Presentations
Author List:
Shao-Yun Chien, Dr. Oleg Zaslavsky (Chair), Dr. Basia Belza (Committee member), Dr. Annie T. Chen (Committee member)
Abstract:
Background:
Older adults are often considered particularly vulnerable to loneliness and social isolation, primarily due to functional declines associated with aging, an increased risk of facing multiple losses, and diminished resilience during their later years. A recent report by the U.S. federal government highlights that loneliness is a critical public health issue, which severely affects the health and well-being of older adults. Addressing this issue and ensuring the mental health of the aging population are urgent health challenges in a rapidly aging global population. With the advancement of technology and the push from the pandemic, Information and Communication Technology (ICT) is a potential strategy to promote social connections and reduce feelings of loneliness. However, there is still a lack of solid evidence supporting the effectiveness of existing interventions, including those involving ICT. The failure of these interventions can be attributed to a neglect of the complexity of loneliness and the diversity of subjects’ backgrounds, including racial and cultural differences. International migration is considered a significant risk factor for loneliness and social isolation, especially in old age. The population of older Chinese immigrants is rapidly expanding and has become one of the largest groups in Western societies. Despite their numbers, older Chinese immigrants have received limited attention in the research literature, even though they exhibit a higher prevalence of loneliness compared to other groups. This not only troubles older adults and their families but also negatively affects the healthcare system and even the stability of society.
Objectives:
This research aims to understand loneliness and social isolation among older Chinese immigrants and develop a culturally sensitive ICT intervention. The objectives include exploring their experiences and challenges with loneliness, social isolation, and technology use; assessing the effectiveness and cultural sensitivity of existing ICT interventions; and designing and testing the web-based platform VOCALE-OCI.
Methods:
The study is divided into three parts. The first part involves qualitative in-depth interviews with 18 older Chinese immigrants in the U.S. to identify key themes related to loneliness, cultural and social factors, and ICT usage. The second part reviews literature on ICT interventions for loneliness among older adults, emphasizing culturally sensitive approaches. The third part entails designing and testing VOCALE-OCI, utilizing Human-Centered Design principles with a focus on cultural relevance and usability.
Main Findings:
The qualitative study unveiled themes around cultural influences, life transitions, and overcoming technological barriers. The literature review highlighted the potential of ICT interventions but also the scarcity of research focusing on minority racial/ethnic groups. The development of VOCALE-OCI based on Bronfenbrenner’s Ecological Systems Theory received positive feedback for its cultural resonance and potential to foster community and belonging.
Conclusions:
This project enhances understanding of loneliness and social isolation among older Chinese immigrants and shows the promise of VOCALE-OCI, a culturally sensitive ICT solution. It emphasizes the importance of cultural sensitivity and user involvement in developing effective interventions. Future work should focus on refining ICT solutions, integrating cultural factors, and creating scalable interventions for other vulnerable populations.”
Author List:
Yanjing Liang, Priscilla Carmiol-Rodriguez, Sarah McKiddy, Paige Bartlett, Heather Wicklein-Sanchez, Basia Belza
Abstract:
Purpose:
Since 1998, the de Tornyay Center for Healthy Aging at the University of Washington has served as a catalyst for promoting healthy aging through its support of research, education, and practice related to aging. As part of this mission, the center has played a pivotal role in mentoring over 165 undergraduate and graduate students, awarding them more than $757,000 in research funding over the years. This poster aims to showcase contributions made by scholars over time, thus capturing the evolution of our scholar community in healthy aging.
Methods:
An online survey was developed for scholars to complete that asked them to reflect on their scholarship experiences and professional achievements. E-mail invitations with a link to the online survey were sent to 87 former de Tornyay Center scholars.
Results:
We attempted to contact 87 scholars; 32 responses were received. Scholars have until February 20 to complete the survey. The scholars reported that following completion of their degree, they pursued careers in 21 (65.6%) clinical work, 18 (56.2%) nursing education, and 13 (40.6%) research. Four themes illustrate the scholars’ professional journeys. First, scholars have made remarkable contributions to nursing research. The publications in prestigious nursing journals showcase the culmination of years of dedicated exploration. Research has influenced the integration and regulation of simulation in education, enhanced and standardized educational practices, and earned widespread recognition by colleagues. Also, our scholars have secured research funding from prestigious institutions like the National Institutes of Health and have been recognized for facilitating interdisciplinary research. Second, in the clinical arena, one of our scholars pioneered innovative nursing practice models in rheumatology, gaining international recognition and adoption. Recognition from peers and nominations for awards underscore the impact of de Tornyay scholars’ clinical achievements. Additionally, scholars’ contributions to the COVID response, vaccine administration, and innovative approaches in outpatient settings during the pandemic underscore their commitment to improving patient outcomes. Leading committees for the prevention of patient pressure injuries and attaining multiple professional certifications further showcase their clinical leadership. One of our scholars revamped the cardiac rehab curriculum at CAPRI Heart & Lung Institute to empower post-heart attack clients, and the institute embraced and utilized her impactful changes. Third, our scholars take pride in using nursing practice experiences to guide students. They have demonstrated a commitment to shaping the next generation of nursing professionals. As the executive director of the Taiwan Association of Nurse Practitioners, one scholar played a pivotal role in developing the nurse practitioner role, establishing regulations, and contributing to workforce development. Faculty members have also created innovative educational models, published materials, and developed objective structured clinical examinations (OSCE) to assess students’ core clinical competencies. Fourth, our scholars are involved in professional service, such as serving on the Japan Academy of Nursing Science Board, American Delirium Society and the Gerontological Society of America. Also, one of our scholars dedicate to volunteering efforts in healthcare institutions and collaborating on evidence-based healthy aging programs in Changsha, China, showcase a commitment to addressing healthcare gaps and community well-being. Additionally, as a community leader, our scholars use nursing expertise to set up local resources, such as a lending library and disaster plan, and chairs a committee combating social isolation in Kitsap County. Others volunteer in professional associations. Scholars commented that the de Tornyay Center boosted their research skills (n=24, 75.0%) and provided crucial career guidance and mentorship (n=24, 75.0%). Early involvement in scientific research at de Tornyay Center was found to influence students’ academic paths. Through the de Tornyay scholar program, students set the stage for their commitment to gerontological nursing, advancing scholarly and career pursuits.
Conclusion:
These results add to our understanding of the scholars’ journey and serve as a foundation for shaping the center’s strategic plan. The results demonstrate the center’s role in nurturing scholars who make significant contributions to healthcare, consistently cultivating a robust talent pool, and building a workforce for healthcare. Meanwhile, the de Tornyay scholar program experience facilitates students’ exploration of the significance of professionalism, thereby paving the way for impacting the scholars’ career paths.”
Author List:
Megan Coe, Sarah Gimbel, Geoffrey Okoth Olieng’o, Megan Lewis, Phlona Amam, Chrisantus Oduol, Catherine Achieng, Beth Kolko, Benson Singa, Arianna Rubin Means
Abstract:
Background:
Malnutrition plays a part in 45% of global child deaths and is an important risk factor for death among hospitalized children in Kenya. Although treatment guidelines for malnutrition have been available for decades, adherence to them remains suboptimal. Feasible implementation strategies that support health workers in providing guideline-adherent care are urgently needed.
