"At the End We Feel Forgotten": Needs, Concerns, and Advice from Blogs of Dementia Family Caregivers.

Illness blogs have been used by many individuals to describe their experiences, share knowledge, and gather support. The purpose of this study was to identify needs, concerns, and advice from the blogs of caregivers caring for a person with dementia at the end of life (EOL). A qualitative thematic analysis was performed of 192 blog postings from six dementia family caregivers during the EOL. A Google search using a systematic identification method was followed. Caregivers were females caring for mothers (n = 5) and husbands (n = 1). Themes varied by EOL stage within the contextual environment of Grief/Loss, Family, and Spirituality. Pre-death themes were Care Transitions and Quality; dying were Physical and Emotional Aspects; and post-death were Relief and Remembering. Four additional themes transitioned across stages: Decision-Making, Health Care Providers, Advice, and Caregiver Support. Findings suggest caregiver needs, concerns, and advice vary by EOL stage. Implications for tailored interventions should be considered.

Predictors of Hospital Nurses' Cultural Competence: The Value of Diversity Training.

BACKGROUND: RNs must be culturally competent to facilitate optimal health outcomes for diverse patients and families. The purpose of this study was to identify factors associated with cultural competence in hospital nurses. METHOD: In this cross-sectional, descriptive study, the Cultural Competence Assessment Tool was administered to RNs (N = 74) from a 500-bed urban medical center in the southeastern United States. The mean age of participants averaged 40.6 (SD = 11.0) years, and most participants were White (63%) and had encountered more than five (66%) different cultures in their work environment in the prior 12 months. Forty-two percent had received two or more different types of diversity training (M = 1.6, SD = 1.1). RESULTS: Mean score for overall cultural competence was 7.3 (SD = 0.8) on a scale of 0 to 10 (10 = highest possible). Years of education was positively associated with diversity training (r = 0.31, p < .01) and cultural competence (r = 0.25, p < .05). Only diversity training predicted greater cultural competence (ß = 0.40, p = .001). CONCLUSION: Results suggest that diversity training is associated with greater cultural competence. Further research is needed to identify optimal types, dose, and frequency of diversity training to enhance overall cultural competence. [J Contin Educ Nurs. 2019;50(10):469-474.].

Diabetes detachment: How cultural, contextual, and personal barriers influence low-income young women with diabetes in Appalachia.

AIM: This study explored the experiences of young low-income women with type 2 diabetes (T2D) in Appalachia, Tennessee. BACKGROUND: Diabetes care remains suboptimal across the United States particularly in underserved communities. METHODS: The study employed a descriptive qualitative case study collecting data using in-depth interview of a group of low-income women in their 20s with T2D. Data was analyzed using qualitative content analysis. RESULTS: The findings identified three themes: "frustration and stigma lead to detachment care," "frozen by fear and unable to overcome resource limitations" and "social support and an empowered perspective lead to a positive outlook." Cultural barriers combined with contextual and personal barriers resulted in detachment from diabetes care among study participants. CONCLUSION: Within Appalachia, leveraging the existing familism values along with culturally congruent education and support can help alleviating the burden of diabetes care.