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Nursing research
American Journal of Nursing Co
Nursing research

American Journal of Nursing Co

0029-6562

Nursing research/Journal Nursing researchSCIAHCIISSHP
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    Telling the Truth

    Pickler, Rita H.
    2页
      原文链接:
    • NSTL
    • Lippincott Williams & Wilkins

    Lifestyle Behaviors and Parents' Mental Well-Being Among Low-Income Families During COVID-19 Pandemic

    Robbins, Lorraine B.Ling, Jiying
    9页
    查看更多>>摘要：Background The coronavirus 2019 (COVID-19) pandemic has negatively altered many families' lifestyles and the mental well-being of parents, especially those who have a low income and young children. To improve low-income parents' mental well-being, especially during a pandemic, understanding parents' and children's lifestyle behaviors and the relationship between their lifestyle behaviors and parents' mental well-being is essential. Objective This cross-sectional study examined relationships between lifestyle behaviors (sleep, physical activity, screen time, and eating behavior of parents and children) and low-income parents' well-being (stress, anxiety, and depression) during COVID-19. Methods Parents were recruited from two Michigan Head Start organizations as well as across the United States; 408 parents completed an online survey. Demographic characteristics were assessed, along with parents' sleep, physical activity, screen time, and dietary intake; stress, anxiety, and depression were also examined. Children's sleep time, physical activity, screen time, and fruit/vegetable intake were assessed. Descriptive statistics, correlations, and the multivariate general linear model procedure were used. Results Approximately 69.4% of parents reported moderate stress levels, and 17.2% reported high levels. Most parents had sleep disturbances, attained minimal physical activity, and consumed 2 hours per day. Only 41% of preschoolers were active 7 days a week and slept >= 10 hours per day. Two thirds had >2 hours per day of screen time, and less than one fifth consumed >= 5 fruits/vegetables per day. After adjusting for parents' demographics and children's lifestyle behaviors, parents' sleep disturbance was positively correlated with their levels of stress, anxiety, and depression. After controlling for parents' demographics and lifestyle behaviors, child sleep time was negatively associated with parents' stress levels. Family demographics and parents' and children's lifestyle behaviors explained 33.4%, 29.8%, and 28.1% of the variances in parents' stress, anxiety, and depression, respectively. Discussion Most parents and preschoolers were not meeting many lifestyle behavior recommendations, indicating a need for interventions. Improving parents' sleep quality and reducing bedtime challenges involving their preschoolers may be necessary for enhancing parental mental well-being.
      原文链接:
    • NSTL
    • Lippincott Williams & Wilkins

    Relationship Between Environmental Air Quality and Congenital Heart Defects

    Hall, Katie C.Robinson, Jennifer C.Cooke, William H., IIIParnell, Aimee S....
    9页
    查看更多>>摘要：Background Congenital heart defects (CHDs) affect 40,000 U.S. infants annually. One fourth of these infants have a critical CHD, requiring intervention within the first year of life for survival. Over 80% of CHDs have an unknown etiology. Fine particulate matter <= 2.5 (PM2.5) and ozone (O-3) may be air pollutants associated with CHD. Objectives The purpose of this study was to explore relationships between first-trimester maternal exposure to air pollutants PM2.5 and O-3 and a critical CHD diagnosis. Methods A retrospective cohort study with nested case controls was conducted using data from January 1, 2014, to December 31, 2016, and consisted of 199 infants with a diagnosed critical CHD and 550 controls. Air pollution data were obtained from the U.S. Environmental Protection Agency air monitors. Geographic information system software was used to geocode monitoring stations and infant residential locations. Data analysis included frequencies, chi-square, independent t-test analysis, and binary logistic regression for two time periods: the entire first trimester (Weeks 1-12) and the critical exposure window (Weeks 3-8 gestation). Results Critical CHD odds were not significantly increased by exposure during the first trimester. However, weekly analyses revealed CHD odds were higher in Weeks 5 and 8 as PM2.5 increased and decreased in Week 11 with increased O-3 exposure. Discussion Our study shows no evidence to support the overall association between air pollutants PM2.5 and O-3 and a critical CHD diagnosis. However, analyses by week suggested vulnerability in certain weeks of gestation and warrant additional surveillance and study.
      原文链接:
    • NSTL
    • Lippincott Williams & Wilkins

