Implications on self-care behaviors among older Korean immigrants diagnosed with diabetes residing in the United States: a path analytical approach.

Background: Diabetes is a prevalent chronic disease. Although self-care is the crucial element in managing diabetes, older Korean immigrants with diabetes face challenges in performing effective self-care related to vulnerability as minority immigrants. Purpose: This study measures sociodemographics, self-efficacy, social support, diabetes knowledge, and diabetes self-care activities among older Korean immigrants in the United States. This study also aims to demonstrate the direct and indirect effects of the related factors on diabetes self-care activities using a path analysis. Methods: This study uses a cross-sectional design. Convenience sampling targeted Korean immigrants aged 55 or older using paper and online surveys. Four instruments were used to measure variables: self-efficacy was measured by the General Self-Efficacy scale, diabetes knowledge by the Simplified Diabetes Knowledge Test, social support by the Lubben Social Network Scale-6, and diabetes self-care by the Summary of Diabetes Self-Care Activities questionnaire. Using path analysis, the effects of related factors on self-care activities were analyzed. Results: 190 older Korean immigrants participated, 53.2% female, and 46.8% male. The mean age was 67.2 (SD = 9.9; range, 58-93). A path model shows that sociodemographics (sex, age, education, and years in the United States), diabetes knowledge, self-efficacy, and family support predict diabetes self-care. Conclusions: The path model demonstrates the effects of sociodemographics, self-efficacy, diabetes knowledge, and social support on diabetes self-care among older Korean immigrants. The findings can help to understand diabetes self-care among the minority ethnic older group and can be used to develop culturally tailored education, counseling, and healthcare services. Supplementary Information: The online version contains supplementary material available at 10.1007/s40200-023-01363-6.

Utilization of Orem's Self-Care Deficit Nursing Theory in Self-Care Among Older Korean Immigrants With Diabetes in the United States.

Background: Diabetes is a chronic illness and increasing among older populations. Self-care is a critical element in managing diabetes. Orem's Self-Care Deficit Nursing Theory (SCDNT) has been used and applied in nursing to explain significant self-care concepts. Although older Korean immigrants are marginalized in maintaining optimal health status and accessing adequate health services, related studies are still lacking. Utilization of Orem's SCDNT allows nurses to better understand associated factors in self-care among older Korean immigrants with diabetes. Purpose: The first aim is to explain the significant concepts of SCDNT. The second aim is to examine basic conditioning factors on self-care among older Korean immigrants with diabetes based on Orem's SCDNT. Methods: Each concept and structure of Orem's SCDNT was described with a table and figure. The 10 basic conditioning factors in self-care among older Korean immigrants with diabetes were investigated based on the previous literature and discussed in terms of Orem's SCDNT. Results: By exploring the 10 basic conditioning factors among older Korean immigrants, nurses can identify related factors in the self-care of this minority immigrant group and initiate the development of culturally tailored and age-specific nursing interventions. Implications for Nursing Practice: This study provides an understanding of related self-care factors among older Korean immigrants with diabetes. Additionally, the findings will help nurses to develop customized effective interventions and implement appropriate diabetes care for this minority group.

Associations and Predictive Pathways Between Shared Governance, Autonomy, Magnet Status, Nurse-Sensitive Indicators, and Nurse Satisfaction: A Multisite Study.

BACKGROUND: Evidence is limited to the effects of shared governance (SG) and autonomy on nurse-sensitive indicators (NSIs). PURPOSE: To explore the effects of SG, autonomy, and Magnet status on nurse and patient outcomes. METHODS: A cross-sectional survey study was conducted using a convenience sample of 404 nurses from 4 hospitals. Descriptive analyses of variance (ANOVAs), and path analysis were conducted to identify hypothesized associations and predictive pathways among study variables. RESULTS: Nurse managers reported higher perceptions of SG, autonomy, and satisfaction than staff nurses. SG and autonomy were significant predictors of patient falls and hospital-acquired pressure injuries. Nurses' autonomy, SG, and Magnet accreditation were significant predictors of nurse satisfaction. CONCLUSIONS: Leadership support of SG and autonomous practice are key strategies to improve nurse satisfaction and NSI outcomes.

