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Caring Science as Embodied Wisdom: Balancing Intrapersonal, Interpersonal, and Extrapersonal Factors
No full textThe intersection of caring science and the balance theory of wisdom reveals profound connections between therapeutic practice and theoretical frameworks of human understanding. We examine how caring science inherently encompasses explicit knowledge—systematic, teachable aspects of healthcare—and tacit knowledge—intuitive, experience-based understanding practitioners develop over time. Exploring these knowledge domains with the lens of the balance theory of wisdom aligns caring science with the theory\u27s core principles of balancing multiple interests, adapting to environmental contexts, and pursuing the common good (1).Practicing through the lens of caring science implicitly aligns with wisdom-based decision-making by balancing intrapersonal (self), interpersonal (others), and extrapersonal (institutional) interests in daily practice. We use a nursing practice exemplar to show how the tacit knowledge developed in caring relationships—including intuitive understanding of patient needs, cultural sensitivity, and emotional intelligence—mirrors the adaptive expertise emphasized in the balance theory of wisdom. We explore the explicit knowledge base of caring science, including theoretical frameworks and evidence-informed practices, in providing the foundation for wise decision-making in healthcare settings. Leadership builds on skills of influence and relationships defined in caring science: caring for self and others acting from universal values of kindness, concern, love for self and others, and respect for diversity and individuality of each person, deepening one’s connection to what it is to be human, generating renewal and energy (2). Caring science embodies wisdom theory by integrating complex knowledge in practice, while the balance theory of wisdom offers a theoretical framework for understanding this integration. These complementary perspectives have important implications for education and practice illustrated in the Sigma call to action.
(1) Pesut, D. (2015). Avoiding derailment: Leadership strategies for identity, reputation, and legacy management. In Leadership & nursing contemporary perspectives (pp. 251-261). Elsevier Churchill Livingston.
(2) Freshwater, D., Horton-Deutsch, S. & Sherwood, G. (2024). Reimagining Ourselves: The role of reflection on critical caritas consciousness and knowledge development. In S. Horton-Deutsch & G. Sherwood (Eds) Reflective Practice: Reimagining Ourselves, Reimagining Nursing. 3rd Ed. Sigma Theta Tau Press. Pp.3-1
Cervical Cancer Screening in Women Over 65 Years of Age
No full textThe study aimed to assess cervical cancer screening practices among at-risk women aged over 65 years, describe adherence to nationally recommended cervical cancer screening guidelines for this same patient group, and provide preliminary insights into adherence among primary care providers (PCPs) and gynecologists
Responding to Mental Health Care Needs: Outcomes of a Telehealth Services Expansion in a Rural State
No full textBackground: One in five adults in the U.S. is living with a mental illness (MI) (Substance Abuse and Mental Health Services Administration, 2024). Among Medicaid beneficiaries (MB), this prevalence is estimated to be 48% (Adelmann, 2003). MB with MI often have challenges in accessing available mental health treatment (Fry et al., 2021; McConnell et al., 2020). However, telehealth has become a responsive modality to enhance mental healthcare by improving access and reducing barriers (Guth, 2023; Mulvaney-Day, Dean, Miller, & Camacho-Cook, 2022).
Purpose: The purpose of this study was to examine the changes in the use of telehealth services among MB with MI in response to an expansion of these services in a rural Southeastern U.S State.
Methods: This retrospective analysis is based on Kentucky State Medicaid claims dataset from January 2018 to December 2022, inclusive of MB with MI (N=174,354). Variables obtained from the data set included age, gender, ethnicity/race, residence, MI diagnosis, payor type, and telehealth use codes. A chi-square analysis was used to examine differences in the telehealth use by year. A logistic regression analysis was used to examine factors associated with telehealth use from among key variables.
Results: The proportion telehealth use increased by year from 0.34% in 2018 to 0.99% in 2022 (Chi-square=251.5 [DF=4], p\u3c.001). In the logistic regression analysis, those with any telehealth service codes were significantly more likely to be of younger age, female, and urban residence, and having a serious MI or a serious MI and substance use disorder (compared to a MI only), and having a fee for service payor type (compared to both managed care organization and Fee for service). There was a significant, nearly 200% increase in telehealth use by 2022 (compared to 2018).