    Predictors of Health Promotion Behaviors Among Working Adults at Risk for Metabolic Syndrome

    Jang, Min KyeongPark, Chang GiHong, Oi SaengPark, Sungwon...
    10页
    查看更多>>摘要：Background: Metabolic syndrome has a high global prevalence, affecting 26% of South Koreans. Lifestyle modifications have shown benefits in studies involving health behavior enhancement, specifically through workplace eating and exercise interventions. However, workplace interventions focusing on health behaviors have been inadequately explored. Objectives: This study examined factors affecting health promotion behaviors of workers at high risk of metabolic syndrome by applying Theory of Planned Behavior constructs (attitude, subjective norm, perceived behavioral control, and intention). Methods: This correlational cross-sectional study collected survey data from 164 hotel workers in South Korea. The study applied factor analysis and structural equation modeling for the data analysis. Results: Analysis revealed five health promotion behaviors: exercise, making healthy food choices, avoiding fatty foods, eating a nutritious and balanced diet, and eating regular moderate meals. Participants were grouped as total participants, those with one risk factor, and those with two risk factors. In the "total" group, four behaviors were influenced by perceived behavioral control: exercise, making healthy food choices, eating a nutritious and balanced diet, and eating regular moderate meals. In the "one risk factor" group, intention and attitude influenced the eating regular moderate meals behavior, and two other behaviors were influenced by perceived behavioral control: exercise and eating a nutritious and balanced diet; in the "two risk factor" group, only perceived behavioral control directly affected exercise. Discussion: Perceived behavioral control was a key predictor of health behaviors, and theory constructs partially explained behaviors. Perceived behavioral control influenced four behaviors and influenced exercise in all three groups. Also, theory constructs showed a greater effect on behaviors in the one risk factor group than in the two risk factor group, indicating that participants with one risk factor more effectively managed their behaviors on their own and with healthcare providers' support. Occupational health providers should conduct early assessments of workers showing metabolic syndrome risk factors to identify their particular risks, intention, and behaviors. As the number of risk factors affects behaviors and perceived behavioral control primarily influences exercise, these findings should be incorporated in metabolic syndrome interventions.
      原文链接:
    • NSTL
    • Lippincott Williams & Wilkins

    Detecting Language Associated With Home Healthcare Patient's Risk for Hospitalization and Emergency Department Visit

    Song, JiyounOjo, MariettaBowles, Kathryn H.McDonald, Margaret V....
    10页
    查看更多>>摘要：Background About one in five patients receiving home healthcare (HHC) services are hospitalized or visit an emergency department (ED) during a home care episode. Early identification of at-risk patients can prevent these negative outcomes. However, risk indicators, including language in clinical notes that indicate a concern about a patient, are often hidden in narrative documentation throughout their HHC episode. Objective The aim of the study was to develop an automated natural language processing (NLP) algorithm to identify concerning language indicative of HHC patients' risk of hospitalizations or ED visits. Methods This study used the Omaha System-a standardized nursing terminology that describes problems/signs/symptoms that can occur in the community setting. First, five HHC experts iteratively reviewed the Omaha System and identified concerning concepts indicative of HHC patients' risk of hospitalizations or ED visits. Next, we developed and tested an NLP algorithm to identify these concerning concepts in HHC clinical notes automatically. The resulting NLP algorithm was applied on a large subset of narrative notes (2.3 million notes) documented for 66,317 unique patients (n = 87,966 HHC episodes) admitted to one large HHC agency in the Northeast United States between 2015 and 2017. Results A total of 160 Omaha System signs/symptoms were identified as concerning concepts for hospitalizations or ED visits in HHC. These signs/symptoms belong to 31 of the 42 available Omaha System problems. Overall, the NLP algorithm showed good performance in identifying concerning concepts in clinical notes. More than 18% of clinical notes were detected as having at least one concerning concept, and more than 90% of HHC episodes included at least one Omaha System problem. The most frequently documented concerning concepts were pain, followed by issues related to neuromusculoskeletal function, circulation, mental health, and communicable/infectious conditions. Conclusion Our findings suggest that concerning problems or symptoms that could increase the risk of hospitalization or ED visit were frequently documented in narrative clinical notes. NLP can automatically extract information from narrative clinical notes to improve our understanding of care needs in HHC. Next steps are to evaluate which concerning concepts identified in clinical notes predict hospitalization or ED visit.
      原文链接:
    • NSTL
    • Lippincott Williams & Wilkins