Reliability and Validity Evidence for Health Care-Seeking Behavior Questionnaire on Sexual Health Among Filipino Men: A Confirmatory Factor Analysis.

Background and Purpose: Healthcare-seeking behavior is an issue affecting the promotion of sexual health among Filipino men. However, tools to measure healthcare-seeking behaviors among men, in general, are scarce. This study aimed to find evidence of validity and reliability of the Health Care-Seeking Behavior Questionnaire (HCSBQ). Methods: A cross-sectional online survey was conducted among N = 464 Filipino men. Linear Structural Relations (LISREL®) was used for statistical analysis. Results: The HCSBQ demonstrates validity and reliability after data analysis. The overall Cronbach's alpha of 0.94 shows excellent internal consistency. The exploratory factor analysis revealed three latent variables, namely, interactional, intellectual, and active and decision-making. Cronbach's alpha for each latent variable is 0.91, 0.84, and 0.88, respectively. A confirmatory factor analysis shows an excellent goodness-of-fit indices (Adjusted Goodness-of-Fit Index [AGFI] = .95; Goodness-of-Fit Index [GFI] = .97; Comparative Fit Index [CFI] = .99; Incremental Fit Index [IFI] = .99; Expected Cross Validation Index [ECVI] = .45; and Root Mean Square Error of Approximation [RMSEA] = .03). Conclusions: The HCSBQ is a valid and reliable tool to measure healthcare-seeking behaviors among Filipino men.

Psychometric Properties of General Self-Efficacy (GSE) Scale Korean Version for Older Korean Immigrants with Diabetes: A Cross-Sectional Study in the United States.

Patients with diabetes must have self-efficacy to perform necessary self-care tasks. Self-efficacy has been considered as one of the primary motivators on diabetes self-care; therefore, it is essential for health care professionals to assess the self-efficacy of patients with diabetes to provide optimal care. Despite older Korean immigrants having greater difficulty in diabetes management, research on self-efficacy for them is lacking. This study aims to examine the psychometric property of the General Self-Efficacy scale Korean version for older Korean immigrants with diabetes in the United States. In this cross-sectional, methodological study, data were collected using convenience sampling. Cronbach's alpha, exploratory factor analysis, and confirmatory factor analysis were employed to examine the psychometric properties. Cronbach's alpha for the entire GSE scale Korean version is 0.81. The initial Eigenvalues show two factors, coping and confidence; however, the confirmatory factor analysis showed reasonable goodness of fit to the data (χ2(35) = 86.24, p < 0.01), χ2/df ratio = 2.46, AGFI = 0.87, GFI = 0.91, IFI = 0.90, ECVI = 0.74, CFI = 0.89, and RMSEA = 0.093 in the one-factor model. The General Self-Efficacy scale Korean version demonstrated acceptable reliability and validity. It can be used to investigate self-efficacy and to devise culturally tailored diabetes interventions.

Reliability and Validity Evidence for Brief Sexual Attitudes Scale (BSAS) Among Filipino Men: A Confirmatory Factor Analysis.

Background and Purpose: It is essential to address sexual health to ensure quality of life and sexual well-being; however, studies to measure sexual attitudes remain scarce. This aimed to find reliability and validity evidence of the Brief Sexual Attitudes Scale (BSAS) using confirmatory factor analysis (CFA) among Filipino men. Methods: A cross-sectional study was conducted. Results: BSAS shows Cronbach's alpha of 0.90. CFA demonstrates goodness of fit (adjusted goodness-of-fit index = .82; goodness-of-fit index = .86; comparative fit index = .91; incremental fit index = .91; expected cross-validation index = 2.27; root mean square error of approximation = .08; [χ2 (213) = 927.45, p ≤ .001], χ2/df ratio 4.35). Conclusions: BSAS is a valid and reliable questionnaire to assess sexual attitudes among Filipino men. Further research is needed to evaluate sexual attitudes in the promotion of sexual health across cultures.

Acculturation, Cultural Beliefs, and Cardiovascular Disease Risk Levels Among Nigerian, Ghanaian and Cameroonian Immigrants in the United States.

