Associations between nurse characteristics, institutional characteristics and perceived nurse knowledge and self-efficacy of reporting suspected child abuse and neglect.

AIM: To determine the association between nurse and institutional characteristics and perceived professional nurse knowledge and self-efficacy of reporting child abuse and neglect. DESIGN: A sample of N = 166 nurses were recruited to respond to the Reporting of Suspected Child Abuse and Neglect (RSCAN) survey. METHODS: A multiple linear regression examined whether nurse characteristics and institutional characteristics were associated with the two RSCAN survey domain scores. RESULTS: Perceived knowledge of a workplace child abuse and neglect protocol was associated with the knowledge subscale. Education and child abuse and neglect expertise were significant predictors of the self-efficacy subscale. Nurses with a master's or higher degree and those who identified as being either forensic, paediatric or Emergency Department nurses, had less perceived institutional barriers to self-efficacy of reporting child abuse and neglect. CONCLUSION: This study provides a preliminary insight into the institutional barriers and facilitators of nurses as child abuse and neglect mandated reporters. IMPLICATIONS FOR THE PROFESSION AND/OR PATIENT CARE: To encourage innovative education and collaborations to support nurses as fully informed child abuse and neglect mandated reporters. IMPACT: This research identifies the gaps and facilitators of nurses as child abuse and neglect mandated reporters to inform healthcare professionals and academic institutions on the importance of nurse education and experience in nurse knowledge and self-efficacy in reporting suspected child abuse and neglect. REPORTING METHODS: The authors of this study have adhered to relevant EQUATOR guidelines: STROBE. PATIENT OR PUBLIC CONTRIBUTION: There is no patient or public contribution as the study only looked at nurses.

Development and psychometric evaluation of the reporting suspected child abuse and neglect (RSCAN) scale for United States registered nurses.

PURPOSE: In the United States (US), nurses have a mandated duty to report child abuse and neglect (CAN). Despite comprising the highest proportion of the US healthcare workforce, limited research has explored the institutional barriers they face in reporting suspected CAN. Furthermore, there is no existing valid and reliable measure of reporting relevant to US. The purpose of this research is to develop and psychometrically evaluate a scale to measure nurse knowledge and self-efficacy as CAN mandated reporters. DESIGN AND METHODS: The Reporting Suspected Child Abuse and Neglect (RSCAN) tool was developed from two existing international tools to examine institutional barriers and facilitators to US nurses' professional knowledge and reporting of CAN. A convenience sample of one hundred and sixty-six US nurses primarily from the Pacific Northwest responded to an online survey. An exploratory factor analysis (EFA) and Cronbach's α were used to examine validity and internal consistency, respectively, of an initial 16-item scale. RESULTS: A two-factor model consisting of eight items indicated good model fit (CFI = 0.986, RMSEA = 0.049, and SRMR = 0.028) and was internally consistent (Cronbach's α = 0.822). CONCLUSION: RSCAN is the first US instrument to reliably measure nurses' professional knowledge and self-efficacy of reporting suspected CAN. PRACTICE IMPLICATIONS: Future research can build upon these findings to recognize and support nurses in their mandated role to report CAN.

Perceived Changes in Social Connectedness Across the Life Course: A Mixed Method Approach.

Social connection is important across the life course, but overall levels have been declining. The COVID-19 pandemic presented a unique context to examine social connectedness and adaptive capacity in times of social adversity. We used a parallel mixed method design to collect online survey data from a representative U.S. sample (N = 359). Applying an exploratory sequential approach, we used a general linear model multivariate approach to repeated measures to test for differences in participants' perceptions of social connectedness by time and age category and qualitative analysis to gain insights about disrupted social contexts. Results indicated that social connectedness decreased after mitigation restrictions for all age groups, but individuals in emerging and late adulthood felt the greatest impact. Two themes emerged: differing emotional responses to altered communication and intentionality of maintaining and/or creating social connections. Experiences of social connectedness need to be understood as a function of life stage and developmental timing.

The Experience of Physical Activity in Adolescents With Cerebral Palsy.

