Sigma Repository
Not a member yet
16599 research outputs found
Sort by
Trauma-Informed Care in Oncology
No full textIntroduction: Trauma-informed care (TIC) refers to the widespread impact of trauma on patients, focusing on safety, trust, empowerment, and collaboration. Oncology patients are particularly vulnerable to trauma due to the emotional and physical distress associated with cancer diagnoses and treatments. This literature review examined the role of TIC in oncology, emphasizing its effects on patient outcomes, healthcare provider practices, and challenges in implementation.Methods: A systematic review was conducted using PRISMA guidelines. Studies published from 2018 to 2024 were selected from PubMed, CINAHL, and PsycINFO. Keywords included trauma-informed care, oncology, patient outcomes, and interdisciplinary collaboration . A total of 10 studies were included, analyzing TIC interventions, patient care outcomes, and barriers to implementation.Results: Evidence supported the positive impact of TIC on patient outcomes, including reduced anxiety, depression, and distress. Davidson et al. (2023) demonstrated that TIC approaches in oncology settings reduced anxiety and improved patient-provider relationships. Andrejko and Katrichis (2022) found psychosocial barriers to care and stressed the importance of trauma-informed practices. Dhawan and LeBlanc (2022) showed that TIC facilitated shared decision-making, particularly for racial minorities with hematologic malignancies. Key barriers identified were insufficient staff training, institutional resistance, and limited resources.Discussion: TIC enhances emotional well-being and patient engagement, contributing to improved care experiences in oncology. Implementing TIC faces challenges, such as the lack of training, time constraints, and institutional barriers. Centers for Disease Control and Prevention (2018) outlined strategies to aid in overcoming obstacles. Fleishman et al. (2019) emphasized the role of nurses in leading TIC integration, fostering improved communication and patient care.Conclusion: Trauma-informed care significantly benefits oncology patients by addressing psychological trauma and improving treatment protocol implementation. This study highlights the importance of TIC training for healthcare providers and institutional support for its implementation. Future research should focus on overcoming implementation barriers and evaluating the long-term effects of TIC in oncology
Pre-Licensure Nursing Student Professional Identity Formation: A Longitudinal Qualitative Study
No full textBackground: The study aimed to explore pre-licensure nursing students’ perceptions of their professional identity in nursing. Forming a nurse’s professional identity is a transformational process that begins during pre-licensure nursing programs, and there is limited evidence regarding effective interventions to facilitate the process (Godfrey & Young, 2025; Thompson, 2022). Educators are responsible for creating a learning environment that fosters professional identity development in pre-licensure nursing students (Godfrey & Young, 2025; Thompson, 2022). Nurses who embody their professional identity can positively influence patient safety, enhance the quality of patient care, and promote a healthy workplace environment (Phillips & Priddy, 2023; Thompson, 2022).
Methods: Institutional Review Board approval was obtained. This longitudinal qualitative descriptive study employed purposeful sampling to recruit pre-licensure nursing students enrolled in a first-semester course at a rural Midwestern university in the United States. Students engaged in multiple innovative active learning activities on professionalism and professional identity in nursing. Students completed a Qualtrics survey consisting of four open-ended questions to encourage reflection on their professional identity as nurses (n = 61) and re-surveyed using the same Qualtrics survey at the end of the fourth semester (n = 53). Data analysis was conducted using Braun and Clarke’s (2006) thematic analysis method. Trustworthiness was ensured through Lincoln and Guba’s (1985) parallel criteria.
Results: The Pre-licensure Nursing Student’s Transformation to their Professional Nurse Identity Model emerged with four key themes: (a) Professional Nurse Values and Ethics; (b) Nursing Knowledge: Research and Evidence-Based Practice; (c) Nursing Students and Nurses as Leaders; and (d) Professional Comportment in Education and Practice. Limitations of the study include being restricted to one program; however, data saturation was achieved.