Cardiovascular disease (CVD) is the leading cause of death in the United States (U.S.). Immigrant groups from sub-Saharan Africa in the U.S. have higher CVD risk than their African American counterparts. This study examines associations of sociodemographic factors (age, sex, education, & income) to acculturation, cultural beliefs, and CVD risk levels (CVDRL) among Nigerian, Ghanaian, and Cameroonian immigrants (NGCI) in the U.S. A correlational cross-sectional design was used. Data from a convenience sample (n = 178) of NGCI were analyzed using correlations, regressions, and path analysis. Acculturation had a statistically significant influence on cultural beliefs (ß = 0.16, P < .05). Age, sex, and education were the strongest predictors of CVDRL among the NGCI sample. High acculturation among NGCI in the U.S. have been associated with more health-promoting cultural beliefs. It is important that NGCI who may have difficulties understanding the culture of the U.S. healthcare system receive quality care.

Comparison of Health-Promoting Behaviors of Nursing Students From Different Racial/Ethnic Groups.

BACKGROUND: Despite the known benefits of maintaining a healthy lifestyle in preventing many health-related issues, few nursing students practice health-promoting behaviors (HPB). METHOD: This cross-sectional, descriptive, correlational study included 866 undergraduate nursing students who were members of the National Student Nurses' Association. RESULTS: The difference in mean Health-Promoting Lifestyle Profile-II scores between White people and Asian Americans was statistically significant (F [4, 861]) = 2.95, p = .019). The difference in the mean self-efficacy scores between Black people and Asian Americans also was statistically significant (F [4, 861] = 4.41, p = .002). The regression model was significant (F [1, 862] = 6.683, p = .001, R2 =.235)], and self-efficacy (ß = .457, t = 15.178, p = .001) significantly predicted nursing students' HPB. CONCLUSION: The differences between racial/ethnic groups noted in this study indicate nursing faculty need to render culturally sensitive interventions to promote self-efficacy and HPB among undergraduate nursing students. [J Nurs Educ. 2021;60(9):500-508.].

Thoughts About Nursing Curricula: Dark Clouds and Bright Lights.

In this essay, several nurse scholars who are particularly concerned about the contemporary state of nursing science present their concerns about the inclusion of nursing conceptual models and theories in the curricula of nursing programs (dark clouds) and ways in which the concerns have been addressed (bright lights). This essay is the second of two essays that were catalyzed by Barrett's paper, "Again, What Is Nursing Science?" The first essay was published in the previous issue of Nursing Science Quarterly.

Sociodemographic and Obstetric Factors Related to Symptoms of Postpartum Depression in Hispanic Women in Rural California.

OBJECTIVE: To investigate the relationships among sociodemographic and obstetric factors and symptoms of postpartum depression (PPD) in Hispanic women living in rural California. DESIGN: Quantitative, cross-sectional, descriptive design. SETTING: Rural southern California communities. PARTICIPANTS: A convenience sample of 223 Hispanic women, ages 18 to 42 years old, with one living infant younger than 12 months old. METHODS: Interviewer-administered Edinburgh Postnatal Depression Scale and sociodemographic and obstetric history survey (maternal age, marital status, education, annual household income, employment, sex of infant, birth type, and number of children). Chi-square and logistic regression analyses were used to determine associations and predictive relationships among sociodemographic and obstetric factors and symptoms of PPD. RESULTS: Low education levels, unemployment, cesarean birth, and more than one young child were significantly related to PPD risk (Edinburgh Postnatal Depression Scale scores ≥ 10). Many of the factors associated with PPD symptoms in this sample of Hispanic women were similar to those previously reported in the literature. CONCLUSION: Our findings highlighted the need for PPD care among Hispanic women in rural areas. Early assessment and intervention for symptoms of PPD are needed to enhance health equity and promote better health for women who live in rural communities.

Self-Care for Health in Rural Hispanic Women at Risk for Postpartum Depression.

