Graduate Nurse Educator Students' Perceptions of the Use of Narrative Pedagogy in Online Learning: A Pilot Study.

ABSTRACT: This pilot study explored graduate nurse educator students' perceptions of the application of narrative pedagogy in an online environment. Four major themes were identified in 15 student discussion posts: adapting challenges, increasing digital human interactions, enabling strategies, and creating a partnership for learning. Results illustrate how integrating narrative pedagogy into online classes enables a transformation of student thinking and learning by providing alternate ways for nurse educators to promote active learning.

Preparing health professional students for interprofessional practice related to neurodevelopmental disabilities: a pilot program.

Many health professional students have insufficient general knowledge about individuals with neurodevelopmental disabilities. Students lack the expertise required to work with this population and their families. Interprofessional practice education (IPE) programs, designed for working with individuals with specialized needs and their families, are needed to improve overall care provided. An IPE program related to neurodevelopmental disabilities for health professional students was implemented focusing on applied learning and community engagement to develop competencies for students related to neurodevelopmental disabilities at a state university in the U.S. The purpose of this research was to describe the development and implementation of an IPE program and to examine the effectiveness of the IPE program aimed at developing identified competencies and increase awareness related to care of individuals with ND for health professional students. The findings suggest the IPE program enhanced health professional students' perceived competencies to identify and provide culturally sensitive and family-centered care for individuals with neurodevelopmental disabilities and their families. This experience also provided an opportunity for personal/professional growth and increased awareness of the unique needs of these individuals with neurodevelopmental disabilities and their families.

Race/ethnicity differences in risk and protective factors for marijuana use among U.S. adolescents.

BACKGROUND: Little is known about how race and ethnicity influence marijuana-specific risk and protective factors in U.S. adolescents. We examined differences in risk and protective factors of marijuana use (MU) and their associations with MU by race/ethnicity. METHODS: The present study used data from the 2015-2019 National Survey on Drug Use and Health. A total of 68,263 adolescents (aged 12 to 17 years) were divided into seven subgroups by race/ethnicity (White, Hispanic, Black, Asian, Native American, Native Hawaiian/Pacific Islander (NH/PI), and mixed race). Marijuana-specific risk and protective factors (RPFs) were examined, including perceived availability of marijuana, adolescents' perceived risk of MU and perceived disapproval of parents, peers, and close friends. Past-month, past-year, and lifetime MU were used as MU outcomes to examine the associations with RPFs as well as with race/ethnicity. RESULTS: Overall, 6.85, 12.67, and 15.52% of the sample reported past-month, past-year, and lifetime MU respectively. Weighted adjusted logistic regression analyses revealed that mixed race adolescents reported the greatest perceived availability of marijuana, whereas Black and Asian adolescents had less access compared to White adolescents. The adolescents' perception of parental disapproval of MU was the lowest for Native American adolescents and highest for Asian adolescents. Mixed race adolescents experienced lower peer and close friend disapproval of MU while Black and Asian adolescents had higher. The MU risk perception was lower in most groups including Black, Hispanic, Native American, and mixed race adolescents, but not in Asian adolescents. Native American adolescents scored the highest on all MU outcomes, whereas Asian adolescents scored the lowest. Perceived availability of marijuana was associated with higher MU in all MU outcomes. Lower disapproval MU perceptions and lower MU risk perceptions were also associated with greater MU. CONCLUSION: These findings suggest there is considerable heterogeneity of marijuana risk and protective factors and MU across race/ethnicity among U.S. adolescents.

Journaling for self-care and coping in mothers of troubled children in the community.

AIM: This mixed method research explored the benefits of a six-week diary writing intervention, and the coping strategies utilized in a sample of affected mothers who have teenagers or adult children with emotional and/or behavioral issues. METHODS: Participants were assigned to write either a best possible self or a gratitude journal, and asked to make entries at least three times per week for six weeks. A snowball sample of 34 mothers completed the six-week journal and post-test. RESULTS: The findings of paired t-tests indicated statistically significant increases in optimism and gratitude levels after completing the writing intervention. The mothers commonly used coping methods for parental distress were emotion-and meaning-focused coping. The three themes of journal writing experience were positive thinking, emotional well-being, and mental health self-care. CONCLUSION: The current study suggests that implementing a positive writing intervention is a practical means of promoting psychological well-being as a self-care strategy for this population.

Cultural Context of Family Religiosity/Spirituality among Korean-American Elderly Families.