Methods:
We used a participatory co-design process to select a challenge to focus on, identify an implementation strategy to address the challenge, and tailor the strategy to meet the needs of health workers at one hospital in Kenya. First, a barrier-strategy mapping workshop utilizing the nominal group technique was conducted to match previously identified barriers to potential interventions. The selected strategy was then tailored for use in the facility through both an iterative design process informed by human-centered design methods and questionnaire responses focused on perceived competence, teamwork attitudes, and role perceptions. The tailored strategy was piloted for ten weeks. Following the pilot, a post-pilot questionnaire repeated assessment of perceived competence, teamwork attitudes, and role perceptions; while additional measures assessed usability and feasibility of the strategy. Qualitative interviews and focus group discussion were also conducted and a mixed methods analysis was completed.
Findings:
Seven health workers participated in the workshop and selected the challenge that reliance on nutritionists to handle critical tasks sometimes delays guideline adherent care. They then brainstormed ideas to overcome this challenge and came to consensus on a strategy that clarifies team member roles in providing care to children with malnutrition and summarizes information from guidelines to support performance of these roles. To develop the Team Approach to Malnutrition Services (TeAMS) Toolkit, 18 design sessions were conducted with participants, with findings incorporated into refinements of the Toolkit. Among 19 participants with both pre- and post- data, mean scores for frequency of completing seven of eight tasks related to malnutrition increased, however changes in perceived competence scores on these tasks were variable. While the survey data did not show increases in competence, in qualitative interviews several participants described additional staff being able to initiate feedings for children with malnutrition by utilizing the information on Toolkit posters. Responses to five out of six items assessing teamwork perceptions increased between the pre- to post-pilot surveys. This aligned with sentiments shared in the interviews describing improved teamwork and information sharing among staff. Among all 29 participants who completed the post-pilot survey, the mean System Usability Score for the TeAMS Toolkit was 77.4 on a 100-point scale, which can be interpreted as good system usability. In interviews, participants noted the ease of use of most of the content in the TeAMS Toolkit, but often requested additional training opportunities to support development of knowledge and skills related to the TeAMS Toolkit.”
Author List:
Meshack Otewa, MSN, BSN, RN, PhD in Nursing Science Student, School of Nursing, University of Washington, Seattle, WA
Barbara Glickstein, MPH, RN, FAAN, Barbara Glickstein Strategies, New York, NY
Diana J. Mason, PhD, RN, FAAN, Center for Health Policy and Media Engagement, George Washington University, School of Nursing, Washington, D.C.
Kahlea Williams, MS, Manning Price Spratlen Center for Anti-Racism & Equity in Nursing, School of Nursing, University of Washington, Seattle, WA School of Nursing, University of Washington, Seattle, WA
Priscilla Carmiol-Rodriguez, M.Ed., BSN, PhD in Nursing Science Student, School of Nursing, University of Washington, Seattle, WA
Nina Zhang, BSN, DNP Student, School of Nursing, University of Washington, Seattle, WA
Monica R. McLemore, PhD, MPH, RN, Manning Price Spratlen Center for Anti-Racism & Equity in Nursing, School of Nursing, University of Washington, Seattle, WA
Abstract:
The nursing profession struggles with addressing historical and ongoing racism within its ranks, impacting individual, community, and societal well-being. In the United States, 63% of nurses reported facing racism in the workplace, and 57 % of nurses have confronted racist situations, and from them, 64% stated that challenging racism resulted in no change. Braves spaces promote open and constructive conversations within an organization to address complex subjects such as discrimination and microaggressions by promoting truth and reconciliation. The purpose of this study was to discover the levers, best practices, and barriers to creating Anti-racist Brave Spaces within the workplace.
A descriptive qualitative analysis was conducted using data from the report Mapping the Landscape of Anti-Racism in Nursing, a research study funded by the Robert Wood Johnson Foundation. Participants were recruited using a snowball sampling approach and represented a wide range of socially defined races, gender identities, work roles, and geographic regions. Forty interviews with 42 nurses in health care or nursing education were conducted via Zoom. The interviews consisted of 10 open-ended questions adapted from an interview guide developed by Lucinda Canty, PhD, RN, and used by the ANA National Commission to Address Racism in Nursing.
The findings noted the following barriers to achieving workplace equity: absent representation in leadership roles and diversity (both in appearance and perspective) are primary impediments. Furthermore, participants highlighted that organizational structures and policies pose challenges when establishing accountability for the organization and its members. In addition, the absence of robust regulatory systems further permits the persistence of racist behaviors. Conversely, the participants underscored the following levers to build brave space: believing and validating the accounts and experiences of nurses who have encountered racism was deemed essential. Additionally, having a well-defined framework for navigating challenging conversations about racism, particularly the truth and reconciliation approach, enables individuals to engage in these discussions reflectively. Finally, collaborative efforts among healthcare professionals are necessary to maximize the impact of anti-racist initiatives. In conclusion, racism is deeply ingrained in our society, affecting our profession and workplaces. To dismantle racism, we must acknowledge its existence within institutional policies and practices. Thus, it becomes vital to incorporate and consistently implement Anti-Racism principles into the organization’s core values and mission statement. Encouraging intersectional dialogues to foster advocacy and establish a culture of accountability is a powerful tool for transforming workplaces into brave and equitable spaces.”
Author Information
Jerusha N Mogaka1 Felix Abuna2 Julia Dettinger1, Mary Marwa2, Ben Ochieng2, Salphine Watoyi2, Eunita Akim2, Nancy Ngumbau2, Celestine Adogo2, Peter Owiti2 , Laurén Gómez1, Grace John-Stewart1 Jilian Pintye1,John Kinuthia1,2
Affiliations
1 University of Washington, USA, 2 Kenyatta National Hospital, Kenya,”
Abstract
Background:
Sexually transmitted infections (STIs) are common among women who use PrEP in Kenya. Consequences of STIs are exacerbated in pregnancy; when infections are detrimental to both women and their infants. Few data are available on the burden of STIs among pregnant PrEP users.
Methods:
We analyzed data from an ongoing RCT enrolling pregnant women at high risk of HIV newly initiating PrEP at 5 antenatal clinics in Western Kenya (NCT04472884). All participants were HIV-negative, ≥18 years, initiating PrEP that day within routine antenatal care, screened for syphilis per national guidelines, and had high HIV risk scores (corresponding to 8.9 HIV infections per 100 person-years). From February to September 2022, women at a subset of facilities were offered chlamydia and gonorrhea (CT/NG) testing using Xpert CT/NG® with same-day results. Women diagnosed with CT or NG were offered immediate directly observed treatment (DOT) and expedited partner therapy (EPT) as per the national guidelines.
