Personal, Social, and Workplace Environmental Factors Related to Psychological Well-Being of Staff in University Settings.

BACKGROUND: Understanding the psychological well-being (PWB) of university staff and factors that influence it is critical for developing intervention programs that promote PWB and enhance productivity and worker engagement. PURPOSE: This study aimed to assess the level of PWB in university staff and identify personal, social, and workplace environmental factors related to their PWB. METHODS: A cross-sectional, correlational study design was used. A convenience sample of university staff was recruited from two universities in Texas. Participants completed an online questionnaire, which included Ryff's PWB scale to measure PWB, along with questions related to personal, social, and workplace factors. Hierarchical multiple regression was used to analyze the influence of these factors on the PWB of university staff. RESULTS: The PWB of university staff (n = 202) was significantly influenced by personal factors (i.e., race and perceived mental health status), social factors (i.e., social support of friends), and workplace environmental factors (i.e., physical demands). CONCLUSION/APPLICATION TO PRACTICE: To effectively promote PWB among university staff, occupational health nurses should proactively track and monitor their PWB. Policies and interventions should consider the various personal, social, and workplace environment factors identified in this study, such as mental health, social support resources, and physical demands.

Role of Magnet®-recognized hospital nurse managers in implementing evidence-based practice: A mixed-method study.

BACKGROUND: Healthcare systems recognize evidence-based practice (EBP) as the prestigious standard for providing safe and high-quality patient care, nursing excellence, and Magnet Recognition. Despite the well-documented benefits, implementation of EBP is inconsistent and remains elusive in the US and throughout the world and many patients still fail to receive evidence-based care. The literature revealed a huge gap between nursing science and practice but provided evidence that nurse managers (NMs) had a pivotal leadership role in implementing EBP. AIM: To gain a deeper understanding of Magnet-recognized hospital nurse managers' (MRHNMs) leadership roles, the influencing factors, and their experience in implementing EBP to enhance EBP initiatives and sustain Magnet recognition. METHOD: This mixed-method study guided by Goodall's (Australasian Psychiatry, 2016. 24, 231) theory of expert leadership used a sequential explanatory method with a quantitative-driven design based on a national correlational survey augmented by a qualitative descriptive component using semi-structured interviews. RESULTS: The findings of the study demonstrated that MRHNMs had a 54.6% effective leadership role in implementing EBP and produced numerous themes indicating that MRHNMs did implement EBP with struggle. MRHNMs in this study viewed EBP as a healthcare priority and leadership of NMs is necessary to promote EBP. However, lack of knowledge, difficulties with the EBP process, time constraints, and staffing issues negatively impacted EBP. Postgraduate degree, formal EBP education, critical care units as workplace, collaboration with doctorally prepared nurses, and Magnet culture enhanced EBP among MRHNMs. LINKING EVIDENCE TO ACTION: EBP is essential for Magnet recognition and is a hallmark of nursing excellence, however, is a complex and challenging process. The leadership of NMs is necessary to shape evidence-based care, and NMs require EBP preparation during leadership training, necessary resources, and time to complete the EBP process. EBP cannot become a reality without leaders being engaged, supportive, and persistent.

An Education Intervention to Increase Human Papillomavirus Vaccination Confidence and Acceptability: A Randomized Controlled Trial.

OBJECTIVES: To explore the effect of an intervention to improve human papillomavirus (HPV) vaccination confidence, attitudes, and beliefs among non-Hispanic Black mothers. SAMPLE & SETTING: Participants were 63 non-Hispanic Black mothers of children aged 9-17 years who resided in the United States and whose children had not received HPV vaccination. Interventions and data collection were conducted via a videoconferencing platform. METHODS & VARIABLES: A randomized controlled trial was performed using two groups. The experimental group received two HPV vaccination education sessions and the control group received two healthy nutrition education sessions. Data were collected after the last intervention and four weeks later. Variables included HPV vaccination confidence, attitudes, and beliefs. RESULTS: The experimental group reported more positive attitudes and beliefs about HPV vaccination (p = 0.002) and greater vaccination confidence than the control group (p = 0.049). IMPLICATIONS FOR NURSING: Nurses can improve HPV vaccination confidence, attitudes, and beliefs among non-Hispanic Black mothers through HPV vaccination education.

Moral distress in clinical research nurses.

