Doctoral graduates' attitudes toward scholarly work and Institutional Review Board and Quality Improvement Committee education and submission processes: A pilot study.

BACKGROUND: Educators are challenged to find better ways to prepare doctoral nursing students to conduct scholarly work involving human subjects. PURPOSE: To better understand doctoral nursing students' attitudes toward programmatic scholarly work and Institutional Review Board (IRB)/Quality Improvement Committee (QIC) education and submission processes. METHODS: Recent Doctor of Nursing Practice (DNP) and Philosophy of Nursing (PhD) graduates were recruited using convenience sampling techniques to participate in this cross-sectional, descriptive, mixed-methods pilot study. Data were collected using two researcher-developed instruments. DISCUSSION: Nineteen doctoral nursing students participated in this study. Students most often used a quantitative approach with health care providers to complete their scholarly work requirements. Both PhD and DNP participants were overall satisfied with the IRB/QIC content in the curricula and the submission process. Four themes were identified: (a) Efficiency, (b) Collaboration, (c) Faculty Mentorship, and (d) Areas for Improvement. CONCLUSION: Findings from this pilot study may be used to enhance IRB/QIC processes through revision of administrative processes and student education.

Prelicensure Nursing Students' Attitudes Toward Patients With Cancer Revisited.

Recruiting graduate nurses into oncology practice postgraduation continues to be challenging. Graduate nurses tend to prefer clinical settings that they consider high-tech or challenging, with oncology ranking low. In additio.

Weight bias reduction intervention among nurse practitioner students using simulation-based experiences.

ABSTRACT: Few nurse practitioner (NP) programs include obesity and weight bias education in their curriculum. However, NPs will likely provide care for people living with obesity, many of whom have been discriminated against based on their weight by previous providers, and many NP students may feel unprepared to navigate weight management competently. This pilot study included a weight bias reduction (WBR) intervention, which included a simulation-based experience (SBE) with a standardized participant (SP) and educational activities embedded within the NP curriculum. Nineteen NP students participated in this pilot study, but only seven students had matching data for preintervention to postintervention scores. There were no statistically significant differences in preintervention and postintervention Attitudes Toward Obese Persons (ATOP) or Beliefs About Obese Persons (BAOP) scores. Despite this small sample size and not achieving statistical significance, SBE-SP holds promise to depict realistic patient encounters to improve NPs' attitudes and beliefs toward persons with obesity and to reduce weight bias. Therefore, incorporating SBE-SP may be a feasible component of the NP curriculum.

Advances in Treatment and Health-Related Quality of Life: A Cohort Study of Older Adult Survivors of Breast Cancer.

OBJECTIVES: To determine whether there are differences in the health-related quality of life (HRQOL) of older adult survivors of breast cancer (BC) diagnosed in different time periods and to gain insight into whether advances in BC treatment have improved HRQOL. SAMPLE & SETTING: Three cohorts of older adult survivors of BC diagnosed before 1995, from 1996 to 2005, and from 2006 to 2015 were examined using the Surveillance, Epidemiology, and End Results-Medicare Health Outcomes Survey linked databases. METHODS & VARIABLES: HRQOL was measured using the Veterans RAND 12-Item Health Survey. Mean cohort HRQOL scores were compared using analysis of variance, then multivariate regression models were used to examine the effects of cohort membership and covariates on mental and physical HRQOL. RESULTS: Adjusted mean HRQOL scores trended significantly lower with each successive cohort. Higher comorbidity count and increased functional limitations were negatively associated with HRQOL, and income, education level, and better general health perceptions were positively associated with HRQOL. IMPLICATIONS FOR NURSING: Regardless of time since diagnosis, older survivors of BC are at risk for poor HRQOL and should be regularly assessed. Maximizing HRQOL requires consideration of the survivor's resources, comorbidities, and functional limitations when planning care.

Pilot Testing of Evidence-Based Symptom Management Telehealth Simulation-Based Experiences in an Oncology Nursing Seminar.

