Impact of COVID-19 on occupational injuries and illnesses among nursing care facility workers: Analysis of California workers' compensation data, 2019-2021.

BACKGROUND: The coronavirus disease 2019 (COVID-19) pandemic greatly affected healthcare workers, both physically and psychologically, by increasing their workload and stress. This may also have increased their risk of occupational injuries. This study analyzed workers' compensation (WC) claims among California nursing care facility workers during 2019-2021, to assess the impact of the pandemic on occupational injury risk. METHODS: This study used data from the California Workers' Compensation Information System. WC claims in prepandemic and pandemic periods were described and compared between nursing care facilities and other settings. Nursing facility cases were described by demographic, job, and injury characteristics. RESULTS: In 2019-2021, we identified 41,134 claims as nursing facility cases in California. Annual claims increased by 64.6% from 2019 to 2020 and then decreased in 2021, returning to levels similar to pre-COVID. In contrast, non-healthcare settings had decreases in claims during the pandemic. COVID-related claims accounted for 50.5% of claims in nursing facilities in 2020-2021; this proportion was much higher compared with other healthcare (35.7%) or nonhealthcare settings (14.3%). Non-COVID claims decreased during the pandemic but mental disorder or stress claims increased in nursing facilities, particularly in 2020 (+42.5%). CONCLUSIONS: Our findings show that nursing care facilities were more severely affected by the pandemic than other settings. We did not find evidence of an increased risk of occupational injuries during the pandemic, except for increased claims for stress or mental disorders. Our findings indicate a clear need to address psychological stress and mental health among nursing facility workers during a pandemic.

Daytime and nighttime correlates of fatigue and lack of energy in adults living with HIV.

OBJECTIVE: To describe correlates of fatigue and lack of energy symptoms in adults living with HIV. METHODS: Adults living with HIV were recruited if they were ≥45 years old, unemployed, and reported either fatigue or lack of energy in the past week. HIV-associated correlates included CD4 cell count, viral load, and hemoglobin. Daytime correlates included physical activity, daytime sleepiness, napping behavior, and symptoms of anxiety and depression. Nighttime correlates included use of sleep medication, sleep duration, and sleep quality. Outcomes included physical and cognitive function. RESULTS: Most (70%) of the 53 participants were male. The mean age was 56.7 ± 6.7 years and participants had been living with HIV for a mean of 22 ± 6.4 years. Controlling for all other factors, African Americans reported less fatigue and more energy than other racial/ethnic groups. Lack of energy was associated with daytime napping and cognitive function. Fatigue was associated with shorter nighttime sleep duration, anxiety, and both physical and cognitive function. DISCUSSION: Findings highlight potential differences between lack of energy and fatigue that could influence intervention outcomes. Avoiding daytime naps and encouraging longer nighttime sleep may improve fatigue as well as physical and cognitive function in this chronic illness population.

Fatigue management for adults living with HIV: A randomized controlled pilot study.

Fatigue is a prevalent symptom for adults living with HIV infection. The purpose of this randomized clinical trial was to pilot test a behavioral-educational intervention to reduce fatigue. The intervention included education about daytime behaviors as well as nighttime sleep behaviors. Participants were HIV-positive, between 45 and 75 years old, unemployed, and experiencing fatigue. They were randomized to intervention (n = 25) or control (n = 26) after obtaining baseline measures, administered the intervention or attention control, and followed with monthly assessments for 3 months. Primary outcome measures included the Fatigue Severity Scale (FSS) and fatigue symptom burden using the four-dimension structure of the Memorial Symptom Assessment Scale that includes occurrence, frequency, severity, and distress of a symptom. Other measures included the International Physical Activity Questionnaire, step counts with a Fitbit Flex, Hospital Anxiety and Depression Scale, Pittsburgh Sleep Quality Index, and Sleep Behavior Rating Scale. Compared with attention controls, the intervention group had significantly (p < .05) lower FSS scores and fatigue symptom burden over time, particularly in the frequency dimension. Secondary outcomes for reducing daytime naps and improving sleep quality were also significant (p < .05). This intervention, focused on both daytime and nighttime behaviors, demonstrated promising effects for reducing fatigue among adults living with HIV. Results provide useful direction for larger clinical trials to reduce fatigue in adults living with other types of chronic illness.

Development of Quantitative Research Skills Competencies to Improve Doctor of Philosophy Nursing Student Training.

BACKGROUND: Competency-based education is essential to prepare future nurse scientists to compete in the world of data-driven science. Yet, few schools of nursing have developed core competencies that guide quantitative research instruction. We described development of new competency-based curriculum in quantitative research for doctor of philosophy (PhD) nursing students. METHOD: We assessed quantitative research methods curricula from among top National Institutes of Health-ranked research-intensive Schools of Nursing. At the University of California, San Francisco School of Nursing, we administered a survey to PhD students and alumni, and interviewed program faculty about current quantitative courses and perceived needs. A committee of PhD faculty framed competencies. RESULTS: Core competencies for quantitative methods training were developed. Faculty modified courses to align with core competencies. This allowed an outcome-based approach to design, implement, and evaluate coursework. CONCLUSION: This effort at generating core quantitative research skills competencies could be useful for other nursing schools interested in redesigning PhD training programs. [J Nurs Educ. 2018;57(8):483-488.].

Engagement with health care providers as a mediator between social capital and quality of life among a sample of people living with HIV in the United States: Path-analysis.

