The Experiences of Skilled Nursing Staff in Memory Care Units During the COVID-19 Pandemic.

BACKGROUND AND OBJECTIVES: The novel coronavirus disease 2019 (COVID-19) resulted in the need for multiple mitigation strategies. The impacts of these safety measures were felt more extremely by healthcare providers. This qualitative study focused on the experiences of staff in skilled nursing facilities, specifically in locked memory care units, during the first year of the COVID-19 pandemic. RESEARCH DESIGN AND METHODS: This study used a basic interpretive methodology. In-depth interviews were conducted with skilled nursing staff members who worked in a locked memory care unit during the 2020 calendar year. Thematic analysis was used to organize and interpret the data. RESULTS: A total of 11 participants provided data that resulted in themes around reasons for working on a locked memory care unit, experiences working with people who have behavioral and psychological symptoms due to dementia, training, outcomes of shared experiences, outcomes of policy changes, management support, and suggestions for a future pandemic. DISCUSSION AND IMPLICATIONS: The results of this study may have implications for skilled nursing facilities with locked memory care units that continue to grapple with the realities of providing care during a pandemic. Providing appropriate training, social support, and appropriate protective equipment are among the suggestions.

New Mothers With Postpartum Depression: A Qualitative Exploration of Healthcare Decision-Making.

Postpartum depression (PPD) is a significant health issue for many new mothers in the weeks and months following a child's birth. Quantitative data suggest that a mother's PPD negatively impacts healthcare decision-making for the child via routine well-baby visits and pediatric care. However, little is known from a qualitative perspective about the factors that challenge or facilitate these healthcare decisions. The purpose of this descriptive qualitative study was to understand the perceptions of new mothers about factors contributing to their healthcare decision-making, for themselves and for their children, while living with PPD. The researchers used purposive sampling to recruit eight women from clinics, community organizations, and social media support groups who met the study's inclusion criteria. Individual semi-structured interviews were carried out with eight participants about their PPD experiences, motherhood, and healthcare decision-making influences. Transcribed interviews and initial themes were shared with participants to verify researcher interpretations and aid in the analysis process. The researchers analyzed interview data using thematic analysis to cultivate an understanding of the phenomenon by identifying and interpreting patterns in the data. Three primary themes were drawn from the data analysis: (1) Importance of Clinician Trust and Support; (2) Balancing the Health of the Mother and Child; and (3) Other Support Structures That Facilitate Healthcare Decision-Making for the Mother and Baby Dyad. Participant experiences underscored the need for cohesive approaches by clinical providers of pre- and postnatal care. Group model approaches to postnatal care appear to mitigate or reduce the impact of PPD.

Perceptions of the caregiver-pediatric physical therapist relationship1.

PURPOSE: Collaboration between physical therapists and caregivers of children who receive physical therapy is integral to providing family-centered care. Successful collaboration depends upon the therapeutic relationship built within the caregiver-therapist dyad. However, the nature of these relationships is not well understood. The purpose of this study was to explore the caregiver-pediatric physical therapist relationship from the perspectives of the caregiver and pediatric physical therapist. METHODS: A qualitative multiple case study methodology was used; a caregiver and pediatric physical therapist represented a bounded case. Each caregiver and therapist engaged in separate, semi-structured, in-depth interviews. RESULTS: Through within- and cross-case coding, three themes were identified: physical therapist as a guide, the caregiver-pediatric physical therapist connection, and professional qualities and performance. CONCLUSION: These themes help to provide an understanding of the therapeutic relationships that can occur between caregivers and pediatric physical therapists, which can help support effective collaboration as part of providing family-centered care.

Telerehabilitation Use With Spinal Cord Injury: Occupational Therapists' Perspective.

