavioral symptoms of patients.

Adolescent smoking prevention is an important issue in health care. This literature review describes the theoretical concept of ecological model for adolescent smoking and tobacco retailers and summarizes previous studies on the association between the density and proximity of tobacco retailers and adolescent smoking. We reviewed nine studies on tobacco retailer density and proximity in relation to adolescent smoking, published in peer-reviewed journals between 2004 and 2014. The tobacco retailer density and proximity were correlated with adolescent lifetime smoking, past 12-month smoking, past 30-day smoking, and susceptibility to smoking. School nurses or other school health professionals may need to include the density and proximity of tobacco retailer factors around schools in school-based tobacco-use prevention programs. Health policy makers may need to consider zoning or licensing restrictions of tobacco retailers around schools for adolescent smoking prevention.

Purpose: To explore the range of teaching approaches and cultural-tailoring elements used in diabetes educations directed at Chinese patients and to determine the strategies that appeared to best address Chinese patients’ needs. Design: A case study approach in three countries was employed, using multiple ethnographic data collection methods including participant observations and qualitative interviews. Findings: Data were collected from 39 participant observations and 22 interviews across seven cases. Collective didactic education was most common. Individual clarification at the end of an education session was used to allow patients to derive their own management plan. Clinicians mainly provided information and used knowledge reinforcement to facilitate behavioral change. Participatory diabetes education models borrowed from the West did not translate well culturally and did not appear to meet Chinese patients’ needs. Conclusion and Practical Implications: Diabetes education for the Chinese may be enhanced by building on traditional Confucian education strategies.

Student engagement represents a critical component of a comprehensive school health (CSH) approach to health promotion. Nevertheless, questions remain about its implementation. This scoping review updates the field of student engagement in health promotion. Of the 1,388 located articles, 14 qualify for inclusion in this study. An analysis reveals four themes. CSH programs that incorporate student engagement promote a sense of belonging to a community, encourage meaningful involvement, give voice to student concerns, and advance supportive relationships. This study finds a lack of research regarding student engagement in health promotion but confirms that student participation in CSH initiatives contributes to a sense of ownership. Consequently, we can infer that student ownership of health promotion takes place through their meaningful engagement and can effect social change.

Incidence rate and patterns of physical restraint use were examined based on a cross-sectional study in 22 wards of a large teaching hospital in Malaysia. Results indicated that the highest rate of physical restraint (19.7%) was reported from neurology–neurosurgery wards. "Un-cooperative for electroconvulsive therapy" and "trying to pull out catheters" were the most commonly reported reasons to use restraint in psychiatric and non-psychiatric wards, respectively. There were some relationships between patterns of physical restraint in this study. Exploring the incidence rate and patterns of physical restraint is important so that effective strategies can be formulated to minimize using restraint in hospitals.

Palliative and end-of-life care (PEOLC) in Mexican American (MA) caregiving families remains unexplored. Its onset was uncovered in our mixed methods, multisite, interdisciplinary, qualitative descriptive study of 116 caregivers, most of whom had provided long-term informal home care for chronically ill, disabled older family members. This subanalysis used Life Course Perspective to examine the "point of reckoning" in these families, where an older person is taken in for care, or care escalates until one recognizes oneself as the primary caregiver. Ninety-three of 116 caregivers recognized and spontaneously reported a "reckoning point" that initiated the caregiving trajectory, while eight cited "gradual decline" into caregiving for elders in their homes. This "reckoning point," which marks the assumption of this role, may afford a fertile opportunity for referral to community resources or initiation of formal PEOLC, thereby improving the quality of life for these older individuals and their families.

Sexual and gender minority (SGM) youth are at disproportionate risk for HIV. Schools play an integral role in educating young people about sexual health in addition to providing sexual health services. This qualitative study examined SGM youths’ perception of school sexual health education and services. A total of 42 self-identified African American SGM males participated in focus groups or in an in-depth interview. Qualitative findings revealed that schools are missing the opportunity to educate SGM youth about sexual health. Youth participants noted several barriers to accessing sexual health education and services at schools including limited, targeted health information and school nurses not being knowledgeable of health issues that impact SGM youth. Participants noted that school sexual health services are not adequately marketed to students and sometimes do not include testing for HIV and other sexually transmitted diseases. Suggestions for future research and implications for school nurses and sexual health services are discussed.

There has been a 2% to 3% increase in Type 1 diabetes (T1D) in children below 11 years old. Preteens (9-12 years old) with T1D are often overlooked regarding future diabetes self-management (DSM) expectations because parents are still in the "driver’s seat." The study purpose was to explore feasibility/ability to recruit and conduct a two-arm trial on reeducation, collaboration, and social support. One component of DSM was reviewed (hypoglycemia) with preteens (n = 22) and parents (n = 22). The experimental preteens discussed hypoglycemia management with a teen mentor and nurse educator using a human patient simulator for practice, and working collaboratively with parents. Concurrently, mothers met with a parent mentor and psychologist to discuss growth and development, and collaborative shared management. Comparison dyads discussed hypoglycemia management with a nurse. Preteens slightly improved in diabetes knowledge; the experimental arm had higher problem-solving scores. Parents in the experimental arm had higher self-efficacy scores. Findings will inform future research.

The purpose of the study was to examine relationships between sleep insufficiency, depressive symptoms, demographic factors, and the nonmedical use of prescription medications (NMUPMs) in the U.S. high school students. Data from the 2013 Youth Risk Behavioral Surveillance System were used (n = 13,570) and analyzed using IBM SPSS 23™ (complex samples). Significant bivariate relationships were found between the NMUPMs and sleep (p < .01), feeling sad (p < .001), grade level (p < .001), and race/ethnicity (p < .01). Logistic regression analyses found that all of the independent variables were significant in predicting the likelihood of the NMUPMs. Findings underscore the potential impact of preventing NMUPMs in high school adolescents by improving their sleep behaviors and assessing adolescents for depressive symptoms.

