A Community-Based Educational Intervention: Increasing Medication Adherence in Rural Older Adults.

PURPOSE: This study evaluated the effectiveness of a community-based, interdisciplinary, medication education intervention for rural older adults. METHODS: The research design was a quasi-experimental pretest/posttest design. Self-efficacy, adherence to refills and medication, and knowledge were examined. An educational intervention was conducted with each participant on their prescribed medications. FINDINGS: Mean scores for the adherence to refills and medication subscale decreased from 9.9 to 8.5 (p = .003) indicating improved adherence. Mean scores for the knowledge subscale increased from 21.8 to 22.4 (p = .192). CONCLUSIONS: Results suggest a community-based, interdisciplinary, individualized medication education intervention could increase medication adherence in rural older adults.

Mental Health in Farming Communities.

Occupational stressors are causing unprecedented levels of stress, depression, and suicide among our nation's farmers, and little is known about how farmers view their personal stress and potential stress-relieving strategies. The current study used a descriptive qualitative approach to conduct focus groups comprising farmers and farm family members (N = 26). Participants were recruited using a snowball approach based on the investigators' connections to farming communities. Preliminary analysis indicates that primary stressors are: lack of control over many aspects of farming and the public's lack of understanding/appreciation for farming. In addition, two communities identified high levels of anticipatory stressors. Despite these stressors, they continue to farm because of their love for farm life and their generational connection with the land. To decrease farmer stress, participants suggested educating the public about farm life and the impact farming has on the general public, creating social groups for farmers to talk to each other, and sharing the farmer story. [Journal of Psychosocial Nursing and Mental Health Services, 61(10), 39-43.].

Lessons Learned: A Process Evaluation of the Rural Elder Awareness of Medication Safety (REAMS) Program.

This process evaluation of the Rural Elder Awareness of Medication Safety (REAMS) program provided identification of successful and unsuccessful elements along with barriers to and facilitators of this home-based pilot program. The REAMS program was developed to assist rural older adults aged >65 years and community health care organizations with strategies to improve health literacy related to medications. Recruitment of older adults, rurality of the program's setting, time constraints, and the onset of the COVID-19 pandemic were the greatest barriers. The collaborative relationship developed with community health care partners was the greatest facilitator. This relationship promoted shared ideas and adjustments in program design to achieve the outcome goals. The lessons learned from process evaluation may benefit future researchers or community health promotion planners with designing community-based programs for older adults in rural areas. Future research should focus on expanding recruitment opportunities in acute care, primary care, and home health with the inclusion of all established health care providers in the community. [Journal of Gerontological Nursing, 47(4), 7-12.].

Beyond Biometrics: Including Mental Health Screenings in Annual Wellness Programs.

Mental health is an important component of overall wellness and is a growing concern in occupational settings. Approximately one half of Americans will experience a mental health disorder at some time in their life. The current descriptive correlational study used a convenience sample of manufacturing employees (N = 236) to examine the association of mental and physical health risks collected during an annual wellness program. A researcher-developed questionnaire was used to holistically screen for health risks. Pearson's r and chi-square tests were performed to determine the relationship among variables. Younger workers and individuals with higher body mass index had increased anxiety and depression scores (p = 0.005). Results suggest younger workers may have increased risk for mental health and biometabolic disorders. Due to the connections between mental and physical health, screening for anxiety and depression should be included in annual worker wellness programs to potentially improve overall health and wellness outcomes. [Journal of Psychosocial Nursing and Mental Health Services, 59(10), 19-25.].

The Burden of Farmer Suicide on Surviving Family Members: A Qualitative Study.

The purpose of this descriptive qualitative study was to better understand the burden of farmer suicide on surviving family members. Themes included: (1) family members expressed guilt; (2) family members experienced symptoms of psychological distress; (3) family members felt attached to the land and chose to remain on the farm; (4) short-term coping mechanisms included family, friends and faith; (5) long-term coping mechanisms included acts of honoring their loved one; (6) there was a lack of awareness of community support resources following the suicide.

Sitting Time: An Increasing Heath Risk Among Nurse Educators.

