Supporting elder persons in rural Japanese communities through preventive home visits by nursing students: A qualitative descriptive analysis of students' reports.

This article describes the evaluation of an innovative nursing education curriculum project, preventive home visiting practice, which began full implementation in 2015, in terms of students' learning outcomes. For the purpose of learning how elder persons live in community, all the 327 undergraduate nursing students, from freshmen to seniors, provided monthly or bi-monthly visits to home-dwelling elderly persons aged 75 or above in their home over 1 year period, in order to provide support for their independent living and to learn from them. The students' reports submitted at the end of the first academic year were qualitatively analyzed to evaluate what they learned. They acquired multiple perspectives for understanding elder persons, including a variety of individual and environmental aspects of wellness, prevention, and community life. They also acknowledged the importance of team practice through working and collaborating with different grade levels and generations. Overall, the observed learning contents were useful for future nursing education with elder persons and facilitating critical changes in nursing education systems to address the problems of aged society.

Tobacco Use Among Arab Immigrants Living in Colorado: Prevalence and Cultural Predictors.

PURPOSE: The authors determined the prevalence of smoking among Arab immigrants living in Colorado. The authors also evaluated the relationship between acculturation and tobacco use, including both cigarettes and hookah among Arab immigrants. METHOD: A cross-sectional survey of 100 adult Arab immigrants living in Colorado was carried out. RESULTS: The results revealed that 19% of the study participants were current cigarette smokers and 21% were current hookah smokers. Participants who were more integrated into Arab culture were more likely to use tobacco products ( p = .03) and to have family members ( p = .02) and friends who use tobacco products ( p = .007). CONCLUSIONS: Acculturation plays a major role in affecting the health habits of Arab immigrants living in Colorado, especially in the area of hookah smoking. IMPLICATIONS FOR PRACTICE: Understanding some culturally relevant predictors of tobacco use might assist health care providers in designing successful smoking cessation programs.

Learning through collaboration: the NEXus consortium as a winning collaborative.

The Nursing Education Exchange (NEXus) is a consortium of academic doctoral programs in nursing, initiated in response to a national shortage of well-qualified nurse educators and the need to increase the number of doctoral faculty in nursing programs across the United States. The vision for the consortium was to use distance-accessible delivery methods to provide rural nurse educators and clinical nurses with access to quality doctoral programs in nursing while remaining in their home environments. In addition, smaller or newly established doctoral programs would be able to offer a wider variety of elective coursework without recruiting and hiring additional faculty, further decreasing their limited available resources. This article describes the initiation and implementation of a successful nursing education collaborative that has gained increasing influence across the country and is recognized by its acronym, NEXus.

Research plan for developing trauma core competencies for nurses in Thailand.

The aim of this research plan was identification and development of core competencies for emergency trauma nurses in Thailand. The research plan was undertaken in three phases. Phase I: a national survey of the critical dimensions of care; Phase II: development of a 64 item tool; and Phase III: efficiency study with emergency nurses representing Level-1, Regional, Community and Rural facilities. Six dimensions of competency were identified: cooperation, decision-making, leadership, problem-solving, teamwork, and technical knowledge with a content validity index (CVI) of 1.00 and internal consistency (Cronbach's alpha) of 0.98 (N=485 RNs in 29 hospitals). Analysis of the first year pilot study data using a 5 point likert scale (N=285 RNs in 16 hospitals), nurses rated themselves as 4.18 (SD=0.69) and their peers at 4.00 (SD=0.68). Head nurse evaluations averaged 3.98 (SD=0.55). ANOVA demonstrated no statistical significance (p=0.09) between groups. The results of the preliminary studies demonstrated appropriateness of the core competency items, but refinement is required prior to national distribution.

Causal model of health: health-related quality of life in people living with HIV/AIDS in the northern region of Thailand.

