Sigma Repository
Not a member yet
16599 research outputs found
Sort by
Variations in Bio-Psycho-Behavioral Profiles and Quality of Life Among Obesity Subtypes
No full textBackground: Obesity, a complex metabolic condition, is linked to chronic diseases and reduced quality of life (QoL) (Ben Othman et al., 2023). Traditional metrics like Body Mass Index (BMI)fail to capture the full spectrum of metabolic health impacts (Iacobini et al., 2019). A nuanced classification into obesity subtypes—metabolically healthy normal weight (MHNW), metabolically unhealthy normal weight (MuHNW), metabolically healthy obese (MHO), and metabolically unhealthy obese (MUO)—reveals significant variations in health outcomes (Després, 2023). Understanding these differences in bio-psycho-behavioral aspects and QoL is crucial but underexplored.
Aim: This study examines bio-psycho-behavioral factors and QoL variations across different obesity subtypes.
Methods: In this cross-sectional study, 257 participants from a Taiwanese health center were classified as MHNW, MuHNW, MHO, or MUO based on BMI (≥24 kg/m2 as obese) and metabolic health (fewer than two metabolic syndrome criteria and no history of hypertension, diabetes, or cardiovascular disease). Psychological distress (DASS-21), dietary habits, physical activity (IPAQ), sleep quality (PSQI), and QoL (WHOQoL-BREF) were assessed. Biological indicators included heart rate variability (HRV) and insulin resistance (HOMA-IR).
Results: Subtype distribution was 35.1% MHNW, 7.7% MuHNW, 20.8% MHO, and 35.5% MUO. The MUO group exhibited higher psychological distress and poorer sleep quality than MHNW and MHO (p \u3c 0.001), comparable to MuHNW. Physical activity was lower in MUO compared to MHNW, MHO, and MuHNW (p \u3c 0.05). HRV indices (SDNN, RMSSD) were reduced in MUO compared to MHNW and MHO (p \u3c 0.001), with levels similar to MuHNW. HOMA-IR was higher in MUO than MHNW (p \u3c 0.05) but not significantly different from MuHNW or MHO. QoL was notably lower in MUO, marked by reduced satisfaction and general health perception (p \u3c 0.05).
Conclusion: Significant differences in psychological, behavioral, and biological factors exist across obesity subtypes. Despite normal weight, MuHNW participants faced risks similar to MUO, indicating hidden health concerns (Oliveira et al., 2020; Tebar et al., 2021). Although metabolically healthier, MHO participants showed elevated insulin resistance (Barazzoni et al., 2018). These findings underscore the limitations of BMI alone for health risk assessment, highlighting the need for multidimensional evaluations and targeted interventions for specific obesity subtypes (Wu et al., 2022)
Cultivating a Culture of Civility in Healthcare
No full textPromoting civility in healthcare is necessary to provide safe, reliable, and effective patient care (Frankel et al., 2017). The consequences of incivility especially affect many aspects of care provision and are detrimental to a healthy work environment. The lasting effects of the COVID-19 pandemic have contributed to an increase of incivility in the workplace, and additional efforts to promote a culture of civility are paramount to enhancing patient care quality and staff psychological safety (El Ghaziri et al., 2022). Assessment of the work environment can reveal opportunities for improvement and more effective interventions to meet organizational needs (Harris et al., 2019). Institutional support is also necessary to ensure a culture of civility remains sustainable. This project, aiming to enhance workforce engagement where individuals are respected and valued, included development and implementation of a civility education program at a pediatric specialty care hospital in Southeast Texas. The program was developed by synthesizing best practices identified from the literature and content experts. Collaboration with representatives from human resources, performance improvement, and nursing leadership teams offered further insight into civility culture. Clark\u27s Workplace Civility Index (WCI), a 20-item, psychometrically sound survey, was then administered to measure employee perspectives of civility in the work environment (Clark et al., 2018). It revealed areas requiring intervention, including interpersonal communication and conflict management. A project plan designed in response to results of the initial Clark\u27s WCI was submitted to the organization\u27s executive leadership team for feedback and to gain institutional support. With leadership\u27s endorsement, an evidence-based educational program was developed and implemented as the method of intervention. To