Usability and Acceptability of a Web-Based Program for Chemotherapy-Induced Peripheral Neuropathy.

Chemotherapy-induced neuropathy is a painful and debilitating adverse effect of certain chemotherapy drugs. There have not been any patient-centered, easily accessible Web-based interventions to assist with self-management of chemotherapy-induced neuropathy. The aims of this study were to evaluate usability and acceptability and to estimate an effect size of a Web-based intervention for assessing and managing chemotherapy-induced neuropathy. Participants (N = 14) were instructed to complete the Creativity, Optimism, Planning, and Expert Information for Chemotherapy-Induced Peripheral Neuropathy program and provide verbal responses to the program. Participants completed the Chemotherapy Induced Peripheral Neuropathy Assessment Tool and Post-Study System Usability Questionnaire. Iterative changes were made to the COPE-CIPN. Participants were asked to provide feedback on the revised COPE-CIPN, repeat the Chemotherapy Induced Peripheral Neuropathy Assessment Tool, and evaluate acceptability using the Acceptability e-Scale. The COPE-CIPN demonstrated high usability (mean, 1.98 [SD, 1.12]) and acceptability (mean, 4.40 [SD, 0.52]). Comments indicated that the interface was easy to use, and the information was helpful. While neuropathy symptoms continued to increase in this group of patients receiving neurotoxic chemotherapy, there was a decrease in mean level of interference with activities from 53.71 to 39.29 over 3 to 4 months, which indicated a moderate effect (d = 0.39) size. The COPE-CIPN may be a useful intervention to support self-management of chemotherapy-induced neuropathy.

A "Triple Threat" to Research Protocols and Logistics: Adolescents, Sexual Health, and Poverty.

The purpose of this article is to discuss lessons learned from conducting research with urban communities. A brief overview of the Health Improvement Project for Teens (HIPTeens) will be provided. It will be followed by several suggestions concerning recruitment and retention of participants, challenges related to working in impoverished environments, hiring and training of research teams, interacting with administration and community, and strategies for doing research in diverse settings.

Military and veteran's health integration across missions: how a college of nursing "joined forces".

BACKGROUND: To address the unique needs of our returning military and veterans, the White House initiated the Joining Forces campaign and has encouraged colleges of nursing throughout the nation to support this mission. METHODS: At the University of South Florida College of Nursing, we have implemented a multifaceted approach that addresses education, research, and employment. These military-related programs have been unified under our RESTORE LIVES (Research and Education to Rehabilitate and Restore the Lives of Veterans, Services Members and their Families) initiative. RESULTS: To accomplish this mission, we enhanced our curriculum to include veteran health care issues, developed research that addresses veteran wellness, launched an accelerated program to enable veterans and military personnel with medical experience to obtain their baccalaureate in nursing, and encouraged a culture within the college that is supportive of military-based health care and employment needs. CONCLUSIONS: We have shared our experiences through webinars and presentations and by hosting a national conference.

Ethical issues related to caring for low birth weight infants.

BACKGROUND: Currently preterm births are the leading causes of newborn deaths and newborn mortality in developed countries. Infants born prematurely remain vulnerable to many acute complications and long-term disabilities. There is a growing concern surrounding the moral and ethical implications of the complex and technological care being provided to extremely low birth weight infants in neonatal intensive care units in the developed nations. RESEARCH PURPOSE: The purpose of this study was to describe the ethical and moral issues that neonatal intensive care nurses experience when caring for low birth weight preterm infants and their families. RESEARCH DESIGN: A phenomenological method design was used to describe the lived experiences of nurses with ethical and moral issues encountered in the neonatal intensive care unit. One-on-one, semi-structured interviews using open-ended questions were used to gather data from the participants. RESEARCH PARTICIPANTS: The setting for this study was a 97-bed neonatal intensive care. A total of 16 female nurses were interviewed. ETHICAL CONSIDERATIONS: Approval to conduct the research study was obtained from the institutional review board of the hospital where the study was conducted. Formal signed consent was obtained from each participant. To ensure confidentiality, each participant was asked to choose a confederate name to be used in the interview and the transcriptions. FINDINGS: The thematic analysis identified five recurring themes: (a) at the edge of viability, (b) infant pain and discomfort, (c) crucial decisions, (d) communicating with parents, and (e) letting go. CONCLUSION: Neonatal intensive care unit nurses indicated that they often had challenges to their own sense of morality as they struggled to protect the infant from pain and unnecessary discomfort, provide care to an infant and their family whom they thought was faced with a lifetime of challenges and poor health, accepting decisions made by parents, and feeling as if parents were not adequately informed about outcomes.

Exit interviews from adolescent girls who participated in a sexual risk-reduction intervention: implications for community-based health education promotion for adolescents.

INTRODUCTION: The purpose of this study was to invite girls who participated in a gender-specific sexual risk-reduction intervention to describe their experiences and identify program characteristics most or least beneficial to their involvement. METHODS: Semistructured interviews were completed with 26 African American, low-income girls aged 15 to 19 years who had participated in a sexual risk-reduction intervention as part of a randomized controlled trial. The girls were interviewed after completing a 12-month postintervention survey. Interviews were recorded, transcribed, and analyzed for categories. RESULTS: Analyses of the interview data identified 6 categories: 1) reasons for participating, 2) strategies for maintaining behavior changes, 3) interacting with others, 4) communicating with mothers, 5) disseminating information to friends and family, and 6) disseminating information to the males in the community. DISCUSSION: Many of the girls participating in the theory-based behavior change intervention reported selecting from a menu of strategies learned through the intervention to reduce their sexual risk. Having the opportunity to discuss sexual health with peers and trained facilitators, particularly in an all-female environment, was cited as a positive benefit. Community health organizations and clinicians who care for adolescent girls can adapt many aspects of this intervention to help reduce their sexual risk.