For adolescents with cerebral palsy (CP), participating in physical activity (PA) can be difficult due to functional limitations that not only affect an adolescent's ability or willingness to participate in PA but also create particular social concerns. Research in the area of PA and adolescents with CP is limited. This research study utilized hermeneutic phenomenology to gain a more comprehensive understanding of the lived experiences of 14 adolescents with CP who participated in PA. The interpretations of each participant offered common understandings and themes to be identified and warranted as valid by the interpretive team. Common understandings identified were (a) developmental tasks of typical adolescents, (b) place of friends, (c) purpose of PA, (d) importance of support, and (e) wanting to be like the primary researcher. Most of the 14 participants had similar experiences within the identified common understandings and themes. Physical activity, in part, helps adolescents find out about themselves and their place within their community. The experiences of adolescents with CP and PA show that participation in PA is a way to connect with friends, meet new people, and gain a feeling of freedom from their disability. We offer healthcare providers a starting point to talk about PA and to help adolescents with CP find activities within their community.

Health Behaviors at the Onset of the COVID-19 Pandemic.

Objectives: We examined perceived behavior change since implementation of physical distancing restrictions and identified modifiable (self-rated health, resilience, depressive symptoms, social support and subjective wellbeing) and non-modifiable (demographics) risk/protective factors. Methods: A representative US sample (N = 362) completed an online survey about potential risk/protective factors and health behaviors prior to the pandemic and after implemented/recommended restrictions. We assessed change in perceived health behaviors prior to and following introduction of COVID-19. We conducted hierarchical linear regression to explore and identify risk/protective factors related to physical activity, diet quality, and social isolation. Results: There have been substantial decreases in physical activity and increases in sedentary behavior and social isolation, but no changes in diet quality since COVID-19. We identified modifiable and non-modifiable factors associated with each health behavior. Conclusions: Negative effects indicate the need for universal intervention to promote health behaviors. Inequalities in health behaviors among vulnerable populations may be exacerbated since COVID-19, suggesting need for targeted invention. Social support may be a mechanism to promote health behaviors. We suggest scaling out effective health behavior interventions with the same intensity in which physical distancing recommendations were implemented.

Essential Care Needs for Patients' Family Members at the Intensive Care Units in Palestine.

BACKGROUND: Understanding the needs of families of hospital patients, especially those in intensive care units is key to providing comprehensive, effective support. The aim of this study is to determine the needs of families of Intensive Care Unit (ICU) patients in four Palestinian hospitals. MATERIALS AND METHODS: This was a cross-sectional, analytic study including 240 participants selected using convenience sampling. Data was obtained from participants from September 2016 to April 2018. The Critical Care Family Needs Inventory (CCFNI) was distributed to examine their needs. Descriptive analysis, t-tests, and Analysis of Variance (ANOVA) were conducted to analyze relationships between demographic characteristics of respondents and their needs. Differences were considered significant at p < 0.05. RESULTS: The results revealed that the assurance domain was the most important, but participants had some unmet needs from the support domain. Parents reported higher levels of importance of all needs than other types of relatives of patients. In addition, participants with a higher level of education reported a significantly higher level of importance in the dimensions of assurance (F3,236= 2.85, p = 0.038), proximity (F3,236= 4.36, p = 0.006), and support (F3,236= 4.13, p = 0.007). Also, married participants had a higher need for all dimensions. Family members of patients who stayed more than 7 days had higher needs for support (F2,237= 3.39, p = 0.035) and comfort (F2,237= 3.92, p = 0.021). CONCLUSIONS: Family members of ICU patients have certain unmet needs, which require attention from healthcare professionals and administration in Palestinian hospitals. In addition, sociodemographic variables influence family member needs.

Becoming a Transformative Nurse Educator: Finding Safety and Authenticity.

The study purpose was to evaluate and strengthen this program's nursing education curriculum to better prepare and develop future nurse faculty. As the dire nursing faculty shortage increases, the transition of expert nurse clinician to novice educator is receiving more attention. In order to prepare, recruit, and retain the nursing faculty needed to meet the growing nurse shortage, understanding what nurse educators need in order to be successful is essential. Fourteen participants from four focus groups of nurse educators shared stories about their role transition. Two administrators were interviewed to determine what they identified as crucial in hiring new nurse educators. Interpretive analysis focused on identification of themes and possible paradigm cases. Themes that emerged included: a) culture of academia surprises, b) exciting "Aha!" moments, and c) Safety with a capital "S". These findings were used to strategically revise the entire nurse educator curriculum.

Nurses' Attitudes Toward the Use of an Electronic Health Information System in a Developing Country.

