An integrative review of humanities-based activities in baccalaureate nursing education.

PURPOSE: The American Association of the Colleges of Nursing has stressed the importance of the liberal arts as a foundation of nursing education that supports the development of clinical reasoning and judgments in their recently updated essentials for professional nursing education. The purpose of this research was to conduct an integrative review of the literature to explore the use of the humanities in baccalaureate nursing programs. RESEARCH QUESTION: Among undergraduate nursing programs, what types of humanities interventions were used in nursing courses and what were the outcomes of these interventions? THEORETICAL FRAMEWORK: This research was guided by the Aesthetic Knowing and Knowledge conceptual model by Chinn and Kramer, which is based on the Fundamental Patterns of Knowing in Nursing by Carper. METHODS: An integrative review method, as outlined by Whittemore and Knafl, was used for this research. RESULTS: After analysis of 227 titles, 19 studies were selected. Studies used art, literature, music and dance-based interventions. A key theme in examining the use of humanities in nursing education is its connection to aesthetic knowing in nursing. This included moral/ethical comportment, therapeutic use of self and scientific competence, as outlined in the Aesthetic Knowing and Knowledge conceptual model by Chinn and Kramer. Additionally, several other common themes emerged across the studies as nursing students reflected on the impact of the inclusion of humanities in their nursing curricula. Nursing student-recognized benefits included enhanced learning, emotional development, communication and new insights into best nursing practices. CONCLUSIONS: Humanities-based interventions are a useful addition to undergraduate nursing education. Future research should use randomized controlled designs to strengthen the body of literature regarding this topic.

The Experience of New Graduate Registered Nurses as Managers of Pain.

BACKGROUND: Beginning their post-licensure clinical practice can be a challenging time for new registered nurses. Pain management is considered an essential responsibility for nurses, requiring pain management that is prompt, safe and effective. Research is needed to examine the experiences of new registered nurses as they adjust to their new role using what they have already learned about pain and pain management. PURPOSE: To examine the lived experiences of new registered nurses, who have been in the role less than a year, as they transition into their registered nurse role as a manager of pain utilizing what they have learned about pain and pain management in the undergraduate program and/or continuing professional development. DESIGN: This research was a phenomenological study in which interviews were audio-recorded and transcribed verbatim. PARTICIPANTS/SETTING: Eight new graduate registered nurses employed less than a year at a 415-bed regional hospital were interviewed. METHODS: Content analysis guidelines were used for the analyses of texts. RESULTS: Themes of navigating relationships, the practice of pain management and disconnect between school and real life were developed from the analyses of texts. CONCLUSIONS: Knowledge generated from this study can be used to better understand the experience of new graduate registered nurses regarding pain management and enhance pain management curricula in undergraduate nursing education and continuing professional development.

Longitudinal differences in pain among older adult Home and Community Based Waiver Program participants in relation to diagnosis of cancer.

Generalized estimating equation analyses models were used to examine the longitudinal association between pain and diagnosis of cancer among older adult, Home and Community Based Waiver Program participants. Daily pain was reported by over half, with 29% experiencing daily pain that was unusually intense. Diagnosis of cancer was a significant predictor of daily pain only as an interaction term with cognitive impairment. Being female, having a medical diagnosis of depression, or increasing measure of comorbid conditions significantly increased the likelihood of daily pain. In comparison, increasing age, being of African American, Hispanic, or "other" race resulted in a significantly decreased likelihood of daily pain.

Associations among indicators of depression in Medicaid-eligible community-dwelling older adults.

PURPOSE: The purpose of this research was to examine associations among 2 separate Minimum Data Set-Home Care (MDS-HC) depression measures (the Depression Rating Scale [DRS] and medical diagnosis of depression) with billed antidepressant medications in Medicaid paid claim files. DESIGN AND METHODS: The sample for this cross-sectional research included 3,041 Medicaid-eligible older adult participants in a Home and Community Based Waiver Program and used data from the MDS-HC, Version 1 and Medicaid Paid Claim Files. Sensitivity and specificity analyses, receiver operating characteristic (ROC) curve analysis, and t tests were utilized. RESULTS: DRS scoring indicated that 15.4% of participants had behaviors indicative of depression, whereas 42% had a medical diagnosis of depression noted in the MDS-HC. Of those with a medical diagnosis of depression, 51% had a prescribed antidepressant medication. ROC analysis suggested that the DRS was a poor distinguisher of participants with and without a medical diagnosis of depression or prescribed antidepressant medications. IMPLICATIONS: Approximately half of Medicaid-eligible older adults medically diagnosed with depression were treated pharmacologically. Longitudinal research is recommended to assess responsiveness of the DRS over time to pharmacological and psychotherapeutic interventions for depression.

The effects of mastery on pain and fatigue resolution.

PURPOSE/OBJECTIVES: To determine whether mastery, the personal control felt over occurrences perceived to have an important effect on one's life, influences the resolution of pain and fatigue severity. DESIGN: Secondary data analysis of two randomized clinical trials. SETTING: Accrual from two comprehensive cancer centers, one community oncology program, and six hospital-affiliated ambulatory oncology centers. SAMPLE: 330 patients with solid tumors who were undergoing chemotherapy and receiving a nurse-presented, six-contact, eight-week intervention for symptom management. METHODS: Analysis included baseline and interventional data. Logistic regression and survival analysis methods were used to explain relationships between mastery and time to resolution and resolution of pain and fatigue severity. MAIN RESEARCH VARIABLES: Mastery, pain and fatigue severity resolution, and time to resolution. FINDINGS: No significant differences in mastery were found among key socioeconomic and cancer-related variables. Mastery was a significant predictor of pain resolution status but did not significantly decrease time to resolution. Mastery did not have a significant effect on fatigue resolution status or time to fatigue resolution after adjusting for other covariates. CONCLUSIONS: Mastery was symptom specific, predicting pain resolution but not fatigue. Cancer may have an equalizing effect on mastery early in diagnosis and treatment. IMPLICATIONS FOR NURSING: Nurses should develop interventions that increase mastery in patients with cancer, which may lead to improved resolution of pain. Additional research is needed to explore how mastery may affect resolution of pain severity and other symptoms experienced by people with cancer.