    Relationship of Cognitive and Social Engagement to Health and Psychological Outcomes in Community-Dwelling Older Adults

    Mueller, KimberlyKoscik, Rebecca L.Smith, MarianneJohnson, Sterling...
    8页
    查看更多>>摘要：Background Cognitive and social engagement is an important yet underdocumented aspect of older adult engagement and function. Objective The purpose of this study was to examine relationships between cognitive and social engagement and health and psychological outcomes in a cohort of community-dwelling older adults aged approximately 55-70 years. Methods Analysis of data from the Wisconsin Registry for Alzheimer's Prevention, a multiwave cohort study with 1,582 participants, using a 1:1 prospective case-control design to examine whether lower cognitive and social engagement at Visit 4 (baseline) is associated with worse health and psychological outcomes at Visit 5 (2 years after Visit 4). Wisconsin Registry for Alzheimer's Prevention participants were included in this study if they had complete data on cognitive and social engagement and self-rated health at both visits. Results After matching potential covariates using propensity scores, participants with low cognitive and social engagement (cases) at baseline continued to have significantly lower cognitive and social engagement than the controls (participants with high cognitive and social engagement at baseline) at Visit 5, and they had lower self-rated health and higher surgery rate. Depressive symptoms, cognitive status, and hospitalization at Visit 5 did not significantly differ between cases and controls. Discussion This study provides evidence supporting cognitive and social engagement as an important marker of early decline in activity engagement that may indicate a potential later decline in functional, psychological, and health outcomes.
      原文链接:
    • NSTL
    • Lippincott Williams & Wilkins

    Neural Processing of Health Information and Hypertension Self-Management in African Americans

    Still, Carolyn H.Jack, Anthony I.Wright, Kathy D.Sattar, Abdus...
    10页
    查看更多>>摘要：Background Uncontrolled blood pressure (BP) rates are persistently high among African Americans with hypertension. Although self-management is critical to controlling BP, little is known about the brain-behavior connections underlying the processing of health information and the performance of self-management activities. Objectives In this pilot study, we explored the associations among neural processing of two types of health information and a set of self-management cognitive processes (self-efficacy, activation, decision-making, and hypertension knowledge) and behaviors (physical activity, dietary intake, and medication taking) and health status indicators (BP, health-related quality of life, anxiety, and depression). Methods Using a descriptive cross-sectional design, 16 African Americans with uncontrolled hypertension (mean age = 57.5 years, 68.8% women) underwent functional magnetic resonance imaging to assess activation of two neural networks, the task-positive network and the default mode network, and a region in the ventromedial prefrontal cortex associated with emotion-focused and analytic-focused health information. Participants completed self-reports and clinical assessments of self-management processes, behaviors, and health status indicators. Results Our hypothesis that neural processing associated with different types of health information would correlate with self-management cognitive processes and behaviors and health status indicators was only partially supported. Home diastolic BP was positively associated with ventromedial prefrontal cortex activation (r = .536, p = .09); no other associations were found among the neural markers and self-management or health status variables. Expected relationships were found among the self-management processes and behaviors and health status indicators. Discussion To advance our understanding of the neural processes underlying health information processing and chronic illness self-management, future studies are needed that use larger samples with more heterogeneous populations and additional neuroimaging techniques.
      原文链接:
    • NSTL
    • Lippincott Williams & Wilkins

    Tripartite Analysis A Data Analysis Technique for Convergent Mixed-Methods Designs