Results:
As of September 2022, 237 HIV-negative pregnant women newly initiating PrEP were enrolled at a median gestational age of 27 weeks (IQR 25-29). The median age of women was 26 years (IQR 22-30), most women were married (73%), and 15% reported a previous pregnancy loss. Overall, 3% of women had syphilis, and 2% reported having a partner known to be living with HIV; 92% reported unknown partner(s) HIV status. Among women offered CT/NG testing, all accepted testing, and the CT prevalence was 8% while NG prevalence was 5%; one participant had syphilis and NG, but no other co-infections were detected. Among women with any STI, only 14% reported STI symptoms (e.g., abnormal vaginal discharge and/or vulvar burning/itching). Frequency of having any STI was higher among women <20 years compared to women ≥20 years (20% vs. 4%, p=0.002). All participants with STIs accepted DOT while 88% of women with STIs accepted EPT for their partners. One month after accepting EPT, all women had dispensed EPT to male partners and all partners accepted—no social harms were reported.
Conclusions:
In our study among pregnant women at high risk for HIV and taking PrEP, STIs are relatively common, especially among younger women, and frequently asymptomatic. CT/NG testing and EPT is highly acceptable and integrating CT/NG screening for pregnant women on PrEP may be a high-yield intervention with benefits for women and their infants, and partners of women testing positive for STIs.”
Author List
Amanda Hapenny, RN, MSN, PMHNP-BC
Elaine Walsh, PhD, RN, PMHCNS-BC
Megan Reibel, M.Ed.
Abstract
Suicide remains a leading cause of death among adolescents in the United States, and instances of death by suicide continue to increase in this population. To mitigate this public health crisis, effective and accessible suicide prevention programming is critical; however, suicide prevention programming is often developed and implemented without input from the adolescents engaged in the training. The current study explores themes generated from student feedback as to how a school-based suicide prevention training, delivered by either peers or school personnel, could be improved. Data was collected from 2,480 adolescents who completed pre-training and post-training surveys between March 2022 and June 2023. Thematic analysis was used to explore participant responses to an open-ended question included in the post-training survey, which asked for suggestions to improve the training. Out of a total of 2203 students who answered the question, 649 also provided specific suggestions for improving the training program. Four themes were generated from the data: empowerment, self-care, increased sensitivity and discretion, and enhanced interactive learning and engagement. Implications for school-based suicide prevention training, particularly in the context of mental health nursing, are discussed.
Author List:
Amal Al-Hadabi, Priscilla Carmiol-Rodriguez, Jenna McHale, Zih-Ling Wang
Abstract:
Aim:
The purpose of this project is to explore faculty perceptions and willingness to use DSGs in nursing education to inform the development of survey questionnaire as a tool for implementation plan guidance.
Background:
Game-based learning, including serious games, aligns with AACN’s active learning focus in nursing education. Digital serious games (DSGs) have the potential to offer tailored, experiential learning, addressing educator shortages and quality concerns present in clinical experiences. Despite the ever-growing body of evidence on the benefits of DSG use on student satisfaction and critical thinking enhancement, use in nursing is still limited, with lecture-based formats the dominate teaching method. Faculty play a crucial role in deciding educational delivery methods, with few studies exploring how factors influence faculty willingness to integrate learning technology into nursing programs. Addressing the knowledge gap of how faculty perceptions affect DSG use in nursing education is essential for developing tools and guidance for successful site-specific implementation
Method:
A cross-sectional exploratory sequential mixed method design was employed to explore faculty perceptions and willingness to use digital serious games in nursing education. From semi-structure interview data, a survey questionnaire was developed and administered within the target population. Findings were merged in a joint table display to generate meta-inferences derived from the integrated findings.
Findings:
Eight concordant meta-inferences (Technology Expectations; Effort and Usability; Individual, Peer, and Group Influence; Enjoyment and Engagement; Infrastructure; Alignment; Trade-Offs; Level of willingness towards exploring/accepting the ‘new’) and one expanded meta-inference (Costs). Based on the findings from both strands, we classified the identified factors in the qualitative phase as barriers or facilitators related to the willingness to use DSGs. DSG acceptance was generally high among nursing faculty, however, significant barriers do need to be addressed before widespread acceptance and use can occur, namely more education on efficacy and considerations for cost, time, and resources for faculty.
Conclusions:
DSGs represent a new frontier in nursing education with the potential to provide a more engaging and accessible format for students. Using an exploratory design, we developed a questionnaire that accurately generalized qualitative findings on a larger scale. This project adds to the field by identifying the need for equity considerations to be explicitly incorporated into technology acceptance models Given the increasing body of evidence showing the potential of DSGs in nursing education, it will be important for nursing programs to consider the complex factors related to DSG usage at both the system and class-specific levels. The developed survey tool aids in exploring and providing needed background knowledge to address system-level layer considerations. For DSGs to be successfully used by the nursing education profession, it will be critical to address these factors before addressing more in-depth course-level considerations that may influence student receptiveness and learning outcomes.
Author list:
Alice Y. Pen, Lalipat Phianhasin, and Sarah R. Martha
Abstract:
Background and Purpose:
Stroke is one of the leading causes of death and disability globally with sex-specific differences in symptoms and outcomes. Approximately 30-50% of post-stroke patients have emotional and mood disturbances (e.g., anxiety, anger, irritability, and aggression). Post-stroke mood disturbances may affect stroke survivors from returning to work, lower quality of life (QOL), and stroke reoccurrence. Women experience worse outcomes compared to males following stroke (e.g., greater age of onset, stroke severity, and misdiagnosis). The identification of mood disturbances as a cause of stroke is important because management may help improve QOL and recovery. Post-stroke symptoms and treatments relating to mood disturbances and sex differences are understudied. The purpose of this study was to assess sex differences in the expression of mood disturbances post-stroke.
Methods: We conducted a scientific review of relevant literature published between 2008 and 2023 by searching PubMed and CINAHL databases using the keywords, “sex differences”, “emotion”, “anxiety”, “anger”, “irritability”, “aggression”, “stroke”, “pathophysiology”, “treatment”, and “management”. Articles not pertaining to post-stroke anxiety, anger, irritability, and aggression were excluded.
Results:
We included 32 studies. Women were associated with higher severity of anxiety, anger, irritability, and lower QOL when compared to men post-stroke. Positive emotions (e.g., anticipation, trust, and joy) were significantly higher (p<0.001) in women, while negative emotions (e.g., disgust, fear, and sadness) were significantly higher (p<0.001) in men. The pathogenesis of post-stroke mood disturbances and association with lesion locations remain uncertain. Mood disturbances may be treated or prevented by pharmacological therapy, exercise, counseling, and education. However, treatment and management are not sex-specific.
Conclusions:
Stroke survivors present with complications of emotional and mood disturbances. Women exhibit different mood disturbances than men, however, treatment and management options are limited and not sex-specific. This highlights the need for long-term screening of mood disturbances in the stroke population and further investigation of underlying reasons for sex differences.”
Author List
Jenna McHale
Abstract
Aims and Objectives
This study discusses the process of using a flexible fidelity approach to mediate skill uptake within nursing digital serious game design using an epistemological pluralist lens.