Conclusions: Forming a professional identity is a transformational process for pre-licensure nursing students that begins in their educational programs and must continue as they graduate and transition into practice. Faculty and clinical practice nurses can facilitate this process by providing supportive learning experiences, mentoring, and role modeling. Future research must include diverse pre-licensure nursing students from multiple educational programs globally
Representing RNs and MAs: Reflections on Patient Portal Messaging Experiences and the Future with AI
No full textBACKGROUND: Though meant to enhance health care delivery, the electronic health record (EHR) has evolved to be the predominant tool used amongst clinicians. The EHR is also intensifying stress among clinicians, especially with the growing volume of patient communications through patient portals messages (PPM, better known as the In-Basket).1 This academic health science center had an dramatic rise in PPM from 332,000 messages total between fiscal years (FY) 2014 to 2018 to 1.6 million messages in FY 2023 without additional staff. Generative artificial intelligence (AI) products and subsequent explosion of large language models may transform PPM responses.2–6 Discussions around AI\u27s role in healthcare largely focus on licensed independent practitioners, leaving a gap of ambulatory staff experiences like ambulatory RNs and medical assistants (MAs).7,8PURPOSE: The purpose was to explore ambulatory RNs’ and MAs’ experiences with patient portal messaging.METHODS: This study was part of a larger, IRB-approved mixed methods study at an academic health center in the United States. The qualitative portion used thematic content analysis to analyze open ended free text responses.RESULTS: There were a total of 289 survey respondents, (RNs= 130; MAs= 159), with 256 responding to open ended questions. Challenges encountered regarding PPM management included: large volume of messages (n=36), software concerns and time consuming (n=21). Emotions about PPMs before logging into the EHR were predominately negative (n=118) with anxiety (n=50), stress (n=34), and overwhelmed (n=29) most cited. Most participants reported negative feelings when the in-basket was not empty, with stress (n=73), overwhelmed (n=41), and anxiety (n=39) the most frequent emotions. When the in-basket is empty, most reported positive feelings (n=182), but several had never experienced an empty in-basket (n=60).IMPLICATIONS: Ambulatory RNs and MAs are underrepresented in EHR research but are highly impacted by PPMs in a Team Based Care Model. Future research is needed to reflect and respond to the negative emotional responses towards PPMs. RN and MA representation is needed in additional research on the potential use of AI to relieve some of the administrative burden related to PPM responses
Anxiety, Depression and Associated Medical Symptoms in Kenyan HIV+ Women: Rural vs. Urban Context
No full textBackground: Advances in HIV therapeutics for women living with HIV (WLWH) in sub-Saharan Africa have shifted focus from deadly AIDS to chronic disease management. This shift underscores the need for integrated mental health and HIV care in low-resource settings, particularly addressing medical comorbidities and antiretroviral (ARV) side effects that exacerbate anxiety and depression. Conditions such as anemia, diabetes, hypertension, and malaria, alongside ARV-related side effects like chronic pain, fatigue, and neuropathy, contribute to overlapping physical and mental health symptoms and challenges. Integrating mental health screening into primary care facilitates identifying primary and secondary symptom etiologies, optimizing outcomes. Urban and rural WLWH face distinct barriers, stressors, and resources, necessitating context-specific approaches. Expanding nursing education and roles may address critical healthcare access constraints.
Objectives: This study aims to: (1) compare the prevalence and severity of anxiety (GAD-7) and depression (PHQ-9) in rural and urban Kenyan WLWH living in poverty; (2) identify medical comorbidities and physical symptoms associated with these mental health conditions and +HIV status; (3) explore context-specific factors influencing mental health outcomes in urban versus rural cohorts; (4) demonstrate enhanced health screening access with expanded nursing role on multidisciplinary teams.
Methods: A cross-sectional, comparative observational study will recruit widowed WLWH enrolled in a Women’s Employment and Empowerment Program (WEEP) run by a Kenyan non-governmental organization (NGO) in rural and urban areas. Participants receive equal financial support, skills training, and healthcare oversight. A mobile multidisciplinary medical team, led by the NGO physician and including Kenyan and U.S. nursing faculty, advanced practice nurses and registered dietician, will conduct comprehensive health assessments. Data to include mental health metrics (GAD-7, PHQ-9), medical comorbidities (hypertension, diabetes, anemia, chronic pain, secondary cancer), and contextual factors.
