Circle Of Life cancer education: giving voice to American Indian and Alaska Native communities.

The Circle Of Life (COL) was first developed in 1991 as a breast health program through a partnership between the American Cancer Society and a committee of lay and professional volunteers in Oklahoma, with representation from Oklahoma American Indian tribal communities. In 2008, The Society was awarded funding from the Centers for Disease Control and Prevention to expand and enhance COL. Since then, The Society has engaged a variety of tribal health and education leaders and Society staff to comprise a COL advisory workgroup. The workgroup's mission was to make recommendations and provide guidance in the revision of COL. Four cultural values emerged from the engagement of the workgroup: (1) the value of visual communication, (2) the value of interconnected generations, (3) the value of storytelling, and (4) the value of experiential learning. These four concepts greatly shaped the revision of the COL educational tools and resources.

Mobile Health Interventions to Improve Health Behaviors and Healthcare Services among Vietnamese Individuals: A Systematic Review.

The purpose of this review is to summarize the feasibility, acceptability, and efficacy of interventions that utilize mobile health (mHealth) technology to promote health behavior changes or improve healthcare services among the Vietnamese population. Ovid MEDLINE, CINAHL, EMBASE, Scopus, and Web of Science were used to identify studies published from 2011-2022. Studies utilizing mHealth to promote behavior change and/or improve healthcare services among Vietnamese were included. Studies that included Vietnamese people among other Asians but did not analyze the Vietnamese group separately were excluded. Three independent researchers extracted data using Covidence following PRISMA guidelines. Measures of feasibility, acceptability, and efficacy were synthesized. The ROBINS-I and RoB2 tools were used to evaluate methodological quality. Fourteen articles met inclusion criteria and included 5660 participants. Participants rated high satisfaction, usefulness, and efficacy of mHealth interventions. Short message service was most frequently used to provide health education, support smoking cessation, monitor chronic diseases, provide follow-up, and manage vaccination. Measures of feasibility, acceptability, and efficacy varied across studies; overall findings indicated that mHealth is promising for promoting lifestyle behavior change and improving healthcare services. Cost effectiveness and long-term outcomes of mHealth interventions among the Vietnamese population are unknown and merit further research. Recommendations to integrate mHealth interventions are provided to promote the health of Vietnamese people.

mHealth Intervention for Vietnamese Living With Diabetes: Protocol for a Stepped Wedge Pilot Study.

BACKGROUND: Evidence indicates participation in a diabetes self-management education and support program improves self-care behaviors and hemoglobin A1c. Language and cultural differences may be barriers to program participation resulting in ineffective self-management, but these factors can be addressed with appropriate interventions. Given the high health care costs associated with diabetes complications, we developed a multicomponent, culturally tailored Self-Management Mobile Health Intervention for US Vietnamese With Diabetes (SMart-D). OBJECTIVE: This study aims to evaluate the SMart-D intervention's feasibility, acceptability, and effectiveness with intentions to scale up the intervention in the future. This mixed methods study incorporates the Reach, Effectiveness, Adoption, Implementation, Maintenance framework to evaluate the intervention. METHODS: This stepped wedge randomized controlled pilot study will be conducted over 2 years in collaboration with primary care clinics. Eligible participants are patients with type 2 diabetes who are receiving health care from participating clinics. Clinics will be randomly assigned to an implementation date and will begin with patients enrolling in the control period while receiving standard care, then cross over to the intervention period where patients receive standard care plus the SMart-D intervention for over 12 weeks. Focus groups or interviews will be conducted with clinicians and patients after study completion. Qualitative data will be analyzed using NVivo. Outcomes on self-care behavior changes will be measured with the Summary of Diabetes Self-Care Activities scale and clinical changes will be measured using laboratory tests. A generalized linear mixed-effect model will be used to compute time effect, clustering effect, and the interaction of the control and intervention periods using SAS (version 9.4; SAS Institute). RESULTS: We hypothesize that (1) at least 50% (n=5) of eligible clinics and 50% (n=40) of eligible patients who are invited will participate, and at least 70% (n=56) of patients will complete the program, and (2) patients who receive the intervention will have improved self-care behaviors and clinical test results with at least 75% (n=60) of the patients maintaining improved outcomes at follow-up visits compared with baseline, and participants will verbalize that the intervention is feasible and acceptable. As of August 2023, we enrolled 10 clinics and 60 patients. Baseline data results will be available by the end of 2023 and outcome data will be published in 2025. CONCLUSIONS: This is the first Vietnamese diabetes self-management education and support intervention that leverages mobile health technology to address the barriers of language and culture differences through collaboration with primary care clinics. This study will provide a better understanding of the implementation process, demonstrate the potential effectiveness of the intervention, accelerate the pace of moving evidence-based interventions to practice among the US Vietnamese population, and potentially provide a replicable implementation model that can be culturally adapted to other non-English speaking ethnic minorities. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID): DERR1-10.2196/48585.