IMPORTANCE: Telerehabilitation provides people with spinal cord injury (SCI) an alternative mode of accessing specialized health care. Further research on occupational therapy practitioners' perspectives of telerehabilitation may provide additional evidence for clinical practice implementation. OBJECTIVE: To explore urban occupational therapists' perspectives on the benefits of and barriers to telerehabilitation use with SCI. DESIGN: A qualitative study design using a demographic questionnaire and a single, individual semistructured interview. Thematic analyses included member checking, constant comparative analysis, triangulation, and self-description and self-reflexivity. SETTING: Residential and community settings. PARTICIPANTS: Six occupational therapists with a range of experience in SCI rehabilitation were recruited using purposeful sampling. RESULTS: Six participants were interviewed, and four primary themes emerged: (1) communication, (2) personal factors, (3) benefits, and (4) barriers. CONCLUSIONS AND RELEVANCE: Telerehabilitation offers numerous potential benefits for SCI intervention. This study provides an understanding of practitioner concerns and potential barriers to use. The results indicate that a hybrid model incorporating both in-person and distance-based treatment is likely optimal. What This Article Adds: Our results provide information that addresses practitioner concerns and recommendations for the use of telerehabilitation with people with SCI. As practitioner concerns are identified and addressed, telerehabilitation may increase in the U.S. health care system, potentially facilitating an alternative treatment delivery method for underserved populations.

Examining body dissatisfaction in college men through the exploration of appearance anxiety and internalization of the mesomorphic ideal.

Although research has explained various psychological factors leading to body dissatisfaction in male, limited research has examined the potential mediating effect of the anxiety male experience to align with societal conceptions of masculine appearance. Objective and participants: In this study, conducted spring semester of 2018, we examined the relationships between internalization of the mesomorphic ideal, appearance anxiety, and body dissatisfaction, as well as the potential mediating effect of appearance anxiety on body dissatisfaction in college-aged male. Methods: In a convenience sample of college-aged male, data were collected using self-reported questionnaires measuring internalization, appearance anxiety, and body dissatisfaction. Results: Responses indicated significant associations between internalization of the mesomorphic ideal, appearance anxiety, and body dissatisfaction. Appearance anxiety was a partial mediator of internalization of the mesomorphic ideal and body dissatisfaction. Conclusions: The authors discuss implications for future research and address factors related to body dissatisfaction for professionals implementing body image programs.

Soft skills and implications for future professional practice: Qualitative findings of a nursing education escape room.

BACKGROUND: Educational escape rooms have been shown to improve student content knowledge; however, research about other skills developed during escape rooms is lacking. OBJECTIVES: To explore baccalaureate nursing students' perceptions of a cardiovascular-themed educational escape room. During the data analysis, researchers uncovered unique findings related to participant soft skill development and implications for participant future professional practice. DESIGN: A basic interpretive qualitative methodology was used. SETTING: The study was conducted at a medium-sized, private, not-for-profit university in the Midwest United States. PARTICIPANTS: Baccalaureate nursing students who had recently participated in a cardiovascular-themed educational escape room were purposefully recruited. METHODS: A total of two focus groups were conducted using a semi-structured focus group guide. Data were analyzed using a conventional content analysis approach with both inductive and deductive components. RESULTS: Four overarching themes were identified in the data, including game and learner characteristics, learning outcomes, and implications for future professional practice. The theme of implications for future professional practice included two sub-themes: soft skill development and the real-life nature of the activity. CONCLUSION: A nursing educational escape room may be one strategy to enhance student professional practice skills.

A realist review of shared medical appointments: How, for whom, and under what circumstances do they work?

BACKGROUND: Shared medical appointments (SMAs) are doctor-patient visits in which groups of patients are seen by one or more health care providers in a concurrent session. There is a growing interest in understanding the potential benefits of SMAs in various contexts to improve clinical outcomes and reduce healthcare costs. This study builds upon the existing evidence base that suggests SMAs are indeed effective. In this study, we explored how they are effective in terms of the underlying mechanisms of action and under what circumstances. METHODS: Realist review methodology was used to synthesize the literature on SMAs, which included a broad search of 800+ published articles. 71 high quality primary research articles were retained to build a conceptual model of SMAs and 20 of those were selected for an in depth analysis using realist methodology (i.e.,middle-range theories and and context-mechanism-outcome configurations). RESULTS: Nine main mechanisms that serve to explain how SMAs work were theorized from the data immersion process and configured in a series of context-mechanism-outcome configurations (CMOs). These are: (1) Group exposure in SMAs combats isolation, which in turn helps to remove doubts about one's ability to manage illness; (2) Patients learn about disease self-management vicariously by witnessing others' illness experiences; (3) Patients feel inspired by seeing others who are coping well; (4) Group dynamics lead patients and providers to developing more equitable relationships; (5) Providers feel increased appreciation and rapport toward colleagues leading to increased efficiency; (6) Providers learn from the patients how better to meet their patients' needs; (7) Adequate time allotment of the SMA leads patients to feel supported; (8) Patients receive professional expertise from the provider in combination with first-hand information from peers, resulting in more robust health knowledge; and (9) Patients have the opportunity to see how the physicians interact with fellow patients, which allows them to get to know the physician and better determine their level of trust. CONCLUSIONS: Nine overarching mechanisms were configured in CMO configurations and discussed as a set of complementary middle-range programme theories to explain how SMAs work. It is anticipated that this innovative work in theorizing SMAs using realist review methodology will provide policy makers and SMA program planners adequate conceptual grounding to design contextually sensitive SMA programs in a wide variety of settings and advance an SMA research agenda for varied contexts.

