Methodological Issues of Research with African-American Women: Influences on Long-Term Physical Activity in Physically Active African-American Women.

This paper reports the methodological challenges encountered while performing a descriptive, qualitative study examining the perspectives of African-American women who successfully maintained long-term physical activity. The socioecological model was used to expand on the dynamics pertaining to the long-term physical activity of 14 African-American women between 35 and 65 years of age. These women were recruited in 2 Midwestern American states and had been physically active for more than 6 months at the time of the study. Content analysis of themes revealed factors influencing physical activity at the individual, social, environmental, and political levels. Methodological challenges the student researcher encountered were choosing the appropriate framework to guide the study, recruiting participants who met the inclusion criteria, and proficiently transcribing and organizing the responses for data analysis using qualitative analysis software. The reflections described in this paper may provide insight to challenges and possible solutions for new researchers to consider when developing a research project.

A qualitative exploration of nursing students' perceptions of the homeless and their care experiences.

The health care needs of the homeless are more complex than those of the population at large. The purpose of this qualitative study was to explore undergraduate nursing students' perceptions of the homeless. Thematic content analysis of responses from 19 undergraduate nursing students yielded four themes describing student experiences with the homeless, their perceptions of homelessness and the health care of the homeless, and their suggestions for best teaching strategies. Students in this study had varying amounts of experience with and knowledge of the homeless. While our participants strongly believed that homeless people deserved compassionate, equitable nursing care, many of their statements suggested an implicit bias toward the homeless. This suggests that student nurses need more comprehensive education concerning the homeless and the health care needs of this vulnerable population. Few interventions aimed at educating student nurses about homelessness and changing their attitudes to mitigate bias are based on research, particularly research conducted from the perspective of the homeless, and few explore the impact of civil interactions on health outcomes. The findings of this study may assist nurse educators in developing education interventions to improve students' knowledge of homelessness.

Perceptions of New Nurses Concerning Incivility in the Workplace.

BACKGROUND: Although an atmosphere of civility in which nurses respect and value each other is crucial to health care, incivility continues to be widespread. METHOD: New graduate nurses completed an online questionnaire in which they described incivility and discussed its impact on new nurses and patients. RESULTS: Findings were categorized according to the impact of incivility on new nurses and patients. Embedded in these categories are rich descriptions of incivility in health care. CONCLUSIONS: The participants witnessed uncivil interactions that negatively impacted them emotionally, professionally, and physically. They also discussed the harmful effects of incivility on patients, whose care may be impeded or their faith in caregivers eroded in hostile, uncivil care environments. Nurses in professional development play a crucial role in promoting a culture of civility through raising awareness, supporting nurses new to the profession, and helping health care workers to better cope with incivility.

Non-Critical-Care Nurses' Perceptions of Facilitators and Barriers to Rapid Response Team Activation.

Rapid response teams can save lives but are only effective when activated. We surveyed 50 nurses for their perceptions of facilitators and barriers to activation. Findings showed that participants need more education on their role and when to activate the rapid response team. Nurses who comprise the team need help building their communication skills. We recommend nursing professional development specialists increase the frequency of offerings and expand the focus on roles, activation criteria, and communication skills.

Feasibility of a Photovoice Study Promoting Respirator Use among Russian Health Care Workers.

