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Embracing Identity: Unmasking Challenges in LGBTQ+ Disclosure Journey
No full textBackground: Lesbian, gay, bisexual, transgender, and queer (LGBTQ+) individuals often experience challenges pertaining to disclosure of their sexual orientation to others, or coming out. Coming out can be stressful and significantly impact an individual\u27s mental health, confidence, and safety due to factors including family and friends support, religion, environment, and finances. This study explored the lived experiences of LGBTQ+ adult individuals coming out, including experiences of ambiguous loss (AL).
Methods: This mixed-methods, IRB-approved study included 429 LGBTQ+ identifying individuals who completed an online anonymous survey about their coming out experience. We utilized virtual and social media platforms, and snowball sampling. A deductive codebook was developed and the data were coded by two researchers to ensure inter rater reliability. Ambiguous Loss theory was used as a framework to guide the findings.
Results: From the data of 429 participants, three major themes emerged: (1) Psychosocial safety (fear of being disowned, shunned, or abandoned); (2) Anxiety, depression, emotional strain, and shame; and (3) Authenticity, self-discovery, and the liberation. Results of this study indicate that individuals had an overwhelming fear of being rejected by their family, friends, and employers. Religious beliefs (n = 254), financial concerns (n = 107), and living in a heteronormative society were major factors in individuals\u27 fear of loss. Although participants identified many challenges, stressors, and losses during the coming out process, most (n = 379) reported that disclosing their sexual orientation improved their health and mental well-being.
Discussion: The findings of this study indicate a need to assess and offer support for ambiguous loss as individuals navigate the challenges of coming out and learn to cope with losses associated with heteronormativity and homophobia. Nurses can use this research to gain a deeper understanding of the interpersonal complexities experienced by LGBTQ+ people who disclose their sexuality. Understanding the impact of ambiguous loss in this context will enable nurses and the interdisciplinary team to provide empathetic care and appropriate resources, support, and guidance needed by the LGBTQ+ population to come out safely and confidently
A Novel Intervention to Prevent Depression in Youth: An In-Progress Randomized Clinical Trial
No full textPurpose: Depressive symptoms are on the rise in youth, with 40% of youth reporting clinically significant levels of depressive symptoms in 2021 [1]. In youth with clinically significant depressive symptoms, nearly half will progress to major depressive disorder by age 25 years [2,3]. However, there are few treatments to prevent mild depressive symptoms in youth from progressing to major depressive disorder [4-8]. The purpose of this study is to conduct a randomized controlled trial (RCT) to assess the effect of a novel intervention, Level Up, on self-management behaviors (mindfulness, sleep) and health status (depressive symptoms, anxiety symptoms, HRQL) in youth who have mild depressive symptoms.Methods: An exploratory 2-group randomized enhanced waitlist control design (n=20 Level Up; n=20 enhanced waiting list) will evaluate the effect of Level Up on health status (depressive symptoms, anxiety symptoms, HRQL) and self-management behavior (mindfulness, sleep) in youth ages 11-13 with mild depressive symptoms. Level Up includes eight 60-minute weekly group sessions that teach youth and a parent self-management collaboration, mindfulness, and sleep skills. Youth will complete measures assessing depressive symptoms, anxiety symptoms, HRQL, mindfulness, sleep, and contextual variables at baseline and 1, 2, and 4 months from start of the intervention.Results: The longitudinal effect of Level Up on sleep, mindfulness, depressive symptoms, anxiety symptoms, and HRQL in youth will be done using linear mixed-effects modeling. We hypothesize that youth receiving Level Up will exhibit decreases in depressive symptoms and anxiety symptoms and increases in HRQL, mindfulness, and sleep.Conclusions: This in-progress study will assess the effect of Level Up to prevent a major depressive disorder diagnosis in youth ages 11-13 years old. When Level Up is found to influence self-management behavior in youth, it can be applied at a large scale to prevent mild depressive symptoms from progressing into clinical depression
Internalizing Stigma and Distancing Behaviors: Social Media Youth Perspectives