A Health Assessment Survey of Veteran Students: Utilizing a Community College-Veterans Affairs Medical Center Partnership.

OBJECTIVE: To assess health status among student veterans at a community college utilizing a partnership between a Veterans Affairs Medical Center and a community college. PARTICIPANTS: Student veterans at Cuyahoga Community College in Cleveland, Ohio, in January to April 2013. METHODS: A health assessment survey was sent to 978 veteran students. Descriptive analyses to assess prevalence of clinical diagnoses and health behaviors were performed. Logistic regression analyses were performed to assess for independent predictors of functional limitations. RESULTS: 204 students participated in the survey (21% response rate). Self-reported depression and unhealthy behaviors were high. Physical and emotional limitations (45% and 35%, respectively), and pain interfering with work (42%) were reported. Logistic regression analyses confirmed the independent association of self-reported depression with functional limitation (odds ratio [OR] = 3.3, 95% confidence interval [CI] 1.4-7.8, p < 0.05, and C statistic 0.72) and of post-traumatic stress disorder with pain interfering with work (OR 3.9, CI 1.1-13.6, p < 0.05, and C statistic 0.75). CONCLUSION: A health assessment survey identified priority areas to inform targeted health promotion for student veterans at a community college. A partnership between a Veterans Affairs Medical Center and a community college can be utilized to help understand the health needs of veteran students.

Understanding the Health Needs and Barriers to Seeking Health Care of Veteran Students in the Community.

OBJECTIVES: Access to care at Veterans Affairs facilities may be limited by long wait times; however, additional barriers may prevent US military veterans from seeking help at all. We sought to understand the health needs of veterans in the community to identify possible barriers to health-seeking behavior. METHODS: Focus groups were conducted with veteran students at a community college until thematic saturation was reached. Qualitative data analysis involved both an inductive content analysis approach and deductive elements. RESULTS: A total of 17 veteran students participated in 6 separate focus groups. Health needs affecting health-seeking behavior were identified. Themes included lack of motivation to improve health, concern about social exclusion and stigma, social interactions and behavior, limited access to affordable and convenient health care, unmet basic needs for self and family, and academics competing with health needs. CONCLUSIONS: Veterans face a range of personal, societal, and logistical barriers to accessing care. In addition to decreasing wait times for appointments, efforts to improve the transition to civilian life; reduce stigma; and offer assistance related to work, housing, and convenient access to health care may improve health in veteran students.

A comparison of lesbian, bisexual, and heterosexual college undergraduate women on selected mental health issues.

OBJECTIVE: To investigate selected mental health characteristics of lesbians and bisexual undergraduate college women as compared with heterosexual college women. PARTICIPANTS: Self-identified lesbians and bisexual and heterosexual female college students who took part in the American College Health Association National College Health Assessment II (ACHA-NCHA-II) in Fall 2008, Spring 2009, and Fall 2009. METHODS: A secondary analysis of the ACHA-NCHA-II data set for 3 semesters was conducted. Comparisons of lesbians and bisexual and heterosexual female college students were made. RESULTS: Bisexual women reported the worst mental health status in all areas studied including anxiety, anger, depressive symptoms, self-injury, and suicidal ideation and attempts. Both bisexual women and lesbians had a far greater likelihood of having these mental health issues when compared with heterosexual women. Lesbians and bisexual women utilized significantly more mental health services (with the exception of clergy) than heterosexual women. CONCLUSIONS: College health professionals should recognize and address the mental health needs of bisexual and lesbian undergraduate college women.