The electronic-based documentation system is considered a major transformation in health care in many hospitals worldwide. Successful implementation of the system makes nurses' jobs easier, saves time, and improves the quality of care that is delivered to patients. However, little is known about the adoption of electronic health information systems in developing countries. The purpose of this study was to understand and evaluate nurses' acceptance and attitudes about implementation of an electronic health information system in Palestinian hospitals. A descriptive, cross-sectional study was conducted with 191 nurses in three governmental hospitals in Palestine. A majority of these nurses understood the need for and accepted the computer-based documentation as demonstrated by their scores on the attitude questionnaire. Inclusion of nurses in early phases of planning and implementation is important. Other developing countries can learn from the Palestinian experience with implementation of electronic health records.

Innovative Practice in Advancement of Academic Nurse Educator Careers: Developing Scholarship From Program Grants.

We describe an innovative practice in advancing careers of academic nurse educators: demonstrating scholarly productivity from program grants. Scholarly productivity is often narrowly defined, especially in research-intensive institutions. The expectation may be a career trajectory based on the traditional scholarship of discovery. However, nurse educators, especially at the associate and full professor ranks, are often involved in leadership activities that include writing and managing program grants. We encourage the academy to value and support the development of program grants that include significant scholarly components, and we offer exemplars of associate and full professor scholarship derived from these projects.

Experiences of RNs Who Voluntarily Withdraw From Their RN-to-BSN Program.

BACKGROUND: The number of RN-to-baccalaureate nursing (BSN) programs is increasing; however, nurses continue to voluntarily withdraw at higher rates than expected. METHOD: A Heideggerian hermeneutic approach was used to interpret the meaning of the experience of RNs, who voluntarily withdraw from their baccalaureate nursing programs. The research aims were to generate a comprehensive understanding of (a) the experiences of RN-to-BSN noncompleters, (b) the meaning noncompleters ascribe to the experience of dropping out, and (c) the interplay between factors that influence dropout decisions. RESULTS: Two overarching patterns of understanding emerged: Withdrawing as Revisiting Failure, and Withdrawing as Impasse: On One Side of the Divide. The factors that influence whether an RN finishes a baccalaureate nursing program are many, but the effect on dignity and well-being are immeasurable. CONCLUSION: Voluntary withdrawal from an RN-to-BSN program leaves nurses professionally place-bound, affecting not only the individual nurse but also the profession. [J Nurs Educ. 2017;56(5):260-265.].

A Course-Based Approach to the Doctor of Nursing Practice Project: Supporting Student Growth From Concept to Completion.

We describe a course-based approach to the doctor of nursing practice project in which students work in groups of 8 to 12 with a faculty member to complete individual final projects that require a minimum of 360 practicum hours in 3-semester-long courses. Project teams include agency or community-based mentors. Project findings are disseminated through written and oral reports. This approach preserves faculty resources and provides students with mentoring, opportunities for reflection, and time for project development.

Validity testing of the quality of life scale, Swedish version: focus group interviews of women with fibromyalgia.

Focus group interviews were used to examine validity of the Quality of Life Scale, Swedish version (QOLS-S) for use with women with fibromyalgia. Five interviews with 18 women with fibromyalgia were completed. The opening question was "What does quality of life mean to you?" Later, participants were asked to respond to questions about the specific domains and items in the QOLS-S. The transcribed interviews were analysed, and categories were identified. Opinions concerning domains and items in the QOLS-S were linked to domains of the QOLS-S. Four categories emerged from the opening question: finances, to be an active person and participate in society, relations with others, and health. Overall, the women's perceptions of quality of life were congruent with the domains of QOLS-S. However, further attention should be given to the translation of certain items and apparent overlaps in some items indicate that they can be combined. Also, the instrument needs to be scrutinized from a cultural perspective because some items in the "social, community and civic activities" domain were not endorsed by the participants.

Item selection in self-report measures for children and adolescents with disabilities: lessons from cognitive interviews.

The aim of the study was to evaluate children's and adolescents' understanding of items from self-report measures. Cognitive interviews were conducted as part of a larger study on pain and fatigue in children with disabilities. A list of guiding questions was used to encourage participants to talk about words or concepts in the scale that they found difficult. The sample included 32 children and adolescents with physical disabilities. Participants had difficulty with words such as intense, severe, and anxiety. They had more difficulty with abstract ideas, such as average, than they did with more concrete ideas, such as naming a recreational or social activity. Because poor outcome measurement hinders symptom evaluation, findings support the need to put greater emphasis on the child perspective when developing and using self-report measures. Suggestions for increasing accuracy of these measures are offered for clinicians and researchers.

Characteristics of patients who return to the emergency department within 72 hours in one community hospital.