ABSTRACT: Telehealth simulation-based experiences (T-SBEs) offer one approach to prepare nursing students with the requisite skills to deliver oncology evidence-based symptom management (EBSM) using telecommunication technology. Fourteen baccalaureate nursing students participated in this one-group, pretest/posttest, convergent mixed-methods pilot study with questionnaire variant. Data were collected before and/or after two oncology EBSM T-SBEs using standardized participants. The T-SBEs resulted in significant increases in self-perceived competence, confidence, and self-confidence in clinical decision-making related to oncology EBSM. Qualitative themes included value, application, and preference for in-person SBEs. Future research is warranted to definitively determine the effect of oncology EBSM T-SBEs on student learning.

Pilot Testing of Virtual Simulation-Based Experiences in an Oncology Nursing Seminar.

BACKGROUND: The coronavirus disease 19 (COVID-19) pandemic challenged nurse educators to develop teaching strategies to engage students in a virtual classroom. This pilot study examined the effect of virtually delivered video-recorded (VDVR) simulation-based experiences (SBEs) with standardized participants on the management of clinical emergencies in patients and families affected by cancer on nursing student learning outcomes. METHOD: A pre- and posttest, one-group, convergent mixed-methods design with questionnaire variant was used. Data were collected before and after SBEs. RESULTS: Nineteen senior baccalaureate nursing students participated in this pilot study. The VDVR SBEs resulted in a significant increase in self-perceived competence. Participants had positive perceptions about the use of VDVR SBEs as a teaching strategy. Qualitative themes included realism, critical analysis, and preference for hands-on learning. CONCLUSION: The VDVR SBEs were well-received by prelicensure nursing students as a supplemental teaching strategy to enhance self-perceived competence. Additional research is needed about the effects of VDVR SBEs on learning outcomes. [J Nurs Educ. 2023;62(3):167-170.].

Correlates of Health-Related Quality of Life in a National Sample of Older Adult, Long-Term Survivors of Colorectal Cancer.

BACKGROUND: Most survivors of colorectal cancer (CRC) are older adults who are at high risk of experiencing adverse effects and decreased health-related quality of life (HRQOL) related to cancer and its treatments. OBJECTIVE: This study aimed to describe HRQOL and the demographic and clinical factors associated with HRQOL among older adult, long-term survivors of CRC. METHODS: A sample of older adult, long-term survivors of CRC (N = 14 458) from the Surveillance Epidemiology and End Results-Medicare Health Outcomes Survey dataset was selected. Hierarchical multiple regression was used to analyze the contribution of demographic and clinical variables to HRQOL as measured by the Veterans Rand 12-item scale. RESULTS: The mean respondent age was 79 years with an average time from diagnosis to survey being about 13 years. In the final model, gender, race, education, income, previous radiation treatment, cardiovascular disease, inflammatory bowel disease, depression, pain, fatigue, functional status, and general health perception were all significantly correlated with mental HRQOL (R2 = 0.53). For physical HRQOL, age at diagnosis, race, marital status, education, time since diagnosis, comorbid conditions, depression, pain, fatigue, functional status, and general health perception were all significant correlates (R2 = 0.85). Symptoms were the largest contributors to mental and physical HRQOL, accounting for 43% and 50% of the variance, respectively. CONCLUSION: Pain, depression, and fatigue significantly affect the HRQOL of older adult survivors of CRC, underscoring the need for long-term survivorship care. IMPLICATION FOR PRACTICE: Aggressive symptom assessment and management may be key to improving the HRQOL in this population.

Standardized Patient Simulation in an Oncology Symptom Management Seminar-Style Course: Prelicensure Nursing Student Outcomes.

A critical role of the professional nurse is to manage symptoms associated with cancer and its treatments. Currently, prelicensure nursing curricula lack adequate oncology content and associated opportunities for clinical application. Thus, many graduate nurses do not possess the requisite knowledge and skills required to effectively manage cancer-related symptoms upon entry to practice. The purposes of this study were to evaluate the effect of standardized patient simulation on nursing students' knowledge, confidence, and competence (objective and self-perceived) related to oncology evidence-based symptom management principles, and to determine nursing students' perceptions, satisfaction, and self-confidence with learning using standardized patient simulation in a seminar-style course. A longitudinal, one-group, convergent mixed-methods design with questionnaire variant was used. Data were collected at three time points: (T1) pre-seminar, (T2) pre-simulation, and (T3) post-simulation. A convenience sample of sixty-three senior baccalaureate nursing students in an oncology symptom management seminar participated in two standardized patient simulation scenarios. There was a significant increase in students' knowledge, confidence, and self-perceived competence over time with a large effect size. All student groups (n = 14) demonstrated objective competence in the colorectal cancer scenario and all participants, with the exception of one student group, demonstrated objective competence in the breast cancer scenario. Participants also reported positive perceptions of, a high level of satisfaction with, and self-confidence in learning with the standardized patient simulations. Qualitative themes identified included unique focus, realism, and application of knowledge. Standardized patient simulation holds promise to enhance nursing students' knowledge, confidence, and competence related to oncology evidence-based symptom management principles.