Background: Clinical research nurses experience unique challenges in the context of their role that can lead to conflict and moral distress. Although examined in many areas, moral distress has not been studied in clinical research nurses.Research aim: The aim of this study was to examine moral distress in clinical research nurses and the relationship between moral distress scores and demographic characteristics of clinical research nurses.Research design: This was a descriptive quantitative study to measure moral distress in clinical research nurses using the Measure of Moral Distress - Healthcare Professionals (MMD-HP) administered electronically. Demographic data were also collected.Participants and research context: Registered nurses working in the clinical research nurse role (N = 322) were recruited through use of social media, emails, digital flyers, and snowball recruitment. Data was analyzed using SPSS. Pearson's correlation, independent t-test, and one-way ANOVA were performed to explore differences among the demographic variables.Ethical considerations: This study was approved by the Institutional Review Board at Texas Woman's University. A consent statement was included, and completion of the questionnaire was construed as consent.Findings/results: Analysis revealed a mean overall moral distress score of 79.58 (SD = 64.27) and median of 67, with a range of 0-354. Moral distress scores were negatively correlated with clinical research nurse age (r = 0-.156, p < 0.05). Reliability of the MMD-HP was demonstrated with a Cronbach's alpha of 0.93.Conclusions: The findings demonstrate that clinical research nurses do experience moral distress and revealed a wide range of scores. Further research is necessary to determine potential patient impact due to moral distress and to develop processes to minimize moral distress in the clinical research setting. This study was conducted during the COVID-19 pandemic, and the digital recruitment methods proved effective in recruiting a wide range of clinical research nurses, both nationally and internationally.

Comparing Intravenous Insertion Instructional Methods with Haptic Simulators.

Objective. The objective of this review was to compare traditional intravenous (IV) insertion instructional methods with the use of haptic IV simulators. Design. An integrative research design was used to analyze the current literature. Data Sources. A search was conducted using key words intravenous (IV) insertion or cannulation or venipuncture and simulation from 2000 to 2015 in the English language. The databases included Academic Search Complete, CINAHL Complete, Education Resource Information Center, and Medline. Review Methods. Whittemore and Knafl's (2005) strategies were used to critique the articles for themes and similarities. Results. Comparisons of outcomes between traditional IV instructional methods and the use of haptic IV simulators continue to show various results. Positive results indicate that the use of the haptic IV simulator decreases both band constriction and total procedure time. While students are satisfied with practicing on the haptic simulators, they still desire faculty involvement. Conclusion. Combining the haptic IV simulator with practical experience on the IV arm may be the best practice for learning IV insertion. Research employing active learning strategies while using a haptic IV simulator during the learning process may reduce cost and faculty time.

Penis Cancer: The Lived Experience.

BACKGROUND: This qualitative study examined the experiences of men with penis cancer. Cancer of the penis is a rare and debilitating disease, affecting 1 in 100 000 men in Western countries. Although much has been written about the medical treatment of the disease, little has been published about the experiences of men who have penis cancer. OBJECTIVE: The aim of this study is to gain an understanding of the lived experiences of men with cancer of the penis. METHODS: Using face-to-face audio-taped interviews with a semi-structured guide, the researcher recruited a purposive sample of 13 men who had been treated for penile cancer. Heidegger's hermeneutic phenomenology served as the philosophical underpinning and Colazzi's method was used to analyze the data. RESULTS: Six main themes emerged from the data: Misdiagnosis, Secrecy, "Cancer is cancer," Sexual Issues, Support, and Awareness and Prevention. CONCLUSIONS: Men diagnosed and treated for penis cancer reported numerous issues related to misdiagnosis, delayed treatment, and reluctance to share experience with family, friends, and coworkers. IMPLICATIONS FOR PRACTICE: Gaining more knowledge of the experiences of men with penile cancer will provide additional insights for healthcare providers to create holistic practice guidelines for the care of men and their loved ones who are affected. It is recommended to change the terminology to penis cancer, instead of penile cancer, to promote public awareness, education, prevention, and early treatment.

Is There Light? Well It Depends--A Grounded Theory Study of Nurses, Lighting, and Medication Administration.