Risk reduction strategies used by urban adolescent girls in an HIV prevention trial.

UNLABELLED: Adolescent girls throughout the globe are particularly vulnerable to HIV infection. In the U.S., sexually-active, adolescent girls in urban settings are at elevated risk for HIV. The purpose of this study was to describe a theoreticallydriven, HIV prevention intervention tailored for adolescent girls and evaluate its effectiveness in reducing sexually-risky behaviors. Sexually-active urban adolescent girls (n=738) recruited in a mid-size, northeastern U.S. city were recruited for a randomized controlled trial and participated in a theory-based, sexual risk reduction intervention or a structurallyequivalent health promotion control group. Preferred sexual risk-reduction strategies were collected using ACASI at baseline, then at 3, 6 and 12-months post-intervention. The manualized interventions included four small group sessions and two booster sessions all of which included information, motivational and behavioral skill constructs. Facilitators were trained in motivational interviewing and incorporated this technique throughout the sessions. Relative to girls in the control group, girls receiving the sexual risk-reduction intervention were more likely to increase the number of sexual-risk reduction strategies at post-intervention; however, girls in the control group also increased the number of strategies used though not at the same rate. Theory-based, HIV interventions tailored to adolescent girls can help increase sexual riskreduction behaviors and provide girls with a menu of options to employ. Due to the manualized structure of this randomized controlled trial, the intervention could be modified to meet the needs of adolescent girls throughout the world. TRIAL REGISTRATION: This study is registered at ClinicalTrials.gov (NCT 00161343).

Sexual risk factors for partner age discordance in adolescent girls and their male partners.

AIMS AND OBJECTIVES: To investigate differences in sexual risk factors between adolescent girls reporting similar-aged or older sex partners. BACKGROUND: Adolescent girls are at significant risk of heterosexual-acquired HIV infection and other long-term reproductive health issues. Sexual partner age discordance in teen girls has been correlated with STIs, lack of protection, multiple partners and earlier age of sexual transition. DESIGN: A descriptive study comparing girls currently involved with age-discordant partners to those with similar-aged partners. Two-sample t-test for continuous variables and chi-squared test or Fisher's exact test for categorical variables were used to compare groups. METHODS: Baseline data from 738 sexually active, urban, adolescent girls aged 15-19 were analysed to determine which behaviours were more likely to occur in girls with older partners. Data were collected as part of a gender-specific HIV-prevention intervention in a randomised controlled trial (RCT) tailored to adolescent girls. RESULTS: Multiple reported sexual risk behaviours were found to significantly differ between the two groups at baseline. Overall, girls with older partners had more episodes of sexual instances (vaginal, anal and oral). Specific sexual risk behaviours were found to be statistically significant between the two groups. Girls with older partners started having sex at earlier ages, had more lifetime sexual partners, higher incidents of STIs and were reluctant to discuss using condoms with their partners. Girls with similar-aged partners were less willing to engage in risky sexual behaviours. CONCLUSIONS: Findings from this investigation support data from other studies. Relationships with older male partners place adolescent girls at increased risk of HIV/STIs and unintended pregnancy. RELEVANCE TO CLINICAL PRACTICE: Adolescent girls in age-discordant relationships are at risk of immediate and long-term sexual health morbidities. Identifying girls who are at increased risk by asking tailored questions will enable nurses to recommend appropriate diagnostics for this population and provide age-specific counselling.

NICU nurses' lived experience: caring for infants with neonatal abstinence syndrome.

PURPOSE: The primary aim of this qualitative methods study was to describe the lived experiences of neonatal intensive care unit (NICU) nurses with ethical and morally challenging issues. SUBJECTS: The target population for the study was registered nurses working in the NICU. Interviews were completed with 16 nurses from 1 hospital. DESIGN: A phenomenological method design was used to describe NICU nurses' lived experiences with ethical and moral issues encountered in the NICU. METHODS: After obtaining signed consent, the principal investigator interviewed all participants, using a semistructured interview guide consisting of open-ended questions. MAIN OUTCOMES: Ethical and moral distress related to neonatal abstinence syndrome was the predominant outcome. PRINCIPAL RESULTS: Caring for infants, coping with families, and discharging infants home were the major concerns voiced by nurses in this study. CONCLUSIONS: Nurses in this study struggled with issues of beneficence and nonmaleficence and were not aware of scientific evidence that guides methadone management of pregnant women.

Using synchronous software in Web-based nursing courses.

To promote learning and enhance immediacy and satisfaction, a college of nursing at a large research I southern university undertook a pilot project to incorporate synchronous classroom software into an ongoing online program. Two synchronous class sessions using voice over Internet protocol were offered in the Community/Public Health Nursing course through Elluminate Live! Upon conclusion of the lecture, students were divided into breakout groups to work on group projects. Surveys were administered to the students and faculty before and after the class sessions. Evaluation of the pedagogical strategies used in the synchronous sessions was conducted by instructional technology faculty. Students in the pilot group reported higher levels of satisfaction with the Web-based course with synchronous sessions. In addition, students reported that group time at the end of the session was helpful for completing group projects. A majority responded that synchronous session activities and assignments facilitated their understanding of course content. This article presents a description of the synchronous classroom pilot project along with recommendations for implementation and pedagogical approaches.