The Effects of a Simulation-Based Experience with Standardized Participants on Learning and Clinical Decision-Making Related to Nursing Management of Oncologic Emergencies.

Upon entry-to-practice, graduate nurses must be able to effectively manage oncologic emergencies to ensure best patient and family outcomes. Thus, nurse educators must develop active teaching strategies to prepare prelicensure nursing students with appropriate nursing oncology knowledge and skills. The purposes of this study were to determine the effect of simulation-based experiences (SBEs) with standardized participants (SPs) involving a patient and family member on baccalaureate nursing students' confidence and competence, anxiety and self-confidence with clinical decision-making, and satisfaction and self-confidence in learning using SBEs related to management of oncologic emergencies within a seminar-style course. A longitudinal, one-group, convergent mixed-methods design was used. Baccalaureate nursing students enrolled in a senior seminar participated in two SBEs. Study data were collected pre-seminar, pre-SBE, and post-SBE. Twenty-five senior nursing students participated in this study. There was a significant increase in students' confidence and self-perceived competence, and a significant decrease in anxiety and increase in self-confidence with clinical decision-making related to the nursing management of oncologic emergencies over time. All seven student groups in the hypercalcemia SBE, and five student groups in the hypersensitivity reaction SBE demonstrated objective competence. Qualitative themes identified included: realism, critical thinking, and benefits for professional practice. Study findings support the use of SBEs with SPs to enhance nursing students' confidence and competence, and to increase self-confidence and reduce anxiety with clinical decision-making related to the management of oncologic emergencies in a seminar-style course. The inclusion of a family member enhanced the realism of complex SBEs.

Pre-licensure nursing students' attitudes toward clinical research, education research, and pedagogical research participation in the United States.

BACKGROUND: Researchers worldwide have found that nursing students tend to have favorable attitudes toward clinical research. However, little is known about their attitudes toward education research and pedagogical research participation. OBJECTIVES: The purposes of this study were to: describe nursing students' attitudes toward clinical research, education research, and pedagogical research participation; explore the association of select demographic and academic factors with students' attitudes; and identify facilitators and barriers of pedagogical research participation. DESIGN: A convergent mixed-methods design with questionnaire variant was used. SETTINGS: Pre-licensure students from nursing programs throughout the United States. PARTICIPANTS: Four hundred and thirty-six pre-licensure students, aged 18 or older, who were active members of the National Student Nurses' Association (NSNA). METHODS: Research participants were recruited using the NSNA e-mail distribution list. Nursing students completed a demographic survey and three instruments that measured attitudes toward clinical research, education research, and pedagogical research participation. RESULTS: Quantitative findings indicated that nursing students had generally positive attitudes toward clinical research, education research, and pedagogical research participation. Prior experience as a research assistant or a research participant was significantly associated with students' attitudes on all three measures. Factors identified by students to enhance pedagogical research participation were the potential to improve practice, research topic interest, and opportunities for personal and professional development; while time-related concerns were identified as barriers to research participation. Qualitative data supported these findings, and also revealed some negative attitudes toward pedagogical research participation, concerns about current educational practices, and confusion about the definition of education research. CONCLUSIONS: Findings from this study provide nurse educators with students' perspectives of education research, which may be used to develop a student-driven framework to enhance the implementation of pedagogical research. Further research is warranted to more fully understand these phenomena with explicit attention to international students' perspectives.

Psychometric Evaluation of the Nursing Students' Attitudes Toward Nursing Education Research Questionnaire.