OBJECTIVE: We know that human vision has limitations, medication administration is a high-risk activity, and some nurses work in environments that do not meet recommended lighting standards. The goal of this study was to inform safe medication administration practices and add evidence for establishing guidelines for lighting decisions by understanding registered nurses' (RNs') decision making about lighting during medication administration. METHODS: Grounded theory methodology was followed (n = 16). Theoretical sampling was used to ensure that participants represented a variety of backgrounds and hospital settings. Results were validated by three expert researchers. Two of the researchers had significant expertise in medication administration errors. RESULTS: Data analysis culminated in the substantive theory It Depends. This theory describes a process of frequently automatic decision making about lighting, whose aspects include assessing variation, balancing safety and healing, and RN bias. All RNs expressed concerns about perceived risks in relation to lighting, but had difficulty describing how they confirmed when the correct decision about lighting was made. CONCLUSIONS: Nurses are often unaware of their reasons for lighting decisions, and there is a need for education and other measures to increase the likelihood that lighting decisions that enhance patient safety are made by nurses.

Foreign-born nursing students in the United States: a literature review.

A thorough search of the literature examined what have been reported as stressors for foreign-born nursing students living in the United States. A comprehensive review of foreign-born nursing student literature within the United States educational system was examined, reviewed, and summarized. Minimal research has been dedicated exclusively to identify those unique stressors experienced among the foreign-born student population. A review of 11 articles revealed four common results interdependent of one another experienced among this group of students. Results identified were (a) language and communication issues; (b) discrimination, prejudice, and lack of support; (c) cultural issues; and (d) loneliness, isolation, and alienation. Foreign-born nursing students may continue to experience a multitude of barriers while seeking educational advancements in the United States until serious endeavors are initiated to close the gap and address the concerns previously documented. Although the needs of this diverse population are important, this research has the potential to reveal crucial information regarding stressors specifically common to those studying abroad in the United States. This topic will provide guidance to deans, directors, and educators in identifying and establishing processes to help validate the foreign-born nursing students' experience while they are enrolled in their prospective schools of nursing within the United States.

The impact of workplace incivility on the work environment, manager skill, and productivity.

OBJECTIVE: The objective of the study was to investigate the impact of workplace incivility (WPI) on staff nurses related to cost and productivity. BACKGROUND: Healthful practice environments are one of the goals of the American Organization of Nurse Executives 2010 to 2012 Strategic Plan. Healthy work environments are linked to patient safety and quality. METHODS: A postal survey was sent to 2,160 staff nurses (n = 659 completed) and included the Nursing Incivility Scale and Work Limitation Questionnaire. RESULTS: Although almost 85% (n = 553) reported experiencing WPI in the past 12 months, nurses working in healthy work environments(defined as MagnetA, Pathway to Excellence, and/or Beacon Unit recognition) reported lower WPI scores compared with nurses working in the standard work environment (P G .001). Workplace incivility scores varied between types of unit. Nurses' perception of their manager's ability to handle WPI was negatively associated with WPI scores (P G .001). Lost productivity as a result of WPI was calculated at $11,581 per nurse per year. CONCLUSIONS: Not only does WPI exist at high rates, but also it is costly. Nursing leaders play a vital role ensuring a healthy work environment.

The impact of workplace incivility on the work environment, manager skill, and productivity.

OBJECTIVE: The objective of the study was to investigate the impact of workplace incivility (WPI) on staff nurses related to cost and productivity. BACKGROUND: Healthful practice environments are one of the goals of the American Organization of Nurse Executives 2010 to 2012 Strategic Plan. Healthy work environments are linked to patient safety and quality. METHODS: A postal survey was sent to 2,160 staff nurses (n = 659 completed) and included the Nursing Incivility Scale and Work Limitation Questionnaire. RESULTS: Although almost 85% (n = 553) reported experiencing WPI in the past 12 months, nurses working in healthy work environments(defined as Magnet®, Pathway to Excellence, and/or Beacon Unit recognition) reported lower WPI scores compared with nurses working in the standard work environment (P < .001). Workplace incivility scores varied between types of unit. Nurses' perception of their manager's ability to handle WPI was negatively associated with WPI scores (P < .001). Lost productivity as a result of WPI was calculated at $11,581 per nurse per year. CONCLUSIONS: Not only does WPI exist at high rates, but also it is costly. Nursing leaders play a vital role ensuring a healthy work environment.

Stress and perceived faculty support among foreign-born baccalaureate nursing students.