    Younas, AhtishamSundus, Amara
    9页
    查看更多>>摘要：Background Effective data integration is a daunting task in mixed methods research. Several frameworks for data integration exist, but the choice of and the technique for integration depend upon the research question and design. Innovative integration techniques continuously need to be developed to tackle the integration challenge and provide alternative ways for researchers to generate plausible mixed meta-inferences. Objectives The purpose of this study was to describe a new data analysis technique, tripartite analysis (TriPA), and illustrate its use in a convergent mixed-methods study. Methods This technique was developed based on a convergent mixed-methods study underpinned by dialectical pluralism aimed to understand Pakistani nursing students' perspectives about compassion and compassionate care and how these perspectives are consistent with the conceptualizations of compassion in nursing literature. Results TriPA entails analysis and integration using joint displays at three levels: case-by-case integrated analysis, separate and then merged quantitative and qualitative analysis, and comparative and integrated analysis of Levels I and II findings. Discussion TriPA can enable researchers to develop a more nuanced understanding of a given phenomenon through integration at various levels by identifying linkages within cases and across the whole data set and recognizing relational connections and emerging patterns.
      原文链接:
    • NSTL
    • Lippincott Williams & Wilkins

    Opportunities for Poetic Analysis in Qualitative Nursing Research

    Tarbi, Elise C.Morgan, Brianna
    6页
    查看更多>>摘要：Background The voices of people living with serious, life-limiting illnesses are often underrepresented in research. Furthermore, a biomedical bias toward treatment and stigma associated with illness prevents healthcare providers from engaging with topics critical for people living with serious illness, such as existential communication and inner strength. Poetry is an established method of analysis and dissemination in qualitative research but is underutilized by nursing researchers. Objectives The purpose of this article is to demonstrate the inherent opportunities in using poetry in nursing research to highlight the voices and issues of people whose experiences are outside the assumed norms of the biomedical paradigm. Methods We apply methods of poetic analysis to qualitative data sets that highlight the voice of people living with serious illness-in naturally occurring palliative care conversations and dyadic interviews of people with dementia and their care partners. Methods of poetic analysis include poetic transcription and voice poems. Results Methods of poetic analysis allowed us to engage with the data reflexively to intensify and evoke the deeper meaning of narratives. Poetic analysis served to center the participant's voices by using their own words to demonstrate themes. Poems are a uniquely accessible method of disseminating complex findings, as poems relay layered cognitive and emotional meaning resonant of universal human experiences in a concise and relatable format. Discussion Especially in circumstances where participant's voices are underrepresented, poetic analysis enables nurse researchers to challenge normative assumptions and reimagine a difference-centered society. Our findings offer opportunities to incorporate poetry into clinical and research nursing training to better meet the needs of the populations we serve.
      原文链接:
    • NSTL
    • Lippincott Williams & Wilkins

    Inflammatory and Immune Protein Pathways Possible Mechanisms for Pain Following Walking in Knee Osteoarthritis

    Resnick, BarbaraRenn, CynthiaKane, Maureen A.Dorsey, Susan G....
    8页
    查看更多>>摘要：Background Knee osteoarthritis affects nearly 30% of adults aged 60 years or older and causes significant pain and disability. Walking is considered a "gold standard" treatment option for reducing knee osteoarthritis pain and maintaining joint mobility but does not reduce pain for all adults with knee osteoarthritis pain and may induce pain-particularly when starting a walking routine. The mechanism by which walking is helpful for knee osteoarthritis pain is unclear. Quantitative sensory testing has revealed that knee osteoarthritis pain has both peripheral and central components, which vary by individual. Objective The purpose of this study was to better understand the mechanisms underlying the value of walking for knee pain. Methods We conducted a pretest/posttest study using quantitative sensory testing to measure neurophysiological parameters and examined systemic protein signatures. Adults with knee osteoarthritis and healthy controls underwent quantitative sensory testing and blood draw for platelet proteomics before and after a 30-minute walk at 100 steps per minute. Results A single 30-minute walk moderately increased pressure pain sensitivity at the affected knee among persons with knee osteoarthritis. Healthy adults showed no difference in pain sensitivity. Protein signatures among participants with knee osteoarthritis indicated changes in inflammatory and immune pathways, including the complement system and SAA1 protein that coincided with changes in pain with walking and differed from healthy participants. Discussion One goal of developing individualized interventions for knee osteoarthritis pain is to elucidate the mechanisms by which self-management interventions affect pain. The addition of therapies that target the complement system or SAA1 expression may improve the pain sensitivity after a moderate walk for adults with knee osteoarthritis.
      原文链接:
    • NSTL
    • Lippincott Williams & Wilkins