The purpose of this study is to explore the cultural context of family religiosity/spirituality among Korean-American elderly families, and how this changed after families immigrated to the USA. Fifty one first-generation Korean-Americans participated in one or two hour, in-depth interviews in Korean at a participant's home or church. These included 27 older adults and 24 family members living together or within a radius of one-hour transit time from their elders, residing in the Southeastern United States. A thematic and interpretive method was used to analyze transcribed interviews. Three themes were identified that explained the cultural context of family religiosity/spirituality: (a) traditional family religious rituals, (b) church oriented routines, and (c) family collectivism. The participants did not distinguish 'religiosity' and 'spirituality' during the interviews. The findings suggest that the family religiosity/spirituality of the participants was influenced by the traditional family religious values, which were shaped by Korean culture. The traditional religions of Shamanism, Buddhism, and Confucianism are prevalent in Asian countries. Thus, the findings of this study may help healthcare professionals identify the cultural contexts of spirituality/religiosity of Asian immigrant families in order to provide holistic care.

Family Spirituality and Family Health Among Korean-American Elderly Couples.

Spirituality has been regarded as an individual and private matter; consequently, research on spirituality as a family phenomenon has been largely neglected. In addition, most published research has been focused on Western cultures. The purpose of this study was to explore the experience of family spirituality and how it influences health among Korean-American elderly couples who are the first generation to reside in the Southeastern USA. A thematic and interpretive data analysis method was used. Thirteen elderly couples (N = 26) participated in in-depth individual interviews in Korean with the primary author. Interviews were audio-taped, transcribed, and then translated by two bilingual researchers with a background in Korean and American culture. Three main themes of family spirituality were identified: (1) family togetherness, (2) family interdependence, and (3) family coping. Also, participants reported that family spirituality strengthened family health by fostering family commitment, improving emotional well-being, developing new healthy behaviors, and providing healing experiences. This finding implies that healthcare providers need to assess family spiritual issues of elderly couples to maximize their strengths for coping with health problems. As our society becomes more culturally diverse, healthcare providers should seek to understand family spirituality from different cultural perspectives to develop a more holistic approach to care.

Promoting cultural awareness in nursing education through international videoconferences.

This paper describes a highly successful, 10 year long international videoconference exchange between nursing students in Iwate Prefectural University in northern Japan and the University of North Carolina Wilmington in the United States. A summary of the literature on the use of videoconferencing in nursing education is presented, as well as a brief overview of the collaborative partnership that led to the development of the annual videoconference series. A description of the process for conducting the annual real-time sessions is included along with student perspectives about their experiences. Planning, support and open-mindedness on the part of both students and nursing faculty have contributed to the success of this collaborative effort.

Beliefs and Experience of Journaling in Mothers of Adult Children With Substance Use Problems: A Pilot Study.

BACKGROUND: The challenges experienced by mothers supporting an adult child with substance use problems suggest intervention is needed to improve such mothers' psychosocial well-being through adaptive coping. AIMS: This study examined beliefs about journaling as well as changes in stress, cortisol levels, and mental health after a 6-week intervention by mothers whose adult children had substance use problems. In addition, the study explored coping methods used and the experience of writing among these mothers. METHODS: A purposeful sample of 17 mothers completed the pretest and posttest. Participating mothers were asked to make journal entries at least 3 times per week for 6 weeks. RESULTS: The mothers used diverse adaptive coping methods to manage stress. In particular, they frequently used religious and meaning-focused coping. The mothers perceived journaling as a highly valuable coping method for daily stress. The findings of paired t tests indicated no statistically significant differences in the stress, mental health variables, and cortisol levels between pretest and posttest. However, participants shared the positive experiences of journaling: emotional well-being, stress management, perspective changes, focus, self-regulation, clarity, and gratitude. CONCLUSION: The present finding suggests journaling is a practical means to promoting adaptive coping in mothers with adult children who have substance use problems.

Adolescents' Marijuana Use Following Recreational Marijuana Legalization in Alaska and Hawaii.

Alaska and Hawaii, the only two noncontiguous states in the United States, have different marijuana policy environments. Alaska enacted recreational marijuana legalization (RML) in 2014, whereas recreational marijuana is still illegal in Hawaii. This study analyzed how RML affects adolescents' marijuana use (MU) by comparing two states. We used data from 2 states (Alaska and Hawaii) from the Youth Risk Behavior Survey, 2009 to 2019 years (N = 35 467). The trends of lifetime MU and current MU were examined. Using difference-in-differences analysis models, this study investigated whether RML increased lifetime and current MU in Alaska compared with Hawaii after adjusting for socioeconomic characteristics. Both lifetime and current MU prevalence among adolescents in Alaska increased after RML, while both rates in Hawaii gradually decreased. The rate of lifetime MU in Alaska was significantly increased after RML (odds ratio [OR] = 1.29) compared with Hawaii. Similarly, the current MU among adolescents in Alaska was significantly increased compared with that in Hawaii (OR = 1.34). Both lifetime and current MU were increased following RML in Alaska, suggesting that RML may affect the increase of MU among adolescents.

