Developing a pediatric nursing simulation scenario template in South Korea: applying real-time Delphi methods.

PURPOSE: This study aimed to describe the process of developing a validated pediatric nursing simulation scenario template using the real-time Delphi method. METHODS: A panel of 13 pediatric nursing experts participated in a real-time Delphi survey conducted over two rounds. Initially, 83 items were included in the questionnaire focusing on the structure and content of the simulation scenario template. Data analysis involved calculating the content validity ratio (CVR) and the coefficient of variation to assess item validity and stability. RESULTS: Through iterative rounds of the Delphi survey, a consensus was reached among the experts, resulting in the development of a pediatric nursing simulation scenario template comprising 41 items across nine parts. The CVR values ranged from 0.85 to 1.0, indicating a high consensus among experts regarding the inclusion of all items in the template. CONCLUSION: This study presents a novel approach for developing a pediatric nursing simulation scenario template using real-time Delphi methods. The real-time Delphi method facilitated the development of a comprehensive and scientifically grounded pediatric nursing simulation scenario template. Our template aligns with the International Nursing Association for Clinical Simulation and Learning standards, and provides valuable guidance for educators in designing effective simulation scenarios, contributing to enhanced learning outcomes and better preparation for pediatric clinical practice. However, consideration of cultural and contextual adaptations is necessary, and further research should explore alternative consensus criteria.

Preparing health professional students for interprofessional practice related to neurodevelopmental disabilities: a pilot program.

Many health professional students have insufficient general knowledge about individuals with neurodevelopmental disabilities. Students lack the expertise required to work with this population and their families. Interprofessional practice education (IPE) programs, designed for working with individuals with specialized needs and their families, are needed to improve overall care provided. An IPE program related to neurodevelopmental disabilities for health professional students was implemented focusing on applied learning and community engagement to develop competencies for students related to neurodevelopmental disabilities at a state university in the U.S. The purpose of this research was to describe the development and implementation of an IPE program and to examine the effectiveness of the IPE program aimed at developing identified competencies and increase awareness related to care of individuals with ND for health professional students. The findings suggest the IPE program enhanced health professional students' perceived competencies to identify and provide culturally sensitive and family-centered care for individuals with neurodevelopmental disabilities and their families. This experience also provided an opportunity for personal/professional growth and increased awareness of the unique needs of these individuals with neurodevelopmental disabilities and their families.

How Do Sleep Disturbances Relate to Daytime Functions, Care-related Quality of Life, and Parenting Interactions in Mothers of Children with Autism Spectrum Disorder?

Sleep disturbance is prevalent in caregivers and associated with negative physical, mental, and functional outcomes. This study examined the effects of sleep disturbance on daytime functions (sleepiness, fatigue, mood, cognitive alertness), care-related quality of life, and daily parenting interactions in 20 mothers of children with autism spectrum disorder for 10 consecutive days using ecological momentary assessment design. Participants responded about daytime functions four times and care-related quality of life and daily parenting interactions once using an online survey. Sleep disturbance was significantly related to all daytime functions and frustration with childcare. Therefore, development of sleep hygiene interventions is warranted to effectively reduce the impact of sleep disturbance and enable these mothers to better tackle daily physical and mental challenges.

Adolescents' Marijuana Use Following Recreational Marijuana Legalization in Alaska and Hawaii.

Alaska and Hawaii, the only two noncontiguous states in the United States, have different marijuana policy environments. Alaska enacted recreational marijuana legalization (RML) in 2014, whereas recreational marijuana is still illegal in Hawaii. This study analyzed how RML affects adolescents' marijuana use (MU) by comparing two states. We used data from 2 states (Alaska and Hawaii) from the Youth Risk Behavior Survey, 2009 to 2019 years (N = 35 467). The trends of lifetime MU and current MU were examined. Using difference-in-differences analysis models, this study investigated whether RML increased lifetime and current MU in Alaska compared with Hawaii after adjusting for socioeconomic characteristics. Both lifetime and current MU prevalence among adolescents in Alaska increased after RML, while both rates in Hawaii gradually decreased. The rate of lifetime MU in Alaska was significantly increased after RML (odds ratio [OR] = 1.29) compared with Hawaii. Similarly, the current MU among adolescents in Alaska was significantly increased compared with that in Hawaii (OR = 1.34). Both lifetime and current MU were increased following RML in Alaska, suggesting that RML may affect the increase of MU among adolescents.

Race/ethnicity differences in risk and protective factors for marijuana use among U.S. adolescents.

