"Will My Baby Be OK?" A Qualitative Analysis of Pregnant Women's Suboxone® Online Forum Posts.

BACKGROUND: Intentional or accidental drug-overdose is a leading cause of mortality in U.S. women of child-bearing age. Opioid use during pregnancy is not only associated with maternal overdose, but with low birth weight at term and neonatal abstinence syndrome (NAS). Buprenorphine was approved as a medication for opioid use disorder (MOUD) in the United States in 2002 and is for many women, a preferred treatment option versus methadone. Buprenorphine is relatively safe during pregnancy and is associated with lower rates of NAS than methadone. Given the importance of MOUD during pregnancy, relatively little information exists regarding patients' questions and concerns about buprenorphine treatment, including the psychological challenges they face. AIMS: The purpose of the study was to describe the perinatal concerns of women with opioid use disorder who posted to an online suboxone forum. METHODS: Qualitative descriptive design to analyze some 170 posts from mothers with OUD to an online Suboxone® support forum over the period 2016-2021. RESULTS: The analysis of the interview data revealed 4 important themes: (a) Stigma resulting in self-deprecation, low self-esteem, and low self-efficacy; (b) stigma from family members and loved ones; (c) stigma from the medical profession; and (d) stigma from the community at-large (social stigma). CONCLUSIONS: There is compelling evidence to emphasize the importance of open communication and support between medical personnel and patients to ensure optimal outcomes for mother and baby.

Where's the germs? The effects of using virtual reality on nursing students' hospital infection prevention during the COVID-19 pandemic.

Background: Virtual reality can be a useful substitute to improve nursing education outside of the hospital setting. In the wake of COVID-19, an opportunity to compare a virtual reality activity for nursing students in the traditional classroom and in an online environment took place. Objectives: The goal of this study was to examine the effects of incorporating a virtual reality activity into the traditional classroom and in an online environment to enhance nursing education. Methods: Fifty nursing students participated in an exploratory descriptive study. Twenty-five students participated face-to-face while in the traditional classroom setting and 25-students participated in an online environment using a communication platform. Through a virtual reality activity, nursing students successfully created a tour which demonstrated identifying infectious sites in a hospital room setting. Results and Conclusions: Results of the pre-and post-test showed students' positive perceptions and performances in both traditional classroom and online settings. However, the study revealed a statistical difference between the two group perceptions towards the use of the virtual reality tour creator. Nursing students who were in the traditional classroom group found that the use the virtual reality tour creator was easier. Implications: Designing a meaningful virtual reality activity has a positive impact of the student learning experience. Students may benefit from a more through orientation to the technology prior to engaging in the activity. A carefully constructed activity can enhance student learning outside of the hospital room.

By utilizing technology can nursing students gain more confidence and decrease anxiety when communicating with chronically ill patients about their sexual relationship?

INTRODUCTION: Effective communication is an essential part of nursing care. Nurses need to effectively communicate with patients, families, providers and staff. The purpose of this study was to show how the use of technology (i.e., video conferencing on an electronic device) could assist nursing students to gain more confidence and reduce anxiety when discussing difficult topics such as sexual intimacy. METHODS: Pre-licensure nursing students were recruited to participate as part of regular class activities. A pre- and post-survey asking about their confidence and anxiety in communicating with patients was completed; then subjects were randomly placed into groups of 4 to 5 utilizing an electronic device. Student groups were able to communicate with a patient diagnosed with a medical condition that affected their intimacy by video conferencing in a breakout session for 15-20 min. RESULTS: A total of 112 students participated. The majority of students stated that communicating about relationships and intimacy issues with chronically ill patients was not as difficult as they anticipated. About 82% of students liked using a video conferencing tool although about half (n = 62) reported they still preferred a face-to-face in-person interaction. Results demonstrated a significant increase in confidence and decrease in anxiety score (p = .001) before and after the intimacy communication activity. CONCLUSIONS: In conclusion, the use of technology can be an effective learning tool to teach pre-licensure nursing students on how to communicate with patients effectively, especially for those difficult topics such as sexual intimacy.

Student Self-evaluation After Nursing Examinations: That's a Wrap.

Examination wrappers are a self-evaluation tool that uses metacognition to help students reflect on test performance. After examinations, rather than focus on points earned, students learn to self-identify study strategies and recognize methods of test preparation. The purpose of the study was to determine if the use of an examination wrapper after each test would encourage students to self-evaluate performance and adjust study strategies. A total of 120 undergraduate nursing students completed self-evaluations after each examination, which were analyzed using content analysis. Three general patterns emerged from student self-evaluation: effective and ineffective study strategies, understanding versus memorization of content, and nurse educator assistance.

