Prevalence of Food Insecurity Among Cancer Survivors in the United States: A Scoping Review.

BACKGROUND: Medical financial hardship is an increasingly common consequence of cancer treatment and can lead to food insecurity. However, food security status is not routinely assessed in the health care setting, and the prevalence of food insecurity among cancer survivors is unknown. OBJECTIVE: This scoping review aimed to identify the prevalence of food insecurity among cancer survivors in the United States before the COVID-19 pandemic. METHODS: Five databases (PubMed, Scopus, CINAHL [Cumulative Index to Nursing and Allied Health Literature], Web of Science, and ProQuest Dissertations and Theses) were systematically searched for articles that reported on food security status among US patients receiving active cancer treatment or longer-term cancer survivors and were published between January 2015 and December 2020. RESULTS: Among the 15 articles meeting the inclusion criteria, overall food insecurity prevalence ranged from 4.0% among women presenting to a gynecologic oncology clinic to 83.6% among patients at Federally Qualified Health Centers. Excluding studies focused specifically on Federally Qualified Health Center patients, prevalence of food insecurity ranged from 4.0% to 26.2%, which overlaps the food insecurity prevalence in the general US population during the same time period (range, 10.5% to 14.9%). Women were more likely than men to report being food insecure, and the prevalence of food insecurity was higher among Hispanic and Black patients compared with non-Hispanic White patients. CONCLUSIONS: Given significant heterogeneity in study populations and sample sizes, it was not possible to estimate an overall food insecurity prevalence among cancer survivors in the United States. Routine surveillance of food security status and other social determinants of health is needed to better detect and address these issues.

Predictors of Body Image Perception among African American Women.

Obesity is a significant health problem in the US with African American (AA) women having one of the highest prevalence of obesity. Some AA women may equate a larger BMI with a positive body image. The purpose of this cross-sectional descriptive study was to examine the relationship between demographic variables, body image perception, coping behaviors and BMI with a non-probability sample of 191 AA women, 18-40 years old. Participants completed a demographic form and Pulver's Figure Rating Scale (PFRS). Weight and height were measure and body mass index (BMI) calculated. Significant findings show that chronological age, hypertension, cigarette smoking and BMI were positively associated with body image perception. Using regression analysis, hypertension and BMI were predictors of body image perception. The study findings indicate that chronic illness and BMI impact body image perception.

Patients' Perceptions of Bedside Handoff: Further Evidence to Support a Culture of Always.

Patients' perceptions of satisfaction, understanding, participation, and feelings of safety were significantly correlated with the frequency of bedside handoff. Mean responses to survey items in these areas were significantly higher for patients who "always" experienced bedside handoff than for those who experienced it sporadically. Quality improvement strategies were effective in increasing the frequency of bedside handoff.

Development of Nurse Self-Concept in Nursing Students: The Effects of a Peer-Mentoring Experience.

BACKGROUND: Positive nurse self-concept has been shown to increase job productivity, retention, and job satisfaction. Student participation in peer-mentoring experiences has been shown to increase self-confidence and understanding of the role of the nurse leader. METHOD: The Nurse Self-Concept Questionnaire (NSCQ) was used to measure the nurse self-concept of senior baccalaureate nursing students before and after completion of a peer-mentoring experience. RESULTS: Female students scored significantly higher on two subscales of the NSCQ than male students prior to the peer-mentoring experience. This difference was not seen after the experience. Mean changes in scores on all six dimensions of self-concept measured by the NSCQ were significantly higher after the mentoring experience. CONCLUSION: Further investigation of male students' experiences in clinical settings may be warranted. The experience of mentoring lower-level students offers practice for upper-level nursing students in providing direction, exercising leadership and management skills, and working as a member of the health care team.

Using gainsharing to increase electronic end-of-course evaluation submissions.

The adoption of electronic course evaluations has resulted in a decrease in completed evaluations at colleges and universities. Gainsharing is used in hospitals to provide an incentive to meet organizational goals. The author describes gainsharing and its use to provide a grade incentive for nursing students to submit electronic end-of-course evaluations. The effect of the incentive on student grades is also examined.

