Developing Nurses and Interdisciplinary Teams in Caring Science.

This program evaluation assessed a caring science program's impact on nurse and interdisciplinary professionals' self-reported caring, compassion satisfaction, and intent to leave at an academic-affiliated community hospital. A 3-session program resulted in self-caring and intent to leave significant increases at 60 days post intervention. Findings demonstrated caring science interventions alone are insufficient to impact staff engagement and intent to leave. Further actions for organizational culture changes are discussed.

Voices of Musicians: Virtual Live Bedside Music Concerts in Inpatient Care.

The COVID-19 pandemic presented unprecedented challenges to patients, family members, and healthcare staff that resulted in increased stress and isolation and decreased quality of life. We evaluate the impact of a novel virtual concert program, the Vital Sounds Initiative (VSI) of Project: Music Heals Us (PMHU), which began at the beginning of the pandemic to combat patient isolation and provide employment to professional musicians. Using a qualitative analysis of VSI data, we examined post-concert written responses by musicians. These responses were coded by independent coders via inductive coding and thematic analysis. Between 7 April 2020 and 20 July 2022, 192 musicians played 2203 h of music for 11,222 audience members in 39 care facilities nationwide. A total of 114 musicians submitted a total of 658 responses. Three main themes (with corresponding subthemes) arose: (1) Patient Experience; (2) Musician Experience; (3) Caregiver (family or staff) Experience. The responses offered valuable insight into the overwhelmingly positive aspects of the virtual concerts. Overall, we found that VSI favorably impacts individuals at every level, including the patients, musician, and caregivers. These findings provide preliminary evidence for the benefits of virtual music concerts. Upscaling similar virtual music interventions/programs should be considered.

Participation in SEPA, a sexual and relational health intervention for Hispanic women.

HIV and intimate partner violence (IPV) risks are linked in Hispanic women, so integrated interventions can efficiently produce meaningful change. Integrated interventions for Hispanic women are promising, but factors that put Hispanic women at risk for HIV and violence may also impede engagement with interventions. This study examined barriers and facilitators of engagement in a group educational intervention, SEPA (Salud, Educación, Prevención y Autocuidado [Health, Education, Prevention, and Self-Care]), for Hispanic women. A total of 274 Hispanic women from South Florida in the SEPA condition of a randomized controlled trial completed baseline measures of violence, depression, familism, Hispanic stress, acculturation, and demographics, and 57% of the women engaged (attended two of five sessions). Education, IPV, and acculturation predicted engagement. Understanding engagement advances intervention development/refinement. Hispanic women who experience relationship violence are open to group interventions. Further program development and outreach work are needed to connect women with low education, who are particularly vulnerable.

Motivation, management, and mastery: a theory of resilience in the context of HIV infection.

BACKGROUND: Clients with HIV infection have been conceptualized as a resilient population. Although a few researchers have documented resilience among clients with HIV infection, a theory of resilience in the context of HIV infection has not been developed. The purpose of this study was to describe the process by which resilience occurs for clients in the context of HIV infection. METHOD: Grounded theory methodology was used to sample and analyze data from 15 qualitative interviews with adults with HIV infection. Data were collected until saturation was reached. RESULTS: A theory, motivation, management, and mastery, a description of the process by which resilience occurs in the context of HIV infection, emerged from the data. CONCLUSION: Many clients living with HIV infection are resilient, despite the physical, psychological, and social challenges of this chronic illness. Nursing interventions to promote resilience among clients with HIV infection should be directed toward identification of client motivation factors and disease management strategies that may influence health outcomes of people living with HIV infection.

Birthplace, culture, self-esteem, and intimate partner violence among community-dwelling Hispanic women.

The purpose of this study was to explore variations in demographics, culture, self-esteem, and intimate partner violence among Hispanic women according to birthplace, and to identify factors associated with these differences in intimate partner violence (IPV). Baseline data from a randomized control trial testing the efficacy of an HIV prevention program were used. Path analyses identified differences in IPV between Colombian women and women from other Central/South American countries. Self-esteem was the only factor associated with these differences. Interventions addressing the unique needs of Hispanic women from different subgroups are needed.

Exploring the concept of HIV-related stigma.

BACKGROUND: HIV infection is a chronic, manageable illness. Despite advances in the care and treatment of people living with HIV infection, HIV-related stigma remains a challenge to HIV testing, care, and prevention. Numerous studies have documented the impact of HIV-related stigma among various groups of people living with HIV infection, but the concept of HIV-related stigma remains unclear. PURPOSE: Concept exploration of HIV-related stigma via an integrative literature review was conducted in order to examine the existing knowledge base of this concept. METHODS: Search engines were employed to review the existing knowledge base of this concept. CONCLUSION: After the integrative literature review, an analysis of HIV-related stigma emerged. Implications for future concept analysis, research, and practice are included.