No full textSignificance: Rates of youth mental health difficulties have risen drastically in recent years. Transition-aged youth (TAY) ages 18-24 years old represent a vulnerable population at risk for poor mental health outcomes, with depression and anxiety diagnoses increasing faster than any other age group. While the cause for this upsurge is multifaceted, these trends have occurred concurrently with the increasing popularity of social media (SM) platforms. Current evidence presents contradictory findings as to the impact of SM platforms on mental health, revealing a critical gap in knowledge.Methods: This interpretative phenomenological study aimed to explore the social media perceptions of TAY with a diagnosed mental health disorder in order to gain a better understanding of this phenomenon. Semi-structured interviews were conducted on ten TAY participants. Open coding was conducted prior to a six-step thematic analysis guided by the hermeneutic circle.Results: Thematic analysis revealed five distinct themes perceived by TAY regarding their social media use, including sharing to find a supportive community; acknowledging negative influences on mental wellness; disengaging through passive use; creating distance to achieve wellness; and internalizing stigma.Discussion: TAY perceive SM platforms as fostering a sense of community based on shared interests and as a critical source of entertainment. They also consider SM platforms to be harmful to their mental health, increasing stress and anxiety, encouraging them to argue with other users, and inspiring social comparisons. Overall, TAY believe the benefits of SM platforms outweigh the negatives, and report no intention to stop or decrease use.Conclusion: Findings from this study are beneficial to nurses, identifying risks to physical and mental health and a prevailing stigma that may influence TAY’s decision to seek care. Findings similarly reveal potential societal impacts, revealing a stunting of development within the TAY population. Startlingly, a significant tendency to avoid political discourse on SM platforms reveals potentially devastating societal ramifications
Research Priorities: An Innovation to Advance Nurse Governance Leadership and Impact Health Equity
No full textBackground: The purpose of this innovative project was to systematize the research trajectory for nurse governance leadership within a national professional organization. Research priorities aimed at generating new knowledge to advance nurse governance leadership have not been established. Tantamount to driving health equity, addressing lagging health outcomes, and achieving the United Nations Sustainable Development Goals (SDG) is the need to develop and expand the expertise of trustees and elected officials.Methods: The Nine Common Themes of Good Practice checklist was used as a frame for the project. The checklist includes three domains: preparatory work, deciding on priorities, and after priorities have been set. Extant research data was analyzed. Research priorities were determined based on criteria from the literature and the organization’s mission and values. With feedback from diverse nurse governance experts, minor revisions to the research priorities were made and approved by the organization’s board of directors. A steering committee of the board was established to develop an implementation plan inclusive of evaluation.Outcomes: Five research priorities were approved and include: board preparation; influence and impact of nurses on boards and nursing practice; influence and impact of nurses on boards within organizations; influence and impact of nurses on boards within communities; and influence and impact of nurses in policy and elected positions. The steering committee implemented a process to establish a research consortium, convene collaborators, identify funding, and commence research. Evaluation of the research priorities will be conducted after one year.Implications: The implications of this work include providing an expanded scope of influence to improve health outcomes, drive health equity, and position key national and global policymakers to achieve the SDGs. New knowledge and evidence generated from the research priorities will empower nurse governance leaders to influence the complex healthcare ecosystem with an appreciation for the impact of the social determinants of health, national and global diversity, and access to communities where health equity is secured
Network Analysis of Behavioral Psychological Symptoms of Dementia Among Older Adults With Dementia
No full textBackground and objectives: Older adults with dementia frequently experience a variety of behavioral and psychological symptoms of dementia (BPSD), which significantly diminish their quality of life, impose a heavy burden on their caregivers, and present major challenges for healthcare professionals in managing them. This study aimed to investigate BPSD in older adults with dementia through network analysis and to explore gender differences in symptom manifestation.
Research design and Methods: A secondary data analysis was conducted using datasets from two previous studies by the research team. This study included data from 213 older adults with dementia aged 60 and older. BPSD was assessed using the Korean version of the Neuropsychiatric Inventory, which evaluates 12 symptoms. Network analysis was employed to examine the structure and interconnections among these symptoms. The data were analyzed using SPSS version 27.0 and Google Colab with Python.
Results: While apathy, irritability, and anxiety had the highest mean scores, network analysis revealed that agitation/aggression and irritability were the most central symptoms, regardless of their mean scores. The strongest connection was between agitation/aggression and irritability. In our gender-specific networks, males exhibited a more dispersed and interconnected network, with agitation/aggression emerging as the highest centrality symptom, connected to most other symptoms. Conversely, females displayed a more centralized network, with agitation/aggression, anxiety, irritability, and aberrant motor behavior as the dominant symptoms with the highest centrality.
