Five-Year Program Evaluation of an Evidence-Based Practice Scholars Program.

The purpose of this article is to describe the findings of a 5-year program evaluation of a hospital-based Evidence-Based Practice (EBP) Scholars Program. The EBP Scholars Program was developed in 2011 to (a) educate and engage staff in the EBP process and (b) develop a cadre of EBP mentors within each clinical unit of the organization. The evaluation of the EBP Scholars Program examined both the feasibility and the impact of the program. The findings suggest that not only is the program feasible to implement and highly acceptable to the participants, but it also significantly increases staff EBP self-efficacy and promotes staff engagement in EBP, organizational leadership, and professional development. Most importantly, this program has been foundational to motivating and sustaining a strong culture of inquiry at our Magnet® designated organization. [J Contin Educ Nurs. 2018;49(12):547-554.].

Nurses' concerns about caring for patients with acute and chronic traumatic brain injury.

AIMS AND OBJECTIVES: As a first step in developing traumatic brain injury-specific nursing education, the purpose of this study was to investigate nurses' concerns about caring for patients with moderate-to-severe traumatic brain injury. BACKGROUND: Patients with moderate-to-severe traumatic brain injury typically have significant immediate and chronic cognitive impairments. These cognitive impairments can negatively affect their inpatient stay after an acute traumatic brain injury and affect their health care later in life when seeking care for other acute health conditions during the chronic phase of traumatic brain injury. Nurses must be knowledgeable about modifying care to accommodate the cognitive impairments of these patients throughout the continuum of care. Yet, current guidelines focus exclusively on acute care and do not address nurses' central role in dealing with residual cognitive impairments of these patients. Thus, educational and training interventions are needed to ensure nurses have adequate knowledge to care for these patients. DESIGN: We conducted a cross-sectional, exploratory survey of 692 nurses across hospital departments at three hospitals between October 2014-August 2015. Nurses answered the following qualitative open-ended question: "What are your primary concerns about providing care to patients with moderate-to-severe traumatic brain injury?" METHODS: Conventional qualitative content analysis was used to analyse nurses' responses. RESULTS: Findings showed nurses reported multiple concerns about caring for patients in the acute phase after traumatic brain injury, but few concerns about caring for patients in the chronic phase. Some of the concerns nurses reported included: (i) preventing physical injury; (ii) missing changes in condition; (iii) providing adequate education; (iv) providing support; and (v) promoting recovery. Barriers to providing adequate care were as follows: (i) lack of knowledge; (ii) limited staffing; and (iii) inadequate resources. CONCLUSIONS: Findings have implications for education of nurses and development of nursing guidelines for management of patients with traumatic brain injury, including providing direction for nurses on development of care plans for patients in the chronic phase after a moderate-to-severe traumatic brain injury.

Young women's reasons to seek sexually transmitted infection screening.

OBJECTIVES: To describe young women's reasons to seek and not to seek sexually transmitted infection (STI) screening; to explore whether reasons differed by age and STI screening history. DESIGN AND SAMPLE: Cross-sectional, descriptive. Female students (N = 216) at a university in the Midwestern United States. MEASURES: An anonymous online survey was designed based on the Theory of Care Seeking Behavior and literature regarding STI screening among young women. RESULTS: The most common reason to seek STI screening was to start treatment promptly (85%); the most common reason not to seek screening was being asymptomatic (54%). Participants' reasons differed by age and screening history. Women under 25 were more likely than women 25 and older to seek screening because of encouragement from female role models (p < .01). Women who had never been screened were more likely than women who had been screened to avoid screening because of embarrassment (p < .05). Novel findings included seeking STI screening because it "should be done" if sexually active and because of encouragement from female role models. CONCLUSIONS: Health care and public health professionals can use these findings to develop strategies to improve STI screening rates among young women.

Formative research for the development of an interactive web-based sexually transmitted disease management intervention for young women.

Sexually transmitted diseases are common among young women and effective self-management is foundational to improving health outcomes and preventing negative sequelae. Advances in technology create the opportunity for innovative delivery methods of self-management interventions. However, it is essential to conduct formative research with the target population to identify both the needs and the preferences for the content and delivery method of a sexually transmitted disease self-management intervention prior to intervention development. Eight focus groups were conducted with 35 young women between 18 and 24 years of age. We found that young women strongly support the use of a Web-based intervention to provide sexually transmitted disease self-management guidance. Women were interested in receiving comprehensive management information from the perspective of both clinicians and other women who have experienced a sexually transmitted disease. There was a clear interest in incorporating new media into the Web-based intervention to allow for communication with providers as well as to create opportunities for social networking between women. This formative research provides critical information about the content and delivery method of a self-management intervention and gives direction for intervention development that is inclusive of varying types of new media to allow for connectivity among users, their peers, and clinicians.

Sexually transmitted disease testing misconceptions threaten the validity of self-reported testing history.