BACKGROUND AND PURPOSE: While nursing students' attitudes about research are generally positive, little is known about their attitudes toward education research. The purpose of this study was to test the psychometric properties of the newly developed Nursing Students' Attitudes toward Nursing Education Research Questionnaire (NSANERQ). METHODS: The 25-item NSANERQ was adapted from an existing tool measuring nursing students' attitudes toward nursing research. Content and construct validity, and internal consistency and test-retest reliability were evaluated. Content validity was assessed using a panel of five experts. Internal consistency reliability and construct validity were assessed in a sample of 156 senior, junior, and sophomore baccalaureate nursing students with a mean age of 20.55 years. A separate sample of 49 freshmen baccalaureate nursing students with a mean age of 18.35 years was used to assess test-retest reliability. Both samples were predominantly female, White, and non-Hispanic/non-Latino. RESULTS: The NSANERQ demonstrated excellent content validity (S-CVI = 0.92), good internal consistency reliability (α = .88), and acceptable test-retest reliability (r = 0.71) over 2 weeks. Exploratory factor analysis resulted in a six-factor solution, which was confirmed through confirmatory factor analysis. CONCLUSIONS: The NSANERQ is a valid and reliable instrument that can be used to measure students' attitudes toward nursing education research.

Nursing Students' Attitudes Toward Nursing Education Research and Participation in Pedagogical Research.

BACKGROUND: Nursing students overall have positive attitudes toward research, but no studies have explored students' attitudes toward education research or pedagogical research participation. PURPOSE: The purposes of this study were to explore nursing students' attitudes toward research in general, education research, and participation as subjects in pedagogical research; describe the relationships among these attitudes; and identify associated factors. METHODS: A mixed-methods, descriptive, cross-sectional study design was used. RESULTS: Nursing students' (N = 195) attitudes about research in general, education research, and participation in pedagogical research were predominantly positive and directly correlated. Age was significantly associated with attitudes about education research and research participation, whereas program year was associated only with research participation. The most prevalent barrier to research participation was time. CONCLUSIONS: Findings provide valuable insight about nursing students' attitudes toward research that may be used to design protocols to enhance student participation in pedagogical research.

Nursing students' attitudes toward research: An integrative review.

OBJECTIVE: This paper describes the state of the science related to undergraduate nursing students' attitudes toward research. DESIGN: The updated integrative review method was used to systematically examine the published nursing literature about students' attitudes toward nursing research. DATA SOURCES: Data sources for this review included: the Cumulative Index of Nursing and Allied Health Literature, PubMed, and Education Resources Information Center databases. REVIEW METHODS: Database searches identified 207 articles. Abstracts were screened for relevance, and, if appropriate, the full article was obtained and reviewed. Ancestral searches of reference lists yielded an additional 29 articles, thus a total of 236 articles were screened for this review. RESULTS: This comprehensive screening process yielded a total of 11 quantitative, 2 qualitative, and 2 mixed method studies about undergraduate nursing students' attitudes toward research. CONCLUSIONS: Nursing students have generally positive attitudes toward research and see the value of research to professional nursing practice. Engaging in a research course or other active research-related activity improves attitudes toward nursing research. More rigorous study is warranted to determine best teaching/learning strategies to enhance students' perceptions of research. Future research is also needed to gain a better understanding of the demographic, academic, and program factors that affect nursing students' attitudes toward nursing research.

Symptom Clusters in Patients With Pancreatic Cancer Undergoing Surgical Resection: Part I.

OBJECTIVES: To describe patient-reported symptoms and symptom clusters in patients with pancreatic cancer (PC) undergoing surgical resection. SAMPLE & SETTING: 143 patients with stage II PC undergoing surgical resection alone or with subsequent adjuvant chemoradiation or chemotherapy were recruited to participate in a nested, longitudinal, exploratory study through convenience sampling techniques from Thomas Jefferson University Hospital, a National Cancer Institute-designated cancer center. METHODS & VARIABLES: The Functional Assessment in Cancer Therapy-Hepatobiliary questionnaire was used to assess 17 PC symptoms preoperatively and at three, six, and nine months postoperatively. Exploratory and confirmatory factor analyses were used to identify symptom clusters. RESULTS: Fatigue, trouble sleeping, poor appetite, trouble digesting food, and weight loss were consistently reported as the most prevalent and severe symptoms. Sixteen distinct symptom clusters were identified within nine months of surgery. Four core symptom clusters persisted over time. IMPLICATIONS FOR NURSING: Findings may be used to provide anticipatory patient and family guidance and to inform clinical assessments of symptoms and symptom clusters in this population.