Home care agencies are initiating "patient health goal elicitation" activities as part of home care admission planning. We categorized elicited goals and identified "clinically informative" goals at a home care agency. We examined patient goals that admitting clinicians documented in the point-of-care electronic health record; conducted content analysis on patient goal data to develop a coding scheme; grouped goal themes into codes; assigned codes to each goal; and identified goals that were in the patient voice. Of the 1,763 patient records, 16% lacked a goal; only 15 goals were in a patient’s voice. Nurse and physician experts identified 12 of the 20 codes as clinically important accounting for 82% of goal occurrences. The most frequent goal documented was safety/falls (23%). Training and consistent communication of the intent and operationalization of patient goal elicitation may address the absence of patient voice and the less than universal recording of home care patients’ goals.

Older Black patients are at increased risk for experiencing a hospital readmission. This disparity may be related to a variety of factors, including care received during hospitalization. The purpose of this study was to elicit the perceptions of older Black patients at high risk for readmission, and explore their nursing care needs and preferences during and following hospitalization. A qualitative descriptive design was used, including individual interviews with 19 Black members of a Program of All-Inclusive Care for the Elderly facility located in a northeastern urban setting. Four themes were captured encompassing characteristics of nursing care quality, unmet care needs, nurse–patient communication, and observations of competing nursing demands. Efforts to improve care transitions and prevent readmissions must address the needs and preferences of high-risk older Black patients while also attending to system-level inefficiencies that decrease the ability for nurses to complete all aspects of care.

This study investigated patients’ experiences of loneliness in professional caring relationships and their associations with perceived recovery, health, psychological distress, and general loneliness in life. The sample consisted of 406 patients who had undergone breast cancer or heart surgery 6 months earlier. The data were collected in May 2014-March 2015 using a postal survey including the Caring Loneliness Scale (CARLOS), questions concerning perceived health and recovery, 12-item General Health Questionnaire (GHQ-12), and a question concerning perceived general loneliness in life. Data analysis was done using Mann–Whitney U test and Kruskal–Wallis test. The variables showing a statistically significant association with professional caring loneliness were perceived health, recovery, psychological distress, and general loneliness in life. It is necessary for health care professionals to identify the phenomenon of this dimension of loneliness because it is bound to affect patients’ experiences. Further studies with different patient groups are required.

Despite advances in mechanical ventilation, severe acute respiratory distress syndrome (ARDS) is associated with high morbidity and mortality rates ranging from 26% to 58%. Extracorporeal membrane oxygenation (ECMO) is a modified cardiopulmonary bypass circuit that serves as an artificial membrane lung and blood pump to provide gas exchange and systemic perfusion for patients when their own heart and lungs are unable to function adequately. ECMO is a complex network that provides oxygenation and ventilation and allows the lungs to rest and recover from respiratory failure while minimizing iatrogenic ventilator-induced lung injury. In critical care settings, ECMO is proven to improve survival rates and outcomes in patients with severe ARDS. This review defines severe ARDS; describes the ECMO circuit; and discusses recent research, optimal use of the ECMO circuit, limitations of therapy including potential complications, economic impact, and logistical factors; and discusses future research considerations.

Questionnaire development involves rigorous testing to ensure reliability and validity. Due to time and cost constraints of developing new questionnaires, researchers often adapt existing questionnaires to better fit the purpose of their study. However, the effect of such adaptations is unclear. We conducted cognitive interviews as a method to evaluate the understanding of original and adapted questionnaire items to be applied in a future study. The findings revealed that all subjects (a) comprehended the original and adapted items differently, (b) changed their scores after comparing the original to the adapted items, and (c) were unanimous in stating that the adapted items were easier to understand. Cognitive interviewing allowed us to assess the interpretation of adapted items in a useful and efficient manner before use in data collection.

Axillary digital thermometers (ADTs) and non-contact (infrared) forehead thermometers (NCIFTs) are commonly used in pediatric settings, where an incorrect body temperature measurement may delay treatments or lead to incorrect diagnoses and therapies. Several studies comparing ADT or NCIFT with other methods have found conflicting results. To investigate whether ADT and NCIFT can be used interchangeably, a comparative observational study was conducted involving 205 children aged 0 to 14 years who were consecutively admitted to the pediatric emergency department. The Bland–Altman plot illustrated agreement between the two methods. A total of 217 pairs of measurements were compared; axillary measurements showed average values significantly higher than forehead measurements (37.52°C and 37.12°C; t = 7.42, p = .000), with a mean difference of 0.41°C between the two methods (range = –1.80 and +2.40). In this setting and population, ADT and NCIFT cannot be used interchangeably.

The aim of this study is to describe and understand experiences related to social support for women with fibromyalgia who suffer from sexual dysfunction. An interpretive qualitative research methodology based on Gadamer’s philosophical hermeneutics was used. Data collection included a focus group and in-depth interviews with 13 women who averaged 44.8 years of age and 14.3 years since being diagnosed with fibromyalgia. Data were analyzed using Fleming’s method and two themes were identified: "searching for understanding in socio-family support" and "lack of formal support regarding fibromyalgia patient’s sexuality." The partner constitutes the main support for women with fibromyalgia. Although they can find understanding and social support in patient associations, they lack formal support from health care professionals. Women demand trusted and expert professionals, like sexologists and nurses, to carry out a multidisciplinary approach to tackle sexual dysfunction associated with fibromyalgia.