Data Analysis: Rural-urban differences in mental health and medical conditions will be analyzed using t-tests or Mann-Whitney U-tests. Multivariable regression will assess associations between GAD-7/PHQ-9 scores and medical comorbidities, controlling for demographic and contextual variables.
Implications: Tailor interventions to unique rural and urban context
Service-Learning in Nurse and Midwifery Education: Building Capacity in the Americas
No full textIntroduction: Service-learning (SL) integrates purposeful and immersive community-based experiences into the curriculum while addressing health disparities.1,2 Growing evidence from North America shows that academic service-learning nursing partnerships can lead to impactful change.3 Yet, the need to integrate SL into the curriculum must be informed by country-specific, regional evidence.
Purpose: To train in and promote integration of SL by nurse and midwife educators in alignment with the Global Strategic Directions for Nursing and Midwifery4 for developing clinically competent and culturally-sensitive practitioners equipped to provide population-targeted services.
Objective: Identify evidence from the Americas region on service-learning integration and best teaching practices.
Methodology: An integrative literature review in PubMed, CINAHL, and Scopus yielded 21 articles on SL best practices, implementation, and sustainability strategies. Synthesized evidence was used to develop a tailored virtual training.
Results: Evidence was mostly experiential (57%), followed by descriptive/qualitative/mixed methods studies (38%). International service-learning (ISL) or “Study Abroad” was most frequently (62%) used across undergraduate nursing and midwifery programs. The majority of ISL initiatives originated from the US, with three from Canada, Jamaica, and Haiti. Host ISL countries included the Dominican Republic, Haiti, Jamaica, Guatemala, Bahamas, and Trinidad. Host settings were community-based units (59%) and free-standing clinics (33%). In most cases, there was no agreement (informal ISL, 85%) and no prior community assessment (70%). Synergy in training, empowerment, education improvement, access to shared resources, and application of knowledge into practice were the most frequently reported outcomes.5,6,7 Planning, implementing and evaluating an ISL initiative required selection of an appropriate model, regular evaluation regularly, and adopting a quality improvement approach.
Conclusion: Throughout Latin America and the Caribbean, SL is not integrated into nursing and midwifery educational programs. It is encountered as “community service” and largely achieved through extracurricular activities. Contextualizing ISL enriches education, promotes cultural humility, and equips nursing and midwifery graduates to become catalysts for change
Young Adults\u27 Experiences With Text Messaging Intervention for E-Cigarette Cessation in Rural Areas
No full textIntroduction: Electronic Nicotine Delivery Systems (ENDS, commonly known as e-cigarettes) use has increased rapidly among young adults (YAs, 18-24 years) in rural communities. E-cigarette use is a higher risk factor for both cardiovascular and pulmonary diseases. Addressing the disturbing rates of e-cigarette use in YAs requires cessation resources to be available and accessible. Regrettably, rural community residents have limited access to cessation resources. The purpose of this study was to explore YAs\u27 perceptions and experiences engaging in text-message intervention to assist with vaping cessation effectively.
Methods: A qualitative investigation with individual interviews was conducted. Participants (n = 8) were from a larger study focused on text messaging cessation interventions in rural Wisconsin, Minnesota, North Dakota, and South Dakota. Research team members conducted post-intervention interviews via Zoom. Content analysis was employed to analyze transcripts using NVivo 20.
Results: Four key themes emerged from the data: (1) Effectiveness of text messaging intervention, (2) Essential attributes of text messaging program, (3) Areas for improvement, and (4) Safety of intervention.