Quench the thirst: lessons from clinical thirst trials.

Thirst, as a symptom, has long been considered the most prevalent clinical complaint patients voice in healthcare settings. Yet, rarely have researchers examined thirst by its correlation with physiologic factors. This review was undertaken to examine the relationships between thirst ratings and factors mediating its primary physiologic correlates: plasma osmolality (pOsm) and arginine vasopressin peptide (AVP). A literature search was undertaken to identify clinical studies in human subjects that investigated the relationship of thirst to specific physiologic thirst-related correlates and associated thirst mediators. Thirst was induced in 17 selected clinical studies by hyperosmolar infusion, through water deprivation or exercise weight-loss regimens. Positive linear relationships between the subjects' thirst ratings and rising serum pOsm levels confirmed the presence of intact osmotic thirst drives. However, there were significant variations in normal compensatory rises in AVP levels that followed the rises in plasma osmolality after the subjects were exposed to cold, physical pre-conditioning and water immersion tests. Notably, older adults in the studies reported diminished thirst ratings. Weak correlations suggest that angiotensin II may play only a minor role in thirst mediation. Atrial natriuretic hormone's inhibitory effect on thirst was inconsistent. Findings indicated that older adults are at higher risk for profound dehydration due to sensory deficits along with failure to correct volume losses. The thirst trials results support the close correlation between serum pOsm values and patients' thirst ratings, with the exception of the older adult.

FAMISHED for support: recovering elders after cardiac events.

BACKGROUND: Heart disease causes disproportionately heavy burdens on unpartnered elders (widowed, divorced, never married) who have limited social resources to contend with recovery demands and complications resulting from acute myocardial infarction (AMI) or coronary artery bypass graft (CABG) surgery. Research suggests that the availability of social support improves recovery after AMI and CABG, yet functional support expressly designed to modify health and stimulate recovery remains unspecified. Advanced practice nurses (APNs) in the clinical nurse specialist (CNS) role who provide social support to recovering elders may be able to improve health outcomes for this vulnerable group. AIMS: The investigators' aims are to (1) quantify the duration and frequency of nurse contact with unpartnered elders recovering from cardiac events and (2) describe the functional support provided by the CNS to the unpartnered recovering elder. METHODS: Forty narrative accounts comprising 670 entries by interventional CNS APNs were examined using thematic analytic techniques. RESULTS: Over a 14-week period, CNS APNs contacted recovering elders 16 times, with a total of 4.5 hours spent per elder, or 13 minutes per phone call and 80 minutes per home visit. Analysis of 670 entries demonstrated functional and emotional support that was captured in the acronym, FAMISHED. CONCLUSIONS: Functional and emotional support from the CNS may enhance self-efficacy for recovery from cardiac events for unpartnered elders.

Partnerships in mending hearts: nurse and peer intervention for recovering cardiac elders.

As a growing number of older adults recover from cardiac events, volunteer programs have emerged to provide low-cost community support to vulnerable elders. Although an increasing number of studies have described the beneficial relationships between patients and volunteers, little is known about the unique partnership between the advanced practice nurse (APN) and the volunteer peer. The purpose of this article was to explore the interaction between the APN and the peer advisor who provide support for unpartnered elders after myocardial infarction or coronary artery bypass grafting. As part of a larger research study, "Improving Health Outcomes for Unpartnered Cardiac Elders" (R01-NR05205), interactions with peers were recorded by APNs. Essential themes related to working with 20 peer advisors emerged from 30 logs. Findings suggest that establishing the peer support role, acknowledging abilities, and overcoming difficulties are important steps in the relationship. A partnership between healthcare professionals and peer advisors enhances social support for vulnerable elders recovering from myocardial infarction and coronary artery bypass grafting.

Recovery trajectory of unpartnered elders after myocardial infarction: an analysis of daily diaries.

The study reported here analyzed daily diary entries of unpartnered elders after myocardial infarction (MI) to gain perspective into their recovery. A total of 33 diaries were included as part of the qualitative analysis of the larger study referred to above. Diary content was evaluated through qualitative descriptive analysis. Six categories--activities of daily living, exercise practices, social support, symptom reporting, healthcare activities, and health-related expenses--were identified from the diaries. Results suggest that recovering, unpartnered MI elders have a need to return to a familiar lifestyle. Moreover, a few differences and similarities based on gender were found. In the rehabilitation setting, nurses should recognize the need for elders to return to normal activities, the importance of social support, the acknowledgement of gender differences, and the potential cost burden for these patients. Diaries were a valuable tool with which to uncover information about the recovery trajectory of unpartnered elders after MI.