Understanding COVID-19's Impact on Nursing Students' Education, Professional Perceptions, Stress, and Coping.

ABSTRACT: This descriptive mixed-methods study was conducted to understand the impact of COVID-19 on undergraduate nursing students' education, perceptions of nursing, stress, and coping. A convenience sample (N = 150) reported high levels of stress with higher stress levels significantly associated with lower coping. The essence of nursing, emotions surrounding the transition to nursing, educational barriers, and faculty-student relationships emerged as themes. The findings can be used to revise curricula and better support nursing students in future disasters and transitions to practice during unpredictable times.

Palliative Care and Stroke: An Integrative Review of the Literature.

Stroke survivors often experience life-altering functional and cognitive changes and burdensome symptoms. Palliative care could provide additional support to improve outcomes of stroke patients and their families. The purpose of this review was to describe how palliative care is conceptualized and implemented within stroke care.An integrative review of the literature published between 1990 and 2016 using the terms "palliative care," "stroke," or "acute stroke" was conducted. Of the 363 articles identified, 44 were screened, 21 met inclusion criteria, and 2 additional articles were identified through reference list review, resulting in a final sample of 23 articles.Palliative care was predominantly understood as end-of-life care and was most commonly offered in acute stages when patients were expected to die. Patients, families, and providers reported challenges surrounding decision making, uncertainty regarding transitions to palliative care, and needs related to communication and physical and psychosocial support. The quality of the research was moderate to good but was limited by retrospective designs, reliability of data collection procedures and tools, recall bias, and generalizability.This review highlights gaps in access to palliative care throughout the illness trajectory and underscores the need for study of models that integrate palliative care into stroke care.

Advancing Care for Family Caregivers of persons with dementia through caregiver and community partnerships.

BACKGROUND: There are currently 15 million Americans who provide over 80% of the care required by their family members with Alzheimer's disease and other dementias. Yet care for caregivers continues to be fragmented and few evidence-based interventions have been translated into routine clinical care and therefore remain inaccessible to most family caregivers. To address this gap, the Caring for the Caregiver program is being developed at UT Health San Antonio, School of Nursing to improve support services and health outcomes for family caregivers. Our purpose is to describe the engagement process undertaken to assess caregiver and community needs and how findings are informing program development. METHODS: We are using a model of public engagement that consists of communication of information, collection of information from stakeholders, and collaboration where stakeholders are partners in an exchange of information to guide program activities. An assessment of the community was undertaken to identify resources/services for family caregivers. Subsequently, stakeholders were invited to a community-academic forum to discuss strategies to build on existing strengths for family caregiving and to identify gaps in care. Detailed notes were taken and all discussions were recorded and transcribed for analysis. Data were analyzed using thematic content analysis. RESULTS: We conducted site visits with 15 community agencies, interviewed 13 family caregivers, and attended community events including support groups and health and senior fairs. Fifty-three diverse stakeholders attended the community-academic forum. Participants identified existing assets within our community to support family caregivers. Consistent among groups was the need to increase awareness in our community about family caregivers. Themes identified from the discussion were: making the invisible visible, you don't know what you don't know, learning too late, and anticipating and preparing for the future. CONCLUSIONS: Incorporating caregiver and community stakeholders was critical to ensure that the priorities of our community are addressed in a culturally responsive accessible program for family caregivers. The forum served as important mechanism to partner with the community and will be an annual event where we can continue to work with our stakeholders around needs for practice, education, and research.

Personal growth, symptoms, and uncertainty in community-residing adults with heart failure.

BACKGROUND: Personal growth has not been studied extensively in heart failure (HF). OBJECTIVES: To characterize personal growth in HF and its relationships with symptom burden, uncertainty, and demographic and clinical factors. METHODS: Associations among personal growth, uncertainty, symptom burden, and clinical and demographic variables were examined in adult outpatients with HF using bivariate correlations and multiple regressions. RESULTS: Participants (N = 103; 76% male, mean age = 74 years, 97% New York Heart Association classes II and III) reported moderate levels of personal growth, uncertainty, and symptom burden. Personal growth was weakly correlated with age and symptom burden but not with other study variables. In a regression model, age, sex, ethnicity, disease severity, time since diagnosis, symptom burden, and uncertainty were not significant independent correlates of personal growth. CONCLUSIONS: Community-residing patients with HF report moderate personal growth that is not explained by uncertainty, symptom burden, or demographic and clinical variables.

Acute coronary syndrome.

Acute coronary syndrome (ACS) is the umbrella term for the clinical signs and symptoms of myocardial ischemia: unstable angina, non-ST-segment elevation myocardial infarction, and ST-segment elevation myocardial infarction. This article further defines ACS and the conditions it includes; reviews its risk factors; describes its pathophysiology and associated signs and symptoms; discusses variations in its diagnostic findings, such as cardiac biomarkers and electrocardiographic changes; and outlines treatment approaches, including drug and reperfusion therapies.