BACKGROUND: Social capital is "features of social organizations-networks, norms, and as trust that facilitate coordination and cooperation for mutual benefit". People with high social capital have lower mortality and better health outcomes. Although utilization of social networks has grown, social capital continues to be a complex concept in relation to health promotion. This study examined 1) associations between social capital and quality of life (QoL), 2) factors of social capital leading to higher QoL among people living with HIV (PLWH), 3) role of health care providers (HCP) as a mediator between social capital and QoL. METHODS: This is a secondary analysis of the International Nursing HIV Network for HIV/AIDS Research. This cross-sectional study included 1673 PLWH from 11 research sites in the United States in 2010. Using path analysis, we examined the independent effect of social capital on QoL, and the mediating effect of PLWH engagement with HCP. RESULTS: The majority of participants were male (71.2%), and 45.7% were African American. Eighty-nine percent of the participants were on antiretroviral therapy. Social capital consisted of three factors - social connection, tolerance toward diversity, and community participation - explaining 87% of variance of social capital. Path analysis (RMSEA = 0, CFI = 1) found that social connection, followed by tolerance toward diversity, were the principal domain of social capital leading to better QoL (std. beta = 0.50, std. error = 0.64, p<.05). Social capital was positively associated with QoL (p<.05). About 11% of the protective effect of social capital on QoL was mediated by engagement with HCP (p<.05). CONCLUSIONS: This study emphasizes importance of social connections and mediating role of HCP in improving QoL for PLWH. To develop social capital effectively, interventions should focus on strengthening PLWH's social connections and engagement to HCP.

Meta-analysis of Mobile Phone Reminders on HIV Patients' Retention to Care.

AIMS: This research aims to systematically review the current clinical evidence of the efficacy of mobile phone reminders on retention to care among HIV patients. This study also seeks to determine an effect size of the intervention and presents implications for future studies. BACKGROUND: Use of mobile technologies is an innovative and affordable approach to HIV prevention and care, particularly in resource limited settings. Approximately two-thirds of people who are initially diagnosed with HIV are lost to follow-up before starting HIV treatment in low and middle-income countries, posing serious global health concerns. While mobile text message reminders for HIV medication adherence have shown positive health outcomes, it is not well understood whether the reminders can also improve patients' retention to care. METHODS: The authors conducted a meta-analysis of literature in the following databases: PubMed, CINAHL, ProQuest, and Web of Science. Of the 667 peer-reviewed research articles reviewed, nine studies were included in the final analysis. Stata version 13 was used for the analysis. RESULTS: Nine studies (5 randomized controlled and 4 before and after studies) from 7 countries included 3,004 HIV patients. Random-effect meta-analysis (I-squared = 94.1%) found that HIV patients who received mobile phone reminders for their follow-up appointments were two times more likely to return to care than those who didn't receive reminders (pooled odd ratio (OR)=2.04, 95% CI: 0.97-4.27). Our sub-group analysis of 5 randomized controlled studies showed a significant effect of mobile phone reminders (OR=2.04, 95% CI: 1.11-3.74). Six studies in Africa showed that HIV patients (mostly women) receiving mobile phone reminders were three times more likely to return to care than those who received no reminders (OR=2.92, 95% CI: 1.13-7.53). CONCLUSION: Mobile phone reminders are an effective intervention to improve retention to HIV care. Women with HIV living in resource limited settings benefit significantly from the intervention. Also, mobile phone reminders using text messages are as effective as phone calls to improve retention to HIV care.

Sources of Social Capital for Malawi People Living With HIV.

With one of the highest rates of poverty and HIV in the world, Malawi faith-based organizations (FBOs), non-governmental organizations (NGOs), and community-based organizations (CBOs) are expected to provide tangible and emotional support to people living with HIV (PLWH). Using Lin's social capital theoretical approach, we examine the perspective of PLWH regarding the adequacy of support responses. Forty-six rural Malawi HIV+ adults provided interviews that were recorded digitally, translated, and transcribed by Malawi research assistants. Atlas.ti was used to organize the data and to aid in the analytic process. Participants expressed disappointment in the lack of resources that could be accessed through the FBOs although their expectations may have been unrealistic. Outcomes from accessing and mobilizing the FBO network were negative in terms of stigmatization by FBO leaders and members, whereas outcomes related to CBOs and NGOs were generally positive in terms of empowerment through HIV information and attendance at support groups.

Qualitative exploration of the acceptability of a mobile phone and pedometer-based physical activity program in a diverse sample of sedentary women.

OBJECTIVES: The objectives of this paper were to explore the acceptability of components of a mobile phone/pedometer-based physical activity program and to understand motivators and barriers to increase physical activity in a diverse sample of sedentary women. DESIGN AND SAMPLE: Face-to-face semi-structured interviews were conducted following a 3-week pilot mobile phone/pedometer-based physical activity intervention. Forty-one sedentary women participated in the study. MEASURES: Subjects were interviewed using a semi-structured interview guide. A qualitative description method was used to thematically analyze the interviews. Two investigators reviewed the transcripts independently and identified codes based on the main concerns in the interview questions. RESULTS: Three themes emerged from qualitative data shedding light on the perceived acceptability and usefulness of a mobile phone/pedometer-based intervention: (1) Monitor me: mobile phone/pedometer as self-monitoring tools, (2) Motivate me: cycle of feedback in goal setting and usefulness/uselessness of daily random messages, (3) Mobilize me: engaging and adapting physical activity to fit one's own lifestyle. CONCLUSION: Mobile phone and pedometer-based physical activity programs might be helpful in keeping sedentary women engaged and motivated to increase their physical activity. A randomized controlled trial of this intervention is warranted.