Conclusion: YAs in rural areas reported that text messaging is an effective intervention for ENDS cessation. The convenience and personalized support YA received via text messaging provided frequent reminders and support. Incorporating participant-driven modifications and expanding the text messaging intervention strategy to a larger cohort has the potential to contribute to a broader public health effort to reduce ENDS use in underserved rural populations
Creating A Standardized Intraoperative Handoff Report
No full textPurpose: Effective communication during nurse-to-nurse relief is vital for patient safety, especially in complex surgeries. In the Operating Room (OR), inconsistencies in handoffs arise due to lack of structure, information gaps and time constraints. This project evaluates the impact of implementing a structured SWITCH (Surgical Procedure, Wet, Instruments, Tissue, Counts, and Have Questions) protocol for nurse-to-nurse handoff reports during breaks and permanent relief, aiming to improve continuity of care, reduce errors, and enhance patient safety.
Relevance: The SWITCH handoff model ensures all relevant surgical information is clearly communicated, reducing the risk of incomplete or unclear handoffs that can compromise patient care. By implementing a structured handoff report, communication improves, incomplete information is minimized, patient complications and errors are reduced, OR nurses experience improved situational awareness and increased satisfaction with handoff reports (1,2,3,4).
Methods: This evidence-based practice project uses the IOWA model as the framework, with a new report template reflecting the SWITCH model. Staff education included a live presentation on project expectations, followed by weekly education reinforcement, socializing the new template, and visual cues at workstations. Outcomes were evaluated through pre-and post-surveys that assess staff perceptions and experiences, as well as audits of the SWITCH handoff templates.
Results: The pre-survey (n=48) indicated that 91% of nurses believed that a standardized handoff report would improve patient safety, with 56% of nurses being “very satisfied” with their non-standardized handoff reports. In contrast, the post- survey (n=23) revealed 82% were “very satisfied” with the practice change of the SWITCH model. Additionally, 86% of participants confirmed that the SWITCH model improved patient safety and that they would continue using it. All audited SWITCH handoff reports were 100% logically and concisely completed, confirming full adherence to the required handoff report standards.
Conclusion: The SWITCH handoff report model effectively standardizes and structures communication, which is critical for improving communication and ensuring patient safety. This model aligns with the conference theme by representing a commitment to structured communication, reflecting on current practices, respecting patient safety and responding with actionable improvements in the operating room
Workplace Incivility and Its Impact on Vulnerability and Well-being of Nursing Faculty in Japan
No full textResearch Design: This research was a non-experimental descriptive study.
Subjects: A convenience sampling method was employed in this study, resulting in a total of 455 nursing faculty across Japan. The participants consisted of 52 males (10.4%) and 341 females (68.1%) with a mean age of 47.2 years (SD = 9.68). Regarding their academic positions, 94 were professors (18.8%), 68 were associate professors (13.6%), 82 were (senior) assistant professors (16.4%), 113 were (junior) assistant professors (22.6%), and 41 were research associates (8.2%).
Instruments: The survey form with open-ended questions to explore the experiences of workplace incivility such as faculty-to-faculty and student-to faculty incivility was developed by the researchers. In order to assess the level of vulnerability, we used two scales: one developed by researchers based on the Vulnerable Populations Conceptual Model and the other, a Japanese-translated version of the Psychological Vulnerability Scale. The Japanese version of the Flourishing Scale, Patient Health Questionnaire 9 and 15 (PHQ-9 and PHQ-15) were used to assess the levels of well-being.
Analysis: Descriptive statistics were examined to further analyze sample characteristics and the means and standard deviations of all the study variables. The participants were grouped according to the experience of workplace incivility as well as the characteristics, and independent samples t-test and analyses of variance (ANOVAs) were used to examine differences among the groups on the level of vulnerability and well-being. Responses to open-ended questions were analyzed thematically to identify the types and patterns of uncivil behaviors experienced by the participants.
Procedures: This research has received approval from the Institutional Review Board (IRB) of the principal investigator\u27s affiliated university.
Results: Analyses of the data in this study are currently in progress, and the results will be reported.