Symptom Clusters in Patients With Pancreatic Cancer Undergoing Surgical Resection: Part II.

OBJECTIVES: To explore the relationship between 16 symptom clusters (SCs), clinical and demographic influencing factors, and clinical outcomes over time in patients with pancreatic cancer (PC) undergoing surgical resection. SAMPLE & SETTING: 143 patients with stage II PC undergoing surgical resection were recruited to participate in this longitudinal, exploratory study conducted at Thomas Jefferson University Hospital, a National Cancer Institute-designated cancer center. METHODS & VARIABLES: Quality of life was measured preoperatively and at three, six, and nine months postoperatively. Statistical methods included simple linear and Cox proportional hazard regression. RESULTS: Preoperative pain was significantly associated with the pain-gastrointestinal SC, and preoperative worry was significantly associated with the mood SC. The strongest negative association with emotional well-being across all study time points was found with the preoperative mood SC. The insomnia-digestive problems SC and the nutritional problems SC demonstrated a trend toward poor survival. IMPLICATIONS FOR NURSING: Findings provide evidence that preoperative worry and pain are associated with SC severity and that SCs may have a detrimental effect on quality of life and survival in patients with PC undergoing surgical resection.

Standardized Patient Simulation to Facilitate Learning in Evidence-Based Oncology Symptom Management.

BACKGROUND: New graduate nurses lack the specialty knowledge and skills necessary to provide effective symptom management to oncology patients. The purpose of this article is to describe the development of a simulation-based learning experience using standardized patients to enhance undergraduate nursing students' ability to apply evidence-based principles learned in the classroom to oncology symptom management practice. METHOD: Faculty developed two standardized patient simulations for a 7-week senior seminar in evidence-based oncology symptom management. RESULTS: Faculty, students, and standardized patients provided positive feedback. Students appreciated the realism and innovation of using simulation in a seminar-style course. Faculty and students identified that more time was needed for the simulations, and revisions are planned for the next offering of the seminar to address this concern. CONCLUSION: The integration of standardized patients is a feasible learning strategy to facilitate learning of evidence-based oncology symptom management principles among undergraduate nursing students. [J Nurs Educ. 2018;57(4):250-253.].

Breast Cancer Stage at Diagnosis in a New Jersey Cancer Education and Early Detection Site.

OBJECTIVES: The National Breast and Cervical Cancer Early Detection Program provides free or low-cost screening to uninsured or underinsured women and has had positive results; however, only a few state programs have been evaluated. This study will provide a first snapshot of the effectiveness of the New Jersey program, by comparing stage at diagnosis for enrollees as compared with nonenrollees who received definitive treatment for breast cancer at the same academic medical center. MATERIALS AND METHODS: A retrospective analysis of 5 years of breast cancer data abstracted from the Cancer Registry of a large urban hospital in the Northeast United States. Bivariate analysis and logistic regression were utilized. RESULTS: One thousand forty women were screened for and diagnosed with breast cancer at this site; they were more likely to be racially (P<0.001) and ethnically (P<0.002) diverse as compared with nonenrollees. Enrollees were more likely to be symptomatic at diagnosis (P<0.001), and diagnosed at a late stage when compared with nonenrollees (odds ratio, 1.88; 95% confidence interval, 1.07-3.29). CONCLUSIONS: This national program was developed to serve low income, under and uninsured women who may otherwise have limited access to cancer screening services. It appears that many women enroll in this program needing diagnostic rather than screening services, after breast symptoms were noted. This finding helps to emphasize the fact that just providing free screening services is not enough to make up for the lack of a usual source of preventive care for low income and uninsured women.

A prospective, randomized, double-blind, placebo controlled trial on the efficacy of ethanol celiac plexus neurolysis in patients with operable pancreatic and periampullary adenocarcinoma.

