Healing from Childhood Loss.

Childhood loss creates environmental challenges that disrupt the integrity of body-mind-spirit, having profound lifelong effects on both health outcomes and life satisfaction. The author in this report describes a middle-range theory of healing childhood loss, which can be used to guide practice and research. Theoretical influences are Levine's conservation model of nursing, the theory of chronic sorrow, and the adverse childhood experiences pyramid. Strategies to support healing of childhood loss are particularly needed and timely during this worldwide COVID-19 pandemic, with prolonged disruption of normal childhood activities and concern about a possible increased incidence of adverse childhood experiences.

Childhood Loss Experiences, Religiousness/Spirituality, and Hope as Predictors of Adult Life Satisfaction.

Purpose The purpose of this study was to explore how adaptive patterns of religiousness/spirituality and hope predict adult life satisfaction in adults, even if they had childhood loss experiences.Design and Methods Using a cross-sectional survey design with132 adult participants (mean age 33.8 ± 15.2, 82% female, 78% Caucasian) we estimated two hierarchical regression models to examine how dimensions of religiousness/spirituality (Brief Multidimensional Measure of Religiousness/Spirituality) and hope (Herth Hope Index) predicted adult life satisfaction (Satisfaction with Life Scale) after controlling for effects of adverse childhood experiences (Adverse Childhood Experiences Study Questionnaire) or chronic sorrow from childhood loss (Kendall Chronic Sorrow Instrument).Results When effects of adverse childhood experiences (ACE) were controlled, higher levels of hope (ß = .416, p < .001) and forgiveness (ß = .273, p = .023) and lower levels of religious/spiritual values/beliefs (ß = -.298, p = .014) predicted higher levels of adult life satisfaction. ACE remained a significant predictor of adult life satisfaction in the final model. When controlling for effects of chronic sorrow, higher life satisfaction was predicted only by forgiveness (ß = .379, p = .003), values/beliefs (ß = -.354, p = .007), and hope (ß = .357, p < .001), with chronic sorrow not a significant predictor of adult life satisfaction in the final model.Conclusion: Greater life satisfaction for adult survivors of childhood loss experiences could be promoted by interventions to enhance hope and foster forgiveness. These adult survivors may also need support as they engage with religious/spiritual struggle to reconcile their values and beliefs with childhood loss.

Better Together: A Win-Win Pediatric Academic Partnership.

As healthcare facilities and academic nursing programs are challenged to be efficient and effective in light of an ever-changing healthcare system, recent literature has focused on the value of creating academic practice partnerships. Using the American Association of Colleges of Nursing (AACN) and American Organization of Nurse Executives (AONE) Academic Practice Partnership Guiding Principles, a children's hospital and state university are working collaboratively to improve evidence-based practice and research, create innovative educational opportunities for undergraduate and advanced practice students, promote academic progression that enables nurses to advance their education, improve access to health care services for underserved families, and implement initiatives that improve patient- and family-centered care. This article will describe the initiatives, processes, and outcomes of this fruitful partnership. The examples we provide using the Academic Practice Partnership Guiding Principles can be adapted in other healthcare facilities and nursing programs.

Neonatal abstinence syndrome: evaluating the effectiveness of an evidence-based multidisciplinary care approach.

An evidence-based, multidisciplinary neonatal abstinence syndrome protocol was developed using a stepwise continuous quality improvement (CQI) approach with the goal of standardizing care procedures for these infants. A retrospective secondary data analysis was performed to evaluate the differential effects of each step of the CQI project on 4 key clinical outcome measures: length of stay (total and post-opioid wean), weaning time from opioids, and use of adjunct medications. Data were analyzed from 386 newborn infants with a diagnosis of neonatal abstinence syndrome undergoing treatment in a level III neonatal intensive care unit. After implementation of a pharmacologic weaning protocol as a foundational first step of the CQI project, the weaning time from opioids remained stable throughout each of the subsequent CQI steps (P = .905). The overall total neonatal intensive care unit length of stay was reduced by 10.35 days (P = .002), and the length of neonatal intensive care unit stay after completing wean from opioids was reduced by 2.79 days (P < .001). Use of adjunct medications also decreased from 30.1% of infants at the initiation of the CQI project to 24.5% at the completion of the project (P = .020). These findings indicate that this multidisciplinary treatment approach led to an overall improved efficiency of both opioid weaning and symptom management for these infants.

Religiousness/Spirituality and anger management in community-dwelling older persons.

Mismanaged anger is associated with adverse health outcomes. This study examined whether dimensions of religiousness/spirituality could predict healthy anger management in a sample of 82 community-dwelling older Americans. A correlational research design was employed using the Deffenbacher Anger Scale and the Brief Multidimensional Measure of Religiousness/Spirituality. Higher scores on Forgiveness, Daily Spiritual Experiences, Religiousness/Spirituality as Coping, and Self-Ranking of Religiousness/Spirituality were correlated with healthier anger management; however forgiveness was the only significant predictor in the regression analysis. Interventions to facilitate forgiveness may promote healthy anger management and minimize the adverse health effects of mismanaged anger.

Evaluating nurse staffing patterns and neonatal intensive care unit outcomes using Levine's Conservation Model of Nursing.