Prolonged sitting time (ST) is a distinct risk factor for early mortality and cardiovascular disease. The purpose of this descriptive correlational study was to examine ST and health of Kentucky nurse educators. The written survey included demographic items, general health items, and ST. Total average ST was 10.8 hours (workdays) and 8 hours (non-workdays). There was no relationship between body mass index and ST; however, the medication used to treat hypertension and hypercholesterolemia was associated with increased ST. Nurse educators are at risk for negative health effects of prolonged ST, and effective interventions are imperative.

Promoting Farmer Appreciation in Kentucky through a Farmer Cultural Awareness Project.

OBJECTIVES: To address the perception among farmers of lack of appreciation and being devalued by the non-farming public. METHODS: Oral history interviews were conducted to gather farmers' viewpoints of what the non-farming public needs to know about their occupation. RESULTS: The creation of a public awareness campaign utilizing interview data, including canvas bags, information cards, and a website. CONCLUSION: The public awareness campaign provides the non-farming public with opportunities to learn about the lives of farmers and their contributions to society.

Unmet health need and perceived barriers to health care among adolescents living in a rural area.

This study investigated the perceived health care needs, unmet health need, and barriers to health care in 224 rural-dwelling adolescents. A cross-sectional, descriptive design was used to survey adolescents attending a public high school in a low-resource, rural Indiana community. One in five adolescents reported an unmet health need. The most common barriers to health care were related to access, apathy, anxiety, and parenting issues. Implications include confidentiality protocols in family healthcare practices, school-based health centers, and intervention research targeting adolescents' communication skills and healthcare consumer skills.

Mental Health Issues Among Farmers: An Online Continuing Education Program for Nurses.

BACKGROUND: An asynchronous online continuing education (CE) program was created to increase nurses' awareness and knowledge of occupationally related mental health issues among farmers. METHOD: The ADDIE (analysis, design, development, implementation, evaluation) model was followed to create the CE program. Articulate Storyline 3 (Articulate 360), a software tool, was used to build an interactive, e-learning, and virtual training module. RESULTS: The course was completed by 113 nurses. Eighty-two (72.5%) of these nurses completed the course evaluation. Of these, 69 (84.1%) reported that the course met their expectations. The majority of respondents indicated that the material was presented in a clear, organized manner (80.0%, n = 80) and that all course objectives were met, including being able to identify sources of stress among farmers (86.3%, n = 80), recognize manifestations of stress among farmers (86.4%, n = 81), understand farmers' mental health status (86.3%, n = 80), and identify mental health nursing practices (87.3%, n = 79). CONCLUSION: Nurses can provide more salient care to the farming population when they are equipped with an understanding of the culture and stress associated with farming. This online educational program has the potential to improve mental health care for farmers and their families. [J Contin Educ Nurs. 2021;52(10):482-488.].

Effect of Evidence-Based Materials and Access to Local Resources on Physical Activity Levels, Beliefs, and Motivation During Pregnancy in a Rural Setting.

BACKGROUND: The purpose of this study was to determine the impact of evidence-based educational materials and access to local resources on physical activity (PA) levels, beliefs, and motivation (including self-efficacy) regarding PA during pregnancy in a rural setting. METHODS: Information on PA levels (step counts, Pregnancy Physical Activity Questionnaire) and beliefs and motivation regarding PA (main surveys: Exercise Beliefs Questionnaire, Protection Motivation Theory and Health Action Process Approach) were collected between 8 and 16 weeks gestation. Women from a rural community were randomly assigned to the PA group (PAG, n = 38) or control group (n = 32). The PAG participants received an evidence-based educational brochure and access (at no charge to them) to local fitness facilities. At approximately 34 to 37 weeks gestation, baseline assessments were repeated. RESULTS: Sedentary time was significantly different between groups over time, with control participants increasing sedentary time and PAG participants decreasing sedentary time (P = .04). Sixteen women (42%) in the PAG utilized the resources provided (prenatal yoga being utilized most). Postintervention, there was a significant group × time interaction for Perceived Self-Efficacy scores; scores in the PAG remained consistent with baseline values, whereas scores in the control group decreased (P = .03). CONCLUSIONS: The intervention reduced sedentary time and maintained self-efficacy scores during pregnancy.