This study identifies characteristics of patients who return to the emergency department (ED) within 72 hr after an initial visit. An exploratory quantitative descriptive study was conducted to identify characteristics of patients with unscheduled 72 hr ED returns. The sample consisted of all patients with 72 hr ED return visits for the month of January 2009 at the study facility. Data were collected from electronic patient records utilizing the National Hospital Ambulatory Medical Care Survey instrument modified to eliminate patient identifiers. There were 169 individuals who had at least one 72 hr return visit to the ED for a total of 393 initial and return ED visits. The most common diagnoses were for gastrointestinal complaints. Over a third of the patients who returned had chronic health conditions. There were more emergency department return visits in individuals who lacked access to primary care.

Relevant nursing leadership: an evidence-based programmatic response.

Community and student demand for relevant nursing leadership graduate programs provided the impetus for this study. The aims were to identify components of highly competent nursing leadership, and strategies to integrate those components into education and practice. Nursing leaders gathered in five focus groups. A semi-structured interview guide was used to elicit narratives about nursing leadership. Interpretive analysis proceeded from identification of themes to uncovering of paradigm cases. Essential nursing leadership competencies comprised communication skills such as listening, conflict resolution, the ability to communicate a vision, motivate, and inspire. Additionally, leaders needed technological adroitness, fiscal dexterity, and the courage to be proactive during rapid change. Implications included a revision in the leadership focus of the nursing masters program, and the necessity that nurse retention should be enhanced by better educated nurse leaders who are grounded in practice and ready to provide a vision for the future.

A survey of physical examination skills taught in undergraduate nursing programs: are we teaching too much?

Because content saturation is a growing concern, as reflected in the nursing literature, the content taught in undergraduate nursing curricula should be critically examined. The purpose of this descriptive cross-sectional research was to determine and analyze the physical assessment content currently taught in undergraduate nursing programs. A total of 198 individuals teaching in undergraduate nursing programs completed a Web-based survey. Of the 122 skills included on the survey, 81% were reportedly being taught in most of the nursing programs. Total scores for 18 systems-based assessment categories were significantly different among associate and baccalaureate nursing programs in all but three categories: assessment of integument, breast, and female genitals. Previous research has shown that nurses use less than 25% of these same skills regularly in clinical practice, regardless of their educational preparation. Findings from this research raise questions about the breadth to which physical examination content should be taught in undergraduate nursing education.

The impact of child disability type on the family.

The purpose of this study is to better understand the differential impact of specific diagnoses on outcomes in families with children who have physical disabilities and to suggest ways in which clinicians across disciplines can use that knowledge to develop and implement more individualized, evidence-based programs. Descriptive statistics, correlation, and a univariate analysis of variance (ANOVA) were used to analyze data gathered from a sample of 205 parents or guardians of children with physical disabilities. Findings revealed a modest effect of diagnosis type on five family outcomes. These outcomes included: (1) how parents or guardians rated their child's current health compared to 1 year before the study, (2) the degree to which the child's physical health caused worry, (3) the degree to which the child's emotional well-being or behavior caused worry, (4) the degree to which the child's health or behavior limited types of family activities, and (5) the degree to which the child'shealth or behavior interrupted family activities. This article presents an interprofessional model of response.

Evaluation research as academic scholarship.

In nursing, the ability of educators to progress successfully toward promotion and tenure may be hampered by heavy teaching or practice workloads and an inability to complete the research mission of the institution. In a 1990 report, Boyer noted that the scholarship of teaching, integration, and application can be embraced in the same manner as the scholarship of discovery and research. One source of data that is often neglected as integral to scholarship is evaluation data that results from teaching, service, and practice. Such data can be reframed and thought of as a compelling avenue for scholarly activity. This article connects the evaluation process with the four types of scholarship outlined in the Boyer model and illustrates how the formal evaluation of a nursing curriculum can be linked to a rigorous scholarship assessment framework.

The relationship between fatigue and quality of life in children with chronic health problems: a systematic review.

PURPOSE: This systematic review synthesized the literature regarding fatigue in children with chronic health problems and examined the relationship to quality of life. CONCLUSIONS: Most studies that have examined fatigue and its relationship to quality of life in children with chronic health problems have focused on children with cancer. Studies found that children often reported fatigue and that it decreased quality of life. PRACTICE IMPLICATIONS: Quantifying fatigue in children with chronic illnesses and disabilities is critical for pediatric nursing assessment. Understanding the impact of fatigue on children with chronic health problems is a first step in improving their quality of life.