Sibling adjustment to diabetes and educational needs: A literature review.

ABSTRACT: As cases of type 1 diabetes mellitus (T1DM) increase, so do their impact on sibling relationships. This literature review of four databases from 2010 to 2024 discusses findings from five studies and the themes that emerged: education needs and family functioning. Improvements in family-centered care and education are needed for siblings of children with T1DM.

Sleep and Type 1 Diabetes Mellitus Management Among Children, Adolescents, and Emerging Young Adults: A Systematic Review.

BACKGROUND: Type 1 diabetes mellitus (T1DM) is one of the most common chronic illnesses among the youth. Emerging evidence has suggested poor sleep as a risk factor for glycemic control. This review aimed to examine the associations between sleep characteristics and diabetes management in children, adolescents, and emerging young adults with T1DM. METHODS: Following PRISMA guidelines, the authors searched articles in PubMed, Web of Science, and Scopus from 2000 through August 2020. Using inclusion and exclusion criteria, observational studies and clinical trials that examined sleep and diabetes management among individuals with T1DM (up to 25 years old) were selected for review. RESULTS: Twenty-four articles met the review criteria. Most studies did not report differences in self-report sleep between individuals with and without T1DM. However, several studies using objective sleep measures (actigraph and PSG) suggested shorter sleep duration and worse sleep quality in individuals with T1DM. Higher A1C levels and undesirable T1DM self-care behaviors were associated with short and long sleep duration, poor sleep quality, sleep disturbances, and irregular sleep, particularly among adolescent boys, young men and those from immigrant families. Self-care behaviors mediated the associations between sleep and subsequent A1C levels. CONCLUSIONS: Too much or too little sleep, poor sleep quality, sleep disturbances and sleep variability are associated with undesirable T1DM management. Although more research is needed, our findings indicate the importance of including sleep education in the plan of care for children, adolescents and emerging young adults with T1DM.

Healthcare providers' challenges during the coronavirus disease (COVID-19) pandemic: A qualitative approach.

The uncertain trajectory of COVID-19 has led to significant psychosocial impacts on nurses and other healthcare providers. Given the critical role of these providers in pandemic response, this study sought to gain a better understanding of the challenges faced by healthcare providers caring for adult patients during the COVID-19 pandemic. A descriptive, qualitative study was conducted via semi-structured interviews. A purposeful sample of healthcare providers (n = 23) caring for patients during the COVID-19 pandemic was recruited to participate in interviews via snowball sampling and an information systems-supported recruiting process (e-recruiting). Thematic analysis revealed four themes: (1) Managing isolation, fear, and increased anxiety; (2) adapting to changes in healthcare practice and policy; (3) addressing emotional and physical needs of patients and their families; and (4) navigating evolving workplace safety. New evidence was introduced about nurses practicing outside their usual role. Nurses and other healthcare providers consistently reported increased anxiety during the pandemic. Hospital administrations can proactively support healthcare providers during this and future pandemics by ensuring access to mental health programs, standardizing communication, and developing plans that address equipment and supply availability.

Leadership, professional quality of life and moral distress during COVID-19: A mixed-methods approach.

AIM: To understand the impact of professional stressors on nurses' and other health care providers' professional quality of life and moral distress as they cared for patients during the COVID-19 pandemic. BACKGROUND: Health care providers caring for patients during the COVID-19 pandemic are at increased risk of decreased professional quality of life and increased moral distress. METHODS: A convergent mixed-methods design and snowball sampling was used to collect survey data (n = 171) and semi-structured interviews (n = 23) among health care providers working in the inpatient setting. RESULTS: Perceived lack of support from executive leadership, access to personal protective equipment and constantly changing guidelines led to decreased professional quality of life and increased moral distress among health care providers. CONCLUSION: Findings from this study indicate that shared governance, disaster management training and enhanced communication may assist executive leadership to reduce the likelihood of decreased professional quality of life and increased moral distress in front line health care providers. IMPLICATIONS FOR NURSING MANAGEMENT: Following the principles of shared governance may assist executive leadership to promote and acknowledge the significance of the role of health care providers at the bedside. Additionally, disaster management training and open communication are crucial to ensure that health care providers are adequately informed and supported at the bedside.

Building a nursing legacy.

ABSTRACT: A nurse's legacy can be defined in multiple ways. This article describes a project based on a qualitative research study that focused on legacy building in nursing.

Maternal experiences of caring for a child with a ventricular assist device.

The purpose of this study was to gain a deeper understanding of maternal experiences of caring for their child with a VAD at home as a bridge to transplant. A descriptive, qualitative study was conducted via telephone-recorded guided interviews. Participants were caring for or had a child with a VAD between 4 and 16 years old. Data collection occurred over a 12-month period. Using the snowball sampling technique, a purposeful sample of mothers (n = 6) was consented and completed the interview. The data were analyzed using an iterative process of thematic analysis. Five themes emerged: physical modifications, the loss of independence, the emotional rollercoaster, support from others, and transitions on and off the device. We introduced new evidence about sleep, contraception, and heart transplantation, and how VAD therapy impacts childhood development. The mean duration of VAD support was 263 ± 170 days. Five children had heart transplants by the time of interview. To the best of our knowledge, this is the first qualitative study in the US that explores maternal experiences of caring for a child who is living at home with a VAD. VAD therapy is a novel approach to managing advanced heart failure among children and presents unique challenges when caring for them at home. Results provide insight into the education, physical environment, and support needed by parents.

