Development and implementation of sexual and gender minority curriculum for advanced practice nursing: A feasibility study.

AIM: To explore the feasibility of development and implementation of an educational intervention addressing sexual and gender minority healthcare issues; examine recruitment processes and instrument appropriateness. DESIGN: Non-randomized feasibility study. METHODS: The educational intervention was developed and implemented in family nurse practitioner courses with data collection from August through December 2022. Clinical preparedness, attitudinal awareness and basic knowledge were measured using the lesbian, gay, bisexual and transgender Development of Clinical Skills Scale. RESULTS: Development and implementation of the intervention was feasible but will require amendment before progressing to the pilot study. Clinical preparedness and basic knowledge increased post-intervention, but attitudinal awareness did not improve. Recruitment did not achieve the desired sample size. Instrument internal consistency reliability was confirmed. CONCLUSION: Feasibility was established but will require amendment prior to the pilot study. IMPLICATIONS FOR THE PROFESSION AND/OR PATIENT CARE: To prepare nurses and nurse practitioners to care for sexual and gender minority patients. IMPACT: This study addressed the feasibility of developing and implementing a sexual and gender minority healthcare education using an e-Learning platform. Findings confirm that the intervention was feasible but will require amendment. The intervention increased knowledge and clinical preparedness in caring for this population, but recruitment was challenging. This research will impact nurses, nurse practitioners and nurse educators. REPORTING METHOD: The authors adhered to the relevant EQUATOR guidelines. The Consolidated Standards of Reporting Trials guideline extension for reporting randomized and feasibility guidelines were used. PUBLIC CONTRIBUTION: Sexual and gender minority community members contributed to the intervention development. WHAT DOES THIS PAPER CONTRIBUTE TO THE WIDER GLOBAL CLINICAL COMMUNITY?: The feasibility of using interactive e-learning educational resources to provide sexual and gender minority healthcare curriculum. Evidence to support the use of the Lesbian, Gay, Bisexual, and Transgender Development of Clinical Skills Scale to measure learning outcomes. TRIAL REGISTRATION: This study was not prospectively registered because it was an educational intervention involving graduate student nurses and did not assess clinical outcomes of patients.

Development of a Moral Resilience Collaborative Program During a Pandemic.

Elevated psychological stress can lead to moral distress affecting health care workers and organizations affecting patient care, job satisfaction, and retention. A Moral Resilience Collaborative program was implemented through an academic partnership between a school of nursing and a rehabilitation facility to provide the health care workers in the facility the skills necessary for self-management of moral distress and move them toward moral resilience. Moral distress and resiliency were measured pre-implementation using the Measure of Moral Distress for Healthcare Professionals (MMD-HP) and Short Resiliency Survey (SRS), respectively. Unfortunately, postsurvey quantitative data collection failed due to COVID-19 surges though qualitative data obtained during debriefing sessions demonstrated effectiveness of the project. Based on debriefing comments and the preimplementation MMD-HP mean score and SRS decompression score, the staff in this facility experienced similar types of moral distress as those working in acute care or critical care settings. Even when resiliency programs are needed the most and readily available, patient care demands, a busy work environment, and external factors can hinder staff participation in such endeavors.

Cultural factors associated with physical activity among U.S. adults: An integrative review.

AIM: The purpose of this integrative review is to identify the cultural factors associated with physical activity (PA) among United States (U.S.) adults. BACKGROUND: Physical inactivity is a significant public health problem that requires comprehensive community-based efforts. Cultural factors influence behavior and attitudes towards PA. Therefore, identifying the cultural factors is a key requirement for the planning of specific measures to enhance the level of PA and are more promising than campaigns aimed at the general population. This integrative review examined existing research on cultural factors influencing adult PA to inform the development of culturally adapted PA interventions in adults. METHODS: Literature searches were conducted in key scientific databases (PubMed, Cumulative Index to Nursing and Allied Health, and PsycINFO) using several key words related to both culture and PA. Fifteen peer-reviewed articles were identified, reviewed, synthesized, and critically analyzed. RESULTS: Eight major categories of cultural factors were identified: 1) collectivism and cultural identity; 2) religiosity; 3) cultural attitudes and gender norms in regards to PA; 4) cultural perspectives on health in regards to PA; 5) cultural expectations of familism and lack of time; 6) lack of role models and lack of motivation; 7) lack of culturally appropriate exercise facilities; and 8) cultural expectations of body image and physical appearance. CONCLUSIONS: Review findings emphasize the need for health promotion targeted toward improving cultural barriers to PA among U.S. Adults.

Stress, Grit, Satisfaction With Life, and Remediation of Prelicensure Nursing Students.