Background
Translating knowledge into understandable and engaging formats so that learner skill acquisition and application are seamless from lesson to real-world application is a fundamental goal within nursing education curriculum design. Digital serious games (games designed with the primary goal of education in a gameplay context) are an emerging technology that, when suitably designed, can blend clinical practice cues, experiential learning, and engagement to optimize skill acquisition. This format capitalizes on learning through play, a foundational skill acquisition process seen in childhood developmental learning theories, and learning through exploratory experiences. However, research on effective curriculum design in digital serious gaming is less understood. While there has been a rising interest in adopting tech-based solutions to mitigate nursing educator shortages, there has been a lack of rigorous testing to validate how digital serious games lead to skill acquisition. Furthermore, most nursing digital serious games still rely on simulated, high-fidelity, care environment-based designs. This study aims to explore the interaction between skill acquisition and the multivariate principles of utilizing flexible levels of physical, functional, and psychological fidelity within digital serious game design.
Method
A literature review was conducted to explore the use of fidelity in digital simulative and serious games as a potential mediator of skill acquisition. Skill acquisition is discussed in the each fidelity domain through an epistemological pluralist lens. Specific fidelity domain examples are reviewed with rationale for design considerations, culminating in a guide of suggested future approaches to fidelity selection and design.
Relevance
Digital serious game design is often costly, and the lack of design-based research specific to nursing can make it challenging to identify what is needed at a minimum viable product level for an effective application. This article provides a simplified guide for nurse educators when considering fidelity design in their digital, experiential curricula.
Conclusion
Fidelity is an important concept in promoting immersive engagement that can facilitate skill acquisition in digital serious games. This article reviews three fidelity domains: physical, functional, and psychological. Through the pluralist lens, there are multiple ways learner approach and interpret material– and high-fidelity, reality-related environments are not the only setting for skill uptake. Learners gain knowledge through various environmental (physical and relative) and psychological cues and understand the world through various lenses and circumstances (domains). Skill uptake is inextricably tied to how the learner interacts with these domains. By allowing for the exploration of different approaches, learner understanding, and goal attainment can be strengthened. In simulative and digital serious game design, there is a balancing nature to fidelity’s three domains and their associated learning cues; skill acquisition is less likely to occur unless there is a balanced nature to the physical, functional, and psychological domains.
Suggestions for future digital games and simulated situation development should focus attention on answering the following questions before proceeding with design:
(1) What learning domain does the outcome exist in (Knowledge, Technical Skills, Cognitive Skills, or Attitude)?
(2) What decision-based problem(s) would you like participants to be able to solve?
(3) What cues would initiate the problem-solving task(s)?
(4) Which domains do these cues belong to (Physical, Functional, Psychological)?
(5) Does this require a 1:1 translation of the environment to prompt each domain-specific cue(s), or can it be completed through alternative means?
(6) What aspect of the environment design will improve or impede participant immersion and flow state?
Future research should investigate how fidelity domain level manipulation encourages or inhibits participant skill uptake at different levels and combinations to understand the mechanisms behind learner immersion, engagement, and cue recognition.”
Posters
Author List
Genevieve C. Aguilar, Kristy Carlin
Abstract
Study Purpose:
Section 1557 of the Affordable Care Act requires that Limited English Proficiency (LEP) families be provided with interpretation and translation services by qualified interpreters. Studies have shown that nurses use interpreters 4-41% of the time during admission. Ad hoc interpreters are used more frequently than professional interpreters and nurses are often just getting by without using professional interpreters. The goal of this project was to examine the barriers and challenges nurses experience when providing translation and interpretation to patients and families that prefer a language other than English during hospitalization.
Study Design:
An electronic survey was developed with input from a variety of stakeholders on this topic. One of the goals was to be able to compare the results across units. The survey was sent to nurses by the directors of their units. House wide emails to nurses also had weekly reminders about the survey. The project lead rounded on nurses at different times of day in all departments to remind them to take the survey. Numbers of responses per unit were monitored to ensure that it was possible to compare between units.
Methods:
The survey contained 23 questions. Participants were asked to rate each question on a scale appropriate to the question. In addition, nurses had an opportunity to share their experiences using the open-ended comment options. Descriptive statistics were calculated for each item, and comments were reviewed and analyzed for themes in order to enrich understanding of the data collected.
Results:
Over three hundred nurses responded to the survey representing all inpatient units and some ambulatory care units. The majority of nurses, 63.1%, enter a patient’s room more than 11 times during their shift. 37.6% of nurses enter a patient’s room more than 15 times during their shift. However, the majority, 79.2%, of nurses reported engaging with an interpreter for families who use a language other than English 1-3 times during their shift. Times vary for how long it takes a nurse to find an interpreter Computer on Wheels (COW). However, the majority of nurses, 67.5%, can find a COW in five minutes or less. For 26% of nurses, it takes 5-10 minutes to find a COW. While most nurses looked at one of their units’ designated locations, nurses were also asking their charge nurses and unit coordinators to help them find a device. Some nurses reported giving up after walking around their unit without finding a device. A smaller portion (20.2%) of nurses tried to find a device on Mobile View.
Conclusions:
Operational complexity is the most common identified barrier to use of interpretation and translation service. Nurses need to be provided with tools and information to increase their ability to overcome barriers for utilizing interpretation and translation services. The hospital and individual patient care units need to identify and mitigate barriers. Additionally, a goal of an increased average number of interpretations per patient per shift should be used.”
Author List:
Megumi Azekawa, MM, MT-BC
Abstract:
This research poster aimed to explore the influence of music on Social Determinants of Health (SDOH) and the various levels and contexts in which music operates through:
- Presenting a diagram to map the hierarchy of terminologies describing the components of social and community contexts.
- Illustrating the dynamism and significance of music in influencing an individual’s health ecology.
By aligning definitions and constructs of SDOH with music, we aim to provide a more holistic perspective on the mechanisms through which music contributes to health outcomes.
This graphic proposed a conceptual framework leading to our scoping review and will contribute to the broader discourse on leveraging cultural and social elements, like music, to address health disparities across the lifespan.
Author List
Kimberly Brinker, PhD Candidate; Greg Whitman, BA; Katie McDowell, MPH; Betty Bekemeier, PhD
Abstract
Purposes/Aims
This study aims to explore strategies in cross-sector collaboration that state public health department (SHD) staff perceive to be successful in addressing health inequities.
Rationale/Conceptual Basis/Background
Within the U.S., the COVID-19 pandemic revealed the significance of chronic conditions as precursors to poor health outcomes, with some of the most prevalent underlying conditions among COVID-19 patients including diabetes, hypertension, and cardiovascular disease. State health departments (SHD) and the transportation sector have critical roles in promoting health equity and reducing chronic disease disparities. The social determinants of health (SDOH), or the social, economic, and built environments in which people live, learn, work, and play, are an important basis for consideration.
The transportation sector is increasingly the locus of innovative partnerships. Public transportation allows the community to access numerous goods and services necessary for well-being, including healthy food options and medical care services among others. A lack of transportation infrastructure contributes to health inequities, and following the COVID-19 pandemic, experts emphasized that safe and thriving public transit options are essential to reducing health disparities.