Barriers and Facilitators Influencing Parental Transition of College-Bound Youth with Type 1 Diabetes Mellitus: An Integrative Review.

PURPOSE OF REVIEW: The purpose of this review was to synthesize current research about potential barriers impacting parents as they transition their college-bound youth with type 1 diabetes mellitus (T1DM) to college. RECENT FINDINGS: Seven studies, 5 qualitative and 2 quantitative, met the qualifications for inclusion in this study by focusing on parents and were included in this review. Three potential barriers impacting the parental experience during the transition of their youth with T1DM to college were identified: developing and promoting autonomy, evolving relationships and roles in the parent/youth dyad, and distress. Parents consistently indicated concern about their youth's ability to self-manage their T1DM and lack of support for their own transition. This review indicates that several barriers may influence parents of adolescents with T1DM as they transition to becoming the parent of a college-bound youth with T1DM. The parental transition of launching their youth to college is more complex and unique for parents of youth with T1DM parents of youth without chronic conditions. Additional research focusing on the identification of desired supports for parents and the development of specific interventions to assist parents as they transition with their college-bound youth with T1DM is recommended.

Risk-Taking Behaviors in Adolescents With Chronic Cardiac Conditions: A Scoping Review.

PROBLEM: Advances in treatment and therapy for children with chronic cardiac conditions have extended their life expectancy. Risk-taking behavior among adolescents requires further exploration. Researchers conducted a scoping review to address a literature gap specific to risk-taking behavior among adolescents with chronic cardiac conditions. ELIGIBILITY CRITERIA: Sources were limited to (1) human subjects, (2) English language or translatable to English, (3) adolescents without age restrictions, (4) all research designs and (5) presence of a chronic cardiac condition. SAMPLE: Searches of six electronic databases (CINAHL Plus Full Text, PubMed, Web of Knowledge, Scopus, ProQuest and Grey Literature Report) were conducted to verify the empirical literature between 1975 and 2018. Seventeen sources were included in this review. RESULTS: Among the 17 sources, 12 sources examined risk-taking behavior by self-report among adolescents with chronic cardiac conditions. Tobacco, alcohol and/or other drug use and physical inactivity were the most prevalent risk-taking behaviors identified through this review. CONCLUSIONS: Findings from this scoping review describe the types of risk-taking behaviors that adolescents with chronic cardiac conditions are engaging in, highlight similarities when compared to other types of chronic conditions, and serve as a foundation for future research among this population. IMPLICATIONS: Discussion of risk-taking behaviors should be integrated into each healthcare encounter beginning in early adolescence and continuing through transition to adulthood and adult health care. Qualitative research studies may serve as an effective method by which to explore risk-taking behavior among adolescents with chronic cardiac conditions in greater detail.

Experiences of College Students Who Are Newly Diagnosed With Type 1 Diabetes Mellitus.

PURPOSE: To gain insight and understanding of emerging adult experiences after a diagnosed with type 1 diabetes mellitus (T1DM) and prior to or during college life experiences. DESIGN AND METHODS: A qualitative research design using a focus group was conducted with 12 college students recently diagnosed with T1DM during emerging adulthood. The focus group took place during a College Diabetes Network retreat. Using Braun and Clarke's six phase process, two researchers independently conducted a thematic analysis from the transcribed, verbatim audiotaped narratives. RESULTS: The 12 participants attended colleges in 11 different states. The mean age was 21 years (SD = 6.3) and the majority were female (n = 7). Qualitative analysis revealed four themes: 1) diabetes affects all aspects of life and complicates college living; 2) college environment affects diabetes management; 3) diabetes diagnosis facilitates growth and maturity; and 4) strategies used for diabetes management in college. CONCLUSION: T1DM is complex to manage in the college environment. However, these emerging adults newly diagnosed with T1DM highlight strategies for diabetes management while in college and the pivotal role of pediatric providers play in the successful management of T1DM. PRACTICE IMPLICATIONS: Diabetes education for emerging adults in college requires an adaptive focus that supports the developmental needs of this population. Nurses should focus on teaching healthy, modifiable behaviors of sleep, physical activity, and nutrition to improve glycemic control as well as adapting to the college life choices.

Innovative Global Health Care Experiences for Nursing Students: Microsemesters and Internships.

Global experiential learning using clinical internships and microsemesters is expanding in nursing as an alternative to full-semester study abroad. When incorporated into the curriculum, students have a broader perspective on global health care issues. For example, students learn historic and cultural concepts that are uniquely Australian while studying diversity in a condensed two-week microsemester. We describe the development and incorporation of global internships and alternative global experiences for undergraduate nursing students.

Biopsychosocial Contributors to Metabolic Syndrome: A Secondary Analysis of 2007-2010 National Health and Nutrition Examination Survey Data.