Using the triangulation approach at the method level, this study explored and described the essence of stress and perceived faculty support as identified by foreign-born students (N = 10) enrolled in a generic baccalaureate degree nursing program. Philosophical principles outlined by Heidegger served as the core component guiding this study. Quantitative data from a larger study examining nursing students' stress and perceptions of faculty support served as the supplementary component. Results uncovered an overarching theme of the foreign-born nursing students wanting to be valued and accepted by the nursing faculty, their classmates, and the educational institution leading to patterns of stress, strain, and cultural ignorance. Language issues, stereotyping, discrimination, cultural incompetence, financial issues, and lack of accommodation as an international student were stressors that were not captured by the quantitative measures.

Community-dwelling, older women's perspectives on Therapeutic Life Review: a qualitative analysis.

The purpose of this study was to elicit the participants' perspective of a Therapeutic Life Review intervention program delivered by a home care worker. Following the intervention by the home care worker, 13 of the 14 older women receiving home care services were interviewed to examine their experiences. Qualitative data analysis revealed five themes: (1) Someone was there to listen to my story, (2) It was a special time, (3) A valued interaction with the home care worker developed, (4) Remembering was meaningful and pleasurable, and (5) Integration with one's lived experiences was healing. Three case scenarios illustrate the lives of these older women.

HIV testing in emergency departments: a recommendation with missed opportunities.

The purpose of this study was to determine the effective use of the 2001 Centers for Disease Control and Prevention (CDC) HIV testing recommendations in emergency department settings. A postal questionnaire was distributed to health care providers in emergency departments across the United States to evaluate the rate HIV tests are routinely offered to individuals presenting to emergency departments for care. A total of 223 emergency department providers responded. Results indicated that health care providers generally were not aware that their institutions were located in areas with high HIV seroprevalence rates. Only 3% of the health care providers surveyed claimed they routinely offered an HIV test to everyone who sought care in their emergency department regardless of patients' presentation to care. The conclusion was that, in 2004, testing for HIV in emergency departments was not a priority for those providing care. In general, despite the fact that the CDC 2001 HIV testing guidelines were less universal than the 2006 recommendations, many had not implemented routine HIV testing programs in their emergency departments. The number of patients who use emergency departments for routine care is on the rise, and missed opportunities for offering HIV tests have detrimental effects for the individual as well as for the public health.

The feasibility of home care workers delivering an intervention to decrease depression among home-dwelling, older women: a qualitative analysis.

Depression is associated with poorer functioning and may even increase the risk of dying. Home-dwelling frail older women with depression often receive inadequate treatment or no treatment at all. Therapeutic life review, an intervention based on Erikson's developmental stages, delivered by home care workers (HCWs) with three hours of training, is a cost effective way to enhance mood in these women. Nine HCWs who had implemented therapeutic life review participated in one of two focus groups and reported enhanced moods among their frail older clients.

Improving depressive symptoms in community-dwelling older adults: a psychosocial intervention using life review and writing.

The purpose of this randomized, controlled trial was to test the efficacy of a community-based intervention, the Life Story Workshop, on depressive symptoms, operationalized as depression subscale scores on the Brief Symptom Inventory 18, in adults age 60 and older. Thirty-three men and women were randomly assigned to one of two groups: an intervention group that attended 2-hour workshops once a week for 10 weeks or a wait-list control group. The intervention provided an opportunity for older participants to reflect on, write, and share stories about their lived and current lives. The depression subscale of the Brief Symptom Inventory 18 was administered before and after the workshops. Mean depression scores were compared using Welch's t test. A significant improvement was measured for the intervention group compared with the control group (p = .03). This research supports the Life Story Workshop as an effective intervention for improving depressive symptoms in older adults.

Intimate partner physical and sexual assault & child behavior problems.

PURPOSE: To describe the type and extent of child behavior problems reported by mothers who report intimate partner physical and sexual assault compared to mothers who reported physical assault only. STUDY DESIGN AND METHODS: A descriptive analysis of child behaviors, as measured on the Child Behavior Checklist, for 109 children, aged 18 months to 18 years, who were exposed to intimate partner physical and sexual assault. Multivariate analysis of variance and analysis of variance were used to determine whether children from physically and sexually assaulted mothers differed significantly in scores from children of physically assaulted only mothers. RESULTS: Scores for youth (n = 21) 12 through 18 years of age of physically and sexually assaulted mothers were significantly higher (M = 61.5, SD = 2.4; p = .025) than scores of youth (n = 10) of physically assaulted only mothers (M = 50.8, SD = 3.5) and higher than scores of clinically referred youth in a treatment sample. Child behavior was associated with the type of violence experienced by the mother; older children were at the highest risk for behavior disorders, especially behaviors of depression and anxiety. CLINICAL IMPLICATIONS: Intimate partner violence assessment of mothers during child health visits is recommended with safety planning and guided referral to community counseling, legal, shelter, and health agencies, along with information on the child behavior problems associated with domestic violence.