improve attendance, interaction, relevancy, and knowledge retention, this education was provided to staff from individual departments in a round table forum. Clark\u27s WCI was readministered following the educational intervention. Results demonstrated, from those hospital employees participating in the civility education program, that the overall civility index increased from 90.29 to 91.14, indicating a very civil work environment. Areas identified as opportunities for improvement from the initial survey also increased, especially in two subsets: speak directly with the person with whom I have an issue and seek and encourage constructive feedback from others. A high degree of civility in the healthcare environment benefits the organization, its workforce, and the patients they serve. Consideration by healthcare leaders should be made to promote relevant interventions. Initial and ongoing work environment assessment can provide insight into areas for improvement and potential sources of incivility. Data from this project suggests that organizations should invest resources into programs that help improve interpersonal relationships and conflict management. Successful implementation requires executive support, individual understanding of civil and uncivil behaviors, and collective ownership of a culture of civility by the entire team (Garcia et al., 2021)
A Health System Approach to Evaluating Nurse Well-Being and Designing Interventions
No full textIn the wake of a global pandemic and societal stressors, clinician wellbeing and the threat of burnout are commanding increasing attention. Burnout contributes to nurse turnover and is threatening the ability of health systems to provide safe, high-quality care for patients (Dyrbye et al., 2017). The National Academy of Medicine (NAM) recommends a systems approach to prevent clinician burnout and promote professional wellbeing as healthy professionals are essential for achieving positive health care outcomes (NAM, 2019). Meaning and joy in nursing practice are contributors to professional wellbeing and are part of the solution for achieving the quadruple aim. One of the recommendations of the NAM report is the use of validated measurement tools to assess the current state of burnout, professional wellbeing, and stress to identify and implement interventions to enhance nurse wellbeing.
This descriptive, cross-sectional, mixed-methods study used online survey data from nursing staff in one academic health system related to their experiences and recommendations to improve wellbeing. The Professional Quality of Life Scale (ProQol) is a validated tool that measures compassion satisfaction, burnout, and secondary traumatic stress (Stamm, 2009/12). Previous studies have explored burnout using this tool (Hicks, 1999; Ilhan et al., 2008; Kanste, 2008; Kanste e al., 2007). The subscale of Pro-Qol consists of Likert items. Meaning and Joy in Work Questionnaire (MJWQ) in nursing is also a validated tool (i.e., α .94) that measures value/connections, meaningful work, and caring (Rutledge et al., 2018). This tool has a total composite score with a range of one=low to five=high rating, validated for use with nurses (Deetz et al, 2020; Hahn et al., 2021). During a 3-week period, nursing personnel were invited by email to complete a voluntary, anonymous, 15-20 minute online survey inclusive of study information, access to the Pro-QoL 5 Scale, an optional MJWQ, a qualitative section with 3 semi-structured questions and a demographics section (N= 562 complete responses). Participant demographics were analyzed using descriptive statistics including frequencies, means, and standard deviations. Independent t-test and ANOVA were used to analyze differences in mean scores of the Pro-QoL subscales and MJWQ across nursing demographic profiles (SPSS, version 26). Thematic analysis was used for qualitative data.
Preliminary data analysis of Pro-QoL responses revealed moderate compassion satisfaction (mean 27.98 +/- 7.91), low compassion fatigue (burnout mean 17.97 +/- 7.36, secondary traumatic stress mean 16.19 +/- 7.89). MJWQ response means ranged from 2.24-2.32. Results serve as baseline data and repeat surveys will be used to evaluate the impact of interventions. Some significant differences based on demographic profile were identified and will be used to inform targeted interventions. Thematic analysis identified job-related factors creating stress for nurses and participant recommendations to reduce job-related stress and cultivate healthier practice environments. Recommendations have been incorporated into a nurse-driven action plan.