Preliminary lessons learned from the "Native Navigators and the Cancer Continuum" (NNACC).

This community-based participatory research (CBPR) study was based on patient navigation (Navigator) among three original sites: Colorado, Michigan, and South Dakota. During 2010, the study added two sites: the Comanche Nation and the Muscogee (Creek) Nation (Oklahoma). The intervention includes 24-h of a Navigator-implemented cancer education program that addresses the full continuum of cancer care. The partners include agreements with up to two local Native American organizations each year, called Memorandum Native Organizations, who have strong relationships with local American Indians. Family fun events are used to initiate the series of workshops and to collect baseline data and also to wrap up and evaluate the series 3 months following the completion of the workshop series. Evaluation data are collected using an audience response system (ARS) and stored using an online evaluation program. Among the lessons learned to date are: the Institutional Review Board processes required both regional and national approvals and took more than 9 months. All of the workshop slides were missing some components and needed refinements. The specifics for the Memorandum Native Organization deliverables needed more details. The ARS required additional training sessions, but once learned the Navigator use the ARS well. Use of the NACR website for a password-protected page to store all NNACC workshop and training materials was easier to manage than use of other online storage programs. The community interest in taking part in the workshops was greater than what was anticipated. All of the Navigators' skills are improving and all are enjoying working with the community.

Online evaluation programs: benefits and limitations.

Patient navigation programs are increasing throughout the USA, yet some evaluation measures are too vague to determine what and how navigation functions. Through collaborative efforts an online evaluation program was developed. The goal of this evaluation program is to make data entry accurate, simple, and efficient. This comprehensive program includes major components on staff, mentoring, committees, partnerships, grants/studies, products, dissemination, patient navigation, and reports. Pull down menus, radio buttons, and check boxes are incorporated whenever possible. Although the program has limitations, the benefits of having access to current, up-to-date program data 24/7 are worth overcoming the challenges. Of major benefit is the ability of the staff to tailor summary reports to provide anonymous feedback in a timely manner to community partners and participants. The tailored data are useful for the partners to generate summaries for inclusion in new grant applications.

Expanding what we know about off-peak mortality in hospitals.

For more than 30 years, a negative "off-peak effect" on patient outcomes has been associated with weekend and/or nighttime hospitalization in more than 25 diagnostic groups. Descriptive studies have verified the presence of this off-peak effect on patient outcomes but have done little to explain its cause. Institutional ethnography is a promising method for describing challenges nurses encounter and deal with on off-peak shifts and for exploring how those challenges arose in institutions designed to avoid such outcomes. The authors discuss their research and suggest a number of steps that nurse administrators might take to enhance their knowledge for handling off-peak challenges in their hospitals.

Grandmother breastfeeding support: what do mothers need and want?