OBJECTIVES: Russian health care workers in tuberculosis hospitals have a high incidence of nosocomial TB. Proper use of respirators in high-risk settings can lower this threat, but health care workers do not always follow protocols that minimize risk. Our objectives were to: (1) determine feasibility of conducting a larger scale study, and (2) test effectiveness of a photovoice intervention for changing attitudes and behaviors of Russian HCWs with regard to following protocols. DESIGN AND SAMPLE: A convenience sample of 20 HCWs was recruited from a regional TB hospital in Russia to participate in this single-group experimental-design feasibility study. MEASURES: Participants completed a survey prior to and following the intervention. INTERVENTION: Participants photographed someone important to them then wrote a short narrative describing why that significant other motivated them to wear and fit-check respirators. AUTHOR: As per journal style, "Intervention" subheading to be included in the "Abstract" section if this heading appears in the "Methods" section. Therefore, either include this heading in the "Methods" section or delete the subheading "Intervention" along with its text found in the "Abstract" section. RESULTS: We identified four areas to revise prior to undertaking a larger experimental study. The intervention had a significant effect on intention to wear and fit-check respirators. Perceived behavioral control predicted intention to wear respirators, F(3,16) = 20.383, p < .001. Subjective norm and perceived behavioral control predicted intention to fit-check respirators, F(3,16) = 44.571, p < .001. CONCLUSIONS: Results suggest photovoice may be an efficacious intervention and larger scale testing is warranted.

Lessons learned from conducting qualitative research in a hospital.

AIM: To examine unexpected barriers to the conduct of hospital research during a study of nurses' activation of rapid response teams. BACKGROUND: We interviewed hospital nurses regarding their decisions to activate rapid response teams and encountered unexpected barriers to the conduct of this study in the hospital setting. DATA SOURCES: Experience of conducting qualitative research with bedside nurses in a community hospital. REVIEW METHODS: Review of the reports of others who have conducted hospital research. DISCUSSION: Barriers related to administrative support, environmental distractors, constraints on nurses' time, apparent lack of investment in research by staff and a cumbersome recruitment process are identified. Recommendations on study site selection, timing of research, gaining access to nurses, scheduling and conducting interviews, and transcribing recorded data are made. CONCLUSION: As evidence is necessary to deliver safe, quality care, it is important that nurses understand and participate in research. This participation involves not only conducting research, but also serving as subjects. Given the importance of bedside nurses' willingness to engage in research, it is crucial to understand factors that impede or assist their participation. IMPLICATIONS FOR RESEARCH/PRACTICE: We offer several recommendations to nurses conducting research in hospitals, including: ■ Seek hospitals that are supportive of research, yet not over-invested in the process. ■ Build extra time into data collection schedules to maximize flexibility and accommodate work-place demands. ■ Emphasise the relevance and benefits of the research to nurses.

Delay in seeking treatment and adherence to tuberculosis medications in Russia: a survey of patients from two clinics.

BACKGROUND: Tuberculosis is a global problem, especially in high burden countries such as Russia, that is fueled by delay in seeking treatment and nonadherence to prescribed medications. Stigma and illness representation (a person's mental image of a specific illness) have the potential to affect treatment seeking and adherence. OBJECTIVES: To describe the illness representation of tuberculosis in Russians with active pulmonary tuberculosis, and to determine if stigma and illness representation are predictors of delay in seeking treatment and adherence to tuberculosis medications. DESIGN: Cross-sectional, descriptive survey. SETTING: Two outpatient clinics in the Vladimir Region, Russia. PARTICIPANTS: A total of 105 adults, 18 years and older, being treated for active pulmonary tuberculosis, and on outpatient therapy for a minimum of four weeks participated in this study. METHODS: Delay was measured with a question asking length of time between onset of symptoms and appointment with a physician. Stigma was measured using the Social Impact Scale. Illness representation was measured using the Revised Illness Perception Questionnaire. Participants' outpatient medication records were reviewed for medication adherence. RESULTS: Symptoms reported were not consistent with those described in the medical literature and other studies. Only four subjects suspected tuberculosis based on their symptoms; 60% believed they had other respiratory infections. Multiple regression showed that illness identity (an attribute of illness representation) (beta=0.23) was a significant predictor of delay, accounting for 29% of the variance (p=0.008); and financial insecurity (beta=-0.28) and internalized shame (beta=0.27) (measures of stigma) were both significant predictors of medication adherence, accounting for 23% of the variance (p=0.003). CONCLUSIONS: Illness identity was associated with delay. Internalized shame was associated with increased medication adherence while financial insecurity was associated with decreased adherence. Results point to the need for broad, culturally specific patient, family, and community education programs.