BACKGROUND: Ethanol celiac plexus neurolysis (ECPN) has been shown to be effective in reducing cancer-related pain in patients with locally advanced pancreatic and periampullary adenocarcinoma (PPA). This study examined its efficacy in patients undergoing PPA resection. STUDY DESIGN: There were 485 patients who participated in this prospective, randomized, double-blind placebo controlled trial. Patients were stratified by preoperative pain and disease resectability. They received either ECPN (50% ethanol) or 0.9% normal saline placebo control. The primary endpoint was short- and long-term pain and secondary endpoints included postoperative morbidity, quality of life, and overall survival. RESULTS: Data from 467 patients were analyzed. The primary endpoint, the percentage of PPA patients experiencing a worsening of pain compared with preoperative baseline for resectable patients, was not different between the ethanol and saline groups in either the resectable/pain stratum (22% vs 18%, relative risk [RR] 1.23 [0.34, 4.46]), or the resectable/no pain stratum (37% vs 34%, RR 1.10 [0.67, 1.81]). In multivariable analysis of resected pancreatic ductal adenocarcinoma (PDA) patients, there was a significant reduction in pain in the resectable/pain group, suggesting that surgical resection of the malignancy alone (independent of ECPN) decreases pain to a significant degree. CONCLUSIONS: In this study, we demonstrated a significant reduction in pain after surgical resection of PPA. However, the addition of ECPN did not synergize to result in a further reduction in pain, and in fact, its effect may have been masked by surgical resection. Given this, we cannot recommend the use of ECPN to mitigate cancer-related pain in resectable PPA patients.

Validity testing of the stopwatch urine stream interruption test in radical prostatectomy patients.

OBJECTIVE: To assess convergent validity of the stopwatch urine stream interruption test (UST). Specific aims were to describe relationships among stopwatch UST scores and 4 common clinical indices of pelvic floor muscle strength: 24-hour urine leakage, confidence in performing pelvic muscle exercise, 24-hour pad count, and daily pelvic muscle exercise count. DESIGN: Secondary analysis; instrumentation study. METHODS: The final sample consisted of baseline stopwatch UST scores and measurements of comparison variables from 47 participants in a randomized clinical trial of 3 approaches to pelvic floor training for patients with urinary incontinence following radical prostatectomy. The sample size provided 80% power to detect correlations of moderate strength or higher. The stopwatch UST was conducted in an examination room at the study site by trained study personnel (MP, ADC, JP, SM). Measurements of comparison variables were obtained from 3 instruments: 24-hour pad test, Broome pelvic muscle self-efficacy scale, and 3-day bladder diary. Relationships among study variables were evaluated with Pearson correlation coefficients. RESULTS: Stopwatch UST scores were moderately correlated with 24-hour urine leakage on the 24-hour pad test (r = 0.35, P < .05), the most robust comparison measure. Correlations between stopwatch UST scores and all other comparison measures were in the appropriate direction, although weak, and did not reach statistical significance. CONCLUSION: Findings suggest that the stopwatch UST may be a valid index of pelvic floor muscle strength in men following radical prostatectomy. With further testing, the stopwatch UST could become a valuable clinical tool for assessing pelvic floor muscle strength in radical prostatectomy patients with urinary incontinence.

A progressive postresection walking program significantly improves fatigue and health-related quality of life in pancreas and periampullary cancer patients.

BACKGROUND: As patients with pancreas and periampullary cancer (PPC) experience improved survival rates and longevity, the focus shifts toward living life while surviving cancer. Fatigue is the most commonly reported symptom in all cancer patients. Exercise has been found to effectively decrease fatigue levels and improve physical functioning in cancer patients. STUDY DESIGN: One hundred two patients with resected PPC consented to participate in this study and were randomized to either an intervention group (IG) or a usual care group (UCG). Subjects completed visual analog scales, the FACIT-Fatigue Scale and the Short Form-36v2 after surgery and again 3 to 6 months after hospital discharge. RESULTS: Patients in the IG and UCG were comparable with regard to demographics, comorbidities, cancer type and staging, type of resection, preoperative fatigue and pain levels, adjuvant therapy, and baseline walking distance. Patients in the IG had significantly improved scores on the FACIT-Fatigue Scale at study completion, improved fatigue and pain scores, as well as overall physical functioning and mental health composite scores. At study completion, participants in the IG were walking twice as far and were significantly more likely to have continued walking or another form of exercise as compared with the UCG. Using hierarchical cluster analysis, 3 mutually exclusive symptom groupings were identified in the cohort. Kaplan-Meier survival analysis did not indicate an overall survival benefit for the IG. CONCLUSIONS: This is the first prospective, randomized controlled trial to report that participation in a home walking program confers a significant benefit in resected PPC patients with regard to fatigue levels, physical functioning, and health-related quality of life.