BACKGROUND: Stress and poor academic performance often lead to high levels of nursing school attrition. PURPOSE: To explore nursing students' perceived stress, grit, and satisfaction with life, and assess the effectiveness of a remediation program for students at risk for poor academic performance. METHODS: Perceived stress, grit, and satisfaction with life were measured, and the effect of remediation given to at-risk students was studied. Examination and psychometric scores were compared between remediation and nonremediation groups. RESULTS: The remediation group had higher levels of perceived stress and a lower satisfaction with life compared with the rest of the cohort. Remediation significantly improved examination scores of at-risk students although scores remained lower than those among nonremediation students. CONCLUSIONS: Perceived stress and grit scores were high in nursing students, and satisfaction varied among age groups. Remediation based on metacognitive theory significantly improved at-risk students' examination scores.

Benefits of, Barriers to, and Needs for an Artificial Intelligence-Powered Medication Information Voice Chatbot for Older Adults: Interview Study With Geriatrics Experts.

BACKGROUND: One of the most complicated medical needs of older adults is managing their complex medication regimens. However, the use of technology to aid older adults in this endeavor is impeded by the fact that their technological capabilities are lower than those of much of the rest of the population. What is needed to help manage medications is a technology that seamlessly integrates within their comfort levels, such as artificial intelligence agents. OBJECTIVE: This study aimed to assess the benefits, barriers, and information needs that can be provided by an artificial intelligence-powered medication information voice chatbot for older adults. METHODS: A total of 8 semistructured interviews were conducted with geriatrics experts. All interviews were audio-recorded and transcribed. Each interview was coded by 2 investigators (2 among ML, PR, METR, and KR) using a semiopen coding method for qualitative analysis, and reconciliation was performed by a third investigator. All codes were organized into the benefit/nonbenefit, barrier/nonbarrier, and need categories. Iterative recoding and member checking were performed until convergence was reached for all interviews. RESULTS: The greatest benefits of a medication information voice-based chatbot would be helping to overcome the vision and dexterity hurdles experienced by most older adults, as it uses voice-based technology. It also helps to increase older adults' medication knowledge and adherence and supports their overall health. The main barriers were technology familiarity and cost, especially in lower socioeconomic older adults, as well as security and privacy concerns. It was noted however that technology familiarity was not an insurmountable barrier for older adults aged 65 to 75 years, who mostly owned smartphones, whereas older adults aged >75 years may have never been major users of technology in the first place. The most important needs were to be usable, to help patients with reminders, and to provide information on medication side effects and use instructions. CONCLUSIONS: Our needs analysis results derived from expert interviews clarify that a voice-based chatbot could be beneficial in improving adherence and overall health if it is built to serve the many medication information needs of older adults, such as reminders and instructions. However, the chatbot must be usable and affordable for its widespread use.

Experiential Skills Laboratory Experiences in a Didactic Undergraduate Reproductive Health Course.

BACKGROUND: Experiential learning provides undergraduate nursing students with hands-on opportunities to integrate knowledge and clinical skills. Using educational theory, nurse educators can integrate experiential laboratory experiences into didactic courses to increase comprehension of knowledge and skills required in the clinical setting. METHOD: Experiential laboratory experiences were coordinated with didactic content in an undergraduate reproductive health course, and student scores on weekly quizzes and a standardized final examination were compared for three cohorts. One cohort participated in a generic laboratory at the start of the semester, one cohort received 4 synchronized laboratory days throughout the semester, and another cohort received the same content in 2-day laboratory sessions. RESULTS: Weekly quiz scores and standardized final examination scores were significantly higher among students who had synchronized experiential laboratory experiences than for students who had a generic laboratory experience. CONCLUSION: Experiential laboratory experiences are helpful in integrating clinical skills and course knowledge comprehension in didactic undergraduate courses. [J Nurs Educ. 2022;61(6):326-329.].

Current Approaches in Telehealth and Telerehabilitation for Spinal Cord Injury (TeleSCI).

Purpose of Review: Telehealth and telerehabilitation in spinal cord injury (teleSCI) is a growing field that can improve access to care and improve health outcomes in the spinal cord injury population. This review provides an overview of the recent literature on the topic of teleSCI and provides insights on current evidence, future directions, and considerations when using teleSCI for clinical care. Recent Findings: TeleSCI is used most often for preventive health; management of chronic pain, anxiety, and depression; and rehabilitation-related interventions. As video telehealth becomes mainstream, growth in wearable monitors, bio and neurofeedback mechanisms, and app-based care is expected. Summary: TeleSCI is growing in prevalence, demonstrates positive impact on health outcomes, and requires ongoing study to identify, refine, and implement best practices.

Scientific Global Nursing Hackathon Experience.