OBJECTIVE: To determine factors that affect self-care of rural Hispanic women at risk for postpartum depression (PPD). METHODS: This study was a descriptive cross-sectional design based on the key concepts of Orem's Self-care Deficit Nursing theory. Data were collected from 223 Hispanic postpartum women residing in Mecca, North Shore, and Thermal in California by an interviewer-administered survey. Four instruments were utilized: Edinburgh Postnatal Depression Scale (EPDS) for PPD, Multidimensional Scale of Perceived Social Support for social support, Duke University Religion Index (DUREL) for spirituality, and Self Rated Abilities for Health Practices for self-care. RESULTS: The prevalence of women at risk for PPD was about 43 %. Social support, spirituality, and self-care ability were significantly correlated in women with PPD. Social support was a strong factor in predicting self-care ability for 'Nutrition', 'Psychological well-being', 'Exercise', and 'Responsible Health Practices' in the rural Hispanic women at risk for PPD. CONCLUSIONS: The study findings can enable nurses and healthcare professionals to develop effective tailored interventions to assist rural Hispanic women's abilities to perform self-care for health, and in particular, during the postpartum period.

Does administrative support negate the consequences of nurse abuse?

AIM: To assess the relationship between disruptive/abusive situations and the 'intention to leave' nursing. BACKGROUND: While every nurse deserves to feel safe in his or her working environment, nurse abuse remains a common occurrence worldwide. Only when hospitals are safe, is retention enhanced and patient care improved. METHOD: A cross-sectional survey was conducted with 1053 nurses. RESULTS: Almost 70% of nurses experienced stressful disruptive/abusive situations that were mainly caused by patients/families. The majority felt skilled in dealing with these situations, yet around 40% considered leaving nursing because of disruption/abuse. Stress from disruption/abuse, the skill in dealing with abuse and the administrations' support were the best predictors for the 'intention to leave'. CONCLUSIONS: It may not be the amount of abuse per se that affects the nurses' intention to leave, but rather how the abuse is perceived, the skill in dealing with it and the support received from administration. IMPLICATIONS FOR NURSING MANAGEMENT: The support received from nursing administration may negate the effect of stress and the 'intention to leave' because of disruptive/abusive situations. This should behove nurse managers and administrators to have a system in place to provide support for nurses, which in turn could improve job satisfaction and retention.

Substance abuse In Middle Eastern adolescents living in two different countries: spiritual, cultural, family and personal factors.

It is estimated that the percentage of students using illicit substances by sixth grade has tripled over the last decade not only in developed countries but in developing countries as well probably due to the transition to a more Western society. Although much has been done to understand the mechanisms underlying substance abuse, few studies have been conducted with minority ethnic and religious groups such as Middle Eastern Youth. The primary goal of this study was to determine whether there are differences in factors contributing to substance abuse in adolescents from Lebanon versus the U.S.A. and to decipher the role of spirituality, religion, and culture among other factors that may influence substance abuse. A correlational cross-sectional design was used with adolescents living in two different countries: Los Angeles, California and Beirut, Lebanon. Muslim adolescents had significantly less rates of alcohol and substance use than Christians in both Lebanon and Los Angeles. More years lived in the U.S.A. increases the likelihood of abuse for both Muslims and Christians. Attachment to God and family was negatively associated with substance abuse. These results among others facilitate a better understanding of the influence of culture, religion, family and personal factors on substance abuse. Culturally sensitive interventions could benefit from the findings of this pilot study.

The validation of the Coping and Adaptation Processing Scale based on the Roy adaptation model.

BACKGROUND AND PURPOSE: To establish the psychometric soundness for Coping and Adaptation Processing Scale (CAPS) using the Roy adaptation model as theoretical framework. METHOD: A descriptive, cross-sectional survey of a convenience sample of 199 nurses working in different acute health care facilities in California. The internal consistency of the multifactor CAPS questionnaire was explored using Cronbach's alpha coefficient. Factors correlation was examined using Pearson product moment correlation. The factor structure was studied using confirmatory factor analyses. RESULTS: In the confirmatory factor analysis, the indices of fitness highly supported these results. The Cronbach's alpha coefficient for the total score was .81 and varied between .31 and .78 in the 5 domains. A positive and significant correlation emerged between CAPS factors and total scores (r = .91, p < .01) ranging from .17 to .81. CAPS showed acceptable validity and reliability for measuring the coping of nurses in acute setting. Future studies using the scale might lead to the improvement of the subscales measurement. CONCLUSION: The psychometric data suggests that CAPS is a highly suitable instrument to measure coping processes.

Assessment of chemotherapy-induced nausea and vomiting in women with breast cancer: a Neuman systems model framework.