Patients' perceptions of bedside handoff: the need for a culture of always.

Current literature on patients' perceptions of bedside handoff describes studies using qualitative, anecdotal, and/or indirect measurement. This study identifies patients' perceptions of the bedside handoff through direct and quantitative measurement. The statistically significant findings from a survey of 103 medical surgical adult patients demonstrate that registered nurse bedside handoff has a positive effect on patient perceptions of safety, understanding, and satisfaction. Bedside end-of-shift handoff is most effective when it is performed consistently.

Challenges to nurses' efforts of retrieving, documenting, and communicating patient care information.

OBJECTIVE: To examine information flow, a vital component of a patient's care and outcomes, in a sample of multiple hospital nursing units to uncover potential sources of error and opportunities for systematic improvement. DESIGN: This was a qualitative study of a sample of eight medical-surgical nursing units from four diverse hospitals in one US state. We conducted direct work observations of nursing staff's communication patterns for entire shifts (8 or 12 h) for a total of 200 h and gathered related documentation artifacts for analyses. Data were coded using qualitative content analysis procedures and then synthesized and organized thematically to characterize current practices. RESULTS: Three major themes emerged from the analyses, which represent serious vulnerabilities in the flow of patient care information during nurse hand-offs and to the entire interdisciplinary team across time and settings. The three themes are: (1) variation in nurse documentation and communication; (2) the absence of a centralized care overview in the patient's electronic health record, ie, easily accessible by the entire care team; and (3) rarity of interdisciplinary communication. CONCLUSION: The care information flow vulnerabilities are a catalyst for multiple types of serious and undetectable clinical errors. We have two major recommendations to address the gaps: (1) to standardize the format, content, and words used to document core information, such as the plan of care, and make this easily accessible to all team members; (2) to conduct extensive usability testing to ensure that tools in the electronic health record help the disconnected interdisciplinary team members to maintain a shared understanding of the patient's plan.

Maintaining a consistent big picture: meaningful use of a Web-based POC EHR system.

OBJECTIVE: To test the hypothesis that Hands-on Automated Nursing Data System (HANDS) "big picture summary" can be implemented uniformly across diverse settings, and result in positive registered nurse (RN) and plan of care (POC) data outcomes across time. DESIGN: In a longitudinal, multisite, full test study, a representative convenience sample of eight medical-surgical units from four hospitals (one university, two large community, and one small community) in one Midwestern state implemented the HANDS intervention for 24 (four units) or 12 (four units) months. MEASUREMENTS: (a) RN outcomes-percentage completing training, satisfaction with standardized terminologies, perception of HANDS usefulness, POC submission compliance rate. (b) POC data outcomes-validity (rate of optional changes/episode); reliability of terms and ratings; and volume of standardized data generated. RESULTS: One hundred percent of the RNs who worked on the eight study units successfully completed the required standardized training; all units selected participated for the entire 12- or 24-month designated period; compliance rates for POC entry at every patient hand-off were 78-92%; reliability coefficients for use of the standardized terms and ratings were moderately strong; the pattern of optional POC changes per episode declined but remained reasonable across time; and the nurses generated a database of 40,747 episodes of care. LIMITATIONS: Only RNs and medical-surgical units participated. CONCLUSION: It is possible to effectively standardize the capture and visualization of useful "big picture" healthcare information across diverse settings. Findings offer a viable alternative to the current practice of introducing new health information layers that ultimately increase the complexity and inconsistency of information for frontline users.

Physical activity, depressive symptoms, and social support among African-American women with type 2 diabetes.

This descriptive-correlational study examined the associations among physical activity, depressive symptoms, and perceived social support in 45 middle-aged and older African-American women with type 2 diabetes receiving care in 1 of 3 community-based primary care centres in the southeastern United States. Of the participants, 82% reported weekly physical activity and 88% reported a high degree of social support.The prevalence of depressive symptoms was also high in the sample (n = 15; 30%), and depressive symptoms were associated with younger age and less social support. Further investigation of physical activity characteristics, depressive symptoms, and social support in African-American women with type 2 diabetes is warranted.