AIMS: To explore the influences of intensity of nursing care and consistency of nursing caregivers on health and economic outcomes using Levine's Conservation Model of Nursing as the guiding theoretical framework. BACKGROUND: Professional nursing practice models are increasingly being used although limited research is available regarding their efficacy. METHOD: A structural equation modelling approach tested the influence of intensity of nursing care (direct care by professional nurses and patient-nurse ratio) and consistency of nursing caregivers on morbidity and resource utilization in a neonatal intensive care unit (NICU) setting using primary nursing. RESULTS: Consistency of nursing caregivers served as a powerful mediator of length of stay and the duration of mechanical ventilation, supplemental oxygen therapy and parenteral nutrition. Analysis of nursing intensity indicators revealed that a mix of professional nurses and assistive personnel was effective. CONCLUSIONS: Providing consistency of nursing caregivers may significantly improve both health and economic outcomes. New evidence was found to support the efficacy of the primary nursing model in the NICU. IMPLICATIONS FOR NURSING MANAGEMENT: Designing nursing care delivery systems in acute inpatient settings with an emphasis on consistency of nursing caregivers could improve health outcomes, increase organizational effectiveness, and enhance satisfaction of nursing staff, patients, and families.

Becoming an older volunteer: a grounded theory study.

This Grounded Theory study describes the process by which older persons "become" volunteers. Forty interviews of older persons who volunteered for Habitat for Humanity were subjected to secondary content analysis to uncover the process of "becoming" a volunteer. "Helping out" (core category) for older volunteers occurs within the context of "continuity", "commitment" and "connection" which provide motivation for volunteering. When a need arises, older volunteers "help out" physically and financially as health and resources permit. Benefits described as "blessings" of volunteering become motivators for future volunteering. Findings suggest that older volunteering is a developmental process and learned behavior which should be fostered in older persons by personally inviting them to volunteer. Intergenerational volunteering projects will allow older persons to pass on knowledge and skills and provide positive role modeling for younger volunteers.

Relationships among stress, infectious illness, and religiousness/spirituality in community-dwelling older adults.

The purpose of this study was to examine the relationships among stress, infectious illness, and religiousness/spirituality in community-dwelling older adults in the southeastern United States. Four assessment tools were completed by 82 older adults (mean age = 74, age range = 65 to 91): the Perceived Stress Scale, the Carr Infection Symptom Checklist (SCL), the Brief Multidimensional Measurement of Religiousness/Spirituality, and a demographic form. A significant correlation was found between stress and SCL scores; however, four dimensions of religiousness/spirituality moderated the relationship between stress and infection. Older adults who were unable to forgive themselves or forgive others, or feel forgiven by God, were more likely to have had an infection in the previous month. Increased infections also occurred when older participants did not feel they had religious support from their congregations. Using these findings, gerontological nurses are well positioned to deliver tailored stress management and forgiveness interventions when older adults report increased stress.

Predictors of American elders' home stay: a secondary data analysis study.

The purpose of this study was to identify the predictors of home stay for American elders. This study used a cross-sectional, descriptive, secondary data analysis design. The National Home and Hospice Care Survey 2000 (NHHCS 2000) public-use data files were used for this study. The sample included 9879 elders who were listed as either current or discharged patients from the NHHCS 2000. Based on multiple logistic regression analysis, the most predictive variable for an elder's home stay was whether the elder was currently living with family members. The overall model of 16 predictors was statistically significant in distinguishing between "home stay" and "not home stay" elders. The model correctly predicted 92.0% of the elderly participants regarding the home stay outcome. Health-care professionals could target these predictors in an attempt to develop interventions that assist elders to reside in their own home.

The relationship between leadership styles and empathy among student nurses.

Much of the nursing literature on leadership describes the qualities of existing nursing leaders, while emphasizing the need for leadership development in student nurses for both managerial and clinical practice. However, there is a lack of research literature on the characteristics of current students. Conducted by the University of Tennessee College of Nursing Empathy Research Group, this pilot study explores the relationship between leadership styles and empathy (cognitive and affective) levels. This correlational descriptive study involved self-report using 3 instruments. Hogan Empathy Scale (HES) and Emotional Empathy Tendency Scale (EETS) measured cognitive and affective empathy levels. The Multifactoral Leadership Questionnaire (MLQ-5x) was used to determine leadership style. Data analysis yielded evidence of a weak positive correlation between the predominant transformational leadership style and empathy levels in both junior and senior students. This correlation has implications for both nurse educators and future employers.

Growing up and growing older.

Americans are living longer than ever before. A child born today can expect to live 80 years, 90 years, or longer. Many of today's children will live to be centenarians. Aging education to prepare people for the long life ahead has been endorsed since the first White House Conference on Aging in 1961. However, little is happening with aging education in our homes, schools, and communities. This article discusses the school nurse's role in helping to prepare children for the long life ahead of them and presents aging education resources and activities. School nurses can help to create a generation of Americans who value older adults, have positive attitudes about aging, and plan for successful healthy aging.

A theory of health promotion for preterm infants based on Levine's Conservation Model of Nursing.

The infant born prior to the completion of term gestation faces many challenges in order to merely survive in the extrauterine environment. A preterm birth is also a time of extreme crisis for the family. There is a great need for the refinement of nursing practice models for neonatal intensive care nursing, to assure that the holistic nursing care needs of the infant and family are met. This article describes a new middle range theory of health promotion for preterm infants based on Levine's conservation model of nursing that can be used to guide neonatal nursing practice.