A systematic approach to measuring nurse wellbeing using validated instruments will allow nurse leaders partnering with clinical nurses to lead meaningful, data-driven change to reduce job-related stress, create healthier practice environments, prevent clinician burnout, reduce turnover and ultimately achieve better healthcare outcomes
Influence of Satisfaction With Work Environment on Nurses` Retention: Importance of the Organizational Culture
No full textPreserving novice nurses is crucial for addressing the nursing shortage and for sustaining the future of the profession. The current research aimed to define factors related to the intention of young nurses to stay in the profession. The organizational culture is found to be extremely important as a predictor of retention.
Detailed abstract is attached
Well-Being of Nurses Who are Family Caregivers: The Impact of Dual Role Caregiving
No full textParticipants will learn about the preliminary data collected from a national sample of nurses who are also family caregivers. In this study, we sought to understand the relationships between caregiver burden, workplace productivity, and holistic well-being (emotional, physical, and financial well-being; purpose/meaning; character strengths) in this unique population.
Detailed abstract attached
Community CPR (C-CPR) Program: An Innovative Hands-On Approach to Teaching [City] Residents Lifesaving CPR Skills
No full textThe C-CPR Program provides a template for other Schools of Nursing with BSN Community Health courses an opportunity to promote improved outcomes for out-of-hospital cardiac arrest for residents in their local communities while offering students an opportunity to conduct hands-on training on very important lifesaving CPR skills.
Detailed abstract attached
Promoting Resources Among Safety-Net Clinic Staff to Address Social Determinates of Health and Improve Wellbeing
No full textBackground: Safety net clinic staff are essential for delivering quality care in underserved communities. Despite their critical role, there is a paucity of research on targeted approaches to managing high levels of burnout during the Covid-19 pandemic (Alvarez et al., 2022). Unlike independent practitioners (MDs, APRNs, etc.), safety net staff often hail from the communities they serve and experience similar negative Social Determinants of Health (food and housing insecurity and legal issues) that compromise the wellbeing of their patient population (Martinez-Hollingsworth et al., 202; Bodenheimer & Sinsky, 2014). Despite their essential role in public health, there is limited information on wellbeing preferences and needs for support among safety net staff.
Purpose: To address negative Social Determinants of Health among safety net clinic staff following an assessment that indicated the underuse of available free or low-cost resources they qualify for and regularly recommend to their patients. This project was part of a larger, HRSA-funded Behavioral Health Workforce program (HRSA 22-109).
Method: This project (June-July 2022) was done in a safety net clinic system in a predominantly Latinx Health Care Provider Shortage Area in the Western U.S. An art-based assessment with clinic staff (n=25) was used to determine well-being resource preferences and deficits. Images were thematically coded; project staff clarified emergent categories through 1:1 conversations with clinic administrators. These talks revealed that staff might not use the resources they provide to their patients despite qualifying for these services. To support improved uptake, our team sought to rebrand these resources by reintroducing them to the staff as part of a resource magazine. This project was informed by Maslow\u27s Hierarchy of Needs model (McLeod, 2018), in that when foundational needs are not met (such as a need for safety or physiological needs for food, shelter, etc.), there is a limited ability to use resources that target higher needs (like Love & Belonging and Self-Actualization).
Results: We identified six (6) critical resource needs areas: food security, childcare, rental assistance, family planning, immigration services, and domestic violence. Our team designed a resource magazine that included this info intermixed with neutral content, such as summer drink recipes. We disseminated this magazine at two (2) on-site staff events within the system. All fourteen participants (n=14) of the in-service event took a resource magazine showing 100% utilization of this intervention.
Conclusion: Current approaches to wellness promotion for healthcare workers and staff often focus on the self-esteem and self-actualization portion of Maslow\u27s Hierarchy of Needs, overlooking the more immediate needs of low-wage workers in community clinic settings. Creating a magazine is a novel and engaging way to disseminate information to providers who are aware of resources but have low utilization rates. Further studies may explore why safety net clinic workers are unwilling to engage in wellness activities and utilize the resources they promote. Future iterations of this work may quantify its efficacy and inform generalizability for use in other community clinic settings
Preparation of Generation Z Nursing Students for the Revised AACN Essentials
No full textGeneration Z has distinctive characteristics that nursing educators must know and embrace to best prepare future nursing professionals. Faculty need to consider these learner distinctions to best address the needs of these students in competency-based nursing curricula and prepare these students for the transition into safe nursing practice.
