A Culture of Inquiry: Practice-Based Knowledge for Nurse Leaders.

A culture of inquiry has not traditionally been associated with nursing leadership. As healthcare evolves, leaders must reevaluate barriers to improving healthcare outcomes. One noted barrier has been a need for more inquisitiveness to innovate. Through an American Organization for Nursing Leadership workgroup, the authors advanced the understanding of a "culture of inquiry," applying a practice-based learning approach for knowledge development. Three recommended foundational elements are psychological safety, building connections, and using design thinking at all organizational levels.

Nurses' Perceptions of Caring at Work: Mixed-Methods Study, Quantitative Report.

OBJECTIVES: Study objectives were to explore nurses' perceptions of self-care, co-worker, and leader caring within healthcare work environments and assess reliability of 3 Watson Caritas Scores. BACKGROUND: Assessing caring in an organization where Watson's Theory of Human Caring guides nursing practice offers insight into the professional practice environment. METHOD: This study reports quantitative data from mixed-methods descriptive, cross-sectional survey of 1307 RNs at a large healthcare system. RESULTS: Mean scores were self = 5.46, co-worker = 5.39, and leader score = 5.53, and median scores were >5.6 (range, 1-7). All scales had a positive and significant correlation to likelihood to recommend the organization, with the largest being feeling cared for by leaders. Internal reliability of the 3 scales was ≥0.9. CONCLUSION: Nurse perceptions of caring may influence the organization's reputation. Assessing the perception of caring among nursing staff after the introduction and enculturation of this framework is needed. Results support psychometric value for 3 Watson Caritas Scores.

Multivariate analysis of factors associated with smoking cessation in women.

BACKGROUND: Appropriate smoking cessation techniques, including counseling patients to stop smoking, could prevent multiple health-related problems. Identification of relevant factors in patients that smoke may be beneficial in targeting smoking cessation efforts. This investigation explores various factors associated with smoking cessation, specifically in women. METHODS: All women (n = 675) presenting to a breast health center over a one year period were surveyed regarding their tobacco use. Any association between smoking cessation and various factors was determined by multivariate analysis. RESULTS: Our population consisted of 47% African American women, 43% Caucasian women, and 10% women of other ethnicities. Sixty percent of all women never smoked. Of the women who had smoked, 57% quit. Except for alcohol use and exercise, no factor, including ethnicity, was associated with never smoking. Smoking cessation was associated with being married, being Caucasian, not using alcohol, and exercising. However, only Caucasian race and marriage were independently associated with smoking cessation. DISCUSSION: In our population, African American women had a lower proportion of smoking cessation than Caucasian women. In patients with similar access to care, specifically preventive care, there are ethnic and social differences in smoking cessation.

Self-reported differences in daily raw vegetable intake by ethnicity in a breast screening program.

PURPOSE: While the literature has no conclusive causal relationship between nutrition and breast cancer, diet is believed to play a role in the development of breast cancer. This investigation focuses on differences of dietary practice between Caucasians and African Americans in a cohort of women presenting for breast cancer screening. METHODS: Over a one-year period, 675 women presenting to the Breast Health Center at Tulane University Medical Center for an initial visit were given a self-reported health behavior questionnaire. Included in this survey were questions concerning the frequency of raw vegetable consumption and fat/oil intake. MAIN FINDINGS: The overall proportion of women who presented for breast cancer screening that reported daily raw vegetable consumption in the study group was 40%. There were statistically significant differences between proportions of Caucasian women's and African American women's consumption of daily raw vegetable (51% versus 29%, respectively; P < 0.0001). These differences were not seen in daily fat/oil intake. No differences were seen in socioeconomic measures. CONCLUSIONS: There is a substantial difference in the consumption of potentially protective foods among major ethnic groups. These dietary differences should be taken into account when investigating the ethnic differences in women with breast cancer, as well as the relationship between breast cancer and nutrition.

Socioeconomic Factors, not Ethnicity, Predict Breast Self-Examination.

The American Cancer Society has recommended monthly breast self-examinations (BSEs) to aid in the early detection of breast cancer. Compliance with BSE recommendations has been shown to be decreased in certain ethnic groups. This investigation evaluates relevant variables involved in BSE compliance in an urban breast cancer screening center. A survey over a 1-year period (June 1996-June 1997) was given to all patients on their initial visit to the Breast Health Center at Tulane University Medical Center. Demographic and socioeconomic factors associated with the compliance of BSE were explored. The overall rate of BSE was relatively high at 80%. There was no difference between ethnic groups in rates of BSE (Caucasians 21% versus African Americans 20%). Statistically significant variables associated with BSE noncompliance were high school education (did not complete high school 16% versus completed high school 33%; p < 0.0004), employment status (employed 16% versus unemployed 31%; p < 0.0004), and marital status (married 15% versus single/divorced 22%; p < 0.05). While the majority of women in our study practiced BSE and ethnicity did not predict BSE, several socioeconomic factors were predictive of BSE compliance. Efforts to increase community outreach to lower socioeconomic patients as well as efforts to ensure proficient BSE techniques by patients may help detect early breast cancer.