Development and Validation of an Instrument to Measure Nurses' Beliefs Toward Deaf and Hard of Hearing Interaction.

BACKGROUND AND PURPOSE: Nurse-patient communication has a significant effect on health outcomes and quality of care. The purpose of this research was to develop and validate an instrument to measure nurses' beliefs toward interacting with Deaf signers, non-signing deaf, and hard of hearing (DdHH) patients. METHODS: Initial pool items created based on literature review. Content validated by DdHH and hearing registered nurses (RNs) and certified interpreters working in healthcare. Resulting D/deaf and Hard of Hearing Interaction Beliefs Scale for Registered Nurses (DdHH-IBS/RN) administered to two groups of RNs. Two validation studies conducted. RESULTS: Analyses demonstrated high inter-item reliability, internal consistency reliability, and stability reliability of a 25-item DdHH-IBS/RN. Confirmatory factor analysis supported hypothesized structure of the scale. CONCLUSION: The DdHH-IBS/RN is a reliable and valid scale to measure nurses' beliefs towards DdHH interaction.

Associations among hearing loss, hospitalization, readmission and mortality in older adults: A systematic review.

OBJECTIVE: Older adults with hearing loss face many challenges impacting health outcomes. The objective of this review was to evaluate current evidence for associations among hearing loss, hospitalizations, readmissions and mortality in older adults living with hearing loss. METHODS: A systematic search, of PubMed, CINAHL and Embase was performed in October 2018. Studies that were included consisted of populations aged 50 and older, publications after 2004, clearly defined hearing loss measurements, and non-aggregated, appropriate outcome variables. We excluded deafness, specified hearing losses, and cochlear implant users. RESULTS: Fifteen mortality studies, four hospitalization studies, and one readmission study were identified. After adjustments, three mortality, three hospitalization, and the one readmission study found significant associations. DISCUSSION: Hearing loss was associated with an increased risk of hospitalizations, readmission and mortality. However, there is insufficient evidence to support that hearing loss is independently associated to increased risk of these outcomes.

Fluency in Nursing Education and Simulation: A Concept Analysis.

AIM: The aim of the study was to realign how nurses view simulation in nursing education as a means of facilitating fluency in knowledge and action to promote expertise in practice. BACKGROUND: Nursing expertise is attained by translating complex phenomena across multiple representations and by constructing meaning through experience. Simulation provides learners the experiences necessary to develop fluency in thought and action. METHOD: Procedures outlined by Hupcey and Penrod (2005) and Walker and Avant (2011) were used to identify uses, defining attributes, philosophical assumptions, contextual factors, and values of the concept. RESULTS: Use of simulation to promote representational fluency in other disciplines fosters deep conceptual understanding and skillfulness, which prepares learners to perform with fluidity and expertise. CONCLUSION: The association between representational fluency and simulation introduces nurse educators to a way of thinking about how novices learn to think and act like experts. Further research is recommended.

Driven from distraction: how infants respond to parents' attempts to elicit and re-direct their attention.

This experiment examined how parents' verbal and non-verbal behavioral cues cause infants to shift and share attention within environments where many objects compete for infants' attention. Fifteen- and 21-month-old infants played with toys while their parent periodically shifted attention to a distal object within a larger array. Parents' attention-shifts were indicated by a change in direction of gaze, a pointing gesture, and/or verbalizations. Verbalizations were either attention-eliciting or attention-directing. In some trials parents covered their eyes to occlude line-of-gaze. Both ages seldom followed simple gaze shifts, but frequently followed gaze with-points or gaze-with-directing verbalizations. Attention-eliciting verbalizations increased infants' looks to the parent. Gaze occlusion reduced infants' responses to directing verbalizations. Responses to eliciting verbalizations increased with age. Infant receptive vocabulary did not predict attention-sharing, even when parents named objects (i.e., directing verbalizations). Implications for development of attention-sharing, language and understanding of visual attention are discussed.