CULTURAL PHENOMENA AND THE SYNDEMIC FACTOR: SUBSTANCE ABUSE, VIOLENCE, HIV, AND DEPRESSION AMONG HISPANIC WOMEN.

Researchers exploring the health of Hispanics in South Florida utilizing a combination of qualitative and quantitative research methods have identified that substance abuse, violence, risky sexual behavior, and depression are not only conceptualized as tightly interrelated health and social problems, but also hold together in a measurement model to represent an underlying phenomenon (i.e., the Syndemic Factor). The purpose of this study is to test hypothesized relationships between cultural phenomena and the Syndemic Factor among community-dwelling Hispanic women. Standardized questionnaires assessing Acculturation, Hispanic Stress, Familism, and the Syndemic Factor were administered to a cross-sectional sample of 548 Hispanic women from South Florida. Structural equation modeling was used to analyze relationships. The model explained 61 percent of the variance in the Syndemic Factor. There was a large positive relationship between the Syndemic Factor and Hispanic Stress, and a small inverse relationship between the Syndemic Factor and Familism. Women with high Hispanic Acculturation and low U.S. Acculturation scored lower on the Syndemic Factor than Integrated/Bicultural women. Familism buffered the relationship between Hispanic Stress and the Syndemic Factor. Structural, community, family, and individual prevention strategies that address underlying conditions associated with the Syndemic Factor must be developed and formally evaluated.

A syndemic model of substance abuse, intimate partner violence, HIV infection, and mental health among Hispanics.

Hispanics are disproportionately affected by substance abuse, HIV infection, intimate partner violence, and mental health conditions. To address health disparities among Hispanics and other vulnerable groups, it is necessary to understand the complex interactions between health conditions clustering together (e.g., substance abuse, intimate partner violence, and HIV) and the social ecology in which these conditions exist. A syndemic orientation, a consideration of clustering epidemics and common individual, relationship, cultural, and socioenvironmental factors linking these conditions, may be helpful in developing comprehensive models that expand our ability to understand and address health disparities. The purpose of this paper is to introduce a Syndemic Model of Substance Abuse, Intimate Partner Violence, HIV Infection, and Mental Health among Hispanics, and provide evidence from the research literature to support the central relationships and risk and protective factors (i.e., potential links between conditions) depicted by the model. The development and evaluation of interventions aimed at the prevention of substance abuse, intimate partner violence, HIV/AIDS, and mental health problems as a syndemic affecting Hispanics is urgently needed. Public health nurses can initiate this endeavor with the guidance of a Syndemic Model.

Substance abuse, violence, HIV, and depression: an underlying syndemic factor among Latinas.

BACKGROUND: Evidence from the literature suggests that substance abuse, violence, HIV risk, depressive symptoms, and underlying socioeconomic conditions are tied intrinsically to health disparities among Latinas. Although these health and social conditions appear to comprise a syndemic, an underlying phenomenon disproportionately accounting for the burden of disease among marginalized groups, these hypothesized relationships have not been formally tested. OBJECTIVES: The aim of this study was to assess (a) if substance abuse, violence, HIV risk, and depressive symptoms comprised a syndemic and (b) if this syndemic was related to socioeconomic disadvantage among Latinas. METHODS: Baseline assessment data from a randomized controlled community trial testing the efficacy of an HIV risk reduction program for adult Latinas (n = 548) were used to measure demographic variables, substance abuse, violence, risk for HIV, and depressive symptoms. Structural equation modeling was used to test a single underlying syndemic factor model and any relation to socioeconomic disadvantage. RESULTS: The results of this study support the idea that HIV risk, substance abuse, violence, and depressive symptoms comprise a syndemic, χ(27) = 53.26, p < .01 (relative χ = 1.97, comparative fit index = .91, root mean square error of approximation = .04). In addition, in limited accord with theory, this factor was related to 2 measures of socioeconomic disadvantage, percentage of years in the United States (b = 7.55, SE = 1.53, p < .001) and education (b = -1.98, SE = .87, p < .05). DISCUSSION: The results of this study could be used to guide public health programs and policies targeting behavioral health disparity conditions among Latinos and other vulnerable populations. Further study of the influence of gender-role expectations and community-level socioeconomic indicators may provide additional insight into this syndemic.