The purpose of this study was to examine the causal relationships between age, antiretroviral treatment, social support, symptom experience, self-care strategies, and health-related quality of life (HRQOL). The subjects were 422 people living with HIV/AIDS. The data were collected via the Personal Resource Questionnaire 85 part 2, Symptom Experience Questionnaire, Self-care Strategies Questionnaire, and HRQOL Questionnaire. The results revealed that symptom experience had a significant negative direct effect on the HRQOL. Age, social support, antiretroviral treatment, and self-care strategies had a significant positive direct effect on the HRQOL. Moreover, social support and antiretroviral treatment had an indirect effect on the HRQOL via self-care strategies. The findings indicated that the health-care team should promote social support, both in the family and the community, including antiretroviral treatment, for enhanced HRQOL in people living with HIV/AIDS in the future.

A model to identify direct costs of nursing education: the Colorado experience.

During spring 2003, national, state, and local economic factors converged in a manner that propelled us to better identify the costs of the educational programs offered within the University of Colorado Health Sciences Center School of Nursing (SON). Two factors prompted analysis of direct costs of the nursing education programs: a shrinking state appropriation and a 36.7% rescission of state funds during that academic year. The SON supports 618 students in four programs (baccalaureate, master of science, doctor of nursing, and doctor of philosophy). During summer 2003, the SON leadership team met numerous times in an iterative process to clarify assumptions and make recommendations in an attempt to cost out academic programs. Data were obtained from a variety of sources. The SON Office of Budget and Finance provided revenue and expense data. The Office of Academic Affairs provided course schedules, the course offering plan, and projected student enrollment in courses. The Division Chairs provided data concerning faculty workload and faculty areas of expertise. The data were compiled in Access tables and arrayed in a series of Excel spreadsheets that captured course data and faculty data. A "what-if" analysis was completed to determine cost of a pilot accelerated baccalaureate program. This method provides a dynamic analytic system shown to be prospectively and retrospectively effective. As a result of this analysis, the following metrics are available: direct cost per student per course/program; revenue per student per course/program; faculty teaching FTE; and faculty-to-student ratio.

Managing caregiving at home: Thai caregivers living in the United States.

The researchers designed a qualitative descriptive study informed by grounded theory and ethnography to generate a beginning substantive theory that illuminates the process of caregiving in Thai families living in the United States. A purposive sample of seven Thai caregivers of chronically ill relatives in the western and the midwestern regions of the U.S. participated in interviews, provided observations and wrote memoranda. Three categories emerged from "managing caregiving at home:" (a) being caregivers, (b) the consequences of caregiving and (c) coping with the difficulties of caregiving. The study participants describe caregiving as a willing burden and an unavoidable duty, attitudes which are clearly influenced by Buddhist beliefs. The results of this study provide nurses with a better understanding of the caregiving process, especially as it exists in the Thai American population.

The role of certified nursing assistants in nursing homes.

UNLABELLED: OBJECTIVE Pilot study to examine the experiences of the certified nursing assistants (CNAs) in Colorado nursing homes. BACKGROUND DATA: CNAs provide 80% to 90% of the care to residents in nursing homes. Their reported turnover rate is as high as 400% in some studies, and the potential pool of CNAs is dwindling. As the demand for CNAs increases, their experiences must be understood to effectively address recruitment and retention issues. METHODS: Minimally structured interviews of 12 CNAs in 6 Colorado nursing homes and observations of care provided were conducted. Atlas/Ti software was used as a data management tool for analyzing and coding data. RESULTS: The overriding theme that emerged from the interviews was "we love our jobs." Three patterns of thought and behavior emerged: attributes of the CNA, working conditions of the CNA, and future success of the CNA and the nursing home. CONCLUSIONS: Issues important to CNAs revolved around basic motivational factors, such as job enrichment opportunities, personal growth opportunities, recognition, responsibility, and sense of achievement. Leadership must become creative and build on that base, providing CNAs with job mobility, job enrichment opportunities, recognition, and increased job responsibility, producing positive outcomes not only for the CNA but also for the resident and the facility.