BACKGROUND: Grandmothers are an important source of support for new mothers. Their infant feeding experience and knowledge can influence mothers' decisions to initiate and continue breastfeeding. The objective of this study was to explore mothers' perceptions of grandmothers' breastfeeding knowledge and support, as part of a larger study to design an intervention that facilitates the development of grandmothers' support of breastfeeding. METHODS: Thirty mothers participated in one of four focus groups held in a North Texas metropolitan area. We analyzed the text of each focus group interview using the content analysis method and identified five themes within and across groups that described mothers' perceptions of grandmother breastfeeding support. RESULTS: The essence of what mothers needed and wanted from grandmothers could be summarized as grandmother breastfeeding advocacy, which is defined by the two themes, "valuing breastfeeding" and "loving encouragement." Three other themes, "acknowledging barriers,""confronting myths," and "current breastfeeding knowledge," reflected mothers' perceptions of what grandmothers need to become their advocates, particularly if they did not breastfeed their own children. CONCLUSIONS: Breastfeeding occurs within the context of an extended family in which grandmothers bring their own infant feeding practices and beliefs to their support of new mothers. Mothers need and want grandmothers' support, but their advice and concerns may reflect cultural beliefs that do not protect breastfeeding. Including grandmothers in conversations about breastfeeding practices can be one way for health caregivers to enhance grandmothers' knowledge and support of breastfeeding.

Managing chronic pain in patients with cancer who have a history of substance abuse.

Oncology nurses may encounter patients recovering from substance abuse who will need acute or chronic pain management. Knowing how to assess, treat, and manage that pain is a benefit to the nurse and patient. In addition, understanding and overcoming bias toward patients with a history of substance abuse can lead to a trusting relationship and more effective pain management. A thorough assessment and documentation of the patient's pain during each visit provide a solid basis for prescribing opioids to patients with a history of substance abuse. The use of long-acting and higher-dose opioids in this population will be discussed. Functional improvement versus absence of pain may be a more realistic goal for patients recovering from substance abuse, and complementary and alternative therapy may be considered. Setting standards to deal with lost prescriptions or medication, missed appointments, and the use of contracts for all patients receiving opioids establishes unbiased treatment.

Addressing excellence of faculty teaching and research.

Many new nursing leaders assuming deanships or assistant or interim deanships have limited education, experience, or background to prepare them for the job. To assist new deans and those aspiring to be deans, the authors of this department, 2 deans, offer survival tips based on their personal experiences and insights. They address common issues, challenges, and opportunities that face academic executive teams, such as negotiating an executive contract, obtaining faculty lines, building effective work teams, managing difficult employees, and creating nimble organizational structure to respond to changing consumer, healthcare delivery, and community needs. The authors welcome counterpoint discussions with readers.

A model of CAM use by women with female-specific cancers.

In this cross-sectional, retrospective, explanatory secondary analysis of the 2002 National Health Interview Survey, complementary and alternative modality (CAM) use by women with female-specific cancers is described. The effect of personal factors on the odds of CAM use was measured using the researcher's model, based on Pender's Health Promotion Model, as a framework. Women age 40 and older, with high levels of edu cation, presence of pain, and presence of depression/anxiety were more likely to use CAM. Because women with female-specific cancers who report depression/anxiety are more likely to use CAM, they need to be targeted by mental health nurses for education regarding safe CAM use.

The experience of being an Anishinabe man healer: ancient healing in a modern world.

PURPOSE: The purpose was to understand the experience of being an Anishinabe man healer. Of particular relevance, healers explained how they provide Indigenous health care in a world dominated by Western biomedicine. DESIGN: A phenomenological approach was utilized to interview four Anishinabe men healers who reside in the United States and Canada. METHOD: In-person interviews were conducted using an interview guide. The interviews were audiotaped when permitted; otherwise notes were taken. Data analysis was conducted using techniques from Colaizzi and van Manen. FINDINGS: Seven themes were identified: (1) The Healer's Path, (2) Health as Wholeness, (3) Healing Ways, (4) Healing Stories, (5) Culture Interwoven with Healing, (6) Healing Exchange, and (7) Connection with Western Medicine. CONCLUSIONS: The themes identified inform nursing practice by pointing out the importance of culture within traditional Indigenous healing, as well as the need for a holistic approach when caring for Indigenous people. Additionally, the Indigenous men healers acknowledged their connection with Western medicine as part of the process of healing for their clients. This emphasizes the need for nurses and other health care providers to become knowledgeable regarding traditional Indigenous healing that their clients may be receiving, in order to foster open communication.

