Reading a Q Methodology Research Article.

Health care studies that use Q methodology have increased dramatically in recent years, but most nurses have not learned about this mixed methods approach in their research classes. This teaching column will help readers understand some of the unique terms and characteristics of Q methodology. Understanding this method can help nurses performing evidence-based practice and education. [J Contin Educ Nurs. 2022;53(1):10-12.].

A scoping review of Q methodology nursing education studies.

OBJECTIVES: The purpose of this review was to examine the characteristics of published Q methodology nursing education studies including the purposes, the methodological variations, and the major implications to inform best practices. DESIGN: Scoping review design using the Preferred Reporting Items for Systematic Reviews Extension for Scoping Reviews. DATA SOURCES: Academic Search Complete, CINAHL Complete, Education Research Complete, Embase, ERIC, Proquest Nursing and Allied Health, PubMed, PsycInfo, SocINDEX, and the Web of Science Core Collection. REVIEW METHODS: A comprehensive search of English language journal articles was conducted for Q methodology studies published between 2015 and 2020 that used undergraduate nursing students or nursing faculty as participants. Data were extracted using a modified version of the Assessment Review Instrument for Q Methodology. RESULTS: Eighteen studies from five countries met inclusion criteria. The majority were single-site studies and used nursing students as participants. The number of stimuli for sorting in the Q sample ranged from 21 to 60. Study aims fell into three broad domains: attitudes about patient populations or settings (N = 7), perceptions about teaching methods (N = 9), or beliefs about professional/practice issues (N = 2). Seven studies specifically explored simulation. Unique viewpoints discovered ranged from one to five in each study. Findings were used to inform teaching, create curricula, evaluate programs, and to generate more questions for study. Strategies for reporting the Q methodology research steps and findings varied significantly. CONCLUSION: Q methodology is a useful research approach to discover variations in perspectives to inform best educational practices. Use of a standardized flow sheet could enhance reporting the Q methodological approach which may lead to a better understanding and acceptance of the method in the discipline.

Family perception of and experience with family presence during cardiopulmonary resuscitation: An integrative review.

OBJECTIVE: The objective was to consider family presence during resuscitation (FPDR) from the perspective of the family member. BACKGROUND: FPDR has been a topic of interest internationally since the first report of this practice more than 25 years ago. Worldwide, many studies have provided insight into the perspective of healthcare professionals (HCPs); however, there is limited research on the perspective and experiences of family members. DESIGN: An integrative review was conducted. An electronic database search was conducted for the years from 1994-2017. METHODS: The Cumulative Index of Nursing and Allied Health Literature (CINAHL), PyschINFO, Academic Search, SocINDEX, PubMed, ProQuest databases and Google Scholar were searched. Search terms were family perceptions, family presence and resuscitation. RESULTS: Twelve reviews met inclusion criteria. Findings suggest that family members view family presence as a fundamental right. Family members involved in a FPDR experience reported that their presence benefitted the patient and healthcare team. In an international sample of studies, family presence overall was viewed positively by family members and they voiced wanting to be given an option to be present during a loved one's resuscitation. CONCLUSIONS: Findings support that family members' desire for FPDR; however, the literature reflects that HCPs do not always embrace the practice of FPDR. Stronger educational preparation of nurses and other HCPs related to FPDR is warranted. Policy initiatives include the formulation of policies that allow family presence during resuscitation of a family member. RELEVANCE TO CLINICAL PRACTICE: The findings are relevant for a clinical practice that promotes a more family-centred approach to allowing FPDR. Creating policy and providing FPDR education for HCPs based on evidence provide more consistency in clinical practice and help to eliminate the moral distress experienced by clinical nurses forced to make difficult decisions during a stressful event.

Characteristics of Reviews Published in Nursing Literature: A Methodological Review.

Integrative and systematic reviews present synthesized research. Scholars have called for increased rigor and reporting in reviews. The purpose of this methodological review was to describe the characteristics of nurse-led reviews. The Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines directed the review process. Many reviews did not clearly report the search strategy used and methods for data extraction and quality appraisal, indicating that there has not been an increase in rigor. Authors of reviews are encouraged to report sufficient methodological details, so peer reviewers and consumers can determine whether the methods were rigorous enough to contribute meaningful results.

Considerations when conducting e-Delphi research: a case study.

Background E-Delphi is a way to access a geographically dispersed group of experts. It is similar to other Delphi methods but conducted online. E-research methodologies, such as the e-Delphi method, have yet to undergo significant critical discussion. Aim To highlight some of the challenges nurse researchers may wish to consider when using e-Delphi in their research. Discussion This paper provides details about the author's approach to conducting an e-Delphi study in which a group of health literacy nurse experts (n=41) used an online survey platform to identify and prioritise essential health literacy competencies for registered nurses. Conclusion This paper advances methodological discourse about e-Delphi by critically assessing an e-Delphi case study. The online survey platform used in this study was advantageous for the researcher and the experts: the experts could participate at any time and place where the internet was available; the researcher could efficiently access a national group of experts, track responses and analyse data in each round. Implications for practice E-Delphi studies create opportunities for nurse researchers to conduct research nationally and internationally. Before conducting an e-Delphi study, researchers should carefully consider the design and methods for collecting data, to avoid challenges that could potentially compromise the quality of the findings. Researchers are encouraged to publish details about their approaches to e-Delphi studies, to advance the state of the science.