OBJECTIVE: Sexually transmitted disease (STD) testing is fundamental to STD prevention and control. We sought to comprehensively examine young women's beliefs about the STD testing process. DESIGN AND SAMPLE: Descriptive, cross-sectional, survey investigation. Women aged 18-24 (n = 302) drawn from four women's health clinics and one university classroom. MEASURES: Participants completed the RoTEST, which measures five domains of women's STD testing beliefs and a demographic survey. RESULTS: Many women believed they would be screened for all STDs when they receive STD testing (40%) and that visual inspection by a provider was a valid method of STD screening for gonorrhea (35%), chlamydia (32%) and HSV (77%). More than a quarter believed that a Pap test screens for gonorrhea (23%) and chlamydia (26%). Twenty-one percent reported that discussing STD testing with a provider is difficult and most reported feeling more comfortable seeking STD testing from an STD specialist rather than a family doctor (79%). CONCLUSIONS: Young women have numerous misconceptions about the STD testing process that may interfere with the validity of their self-reported STD testing history and subsequently undermine public health efforts to improve STD prevention and control. Innovative approaches to educating women about the testing process are needed.

Young women's Representations of Sexually Transmitted Diseases (RoSTD): a psychometric study.

Measurement of beliefs about sexually transmitted diseases (STDs) is important to understanding sexual health behaviors. The purpose of this study was to develop and test the psychometric properties of the Representations of STDs (RoSTD) Scale. The RoSTD was developed to measure young women's representations of STDs, and it is intended to be used to measure beliefs about any of the seven most common STDs. Confirmatory factor analysis indicated a four-factor structure for the 40-item RoSTD: Future Perspective, Cause, Psychosocial Consequence, and Identity. Internal consistency for the subscales (measured for each of seven different STDs) ranged from .67 to .93 and 2-week test-retest correlations ranged from .69 to .90. The RoSTD shows evidence of reliability and validity in young women.

Young women's beliefs regarding human papillomavirus.

OBJECTIVE: To describe young women's perceptions of human papillomavirus (HPV) using the Common Sense Model and examine whether perceptions differ based on history of HPV diagnosis or sexually transmitted disease (STD) testing. DESIGN: Cross-sectional, survey data. SETTING: Four women's health clinics and one university classroom. PARTICIPANTS: Three hundred and two women ages 18-24. METHODS: Young women's beliefs regarding HPV were measured using the HPV Representations of Sexually Transmitted Diseases (RoSTD) survey. RESULTS: Most survey respondents believed HPV diagnosis was likely to result in cancer and death. Negative beliefs about the psychosocial consequences of HPV diagnosis were common. Compared to those who had not been diagnosed with HPV (or had never received STD testing), young women with a history of HPV diagnosis or STD testing had less serious and more accurate beliefs about HPV. CONCLUSION: Young women tend to have misconceptions about HPV in addition to noteworthy concerns about the psychosocial consequences of HPV diagnosis. Clinical attention to young women's beliefs about HPV may provide direction for improving the delivery of patient-centered education and counseling about this exceedingly common illness.

Young women's beliefs about the terms sexually transmitted disease and sexually transmitted infection.

OBJECTIVE: To determine whether young women differentiate between the terms sexually transmitted disease and sexually transmitted infection and if they do whether their reasons are consistent with those of health care providers. DESIGN: Secondary analysis of cross-sectional, survey data. SETTING: Four women's health clinics and one university classroom. PATIENT/PARTICIPANTS: Three hundred and two women aged 18 to 24. METHODS: The women completed a survey that measured beliefs about seven sexually transmitted diseases, a demographic and sexually transmitted disease health information questionnaire, and a single item assessing whether the terms sexually transmitted disease and sexually transmitted infection were interchangeable. RESULTS: Fifty-seven percent (n=155) responded that sexually transmitted disease and sexually transmitted infection do not mean the same thing, 28% (n=76) responded that sexually transmitted disease and sexually transmitted infection mean the same thing, and 15% (n=42) responded they do not know. Beliefs about sexually transmitted disease stigma and symptoms were not related to sexually transmitted disease terminology; beliefs about curability were related but not in the hypothesized direction. CONCLUSIONS: A majority of the young women do differentiate between the terms sexually transmitted disease and sexually transmitted infection; however, the rationale for doing so is not consistent with the rationale used by health care providers. Professionals should clarify their use of the terms sexually transmitted disease and sexually transmitted infection when talking with patients as a means to improve health communication and subsequently improve sexually transmitted disease health care.

Providers' experiences with young people's cognitive representations and emotions related to the prevention and treatment of sexually transmitted infections.

OBJECTIVE: The Common Sense Model (CSM) was used as the organizing framework to examine providers' experiences with young people's cognitive representations and emotions related to the prevention and treatment of sexually transmitted infections (STIs). This study was conducted to develop insights into potential avenues for enhancing the effectiveness of STI education and counseling for young people. DESIGN: This was a qualitative investigation using semi-structured focus group interviews. SAMPLE: The 5 focus groups were comprised of 30 providers of STI education and counseling: public health nurses, peer educators, and nurse practitioners. MEASUREMENT: Content of transcribed focus group interviews was coded using a predetermined coding scheme based on the five dimensions of representational beliefs and emotions defined by the CSM. RESULTS: The providers identified that young people hold a number of STI misconceptions within each dimensions of the CSM. Anger and embarrassment about STIs are common emotions experienced by young people. CONCLUSIONS: This investigation suggests that providers are able to elicit and identify STI-related misconceptions held by young people, and that the CSM model is a useful classification method. Identifying misconceptions could be useful in developing tailored STI education and counseling interventions by public health nurses.