The experience of being an Anishinabe man healer: ancient healing in a modern world.

PURPOSE: The purpose was to understand the experience of being an Anishinabe man healer. Of particular relevance, healers explained how they provide Indigenous health care in a world dominated by Western biomedicine. DESIGN: A phenomenological approach was utilized to interview four Anishinabe men healers who reside in the United States and Canada. METHOD: In-person interviews were conducted using an interview guide. The interviews were audiotaped when permitted; otherwise notes were taken. Data analysis was conducted using techniques from Colaizzi and van Manen. FINDINGS: Seven themes were identified: (1) The Healer's Path, (2) Health as Wholeness, (3) Healing Ways, (4) Healing Stories, (5) Culture Interwoven with Healing, (6) Healing Exchange, and (7) Connection with Western Medicine. CONCLUSIONS: The themes identified inform nursing practice by pointing out the importance of culture within traditional Indigenous healing, as well as the need for a holistic approach when caring for Indigenous people. Additionally, the Indigenous men healers acknowledged their connection with Western medicine as part of the process of healing for their clients. This emphasizes the need for nurses and other health care providers to become knowledgeable regarding traditional Indigenous healing that their clients may be receiving, in order to foster open communication.

Geographic Health Disparities: Satellite Clinics for Cancer Care in Rural Communities.

BACKGROUND: Cancer treatment is time-consuming and challenging for most patients, but particularly for those who live in geographically isolated areas. Satellite chemotherapy infusion centers offer a possible solution to geographic disparities in health care. OBJECTIVES: This article analyzes a satellite chemotherapy infusion center on the island of Martha's Vineyard in Massachusetts. METHODS: Interviews were conducted with staff of the infusion department of Martha's Vineyard Hospital, which has partnered with the cancer center at Massachusetts General Hospital to offer a satellite chemotherapy infusion center for island residents. FINDINGS: High-quality community hospitals are increasingly able to offer specialized oncology treatment and nursing care at greater convenience for patients through the use of satellite clinics.

Lesson from comparison of CAM use by women with female-specific cancers to others: it's time to focus on interaction risks with CAM therapies.

There has been no examination as to whether the prevalence of complementary and alternative medicine (CAM) use, as well as personal factors associated with CAM use and predictive of CAM use for women with female-specific cancers, is similar to those in other diagnostic groups. The purpose of this review is to compare CAM use and personal factors associated with and predictive of CAM use by women with female-specific cancers to samples of other diagnostic groups. If it is the case that CAM use is similar across various types of samples, then it may be unnecessary to continue to study detailed CAM use by those in separate diagnostic groups and instead focus energies on the examination of CAM therapies that may have risks for interaction with conventional therapies, such as biologically based therapies. The researcher concludes that we are now in an era in which we need to use our restricted time, human resources, and finances to examine biologically based CAM use that may carry high risks for interactions or toxicities for specific groups under examination, rather than examine global CAM use, unless the situation warrants such all-inclusive study.

Healing Touch: a low-tech intervention in high-tech settings.

Healing Touch is a complementary therapy that can be used as a nursing intervention for patients in critical care settings. Use of healing touch may facilitate positive patient outcomes. However, further research is needed to adequately evaluate the effectiveness of healing touch in the critical care setting. The use of Healing Touch in critically ill patients is explored in this article.

Preparing faculty and students for an international nursing education experience.

As society becomes increasingly globalized, it is imperative to include international educational perspectives in the nursing profession. This article shares experiences of a university and hospital in facilitating education of students of nursing from India. It includes implementing partnerships, student selection process, and transcultural considerations. These considerations include faculty preparation for receiving students from India. In addition, ways to prepare Indian and U.S. students are examined.