BACKGROUND: Little is known about how race and ethnicity influence marijuana-specific risk and protective factors in U.S. adolescents. We examined differences in risk and protective factors of marijuana use (MU) and their associations with MU by race/ethnicity. METHODS: The present study used data from the 2015-2019 National Survey on Drug Use and Health. A total of 68,263 adolescents (aged 12 to 17 years) were divided into seven subgroups by race/ethnicity (White, Hispanic, Black, Asian, Native American, Native Hawaiian/Pacific Islander (NH/PI), and mixed race). Marijuana-specific risk and protective factors (RPFs) were examined, including perceived availability of marijuana, adolescents' perceived risk of MU and perceived disapproval of parents, peers, and close friends. Past-month, past-year, and lifetime MU were used as MU outcomes to examine the associations with RPFs as well as with race/ethnicity. RESULTS: Overall, 6.85, 12.67, and 15.52% of the sample reported past-month, past-year, and lifetime MU respectively. Weighted adjusted logistic regression analyses revealed that mixed race adolescents reported the greatest perceived availability of marijuana, whereas Black and Asian adolescents had less access compared to White adolescents. The adolescents' perception of parental disapproval of MU was the lowest for Native American adolescents and highest for Asian adolescents. Mixed race adolescents experienced lower peer and close friend disapproval of MU while Black and Asian adolescents had higher. The MU risk perception was lower in most groups including Black, Hispanic, Native American, and mixed race adolescents, but not in Asian adolescents. Native American adolescents scored the highest on all MU outcomes, whereas Asian adolescents scored the lowest. Perceived availability of marijuana was associated with higher MU in all MU outcomes. Lower disapproval MU perceptions and lower MU risk perceptions were also associated with greater MU. CONCLUSION: These findings suggest there is considerable heterogeneity of marijuana risk and protective factors and MU across race/ethnicity among U.S. adolescents.

Factors Influencing Sleep Quality among Female Staff Nurses during the Early COVID-19 Pandemic in the United States.

This study aimed to assess the overall level of sleep quality among female staff nurses in the United States during the early COVID-19 pandemic. It also aimed to examine factors associated with sleep quality and its seven subcomponents: subjective sleep quality, sleep latency, sleep duration, habitual sleep efficiency, sleep disturbance, use of sleeping medications, and daytime dysfunction. A descriptive, correlational, and cross-sectional study design was used. We performed descriptive, and regression analyses with a sample of 215 female staff nurses enrolled in post-licensure online nursing programs at a southeastern state university. Data collection was conducted using an online survey from April to May 2020. Sleep quality was measured using the Pittsburgh Sleep Quality Index (PSQI). Nurses working part time (p = 0.02), with lower perceived physical health (p = 0.01), a lower self-care self-regulation score (p < 0.001), and higher work stress (p < 0.05) showed poorer sleep quality. Factors associated with subcomponents of sleep quality varied. Poor sleep quality among nurses during the COVID-19 pandemic was reported. Various factors, including work environmental factors were associated with the sleep quality in this sample. Hospital administrators should consider developing intervention programs for improving the work environment, which would impact sleep quality, health status, and job performance.

Relationships among parenting stress, health-promoting behaviors, and health-related quality of life in Korean mothers of children with cerebral palsy.

Health-promoting behaviors have been shown to enhance the quality of life across diverse populations. In this study, we examined the indirect effects of several health-promoting behaviors on the relationship between parenting stress and health-related quality of life in mothers of children with cerebral palsy (CP). A convenience sample of Korean mothers (N = 180) of children aged 10 months to 12 years with CP was recruited from clinical and school settings. Health-promoting behaviors were measured using the health-promoting lifestyle profile II, which is comprised of six subscales: health responsibility, physical activity, nutrition, spiritual growth, interpersonal relations, and stress management. Multiple mediation analyses were conducted to examine the mediating role of these behavioral categories. Spiritual growth (ß = .56, p < .05) had an indirect effect on the relationship between parenting stress and physical health-related quality of life while spiritual growth (ß = -1.00, p < .01) and stress management (ß = -.80, p < .05) were found to mediate the association between parenting stress and mental health-related quality of life. The findings of multiple mediation analyses provide evidence of the influence of specific health-promoting behaviors on health-related quality of life, thereby informing the development of intervention programs for mothers of children with disabilities.

Assessment of Patient Safety and Cultural Competencies among Senior Baccalaureate Nursing Students.

This descriptive, correlational, cross-sectional study examined nursing students' educational experiences on self-reported perceptions of patient safety and cultural competence in terms of curriculum content and learning venues. We performed descriptive analyses and a one-way analysis of variance with a sample of senior-year nursing students (N = 249) attending three state universities in the United States. We used the Nurse of the Future Nursing Core Competency Model, the Patient Safety Competency Self-Evaluation Tool for Nursing Students, and The Cultural Competence Assessment Instrument. Overall, participants reported that patient safety and cultural competencies were addressed in their curricula primarily through classroom activities as opposed to laboratory/simulation or clinical settings. Among the required patient safety knowledge topics, elements of highly reliable organizations were covered the least. For patient safety competency, participants reported higher scores for attitude and lower scores for skill and knowledge. For cultural competency, participants scored much higher for cultural awareness and sensitivity than behavior. There was no statistically significant difference between scores for patient safety and cultural competencies by nursing school. The results support the need for curriculum development to include all important aspects of patient safety and cultural competencies in various teaching/learning venues.

Suicidal ideation, plan, and attempts and nonmedical prescription opioid use among U.S. adults.