Conclusions: We expect that the findings of this study will demonstrate the nature and magnitude of workplace incivility as experienced by Japanese nursing faculty and will contribute to the development of a strategy to minimize and prevent incivility in nursing academia in Japan
The Effects of Resilience Enhancing Nursing Program among Pregnant Teenagers, Thailand
No full textThe situation of teenage pregnancy in Chawang district, Thailand has become a significant problem and of social concern. Teenage pregnant women who lack resilience are more likely to face adversity, including the risks and complications associated with physical and mental health.
A quasi-experimental one group pre-post test repeated measures design was used to test the effects of a resilience enhancing nursing program on resilience, knowledge of contraception, and the decision-making of contraceptive use during the postpartum among pregnant teenagers, Chawang district, Nakhon Si Thammarat, Thailand. Purposive sampling was used to select 20 adolescent pregnancies based on the inclusion criteria. The program consisted of establishing a trusting relationship, improving resilience, monitoring and encouraging the resilience practice, and knowledge of contraception. All the activities in the program were used 4 times with about 45 minutes spent on each activity face-to-face and during the follow-up via telephone. The instruments for data collection consisted of the demographic data form, the resilience scale, the knowledge of contraception questionnaire, and the postpartum contraception decision-making questionnaire. The program and all the instruments were content validated by three experts. Reliability was examined with twenty teenage pregnancies using KR-20 for the knowledge of contraception questionnaire which was equal to 0.83. Cronbach\u27s alpha coefficient was used for the resilience scale and the postpartum contraception decision-making questionnaire which were equal to 0.94 and 0.83, respectively. Data were analyzed using descriptive statistics, a Friedman test, and a Wilcoxon Matched Pairs Signed Rank test.The findings revealed that there were significant differences in the overall mean ranks of resilience, knowledge of contraception, and postpartum contraception decision-making at baseline, week 12, week 20, week 32, and the postpartum period (p\u3c .001). A Wilcoxon signed rank test revealed a significant difference in the resilience rating, knowledge of contraception, and postpartum contraception decision-making between the baseline, week 12, week 20, week 32, and the postpartum period (p\u3c .01)The results can contribute to guiding nurses to enhance the resilience of pregnant teenagers in the early first trimester and provide appropriate interventions for teenage mothers in all periods until postpartum
Responding to Faculty Research Literacy Needs at a Non-Research Intensive University
No full textNursing faculty at non-research-intensive universities must develop and demonstrate literacy in research topics to support the education of their students. Many faculty members at research-intensive universities are considered to be experts in their fields of research methodologies and funding acquisition. Although faculty at non-research-intensive universities may not be engaged in managing large research programs, they are teaching students in research-focused courses at the BSN, MSN, and DNP levels. At the DNP level, faculty must be able to demonstrate and understand quality improvement methodologies. This activity will describe an innovative program developed at a non-research-intensive university to address the research literacy needs of nursing faculty.
The Research Committee, a part of the shared governance structure of the university, conducted a needs assessment to understand the research literacy needs of faculty at the university. The needs assessment was an evidence-based survey sent to all faculty. Based on the survey results, a program was devised to meet the learners\u27 needs. Respondents indicated topics that were very interesting, moderately interesting, or not interesting to them. The program planners attempted to focus on topics that were considered to be very or moderately interesting. A lunch and learn format was used to deliver content by expert speakers, and time for interaction with the speaker was included in each session. The meetings took place monthly via Zoom as the faculty live in many different parts of the country. The speakers for the session were faculty at the university who had experience and expertise in the topic to be presented. The meetings were recorded each month. The planners created an evaluation tool to elicit feedback for each session. The participants indicated that the sessions were valuable to their understanding of the topics, and they appreciated the interaction with the presenters in which they could ask questions in a nonjudgmental environment. The sessions were well-attended, with most participants attending them synchronously via Zoom. The decision was made to continue these sessions.
Often, we focus on the research literacy needs of our students. This program demonstrates the importance of supporting nursing faculty in non-research-intensive universities to ensure they have the knowledge and information they need to successfully support their students in research and quality improvement endeavors