Discussion: Despite increases in the use of telehealth services over the 5 year-period, the low rate of codified use suggests an opportunity to improve the availability of telehealth services for MB with MI in a rural southeastern state. Nurse administrators/leaders advocating for these services can consider better responsiveness to MB\u27s in rural areas, males, and among those with substance use disorders. Given the current findings, there is a need for further nursing-led investigations regarding the use of novel technologies that may respond to the access needs and reduce the current burden of MI in vulnerable populations globally
Experiences of Transgender Individuals in Healthcare: Towards Establishing an Affirming Model of Care
No full textIssue: In recognition of the health disparities among the lesbian, gay, bisexual, and transgender (LGBT) population, health authorities have called for increased knowledge and research. Evidence shows that transgender individuals often face the most severe forms of discrimination and health disparities. Given this, establishing an affirming care model is crucial for guiding both research and practice. The purpose of the literature review is to provide insight into the current state of knowledge on the experiences of transgender communities in healthcare to contextualize the need for an affirming framework.
Description: Relevant peer-reviewed articles were retrieved from Ovid MEDLINE(R), OVID Embase, CINAHL, and Web of Science within the last 10-15 years using key search terms.
Results: Sixty studies were imported for screening. After screening, 10 studies were included - 8 qualitative, 1 cross sectional secondary analysis, and 1 mixed methods study. The themes that emerged from the literature were barriers to accessing healthcare including discrimination and stigma and lack of medical provider knowledge, mental health impacts, and positive experiences towards best practices.
Conclusions and Recommendations: This review sought to provide a more in-depth understanding of the challenge’s transgender communities face within health care and potential affirming models of care. The findings highlight the need for additional research on interventions, such as a trauma informed framework, to reduce health disparities. Future research directions are to conduct a secondary analysis with systematic coding of qualitative data from patient and medical provider interviews at a community-based transgender clinic
Improving Nurse-Patient Communication by Fostering Ethnocultural Empathy
No full textThe Improving Nurse-Patient Communication by Fostering Ethnocultural Empathy quality improvement project engaged bedside nurses at an East Bay urban medical center in online cultural competency curriculum and focus group discussion. Nurses Scale of Ethnocultural Empathy (SEE) was assessed pre- and post – training using the SEE assessment tool.
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Emergency Department Nurses and Their Experiences of Healthy Eating: A Qualitative Study
No full textThis project explores the self-reported eating habits of emergency department (ED) nurses and identifies barriers blocking them from eating nutritious foods during shifts. ED nurses shared why they often chose unhealthy snack options, underate, and overate when on the job and at home
New Nurse Graduates’ Translation of Evidence for a Sustained Healthy Work Environment
No full textThis program discusses how novice nurses engaged in evidence-based clinical inquiry and appropriately translated evidence into practice to deliver high-quality care, optimize and sustain a healthy work environment, and promote positive patient outcomes.
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Posttraumatic Growth Experienced by US Nurses: A National Study
No full textPost-traumatic growth (PTG) experienced by US nurses who provided care during the COVID-19 pandemic has not been examined. The findings from this multisite study of over 2,000 nurses provide information about the various factors of PTG that were experienced. Recommendations to promote PTG among nurses will be provided.
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Silver- Lining of Pandemic Nursing: Comparing Resilience, Burnout, and Culture; Pre- and Post-COVID Waves
No full textAlthough the pandemic may be correlated with healthcare workers leaving the profession, it is also associated with shaping a tenacious and hardy workforce. This novel research examines a sample of the healthcare workforce during different waves of the pandemic. Hospitals focused on culture and teamwork reduced turnover and enhanced resilience.
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The Utilization of Self-Tracking Technologies for Managing Nurses’ Shift Work Related Fatigue: A Study Protocol
No full textThis study will provide insights on utilizing self-tracking technologies to improve the health and well-being of professional nurses in clinical settings. The presenter will introduce the synthesis of existing literature on the effects of self-tracking health behaviors and the future mixed-methods study protocol.
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