OBJECTIVE: The increase of nonmedical prescription opioid use (NMPOU) in the United States has become a public health concern. The purpose of this study was to examine the relationship between nonmedical prescription opioid misuse and past-year suicidality (suicide ideation-SI, suicide plan-SP, and suicide attempts-SA) among U.S. adults. METHOD: Secondary data analysis was conducted using the 2016 National Survey on Drug Use and Health with 42,625 respondents. NMPOU was grouped in 4 categories: (1) never used, (2) current user, (3) recent user, and (4) past user. The outcome variables were SI, SP and SA and they were predicted in multivariable logistic regression. RESULTS: Compared to the never-use of NMPO groups, the current, recent, and past users of NMPO showed significantly higher likelihoods of SI, SP, and SA models adjusting for sociodemographic and mental health-related factors. Presence of a major depressive episode had the significantly highest Odds Ratio of SI, SP, and SA. Suicidality among NMPO users is high, and there are multiple, sociodemographic and mental health related factors associated with this finding. CONCLUSION: Policy and prevention efforts to improve screening and treatment should focus on the at-risk populations identified in this study.

Determinants of Health-related Quality of Life Among Mothers of Children With Cerebral Palsy.

PURPOSE: Caring for a child with cerebral palsy (CP) can impact both the physical and mental health of parents. However, determinants associated with health-related quality of life (HRQOL) in these parents have yet to be adequately examined. The study aims were to identify the determinants affecting HRQOL among mothers of children with CP. DESIGN AND METHODS: Participants in this cross-sectional study (N = 180) were mothers of children with CP recruited from clinical and school-based settings in Korea. Variables examined were characteristics of child (demographic factors and disability parameter), mother (demographic factors, number of chronic conditions, health-promoting behaviors (HPB), and parenting stress), and environmental factors (use of personal assistant care, leisure time and social support). Multivariate regression analysis was performed to examine the child, mother, and environmental factors associated with HRQOL. RESULTS: The HRQOL results revealed that the physical HRQOL was higher than mental HRQOL in the sample. Longer length of disability of children and lower number of chronic conditions of mothers were significant factors of higher physical HRQOL. Lower parenting stress, more leisure time, engagement in HPB, and greater social support were significantly associated with higher mental HRQOL. CONCLUSIONS: The levels of HRQOL of mothers of children with CP were very low and our findings suggest modifiable factors. Decreasing parenting stress, engaging in HPB, and providing social support should be considered when developing psychosocial intervention for this population. PRACTICE IMPLICATIONS: Study results may inform programs aimed at health promotion, stress reduction, and QOL improvement among parents of children with disabilities.

Differences in physical health, and health behaviors between family caregivers of children with and without disabilities.

BACKGROUND: Providing care for children with disabilities can negatively influence the physical health and health behaviors of family caregivers. OBJECTIVES/HYPOTHESIS: The study purposes were to compare the prevalence of chronic conditions and health risk behaviors of family caregivers of children with and without disabilities and to examine associations between disability status of children and family caregivers' chronic conditions and health risk behaviors. METHODS: This study compared chronic conditions and health risk behaviors across adult family caregivers of children with a disability (FCG-D) and family caregivers of children without a disability (FCG) living in a U.S. household using 2015 National Health Interview Survey data. Health risk behaviors were defined as heavy drinking, current smoking, physical inactivity, and unhealthy sleep. Multivariable logistic regression was conducted to compare chronic conditions and health risk behaviors between FCG-D and FCG with adjustments for demographic and healthcare coverage covariates. RESULTS: FCG-D showed significantly greater likelihoods of chronic conditions (e.g., asthma, back pain, chronic bronchitis, heart conditions, migraine, and obesity) than FCG. FCG-D also exhibited significantly more smoking and unhealthy sleep. CONCLUSIONS: Family caregivers of children with a disability reported significantly greater likelihoods of various chronic conditions and were more likely to engage in health risk behaviors (smoking and unhealthy sleep). Further study is needed to develop intervention programs for encouraging effective health-promoting behaviors among family caregivers of children with a disability as well as health policies for decreasing health disparities experienced by this population.

[Comparison for risk estimate of aspiration between the revised dysphagia assessment tool and videofluoroscopy in post-stroke patients].

PURPOSE: The purpose of this study was to determine the significant factors for risk estimate of aspiration and to evaluate the efficiency of the dysphagia assessment tool. METHODS: A consecutive series of 210 stroke patients with aspiration symptoms such as cough and dysphagia who had soft or regular diet without tube feeding were examined. The dysphagia assessment tool for aspiration was compared with videofluoroscopy using Classification and Regression Tree (CART) analysis. RESULTS: In CART analysis, of 34 factors, the significant factors for estimating risk of aspiration were cough during swallowing, oral stasis, facial symmetry, salivary drooling, and cough after swallowing. The risk estimate error of the revised dysphagia assessment tool was 25.2%, equal to that of videofluoroscopy. CONCLUSION: The results indicate that the dysphagia assessment tool developed and examined in this study was potentially useful in the clinical field and the primary risk estimating factor was cough during swallowing. Oral stasis, facial symmetry, salivary drooling, cough after swallowing were other significant factors, and based on these results, the dysphagia assessment tool for aspiration was revised and complemented.