Detailed abstract attached
A Model of the Determinants of Maternal Mortality in Indigenous Women
No full textDespite increasing attention to the well-documented maternal health crisis in the U.S., stark disparities persist between groups of women. In December 2021, Indigenous mothers experienced 118.7 maternal deaths per 100,000 live births, whereas their White counterparts had 26.6 [1]. Maternal mortality is a multifaceted, complex issue that complicates the health and wellbeing of Indigenous women, yet the root causes of this disparity are not well-described. We need a deeper understanding of the determinants of health (social, structural, biological, political) that contribute to Indigenous maternal mortality. Indeed, the existing literature lacks adequate theoretical understanding to address this phenomenon. Therefore, the purpose of this project was to develop a model of the determinants of maternal mortality for Indigenous women in the U.S.
Methods: Non-Indigenous academicians and an Indigenous tribal citizen partnered to amplify Indigenous women’s voices. Situated in decolonizing [2] and Indigenist [3, 4] paradigms, we used Walker and Avant’s theory derivation [5] to create the model.
Results: We identified social, structural, political, and biological pathways to Indigenous maternal mortality. Risk factors include biological warfare and ongoing cultural genocide. Protective factors included resilience and cultural connectedness. Finally, we illustrate complex and multifaceted relationships among and between these concepts in the model.
Implications: Solutions that address determinants of Indigenous maternal mortality are critical for Indigenous families to flourish. Ideally, this model will inform the nursing research, policy development, and trauma-informed and culturally relevant clinical practice that is needed to eliminate the disparities in maternal mortality that Indigenous women experience. Academic researchers and tribal communities must continue to partner to support the safety and vitality of Indigenous women
Multimorbidity Treatment Burden Predicts Self-Care in Multimorbid Patients With Hypertension
No full textBackground & Purpose: Patients with multimorbidity experience unique challenges in performing self-care due to the complexity of dealing with multiple diseases simultaneously. The burden of managing multiple conditions and its impact on patients’ well-being (i.e., multimorbidity treatment burden) can negatively affect their ability to engage in recommended self-care regimens. While most studies have focused on disease burden, an outcome of disease progression that is often less modifiable, the relationship between multimorbidity treatment burden and self-care remains less explored. Therefore, the purpose of this study was to determine whether multimorbidity treatment burden was an independent predictor of self-care in patients with hypertension and additional chronic conditions.
Methods: This cross-sectional study included 503 patients who had hypertension and at least two comorbidities. Multimorbidity treatment burden was measured using the Treatment Burden for Multimorbidity Scale, and disease burden was measured using a self-report instrument that evaluates the extent to which each condition limits daily activities. Self-care was measured with the Partners in Health Scale. Hierarchical regression analysis was conducted to evaluate the extent to which multimorbidity treatment burden explained self-care after adjusting for disease burden and covariates. The first model (Model 1) included age, sex, living arrangement, employment status, social support, and health literacy as covariates. Model 2 added disease burden, and Model 3 included all covariates, disease burden, and multimorbidity treatment burden.
Results: In Model 3, multimorbidity treatment burden and disease burden predicted self-care (β=-0.18, p\u3c 0.001 and β=0.10, p\u3c 0.001, respectively), with greater multimorbidity treatment burden and lower disease burden associated with poorer self-care. The Model 3 explained 21.6% of variance in self-care, with multimorbidity treatment burden accounting for 2.0% of variance (adjusted R2 change = 0.02).
Conclusion: We found that both multimorbidity treatment burden and disease burden predicted self-care. However, as disease burden is often non-modifiable, multimorbidity treatment burden is a modifiable target for intervention to improve self-care in multimorbid patients with hypertension. Thus, interventions aimed at alleviating multimorbidity treatment burden may effectively improve self-care in this population