A Nurse-Led Population-Based Health Education Project to Improve Infant Care Knowledge for an Old Order Mennonite Community.

Population health is changing the focus of nursing practice as nurses are challenged to focus on health promotion and education for communities rather than limiting their practice to restorative care for individual acute care patients. This new focus is necessary to improve knowledge of maternal and infant health among vulnerable populations. One particularly vulnerable population is members of Old Order Mennonite communities, who frequently rely on self-trained local midwives in the community for home births and home remedies when caring for their infants. Providing evidence-based education to members of this isolated population can be a challenge because they do not typically access information outside of the community. The purpose of this article is to share the process of developing, publishing, and disseminating a culturally sensitive infant care manual for an Old Order Mennonite community using a community-based participatory model and to highlight the impact nursing outreach can have on improving health knowledge.

Are Kentucky Farmers Prepared for Farm-Related Emergencies?

OBJECTIVES: Farming is a hazardous occupation with a high incidence of fatal and non-fatal injuries. Little is known about the preparedness of Kentucky farmers to respond to farm emergencies. The purpose of this study was to determine the knowledge, preparation, and concerns of Kentucky farmers relative to being prepared to take appropriate action in the event of a farm emergency. METHODS: For this descriptive study, a 36-item questionnaire was used to assess the farmer's education and training, access to supplies/equipment to deal with farm emergencies, and their concern regarding emergency preparedness. Data were collected from a sample of 115 farmers attending an agricultural related conference or meeting in the Commonwealth of Kentucky. RESULTS: A majority of the farmers reported: 1) limited CPR/first aid training, 2) minimal access to first aid kits/fire extinguishers on the farm, and 3) concern that EMS could not locate their farms. A large majority of the farmers reported use of a smartphone with a GPS locator; however, some farms were reported to be without cell service. The farmers were interested in attending training on emergency preparedness if training sessions were scheduled at a convenient time. CONCLUSION: Information obtained from this survey will guide the development of a multi-component community-based program to prepare farmers to take appropriate action and receive quick emergency medical services (EMS) in farm emergencies. New community partnerships will be established to identify, implement, and evaluate creative strategies to ensure that Kentucky farmers are prepared for emergency events.

A descriptive study of bathing practices in acute care facilities in the United States.

BACKGROUND: Patient bathing basins are a potential source of health care-acquired infections. This descriptive study was designed to describe current patient bathing procedures and the cleaning and storage of disposable bath basins after use. METHODS: After instrument validation, a 20-item questionnaire designed by the researchers was delivered electronically to infection prevention professionals working in acute care facilities in the United States. Descriptive statistics including frequencies and percentages were used to analyze the data. RESULTS: A total of 344 participants completed the survey. Of those responding, most were employed in facilities with ≤300 beds and accredited by the Joint Commission. Many of the facility staff assisting patients with bathing were nursing aides. Participants reported varying bathing procedures in their facilities. CONCLUSIONS: A collaborative approach is needed to ensure standard and efficient procedures that focus on quality, safety, and patient satisfaction. A mechanism to continually evaluate patient bathing practices should also be developed to address evolving changes in the health care system.

Suicide: An Unrecognized Epidemic Among Farmers.

Stress and depression are prevalent among farmers, and suicide has reached epidemic status. Occupational health nurses are in key positions to recognize these mental health issues and use strategies to control this epidemic.

Nurse Educators' Occupational and Leisure Sitting Time.

Prolonged sitting time (ST) is a risk factor for all-cause mortality, independent of physical activity. Nurse educators are particularly at risk due to limited physical activity, older age, and the increasing use of computers. This descriptive correlational study was designed to explore the ST of nurse educators in relation to their self-reported health status and general health indicators. A convenience sample of 56 nurse educators was recruited, and participants completed demographic items, general health questions, and the Workforce Sitting Questionnaire (WSQ; Chau, van der Ploeg, Dunn, Kurko, & Bauman, 2011). More than one half of the participants were either overweight or obese based on their body mass index (BMI). Sitting time domains for "watching TV" on a non-working day ( r = 1.00) and during "other leisure activities" on a non-working day ( r = 1.00) were associated with a current diagnosis of diabetes. These findings add to an understanding of the effects of ST on health risks for nurse educators.