Factors Influencing Sleep Quality among Female Staff Nurses during the Early COVID-19 Pandemic in the United States.

This study aimed to assess the overall level of sleep quality among female staff nurses in the United States during the early COVID-19 pandemic. It also aimed to examine factors associated with sleep quality and its seven subcomponents: subjective sleep quality, sleep latency, sleep duration, habitual sleep efficiency, sleep disturbance, use of sleeping medications, and daytime dysfunction. A descriptive, correlational, and cross-sectional study design was used. We performed descriptive, and regression analyses with a sample of 215 female staff nurses enrolled in post-licensure online nursing programs at a southeastern state university. Data collection was conducted using an online survey from April to May 2020. Sleep quality was measured using the Pittsburgh Sleep Quality Index (PSQI). Nurses working part time (p = 0.02), with lower perceived physical health (p = 0.01), a lower self-care self-regulation score (p < 0.001), and higher work stress (p < 0.05) showed poorer sleep quality. Factors associated with subcomponents of sleep quality varied. Poor sleep quality among nurses during the COVID-19 pandemic was reported. Various factors, including work environmental factors were associated with the sleep quality in this sample. Hospital administrators should consider developing intervention programs for improving the work environment, which would impact sleep quality, health status, and job performance.

Perceptions of Spiritual Care Education, Competence, and Barriers in Providing Spiritual Care Among Registered Nurses.

Purpose: The purpose of the study was to explore registered nurses' (RNs) perceptions of their spiritual care competence (SCC), preparedness, and barriers to providing spiritual care and frequency of provision of spiritual care. Additionally, the study aimed to examine associations between spiritual care education, preparedness, competence, and frequency. Method: A descriptive, cross-sectional study included demographic questions, the Spiritual Care Competency scale, the Nurses' Spiritual Care Therapeutics scale, the Spiritual Care Practice questionnaire subscale II, and three open-ended questions. Findings: This online survey was completed by 391 RNs enrolled in postlicensure programs at a public state university in southeastern United States. A majority of participants reported not feeling prepared to provide spiritual care. There were strong associations between receiving spiritual care education in prelicensure programs or at work, and self-reported feelings of preparedness, as well as overall SCC. The level of SCC was positively correlated with spiritual care frequency and number of years working as an RN. Conclusions: The results of this study highlight the need for spiritual care education in prelicensure programs as well as on the job training for RNs.

Gender differences in intimate partner violence and alcohol use among Latino-migrant and seasonal farmworkers in rural southeastern North Carolina.

The purpose of this study was to assess intimate partner violence (IPV) and alcohol use among Latino migrant and seasonal farmworkers. The 291 Latino participants were interviewed in Spanish at migrant camps and residences in 3 counties located in southeastern North Carolina. The findings of this study indicate significant gender differences in IPV and alcohol use among the Latino population in the southeastern United States. The findings also indicate that there is a serious problem of IPV and alcohol use among Latinos in the southeastern United States, suggesting the need for routine screening in primary care settings.

Incidence, sources, and self-management of depression in persons attending a rural health clinic in southeastern North Carolina.

The purpose of this study was to determine the incidence, sources, and self-management strategies of depression in a sample of 48 persons visiting a primary care clinic in rural Southeastern North Carolina. Forty percent of the participants met the criteria of clinical depression on the Center for Epidemiological Studies Depression Scale (CES-D). Highest rates of depression found in single, African American men who were employed with adequate health insurance were attributed primarily to work related stressors in dealing with overwhelming social problems of other rural residents, as well as economic stressors. Critical incident interviews identified depression self-management strategies and sources of social support.

Nurses' Knowledge and Treatment Beliefs: Use of Complementary and Alternative Medicine for Pain Management.

Purpose: To examine the relationship between nurses' knowledge, attitudes, and beliefs about medicines, in general, and complementary and alternative medicine (CAM) and identify the predictors of referrals for pain management. Method: This descriptive, correlational study utilized an online survey to collect data from direct care nurses at a large medical center in southeastern United States. The online survey consisted of the Complementary and Alternative Medicines and Beliefs Inventory (CAMBI), the Beliefs about Medicine Questionnaire, and four open-ended questions. Referral data were obtained from the Information Management Department at this medical center. Results: Among the 218 nurses who completed the survey (15.12%), majority (85%) supported CAM use, but only 32% reported utilizing CAM therapies with patients. Medical surgical, emergency department, and perioperative nurses scored higher on their CAMBI total score and were more likely to refer for CAM therapies when compared with intensive care unit nurses. Conclusions: Beliefs about CAM specifically were not related to referrals for CAM therapies. This study suggests the need for further education on the nurse's role in CAM usage. Understanding the link between nurses' knowledge, attitudes, and treatment beliefs and their relationship to CAM usage provides direction for future educational interventions.