Methods
With support from the Centers for Disease Control and Prevention and the Association of State and Territorial Health Officials (ASTHO), we conducted semi-structured interviews with SHD and state transportation agency staff. ASTHO identified case study SHDs for apparent, innovative cross-sector collaborations related to SDOH. Interview questions included those inquiring about SHD staff roles, funding, sustainability, and the advancement of health equity initiatives in these cross-sectoral collaborations. Atlas.ti v23 software was used to complete a thematic content analysis of the qualitative data.
Assessment of Findings/Outcomes Achieved
Common themes included funding/resource planning, program sustainability/growth, and benefits/challenges of collaboration. Braiding of funds was considered complex, and some states utilized innovative strategies for working with private, community-based, and philanthropic entities. Organizations with leadership buy-in and cultures that fostered collaborations were beneficial in enhancing program progress. Collaboration benefits included that shared interests and goals provided a synergistic effect. Overall, capacity, efficiency, and advocacy were perceived to be enriched by collaborations. Challenges were that organizational priorities sometimes conflicted, and misunderstandings of a particular entity’s resources and capabilities sometimes occurred. Finding a balance between communicating with all necessary organizations without overburdening community partners was considered difficult.
Conclusions/Implications that emphasize next steps (for policy, clinical or educational practice) and recommendations for future undertakings
Recommendations for SHDs include (1) allowing an intermediary agency to coordinate the budget and programs; (2) applying for grants that make specifications within requests for proposals allowing for funding flexibility in project budgets; (3) developing a culture of collaboration and making use of interagency councils to share information vital to managing funds; (4) integrating administrative data via development of sharing agreements across sectors or organizations to support funding needs; and (5) including a robust evaluation of cross-sector initiatives to support future braiding opportunities. Innovative solutions for coordinating public health and transportation initiatives and promoting the sustainability of successful collaborations are needed to enhance these efforts. SHDs play an important role in developing and building relationships with transportation partners to address health inequities.
Author List
Priscilla Carmiol-Rodriguez
Author List
Lee-Ling Chen
Abstract
Author List
Falls among older adults pose a significant public health concern, leading to high rates of morbidity and mortality. This Doctor of Nursing Practice (DNP) project aimed to enhance fall prevention and management strategies within Assisted Living (AL) services in South Seattle. The study identified and addressed gaps in the existing fall prevention policies, which had not been updated since 2013, despite a high incidence of falls among AL residents. The project involved an assessment of current practices, incorporating evidence-based strategies, staff and resident interviews, and physical environment evaluations. Recommendation/Findings indicated a need to (1) revise the fall prevention policy to include interdisciplinary input, frequency of conducting fall risk assessments, consistent staff training, and improved resident education; (2) form an interdisciplinary fall prevention and management committee; (3) perform regular safety checks, focusing on reducing clutter and ensuring safe flooring.
Author List
Susie Cho, Donna L. Berry
Abstract
Aim/Purpose
This study aimed to explore the experience of palliative care (PC) referral concerning the diagnosis and treatment of advanced ovarian cancer, providing context to factors impacting care transitions in patients.
Methods
A phenomenological hermeneutic approach was applied to delve into the experiences of individuals with advanced ovarian cancer, exploring their perspectives on treatment and palliative care (PC). Participants were drawn from a previous electronic Self-report Assessment and Care (eSAC) study and selected based on pain and/or quality of life scores triggering a PC recommendation. Data were collected via semi-structured telephone interviews. The analysis, following Braun and Clarke’s thematic analysis, involved iterative processes of coding, mapping, and interpretation, ultimately culminating in the identification and refinement of overarching themes and subthemes encapsulating the participants’ narratives.
Results
In a study of 13 women with advanced ovarian cancer, participants described feeling overwhelmed by the rapid pace of their diagnoses and treatments. They had limited discussions about PC with their healthcare teams and often associated it with end-of-life care, leading to reluctance in seeking it. The women felt that integrating PC into their complex medical routines would add further burden to their already overwhelming situations. This lack of understanding and perceived additional load influenced their hesitance towards considering or accepting PC services.
Conclusions or impact
This study highlights that there remains a challenge in improving patient understanding and engagement with PC despite the increasing health system recognition of the benefits of integrating PC into cancer care. The findings of this study indicated that the task of PC referral will continue to be a complex communication task that requires improvement. This practice will likely include comprehensive assessments that include exploring the patient’s understanding of PC, step-by-step introduction to PC care, and providing resources through a collaborative process of various disciplines including both medical and non-medical providers. Practice should focus on unloading the patient’s burden of seeking and integrating PC in an oncology setting through studies exploring efficient delivery of PC services.
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Author List:
Rinlita Itthikomolsil
Abstract:
“Aim: This study aims to explore and utilize concept analysis to better understand the concept of CoC in children with chronic conditions and to identify the concept’s attributes, antecedents, and consequences.
Background: Continuity of care (CoC) has been the core principle of primary care and general practice that reduces the probability of children developing serious illnesses and frequently results in better outcomes for people with chronic conditions. Although the concept of CoC has been discussed numerous times, it overlaps with other concepts, such as patient-centered care and care coordination, and its definition has not been clearly defined. Moreover, many studies focus on CoC in the adult and elderly population, but few focus on CoC in children with chronic conditions who have unique characteristics and needs different from other populations.
Definition: CoC in children with chronic conditions is care over a period of time that is high-quality, accessible to patients, and managed by a collaborative care team partnering with the child and parent through the various stages of medical care. This concept emphasizes the children in care decision-making and supports them in working with the care team.
Method: Rodger’s evolutionary approach was employed to guide the concept analysis, using an inductive process to explore a concept through its common use and define its characteristics. The concepts and keywords: “continuity of care,” “continuity of patient care,” “child,” “adolescent,” “infant,” “children,” “teenage,” “youth,” “chronic disease,” “chronic illness,” and “chronic condition” were searched in international databases, including PubMed, Web of Science, CINAHL, and Google Scholar, without a time limit until December 2023. The full text of the selected articles was reviewed. Based on the data, a detailed definition was formed, considering attributes, antecedents, and consequences. Exemplars and further concept development were also identified.
Results: The antecedents of the concept were children with chronic conditions and healthcare access. The attributes of CoC in children with chronic conditions are defined as information, patient-provider relationship, and care consistency. The consequences relate to the healthcare utilization and quality of life for the child and parent.
Conclusion : This concept analysis obtains a better understanding of CoC in children with chronic conditions in all age ranges and might guide better nursing practice and patient care. Healthcare providers and organizations can utilize the insights from this analysis to assess and improve care delivery to children with chronic conditions. By prioritizing the attributes of CoC and addressing the identified antecedents, they can enhance the overall patient experience and health outcomes. However, children in specific age ranges require different support and care from parents, healthcare providers, and other relevant organizations regarding chronic conditions. The future concept analysis in CoC in children should select the specific age or chronic condition to better understand the specific population that allows improvement in the care plans.”