Discussion and Implications: This study is novel in applying network analysis to BPSD and is the first to explore gender differences within these networks. The findings highlight the critical role of agitation, aggression, and irritability, emphasizing the need for clinical assessment and interventions tailored to these symptoms with a gender-sensitive approach. Specifically, broader, multi-symptom interventions for males and key-symptom-focused interventions for females could effectively manage BPSD. Interventions informed by a deeper understanding of BPSD dynamics would have the potential to enhance the quality of life for both older adults with dementia and their caregivers
Pregnancy Ambivalence, Contraception, and Pregnancy Incidence Among Youth Experiencing Homelessness
No full textBackground: Youth experiencing homelessness (YEH) are 5-8 times more likely to become pregnant than their housed peers, with pregnancy estimates ranging from 30-60%. Similar to their housed peers, the majority of these pregnancies are unintended, a factor associated with negative health, economic, and social outcomes. Contraceptive use has been considered the behavioral link between attitude toward pregnancy and incidence of pregnancy; however, recent studies suggest that pregnancy attitudes and contraceptive use behaviors may be less consistent than previously thought, especially for marginalized individuals, such as YEH.
Purpose: The purpose of this study is to describe pregnancy ambivalence, pregnancy, and contraceptive use among YEH.Methods: Cross-sectional data was collected at baseline during a randomized wait-list controlled trial to assess the efficacy of an HIV prevention intervention among YEH (n=450). Demographics, lifetime incidence of pregnancy, and contraceptive use were assessed by single items. Pregnancy ambivalence was measured using three Likert scale questions assessing feelings and preferences about becoming pregnant.
Results: The sample (n=450) had an average age of 21.1 years, was majority Black (62%) or Hispanic (16%); 50% male, 44% female, and 6% other gender. Most of the sample reported having sex in the last 3 months (68%). Over a third (39%) reported ever being pregnant and 15% reported currently using contraceptives. Correlation analyses will examine the relation between pregnancy ambivalence, incidence of pregnancy, and contraceptive use.Conclusion: Results of this study highlight pregnancy ambivalence, contraceptive use, and the experience of pregnancy in YEH. Understanding pregnancy attitudes and correlations with contraceptive use may help nurses support contraception decision making and inform policies and programs that are responsive to the needs of YEH
A Systematic Review of Risk Factors for Accidents in Motorcycle Workers
No full textPurpose: A systematic review is a reliable strategy for integrating empirical evidence that guides practice. This systematic review aims to identify and synthesize studies on risk factors for accidents among motorcycle workers. To effectively reduce accidents in this population, interventions should be based on evidence regarding relevant risk factors.
Methods: We followed the Systematic Reviews of Effectiveness in JBI Manual for Evidence Synthesis. Six electronic databases were searched: PubMed, Medline, Cochrane, Web of Science, Embase, and CINAHL. The inclusion criteria comprised observational studies (cross-sectional, case-control, retrospective, cohort, and case studies) that reported on accidents involving motorcycle workers. Only articles published in peer-reviewed journals were considered, with no restriction on publication date. A librarian from the presenter’s institution guided the comprehensive search strategy. Two reviewers will independently assess the quality of the included studies using the Joanna Briggs Institute’s standardized critical appraisal instrument.
Findings: The initial search yielded 2,446 studies. After removing duplicates, 1,053 articles remained. Screening the titles and abstracts reduced this to 119 articles. During this process, two researchers resolved any disagreements through discussion to establish consistent criteria. A full-text screening led to a final selection of 23 articles. Of these, 14 (60.9%) were published after 2020. In terms of study design, the selected articles included 17 cross-sectional studies (74.0%), 2 case-control studies (8.7%), 1 retrospective study (4.3%), and 3 case studies (13.0%).
Conclusions: Accidents among commercial motorcycle workers have some of the most devastating health consequences. This systematic review seeks to identify factors contributing to these accidents, with the goal of supporting accident prevention efforts to maintain and improve the health of individuals in this population. The most significant risk factors identified will inform policy enhancements and the development of accident prevention programs for commercial motorcycle workers
Cultivating Compassion: Integrating Trauma-Informed Care into a BSN Nursing Curriculum
No full textBackground: Trauma-Informed Care (TIC) is a framework that recognizes the impact of trauma on individuals\u27 health and well-being.1-5 Nurses play a key role in creating healing environments for trauma-affected patients. To prepare future nurses, it is crucial to integrate TIC education into nursing programs. This quality improvement project aims to incorporate TIC principles into an accelerated pre-licensure nursing curriculum, ensuring students gain the knowledge and skills necessary to provide trauma-sensitive care.
Methods: This continuous quality improvement project assesses nursing students\u27 current understanding of TIC and their learning preferences through a survey. TIC principles will be embedded throughout the nursing program across didactic, clinical, and simulation environments, with systematic exposure each semester. Using the Model for Improvement, PDSA cycles will guide the planning, implementation, and evaluation of curriculum changes over four semesters for one cohort. The curriculum will focus on creating supportive, safe environments to improve patient outcomes.