BACKGROUND: Hackathons are organized to bring together both experienced and novice individuals from a variety of backgrounds to brainstorm creative solutions to complex issues. Hackathons may last from a few hours to a few days and may provide rewards for winning entries. PURPOSE: In this article, we describe an experience with a scientific hackathon at an international nursing research congress in Calgary, Canada. We discuss the purpose, process, benefits, and challenges of this hackathon. APPROACH: For this article, we have used a descriptive approach. OUTCOMES: The scientific hackathon experience united international nursing scholars into a community with a common focus enabling the continuation of mutual, future endeavors. CONCLUSION: Hackathons are a means of connecting novices and experts from different backgrounds to develop technology-based solutions for health care issues. The ideas generated at hackathons may be further developed to bring the project to fruition to positively impact health care.

Health Beliefs Regarding Cardiovascular Disease Risk and Risk Reduction in South Asian Immigrants: An Integrative Review.

Introduction: The risk for cardiovascular disease (CVD) is higher in South Asians (SAs) than in other ethnic groups. The purpose of this review is to explore SAs' health beliefs regarding CVD risk and risk reduction behaviors including physical activity and healthy diet. Methodology: An integrative review was conducted to examine the peer-reviewed literature published before May 2017. Searches from PubMed, Scopus, and CINAHL yielded 1 mixed-method, 4 quantitative, and 14 qualitative studies. Results: Stress, lack of exercise, and high-fat diet were perceived as causes of CVD in most studies. Lack of time, sociocultural norms, and insufficient guidance from health care providers were perceived barriers to CVD risk reduction. Exercise and healthy diet were perceived to be beneficial in a few studies. Cues to action included information from community leaders and health care providers. Discussion: Understanding the unique health beliefs of SAs regarding CVD is important in planning and delivering culturally competent preventive and educational services.

Changes in Patient-Reported Outcome Measures With a Technology-Supported Behavioral Lifestyle Intervention Among Patients With Type 2 Diabetes: Pilot Randomized Controlled Clinical Trial.

BACKGROUND: In the United States, more than one-third of the adult population is obese, and approximately 25.2% of those aged ≥65 years have type 2 diabetes (T2D), which is the seventh leading cause of death. It is important to measure patient-reported outcomes and monitor progress or challenges over time when managing T2D to understand patients' perception of health and quantify the impact of disease processes or intervention effects. The evaluation of patient-reported outcome measures (PROMs) is especially important among patients with multiple chronic conditions in which clinical measures do not provide a complete picture of health. OBJECTIVE: This study examined the feasibility of collecting Patient-Reported Outcome Measurement Information System (PROMIS) measures, and preliminarily evaluated changes in PROMIS scores and compared the scores with standard scores of the general US population. The parent study is a pilot randomized controlled clinical trial testing three different modes (mobile health [mHealth], paper diary, and control) of self-monitoring in a behavioral lifestyle intervention among overweight or obese patients with T2D. METHODS: Patients with comorbid overweight or obesity and a diagnosis of T2D for at least 6 months were recruited from a diabetes education program. Participants were randomized to the following three groups: mHealth, paper diary, and control (standard of care) groups. Paper diary and mHealth experimental groups received additional behavioral lifestyle intervention education sessions, as well as tools to self-monitor weight, physical activity, diet, and blood glucose. All participants completed PROMIS-57 and PROMIS-Global Health (GH) version 1.0 questionnaires during visits at baseline, 3 months, and 6 months. The PROMIS-57 includes the following seven domains: anxiety, depression, fatigue, pain interference, physical function, satisfaction with participation in social roles, and sleep disturbance. The PROMIS-GH is composed of the following two domains: global mental health and global physical health. RESULTS: A total of 26 patients (mHealth, 11; paper diary, 9; control, 6) were included in our analysis. The study sample was predominantly African American (68%) and female (57%), with a mean age of 54.7 years and a mean BMI of 37.5 kg/m2. All patients completed the PROMIS-57 and PROMIS-GH questionnaires, and we compared the mean scores of the three groups to investigate potential differences. No relevant differences were noted across the groups. However, positive trends were noted in both intervention (mHealth and paper diary) groups in the middle (month 3) and end (month 6) of the study. CONCLUSIONS: Our pilot study provides evidence for the feasibility of using PROMIS questionnaires to record important components of T2D-related symptoms among overweight or obese individuals. The results from our study support the use of PROMIS questionnaires to provide clinicians and researchers with a benchmark for assessing the overall need for symptom management and determining the success or challenges of an intervention. TRIAL REGISTRATION: ClinicalTrials.gov NCT02858648; https://clinicaltrials.gov/ct2/show/NCT02858648.