Author List
Hsin-Ni Lee, Basia Belza, Sarah McKiddy
Author List:
Hyunhae Lee; Kerry W. Reding; Warren Szewczyk; Chi-Shan Tsai; Sean A. Munson; Jaimee L Heffner; Teresa M Ward
Abstract:
Background/Significance:
With the increasing role of smartphones in essential parts of daily life, new types of insomnia interventions have been developed using this technology, such as multi-dimensional mobile health (mHealth) applications. However, few mHealth sleep apps have focused on cancer survivors despite a high prevalence of distressing sleep problems after cancer treatments. Cancer survivors may benefit from a cancer-specific sleep intervention because the leading causes of insomnia are associated with cancer diagnosis or treatments: hot flashes, peripheral neuropathy, and decreased physical activity. Furthermore, non-mobile insomnia applications administered through the Internet have shown promise for reducing insomnia in breast cancer survivors.
Purpose:
The study aims to explore the perspectives of mobile health technologies for improving sleep quality in cancer survivors across a wide age range
Methods:
Three focus groups of older cancer survivors (n=13) and two younger cancer survivor groups (n=7) with current insomnia were conducted to explore perspectives of mHealth apps for sleep. Thematic analysis was used to analyze qualitative data.
Results of Project/Research:
The most notable difference between the two groups is their age: the median ages of older and younger cancer survivors were 60 (52 – 72) and 33 (28 – 38) years, respectively. For both groups, 2 main themes were generated: (1) Attitudes toward technology and (2) Recommendations for future mHealth sleep interventions. 12 out of 13 older survivors and 6 out of 7 younger survivors expressed positive attitudes toward mHealth, 2 older cancer survivors expressed concerns that the use of smartphone itself could disrupt sleep. In the younger cancer survivor group, the majority of participants showed a positive reaction to mHealth; however, 4 out of 7 expressed worries about privacy or data tracking. Older cancer survivors did not express related concerns. Both groups wanted interventions to include reminders or scheduling functions. Only younger cancer survivors emphasized the desire for personalized features directed at cancer survivorship. They suggested analyzing users’ data to recommend activities for personalized sleep difficulties and schedule reminders while emphasizing the importance of an affordable price. Furthermore, they asked for in-app functions, including messages or hotline features, while older cancer survivors did not. On theother hand, older groups suggested having community groups to connect with other survivors through mHealth, while younger groups did not.
Implications (including those related to equity, diversity, and/or inclusion):
The different needs expressed across these age ranges of cancer survivors indicate the need to be responsive to differing perspectives in these groups. It should be considered that expectations towards technology vary across generations, but despite it, by utilizing the functions that cancer survivors actually need and suggest in the development of interventions and supporting them with consideration for age, it would have the greatest potential for effective insomnia-related mHealth interventions.”
Author List
Sabrina Mangal, PhD, RN, Elizabeth Frazier, MN, RN, Judy Kwan, BSN, RN, Tao Zheng, MN, RN, Jonathan Auld, PhD, MAT, RN
Author List
Emilie Martel-Rousseau
Author List
Sarah McKiddy
Abstract
The surge in interest surrounding music-based interventions (MBIs) for cognitive health, particularly in Alzheimer’s disease and related dementias (ADRD), has catalyzed interdisciplinary inquiry into the therapeutic potential of music. However, the collaborative nature of these efforts has understandably led to discrepancies in terminology and conceptual frameworks, hindering the development and interpretation of interventions. In a systematic review conducted by Robb et al. (2018) on the quality of reporting MBI research in healthcare, discordant terminology was identified as a persistent barrier in MBI research. To address this, a search strategy was devised, yielding relevant studies published between 2015 and 2023. The primary aims of this scoping review were to: (1) identify and define the terminology employed in empirical studies describing MBIs within the context of Robb et al.’s (2011) Guidelines for MBIs and studies involving ADRD, (2) describe how these terms were operationalized, and (3) propose implications for future research and practice. Included studies demonstrated a wide array of MBI strategies and outcomes in ADRD research, ranging from music therapy practices to social prescribing. However, inconsistencies in terminology usage, such as interchangeably employing terms like “music therapy” and “music intervention,” were observed. To enhance the clarity of the literature and foster rigor in methodologies, researchers are encouraged to consistently establish and apply clear, operationalized definitions for terminology while also referencing established concepts and seeking consensus within the MBI community.
Additional Authors
Premgamon Kuntajak & Dr. Hilaire Thompson
Abstract
Aim:
To examine the concept of psychological resilience among older adults within the context of Traumatic Brain Injury (TBI).
Background:
Psychological resilience fosters adaptation after TBI and is a crucial indicator of recovery and a key element in successful rehabilitation. However, despite being recognized for over two decades, resilience remains a relatively new and poorly defined concept within the realm of TBI. Psychological resilience is also confused with the concept of coping. Thus, there is an urgent need for further exploration of psychological resilience within TBI to enhance the understanding and clarify the meaning of psychological resilience and its significance to older adults with TBI.
Method:
Walker and Avant’s modified method of concept analysis was used to guide this analysis. Literature from multiple scholarly databases was identified keywords: “Resilience,” “Psychological Adaptation,” “Hardiness,” and “Psychological Well-Being,” which were imputed using established inclusion criteria: full text, peer-reviewed, and printed in the English language from 2013-2023. Eligible articles were examined to determine the context of resilience and to comprehend and analyze its attributes, antecedents, and consequences of resilience in TBI.
Outcomes:
Antecedents of psychological resilience include exposure to adverse events and a social support system. Two principal attributes consisted of personal traits and the adaptation process. Psychological resilience facilitates improved physiological and psychological health outcomes, enhances recovery, and decreases complications among older adults with TBI.
Conclusion:
Research in the TBI population is transitioning from a deficit-oriented perspective to a strengths-based approach. This analysis contributes to a comprehensive and fundamental understanding of the psychological resilience concept. A firm knowledge of psychological resilience from this paper offers valuable insights that can guide nursing interventions, inform the application of theory, influence policymaking, and drive research possibilities aimed at improving health outcomes for older adults with TBI and their families.
Keywords: concept analysis, resilience, psychological resilience, psychological adaptation, traumatic brain injury”
Author List
Aymee Steidl
Abstract
Aims/Purpose:
The Pediatric Self-management Model (PSMM) is a middle-range theory geared at understanding the relationship between the child and the factors influencing their chronic illness management. PSMM is a family-centered model that focuses on the unique factors present in the pediatric population. Pediatric asthma is a leading chronic respiratory condition in the United States, affecting over four million children in 2020. Over 40% of children with asthma will have at least one exacerbation per year. On average, a child with asthma will miss nine additional school days annually.
Methods:
Using the Walker and Avant framework for theory analysis, the PSMM is examined through the lens of pediatric asthma to evaluate its applicability to pediatric asthma shared management and adherence.
Results:
The PSMM has been used as a framework for understanding the roles of managing chronic illness in children, but it has yet to be applied to pediatric asthma. Asthma outcomes inherently depend on preventative medication and home care strategies for symptom management and response outside the healthcare facility.
Impact:
The PSMM may provide a new framework for understanding barriers and facilitators within pediatric asthma management and highlight the importance of the dyadic relationship between child and parent to successfully share healthcare responsibility.