The importance of nursing theory and models for the development of the nursing profession is becoming increasingly evident in literature. This article demonstrates the use of the Betty Neuman Systems Model (NSM) to assess, as well as determine the predictors of chemotherapy-induced nausea and vomiting (CINV) in patients diagnosed with breast cancer receiving doxorubicin-based chemotherapy. The selection of the model for practice reflects the congruency between the level of severity of CINV and the patient-related risk factors. In addition, the NSM was used to determine the appropriate nursing interventions necessary to strengthen the flexible lines of defense and the lines of resistance in addition to maintaining system stability.

Clinical nurse specialists shaping policies and procedures via an evidence-based clinical practice council.

In the practice of nursing, organizations with progressive evidence-based practice programs implement structures and processes whereby nurses are engaged in the review of existing research and in the development of clinical practice documents to better align nursing practices with the best available scientific knowledge. At our academic hospital system, clinical nurse specialists (CNSs) took the lead to help transform a traditional nursing policy and procedure committee into a hospital-wide, staff-represented Clinical Practice Council (CPC) that ensures evidence-based nursing practices are reflected in the organization's nursing practice documents for the provision of patient care. Clinical nurse specialists function as mentors and cochairs who are dedicated to ensuring that nursing practice is supported by the latest evidence and committed to guiding staff nurses to continually move their practice forward. The success of the CPC is due to the leadership and commitment of the CNSs. This article describes the structure, process, and outcomes of an effective CPC where CNSs successfully engage frontline clinicians in promoting nursing care that is evidence based. Clinical nurse specialist leadership is increasingly made visible as CNSs effectively involve staff nurses in practice reforms to improve patient outcomes.

Effect of early nutritional support on intensive care unit length of stay and neurological status at discharge in children with severe traumatic brain injury.

Pediatric severe traumatic brain injury treatment guidelines for nutrition indicate that "there are insufficient data to support a treatment guideline for this topic" (P. D. Adelson et al., 2003). Based on adult studies, the guideline provided an option for practitioners to start nutritional support within 72 hours of admission and full replacement by day 7. This retrospective, descriptive correlation study examined the timing of nutritional supplement initiation and the timing of achieving full caloric intake in relation to length of stay (LOS) in the intensive care unit (ICU) and patient disposition status at discharge from hospital in children 8-18 years old. Median time to initiation of nutrition was 1.5 days (0.02-11.9 days), and full caloric goals were achieved in 3.4 days (0.5-19.6 days). Median ICU LOS was 2.1 days (0.01-97.9 days). Overall, 48% of patients were discharged home; 28% experienced mild, moderate, or severe disability; and 24% either died or survived in a vegetative state. Early initiation and achieving full caloric intake were both positively correlated with shorter LOS in the ICU (p < .01, Spearman's rho correlational matrix) and better disposition status at discharge from the hospital (p < .05, Kruskal-Wallis test).

An educational project to improve knowledge related to pulse oximetry.

BACKGROUND: Pulse oximetry is a frequently used, noninvasive monitoring tool for assessing arterial blood oxygenation. Physicians, registered nurses, and respiratory therapists are responsible for the accurate interpretation of pulse oximetry data as part of the evaluation and management of acutely and critically ill patients. OBJECTIVES: (1) To evaluate the extent of current knowledge about pulse oximetry and (2) to increase clinicians' knowledge of research-based practices related to the appropriate use of pulse oximetry and interpretation of its results. METHODS: A test/survey of 17 true-false questions based on the research-based practice protocol of the American Association of Critical-Care Nurses was developed to evaluate current knowledge of pulse oximetry. A convenience sample of medical, nursing, and respiratory therapy staff was invited to complete the test/survey before and several months after an educational program to improve staff members' knowledge of pulse oximetry. The program included educational forums, policy changes, competency checklists, and verification of inclusion of research-based principles in orientation programs. RESULTS: A total of 442 staff members completed the test/survey given before the educational program: 331 nurses, 82 physicians, and 29 respiratory therapists. The overall mean percentage of correct answers was 66%. Differences between disciplines were significant: respiratory therapists scored slightly higher (76%) than did nurses (64%) and physicians (66%) (P = .01). The scores on the test/survey given after the educational program increased significantly, from 66% to 82% (P < .01). CONCLUSIONS: This educational project improved staff members' knowledge of pulse oximetry monitoring.