Outcomes & Measures: The primary outcome measure will be the percentage of students demonstrating cognitive and affective changes in applying TIC principles in assignments and evaluations, with a goal of 20% competency by Spring 2026. The process measure will assess the incorporation of TIC content in 20% of required BSN courses, as evidenced by curriculum maps by Spring 2026. A balancing measure will collect faculty feedback on the impact of TIC integration on workload and stress levels through anonymous surveys, aiming to ensure faculty burden remains manageable.
Implications for the Nursing Profession: This project aims to equip nursing students with the skills to recognize and address the needs of trauma-affected patients, advancing holistic, patient-centered care. By prioritizing TIC in nursing education, we align with the broader goal of developing a workforce that embodies trauma-sensitive practices. Ultimately, this work contributes to a nursing culture that is empathetic, informed, and responsive to the needs of vulnerable populations
A Correlational Study of Pharmacology Knowledge Versus Confidence Levels in Student Nurses
No full textBackground: Student nurse knowledge and confidence levels when administering medications play a large role in error risks. Little information exists about the complex relationship between medication knowledge and error risks influenced by perceived certainty (Caboral-Stevens, M, et al, 2020.) Graduate nurses’ educational experiences affect their ability to meet novice nurse competencies such as safe medication administration (MA) practices (Musharyanti, L.,et al 2021, Tsegaye, D., et al, 2021.)
Purpose: The purpose of this study was to compare student medication knowledge and decision-making skills with their self-identified confidence levels.
Methods: This correlational study design compared 270 junior and senior BSN nursing students’ medication knowledge exam responses with response confidence. Institutional Review Board approval was secured to retrospectively review and report on aggregate data. Confidence was measured using a 4-point certainty scale that incorporated students’ likelihood to consult resources before medication administration.
Results: Correct responses’ confidence levels were rated “confident” 71% of the time. Incorrect responses were rated “confident” 43% of the time, and most likely would not consult resources before MA. Overconfidence occurred with math calculations, pump settings, anticoagulant medications, and basic pharmacology concepts. Spearman’s Coefficient indicated a statistically significant positive correlation between correct answers and certainty and a statistically significant negative correlation between correct answers and uncertainty. A statistically significant negative correlation between incorrect answers and certainty, revealing potential error risk was also indicated. A coefficient between incorrect answers and uncertainty was statistically significant.
Discussion: This study promoted students’ knowledge versus confidence self-awareness and provided faculty with medication error risk information. Incorrect responses with high confidence levels indicated students would not consult with resources, signifying a high error risk. Study results were used to identify content areas for which review and alternative teaching strategies are needed. Teaching strategies implemented in response to the study results include a first semester scaffolded dosage calculation program, focused content reviews on missed exam concepts, and a pharmacology teaching and learning technology platform
Using Simulation to Assess Knowledge and Attitudes of Healthcare Providers Regarding CPR
No full textPurpose: The purpose of this study was to assess knowledge and attitudes of doctors, nurses and nursing technicians regarding cardiopulmonary resuscitation (CPR) before and after simulation-based learning (SBL).
Background: The Cardiopulmonary Resuscitation (CPR) is a vital component of the chain of survival for people who undergo cardiac arrest. The global incidences of cardiac arrest have increased over the past years (Lim et al., 2020). Subsequently, the incidences of cardiac arrest in the lower middle-income countries are higher with alarmingly poorer survival rates (Ahmed et al., 2021). This imposes greater responsibility on the healthcare system to respond to the cardiac arrest situations with utmost preparedness. Most of the cardiac arrests happening within-hospital are first encountered by doctors, nurses or paramedical staffs most of the time. The efficiency, skill and timeliness to begin CPR for these frontliners is directly associated with the positive health outcomes for the patients (Dedeilia et al., 2020). To inform the healthcare delivery system and identify areas that require further development, it is crucial to assess the knowledge and attitudes of healthcare providers regarding CPR.
Methodology: The study used the quasi-experimental pre-test and post-test design. The doctors, nurses and nursing technicians from the medicine ward of a tertiary care hospital in Karachi, Pakistan, were recruited based on total sampling method whereby 99 frontline healthcare providers took part. The data was collected using two previously validated tools: Basic Resuscitation Skills Self-Efficacy Scale (BRS-SES) for attitude assessment (Hernández-Padilla et al., 2014) and a 15-item knowledge-based questionnaire (Iqbal et al., 2021).
Results: The study affirmed that baseline knowledge and attitudes of healthcare providers were poor. The preset knowledge of healthcare providers was insufficient (6.44 ± 3.22) and increased significantly (13.82 ± 2.03) post-simulation. Similarly, the attitude pretest scores were suggestive of unsatisfactory results (43.94 ± 20.2), which surpassed with (91.95 ± 8.2) significantly improved scores on the post-test