Author List
Abstract
The Nightingale Pledge, a symbolic transition for nurses entering professional practice, has historically been a cornerstone of nursing ethics. Despite its widespread use, a critical analysis of its implications remains absent in scholarly discourse. This work aims to critique the Nightingale Pledge, exploring its origins, contemporary relevance, and its role in shaping ethical foundations in nursing. The central premise is that a nursing pledge should serve as a transparent conduit for ethical principles, use unbiased and accessible language, and be a tool for building a respected and inclusive nursing profession and practice. However, the Nightingale Pledge upholds a gendered and biblical idea of nursing and reinforces a white, Western epistemological dominance. Consequently, it falls short of the criteria and no longer reflects nor appropriately addresses nurses’ ethical obligations in modern U.S. society and health. A critical theory lens is used to illuminate the power structures within the Nightingale Pledge. Through critical theory thought, one can explore how gender, religion, coloniality, and race historically and socially sculpted an institutional rite of nursing passage. Critical Theory also provides the framework to rectify the pledge’s problematic heritage by first making apparent the forces and systems that crafted the hegemonic ideologies of society at its inception and then seeking emancipation from said systems. This work’s key takeaway is a call to action to move beyond the Nightingale Pledge and reimagine what a nursing pledge can and should be in the modern ethical landscape of nursing. The transformative approach of Critical Theory contributes to ongoing discussions within nursing theory and knowledge development, offering innovative solutions for a more inclusive and ethically robust nursing profession.
Author List
Chi-shan Tsai, HyunHae Lee, and Kerryn Reding;
Abstract
Cancer-related Cognitive Impairment (CRCI) is a common concern reported by cancer survivors. However, there are few comprehensive reviews on the impact of CRCI on the quality of life (QoL) of breast cancer (BC) survivors. The purpose of this scoping review is to provide a synthesized summary of the evidence and identify gaps in our knowledge of the QoL in BC Survivors living with CRCI.
An electronic search was performed on the PubMed, CINAHL, PsycINFO databases. We identified published literature from January 2013 to October 2023. A total of 360 abstracts were screened, and 14 met the inclusion criteria. Eligibility was determined by two independent researchers.
A total of 13 studies employed quantitative designs, and 1 utilized qualitative designs. As for CRCI, 8 studies measured subjective CRCI, and 6 studies assessed both subjective and objective CRCI. The commonly used assessment tools for CRCI were Functional Assessment of Cancer Therapy – Cognitive Function (FACT-Cog) (n=7). The commonly used assessment tools for QoL were the European Organization for Research and Treatment of Cancer Quality of Life Core Questionnaire 30 (EORTC-QLQ-C30) (n=3), subscale QoL of Functional Assessment of Cancer Therapy – Cognitive Function (FACT-Cog) (n=3). Subjective cognitive impairment was reported to be consistently associated with reduced quality of life in BC survivors. Additionally, one study demonstrated that a woman’s perception of cognitive deficits significantly influenced her perception of quality of life.
Further research is needed to explore QoL among BC survivors living with CRCI. Current literature lacks qualitative or mixed-methods studies, which could offer a more profound understanding of the experiences of these survivors, especially those who may be affected by health inequalities. Long-term follow-up studies are also required to track progressive changes in QoL and cognitive function, as well as to investigate how cognitive impairment influences specific dimensions of QoL. Furthermore, a more comprehensive comparison between subjective and objective cognitive function assessments is needed to elucidate their influences on QoL. Lastly, the development of effective intervention strategies should also be a major focus of future studies to better address the impact of CRCI on the QoL of breast cancer survivors.
Author List
Chi-shan Tsai, Lesley E. Steinman, Jason Stevens, and Kerryn Reding
Abstract
Background and Purpose:
Stroke is one of the leading causes of death and disability globally with sex-specific differences in symptoms and outcomes. Approximately 30-50% of post-stroke patients have emotional and mood disturbances (e.g., anxiety, anger, irritability, and aggression). Post-stroke mood disturbances may affect stroke survivors from returning to work, lower quality of life (QOL), and stroke reoccurrence. Women experience worse outcomes compared to males following stroke (e.g., greater age of onset, stroke severity, and misdiagnosis). The identification of mood disturbances as a cause of stroke is important because management may help improve QOL and recovery. Post-stroke symptoms and treatments relating to mood disturbances and sex differences are understudied. The purpose of this study was to assess sex differences in the expression of mood disturbances post-stroke.
Methods:
We conducted a scientific review of relevant literature published between 2008 and 2023 by searching PubMed and CINAHL databases using the keywords, “sex differences”, “emotion”, “anxiety”, “anger”, “irritability”, “aggression”, “stroke”, “pathophysiology”, “treatment”, and “management”. Articles not pertaining to post-stroke anxiety, anger, irritability, and aggression were excluded.
Results:
We included 32 studies. Women were associated with higher severity of anxiety, anger, irritability, and lower QOL when compared to men post-stroke. Positive emotions (e.g.,
anticipation, trust, and joy) were significantly higher (p<0.001) in women, while negative
emotions (e.g., disgust, fear, and sadness) were significantly higher (p<0.001) in men. The
pathogenesis of post-stroke mood disturbances and association with lesion locations remain uncertain. Mood disturbances may be treated or prevented by pharmacological therapy, exercise, counseling, and education. However, treatment and management are not sex-specific.
Conclusions:
Stroke survivors present with complications of emotional and mood disturbances. Women exhibit different mood disturbances than men, however, treatment and management options are limited and not sex-specific. This highlights the need for long-term screening of mood disturbances in the stroke population and further investigation of underlying reasons for sex differences.”
Author List
Chanakarn Waijamee, Jane Maguire and Daniel Demant (University of Technology Sydney, Australia)
Abstract
Aims:
To capture the quantitative and qualitative best evidence of enhancing adherence to treatments of venous leg ulcers (VLUs).
Methods:
A mixed-methods systematic review with a convergent segregated approach was used. PubMed, CINAHL, Ovid MEDLINE, Cochrane Library and Scopus were explored to identify articles published between January 2000 and December 2020. The quantitative review examined interventions designed to promote patients’ adherence to treatments of VLUs, while the qualitative review explored patients’ experiences with treatments at the outpatient clinic.
Results:
Three randomised controlled trials and eight qualitative studies meeting all the inclusion criteria were included in this review. The quantitative findings indicate that the interventions including comprehensive patient education and self-management support can promote patients’ adherence to the treatments and positively affect wound healing. According to the qualitative review, patients’ treatment experiences varied, and patients needed improvement in the instructions and the communication and relationship with healthcare providers, as well as support.
Conclusion:
Several strategies are recommended to promote patients’ adherence to treatments. Comprehensive patient education or personal counselling sessions are the principal strategy to create a healthier learning environment with effective communication. Self-management support should be provided to achieve long-term self-care. Supplying educational materials could motivate patients to adhere to treatments. Simultaneously, patients’ trust should be established by creating therapeutic relationships and providing professional, holistic care and consistent treatments. More rigorous research on adherence-enhancing strategies should be conducted to assess adherence and variations among different compression types.