Health Literacy Competencies for Registered Nurses: An e-Delphi Study.

BACKGROUND: The Institute of Medicine's landmark report, Health Literacy: A Prescription to End Confusion, recommends that health professionals be trained to effectively communicate with patients with limited health literacy. Nurse-specific competencies that explicitly address the needs of patients with low health literacy are lacking. METHOD: A national group of nurse health literacy experts (N = 41) participated in a three-round e-Delphi study to identify essential health literacy competencies for RNs in any work setting. RESULTS: Based on partial replication of prior work by Coleman, Hudson, and Maine, a final list of 50 nursing health literacy core competencies were identified in round two and prioritized in round three. CONCLUSION: The final list of prioritized competencies generated in this study have been provided as a starting point for health literacy education efforts in practice. J Contin Educ Nurs. 2016;47(12):558-565.

Registered Nurses' Experiences With Individuals With Low Health Literacy: A Qualitative Descriptive Study.

The nursing profession is charged to provide effective communication and education to patients. A qualitative descriptive study that explored what nurses experience when interacting with patients thought to possess low health literacy was performed. Findings suggest that nurses are promoting health literacy using several evidence-based strategies. Major barriers encountered by nurses were limited cultural and linguistic resources within their healthcare organizations. This study provides nursing professional development specialists information about the educational gaps of nurses in practice related to health literacy and the identification of systems barriers.

Barriers to Asthma Management for School Nurses: An Integrative Review.

Childhood asthma is a growing health concern. Asthma is the most common chronic illness of childhood and a leading cause of emergency room visits, hospitalizations, and school absenteeism. School nurses play a valuable role in asthma management. The purpose of this integrative review is to examine barriers to asthma management for school nurses in the school setting. Findings revealed multiple barriers school nurses encounter in managing asthma. Six themes emerged that included lack of resources and support, insufficient time, communication challenges, limited knowledge, and lack of awareness of school nurses' expertise. Students, parents, primary care physicians, school administration, staff, and school nurses themselves all play a role in constructing barriers to asthma management. There is a need for school nurses and school nurse leaders to focus efforts to develop strategies to overcome barriers to ensure evidence-based, best practice management of asthma in the school setting.

Health Literacy Education in Health Professions Schools: An Integrative Review.

BACKGROUND: Most Americans lack the health literacy skills to function in today's health care environment. The Institute of Medicine's Health Literacy: A Prescription to End Confusion report recommended that health professionals be trained to effectively communicate with patients with low health literacy. METHOD: An integrative review was conducted, using six electronic databases: CINAHL, ERIC, MEDLINE, PsycINFO, SocINDEX, and Web of Science. RESULTS: Nine articles met the inclusion criteria. Educational interventions include multimodal approaches using didactic content, followed by active learning strategies. Evaluative methods in the classroom were used in all studies; however, only one study assessed students' health literacy skills. CONCLUSION: Findings support research efforts that (a) clarify where health literacy should be taught, (b) target the assessment of students' health literacy skills, (c) perform rigorous psychometric testing of evaluative instruments used, and (d) create interprofessional learning opportunities.

Measuring critical thinking dispositions of novice nursing students using human patient simulators.

This study assessed the influence of human patient simulator (HPS) practice on critical thinking dispositions in a sample of novice baccalaureate nursing students. Eighty-five second-year nursing students were randomly assigned to an experimental (n = 42) or a control (n = 43) group based on exposure to a 2-hour HPS practice session prior to a course competency examination. The California Critical Thinking Disposition Inventory (CCTDI) was administered before and after the competency examination. No between-group differences were found on overall or subscale CCTDI mean scores. Within-group differences for the HPS practice group were significant for overall scores (p < 0.05) and the truth-seeking (p < 0.01) and judiciousness or maturity of judgment (p < 0.01) subscales. This preliminary data analysis suggests disposition gains for individual students practicing critical assessment skills using HPS. The cohort will be followed for 2 years to assess long-term critical thinking outcomes following practice with HPS.

Registered nurses and influenza vaccination. An integrative review.

Influenza is a serious infectious disease, causing 226,000 hospitalizations and 36,000 deaths in the United States each year. Since 1981, the Centers for Disease Control and Prevention (CDC) has recommended that all health care workers receive influenza vaccination annually. Current CDC reports indicate that only 40% of health care workers receive influenza vaccination. Vaccination rates are lower among registered nurses than other health care workers. This integrative review encompasses international research published between 2003 and 2009, and explores factors that influence nurses' decision to receive or decline influenza vaccination. Findings indicated that concerns about the vaccine's safety and efficacy continue to be major barriers for registered nurses. Future efforts to improve vaccination rates should include rigorous education on vaccine efficacy and safety specific to nursing personnel.