Beliefs about HIV disease and medication adherence in persons living with HIV/AIDS in rural southeastern North Carolina.

The purpose of this study was to assess personal beliefs about the causes and meaning of having HIV disease and personal beliefs about medication adherence in persons living in rural southeastern North Carolina. Of the total sample of 34 participants, 29 (85%) were African American. The sample included 21 men (62%) and 13 women (38%), with a self-reported mean CD4 count of 499.38 (SD = 377.69) and a mean duration of HIV of 8.0 years. The majority of participants held beliefs that HIV was a serious and chronic condition and that the disease could be controlled by HIV therapies. Participants offered disparate views about whether or not the course of HIV disease was amenable to personal control. The persons who held the belief that the cause of HIV/AIDS was because of chance/bad luck (p = .03) or God's will (p < .001) were also most likely to believe that the progression of their HIV disease depended on chance or fate. The respondents currently taking HIV medication were also more likely to believe that HIV was caused by chance or bad luck (p = .038) or God's will (p = .016). The results reflect the important role of spirituality on self- regulation of illness and treatment in the rural southern culture.

Student Perceptions of Peer Evaluation in an Online RN-to-BSN Course.

The purpose of this study was to explore student perceptions of peer-evaluation experiences in an online RN-to-BSN nursing research course. A total of 140 students completed the online survey. A majority of students reported their peer-evaluation experience was helpful for learning (69%), and 81.8% of students indicated their writing skills improved. Findings of the study support the use of peer evaluation in online nursing courses.

Prerequisites to providing culturally competent care to Mexican migrant farmworkers: a Delphi study.

The purpose of this study was to identify prerequisites to providing culturally competent care to Mexican migrant farmworkers. A national sample of nurse experts who worked with Mexican migrant farmworkers (N = 93 [50.2%] in round 1; and N = 142 [54.8%] in round 2) participated during the period of August 1998 to April 1999. Using a two-round modified Delphi method, a list of 89 items was generated. The nurse experts agreed that the 89 items identified were prerequisites to cultural competence, showing consensus rates of 85.4% in round 1 and 88.8% in round 2. The prerequisites to culturally competent care identified by participants encompassed caring, cultural sensitivity, cultural knowledge (general/specific), cultural abilities/skills, and others (bi-cultural status; cultural and learning experiences).

RN-BSN Students' Perceptions of the Differences in Practice of the ADN- and BSN-Prepared RN.

This study explored RN-BSN students' perceptions of practice differences between nurses prepared with an ADN and BSN. Five themes were identified in 20 students' discussion posts: "a nurse is a nurse" at the bedside, beyond the bedside, BSN wanted, digging deeper, and appraisal. Results illustrate the need for educators to assist nurses in translating the differentiated educational competencies to the practice role of the bedside RN.

Stress among migrant and seasonal farmworkers in rural southeast North Carolina.

CONTEXT: Although funding to enhance the delivery of health care among migrant farmworkers has primarily focused on urgent care issues within this population, the etiology of mental health risks and perceived stress is poorly understood. PURPOSE: To identify the type and severity of stress perceived by migrant and seasonal farmworkers in rural southeast North Carolina. METHODS: During the pre-agricultural season in 2002, 151 migrant and seasonal farmworkers completed the 39-item Migrant Farmworker Stress Inventory (MFWSI) in either English or Spanish. FINDINGS: Fifty-one percent (n = 77) of the respondents perceived themselves at a high level of stress (mean score above 80 of "caseness") that may subsequently put them at greater risk for experiencing psychological difficulties. The stressors highly ranked (mean>2.5 in a maximum of 4, with "extremely stressful" in a 5-point Likert scale 0 to 4) were related to their mobile lifestyle, language barriers, insecure job and legal status, financial restraint, and long working hours. Also, drug and alcohol use in the migrant community was found to be one of the significant sources of stressors. Variables influencing high levels of stress include education, social support, religion, marital status, and age. Despite a relatively high level of perceived stress, the majority of respondents (71.5%) viewed their physical health as either "good" or "excellent." CONCLUSIONS: Findings from the study suggest the availability of social support systems may provide significant insight into developing appropriate health services for migrant and seasonal farmworkers and their families.

Postpartum beliefs and practices among non-Western cultures.

Postpartum health beliefs and practices among non-Western cultures are each distinct, but have many similarities. Two common belief systems surround 1) the importance of hot and cold, and 2) the necessity of confinement during a specific period of time after giving birth. This article describes common postpartum health beliefs among women in Guatemala, China, Jordan, Lebanon, Egypt, Palestine, India, and Mexico, and offers an exemplar from the author's experiences as a Korean woman giving birth in the United States. Cultural competence in the provision of postpartum care is essential for nurses in the healthcare world of the 21st century.