Keywords: venous leg ulcer, venous ulceration, adherence, compliance, review”
Author List
Zih-Ling Wang , Jenna R. McHale, Basia Belza, Jennifer Sonney
Research Abstract
Aims
To analyze the concept of eating experiences in people living with dementia.
Design
Rodgers’ evolutionary method of concept analysis was used as a framework for the paper.
Data Sources
The literature was searched using electronic databases PubMed, Google Scholar, CINHAL, PsycInfo, Web of Science, Embase, and Elsevier databases. These databases cover a variety of disciplines, including but not limited to nursing, medicine, and occupational therapy. The relevant literature published from 1989 up through April 2023 was thoroughly examined. Any quantitative or qualitative studies published in English, focused on eating or dining experiences in people with dementia were included.
Review Methods
Rodgers’ evolutionary method for concept analysis was used. The attributes, antecedents, consequences, and case examples of the concept were identified.
Results
Twenty-two articles met the inclusion criteria, identifying key attributes of self-connection, the special journey of life, and self-interpretation. Antecedents, as framed by the socio-ecological model, were categorized to represent Intrapersonal (personal preferences, individual culture, mealtime routines), Interpersonal (social interaction), and Environmental (dining room environment, policies) factors. Consequences were divided into external (nutritional health, physical health, and quality of life) and internal (personhood, autonomy and independence, dignity and feeling valued, and mental well-being) domains.
Conclusion
A theoretical definition and conceptual model of eating experiences in people living with dementia was developed. The identified attributes, antecedents, and consequences can be utilized in nursing education, research, and intervention approaches.
Impact
This article allows nurses and other health care professionals to better understand people living with dementia through the relationship between eating and interpersonal, intrapersonal, and environmental aspects to develop personalized interventions and care strategies to achieve an optimal quality of life.
Author List
Zih-Ling Wang, Sarah McKiddy, Kelly Ash, Paige Denison, Judi Pirone, Meghan Thompson, Allison Webel, and Basia Belza
Research Abstract
Purpose
The purpose of this pilot study is to evaluate the feasibility and preliminary efficacy of an in-person evidence-based, physical activity intervention, Enhance®Fitness (EF), for improving the physical, psychological, and cognitive health of people with memory loss and their care partners. This study aims to (1) pilot in-person classes for people with memory loss and their care partners in a single setting and (2) describe adaptations needed for offering EF for people with memory loss and their care partners.
Methods:
In partnership with a senior center in the Pacific Northwest we recruited 8 dyads of one with memory loss and their care partner. Two senior center staff completed EF instructor training. The dyads were invited to participate in an in-person EF program. Classes were held three times a week for 8 weeks. We assessed self-assessment of health status, depression using the Center for Epidemiologic Studies Depression Scale (CES-D), and cognitive status using the Montreal Cognitive Assessment (MoCA) at baseline and post-intervention. We objectively measured upper and lower body muscle strength, agility, and balance using valid and norm referenced outcome measures. The three measures were 1) a chair stand test (30 seconds), 2) an arm curl test (30 seconds), and 3) an 8-foot up-and-go test at baseline and post-intervention. Participant interviews will be conducted at the end of the study to capture lessons learned and future recommendations. IRB approval was obtained before initiating study procedures.
Results
We enrolled 8 dyads/16 participants, with an average age of 73 years and 8 (50%) females and 8 (50%) males. Most (n=6) care partners were spouses along with one mother-daughter and one father-son dyad. Depression screening showed a low mean CES-D Score of 9.8 (the range of scores is 0 to 60), indicating most participants did not have depressive symptoms. Cognitive assessments indicated a range of cognition, from 0 to 30 with 5 (31.3%) having severe impairment, 2 (12.5%) having moderate impairment, and 5 (31.3%5) having mild impairment. The results of the Fitness tests varied: most participants were below average in the Chair Stand (N=6, 37.5%), Arm Curls (N=8, 50%), and 8-foot Up-and-go tests (N=12, 75%). Program completion is set for February 9, 2024. To date, we have had 3 of 8 dyads drop out due to illness, fatigue, and injury before the commencement of the study.
Impact: Initial findings suggest that participants, despite varied levels of cognitive function and below-average fitness scores, are engaging with the intervention and are likely to benefit from the program. The study’s success in a single setting, with necessary adaptations for people with memory loss, sets a precedent for expanding the program. Future research with a larger and more diverse sample size is essential to fully understand the EF program’s impact on this population’s health outcomes.
Author List
Hongyu Yu, Weiyu Qiu, Yanfeng Wang, Qinyang Wu, Ke Hu, Qiuyun Ye, Qiaohong Yang on The Development of mHealth App Usability Scale for Older Adults with Chronic Diseases
Author List
Xiaoyu Zhang; Linda Yoo; Kendra Kamp
Abstract
Background and Purpose:
Inflammatory Bowel Disease (IBD) is a chronic inflammatory condition affecting the gastrointestinal tract, which includes Crohn’s Disease and Ulcerative Colitis. The prevalence of IBD among adults in the United States is estimated to be 3.1 million. Common symptoms of IBD can be diarrhea, abdominal pain, nausea, vomiting, and constipation. These unpleasant symptoms are associated with non-gastrointestinal symptoms such as fatigue and sleep disturbances. Previous studies had reported that IBD symptoms are also linked with psychological symptoms such as anxiety and depression. However, limited study explores the effects of taking naps among adults with IBD. The purpose of the study was (1) To describe the demographic characteristics of adults with IBD; (2) To compare the symptoms between adults with IBD who take naps and those who do not.
Methods:
We conducted a secondary data analysis of an IBD sleep study. Participants ages 18-55 years old were recruited to complete questionnaires and wear a wrist-warn actigraphy for 10 days. Participants completed daily questionnaires regarding naps. We analyzed the self-reported symptoms and napping habits of 27 adults diagnosed with IBD. Our analysis employed t-tests to compare symptoms between individuals who reported napping and those who did not.
Results: 27 participants (mean age 33.1 years, 59.2% female, 74.1% Crohn’s disease ) were included after excluding missing data. Our sample included 15 individuals who reported napping (mean age 33.0 years, 53.3% female, 66.7% Crohn’s disease, 53.3% inactive disease) and 12 individuals who did not report napping (n=12, mean age 33.4 years, 66.7% female, 83.3% Crohn’s disease, 75% inactive disease). There was no significant difference in symptom severity between the two groups (those who napped compared to those who did not nap) across a range of symptoms including fatigue (p= 0.78 ), anxiety (p=0.85), depression (p= 0.32). Also, there is no significant difference in sleep measures including: sleep disturbance (p=0.73), sleep-related impairment (p=0.91), PSQI Total (p=0.90).
Conclusions and Implications:
In conclusion, our results suggest that taking naps in this population does not appear to have a significant impact on self-reported symptoms of anxiety, depression, fatigue, sleep disruption, sleep-related impairment, and PSQI Total. The findings suggest that napping may not significantly influence the symptom experience in adults with IBD. Further research is required to explore other potential moderating factors that might impact symptom severity in this population.