Testing therapeutic life review offered by home care workers to decrease depression among home-dwelling older women.

The purpose of the study was to test a psychosocial intervention, therapeutic life review, offered by home care workers to decrease depression among home-dwelling older women. A quasi-experimental, one-group time-series design measured the effect of a once-a-week, 40-minute therapeutic life review intervention, delivered for six weeks by home care workers, on the depression scores of women 65 years and older, compared to their scores during the ten weeks prior to the intervention. Over time, depression scores improved with a significant decrease in depression immediately following the six-week intervention. Based on these findings, we concluded that home care workers can deliver a community-based psychosocial intervention that decreases depression in their home-dwelling clients.

Intimate partner sexual assault against women and associated victim substance use, suicidality, and risk factors for femicide.

In order to establish the frequency of substance use, following and attributed to sexual assault, and describe the danger for femicide and suicidality for women physically and sexually abused compared to physically-abused only women, a personal interview of 148 African-American, Hispanic, and white English and Spanish-speaking abused women was completed. Women who reported more than one sexual assault were 3.5 (95% CI, 0.9, 13.4) times more likely to report beginning or increasing substance use compared to women who reported only one sexual assault. Sexually assaulted women reported significantly (p=.002) more risk factors for femicide compared to physically- abused only women. Specific to suicide, women reporting sexual assault were 5.3 (95% CI, 1.3, 21.5) times more likely to report threatening or attempted suicide within a 90-day period compared to physically-abused only women. The health assessment and intervention of intimate partner violence must extend beyond injury to include behavior risk sequelae of substance abuse and suicidality.

Intimate partner sexual assault against women: frequency, health consequences, and treatment outcomes.

OBJECTIVE: To describe the characteristics and consequences of sexual assault within intimate relationships specific to racial or ethnic group, compare the findings to a similar group of physically assaulted-only women, and measure the risk of reassault after victim contact with justice and health services. METHODS: A personal interview survey of 148 African-American, Hispanic, and white English- and Spanish-speaking abused women seeking a protection order. Extent of sexual assault, prevalence of rape-related sexually transmitted diseases and pregnancy, symptoms of posttraumatic stress disorder (PTSD) and depression, and risk of reassault after treatment were measured. RESULTS: Sixty-eight percent of the physically abused women reported sexual assault. Fifteen percent of the women attributed 1 or more sexually-transmitted diseases to sexual assault, and 20% of the women experienced a rape-related pregnancy. Sexually assaulted women reported significantly (P = .02) more PTSD symptoms compared with nonsexually assaulted women. One significant (P = .003) difference occurred between ethnic groups and PTSD scores. Regardless of sexual assault or no assault, Hispanic women reported significantly higher mean PTSD scores compared with African-American women (P = .005) and White women (P = .012). The risk of sexual reassault was decreased by 59% and 70% for women who contacted the police, or applied for a protection order, after the first sexual assault. Receiving medical care decreased the woman's risk of further sexual assault by 32%. CONCLUSION: Sexual assault is experienced by most physically abused women and associated with significantly higher levels of PTSD compared with women physically abused only. The risk of reassault is decreased if contact is made with health or justice agencies.

Protection orders and intimate partner violence: an 18-month study of 150 black, Hispanic, and white women.

OBJECTIVES: We compared types and frequencies of intimate partner violence experienced by women before and after receipt of a 2-year protection order. METHODS: Participants were 150 urban English- and Spanish-speaking Black, Hispanic, and White women who qualified for a 2-year protection order against an intimate partner. RESULTS: One woman committed suicide 6 weeks into the study. The remaining 149 women completed all interviews. Results showed significant reductions in threats of assault, physical assault, stalking, and worksite harassment over time among all women, regardless of receipt or nonreceipt of a protection order. CONCLUSIONS: Abused women who apply and qualify for a 2-year protection order, irrespective of whether or not they are granted the order, report significantly lower levels of violence during the subsequent 18 months.