BACKGROUND: Metabolic syndrome (MetS) is a medical disorder that encompasses obesity, hypertension, dyslipidemia, and insulin resistance and increases the risk of type 2 diabetes, cardiovascular disease, and mortality. OBJECTIVES: A secondary data analysis was conducted using the National Health and Nutrition Examination Survey 2007-2010 data to evaluate the association of biopsychosocial factors with MetS among U.S. adults. METHODS: Complex samples logistic regression models were used to estimate a parsimonious model, including contributions of biomedical, biosocial, and psychosocial factors to MetS. RESULTS: According to the study's representative sample, more than 47 million Americans had MetS. Using the biopsychosocial model, the effects of biosocial and psychosocial variables, including education, smoking, low exercise, and depression, were independent predictors of MetS after controlling for the contributions of age, gender, and race. DISCUSSION: There is a need for large-scale, longitudinal, and interventional studies to evaluate and alter these potential risk factors, thus reducing MetS.

Attitudes of Nurse and Physician trainees towards an interprofessional simulated education experience on Pain Assessment and Management.

An interprofessional group of educators from multiple institutions piloted a simulation-based learning experience focusing on acute pain management. The participants in the program were resident physicians-novice nurse dyads, and medical student-nursing student dyads from large universities and a magnet health care system. Each dyad was challenged to assess and manage acute pain in a simulated hospitalized patient using effective collaboration skills. The simulations included pre-debriefing, simulation, and a debriefing session. Participants completed pre- and post-surveys measuring confidence in pain management and attitudes toward physician-nurse collaboration. There was a significant positive shift in the confidence of the learners' ability to assess and manage acute pain in a hospitalized patient after the simulation and debriefing (23.2% strongly agreed versus 7% at baseline). Participants' attitudes regarding education to enhance interprofessional collaboration improved after the simulation experience (83.9% strongly agreed versus 73.7% at baseline). Based on these encouraging findings, we are extending this interprofessional experience to a larger group of learners with the same targeted dyads.

Development of a Clinical Competency Checklist for Care of Patients Experiencing Substance Withdrawal Delirium or Delirium: Use of a Delphi Technique and Expert Panel.

Health care providers are challenged by the presentation and management of inpatients experiencing substance withdrawal delirium (SWD) and delirium. The current Delphi study used an expert panel to develop a clinical competency checklist for nurse and physician educator use in teaching health care providers about the initial care of patients with SWD or delirium. The checklist includes categories of patient safety, history and information gathering, physical examination and assessment, treatment plan, and patient/family-centered care.

Educational Outcomes in Undergraduate Nursing: A Systematic Review.

BACKGROUND: Baccalaureate nursing education has experienced tremendous challenges requiring new flexibility of moving among traditional classroom, online education, and other teaching modalities to improve student outcomes, combined with the pressing need for determining which educational methods deliver quality instruction while having a positive effect on outcomes. This systematic review explored different teaching modalities and measurable educational student outcomes in undergraduate baccalaureate education. METHOD: A systematic review was conducted following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. RESULTS: Of the 20 articles included in this systematic review, simulation, face-to-face, asynchronous, problem-based learning, gaming, flipped classrooms, reflective writing, tweets, and podcasts were represented. Three distinct educational outcomes that were identified included competence, confidence, and communication. CONCLUSION: A variety of educational methodologies drives positive outcomes in educating the next generation of nurses to have increased competence, confidence, and improved communication. [J Nurs Educ. 2024;63(6):380-386.].

Communal coping and glycemic control: Daily patterns among young adult couples with type 1 diabetes.

INTRODUCTION: Young adulthood is a time when persons with Type 1 diabetes (T1D) become more fully responsible for diabetes management. Establishing healthy diabetes routines during this period is foundational for successful management across adulthood. Although partner support is generally considered helpful in T1D management, less is known about specific partner behaviors that could benefit glucose levels. The aim of this study was to explore associations between communal coping behaviors and T1D glucose management. METHOD: During 2018-2020, 23 young married opposite-sex couples (Mage = 25.7 years), wherein one spouse had T1D, completed daily measures of communal coping for 9 consecutive days. Daily average glucose and time-in-range were computed from the person with T1D's glucose meter or continuous glucose monitor. RESULTS: Multilevel model results suggested that higher time-in-range on a given day was predicted by reports of lower daily spousal instrumental support, lower overprotective and controlling behaviors, and by higher emotional support. Controlling spousal behavior on one day was associated with higher time-in-range the next day. At the same time, patient reports of higher average spousal controlling behavior (across all days) were associated with lower time-in-range and higher average glucose. Average glucose was also predicted by communal coping behaviors (especially within-person higher instrumental support), yet results were less robust after covariates were considered. DISCUSSION: Some young romantic partners may engage in behaviors that are associated with higher average blood glucose and lower time-in-range for the person with T1D. Persons with T1D could communicate to their partners types of support that are helpful versus not. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

Acclimating Nursing Students After the Pandemic: "It's ASNAP!"

BACKGROUND: This article describes the development of a comprehensive pilot program, "It's ASNAP!" (Acclimating Nursing Students After the Pandemic). The program incorporated the academic, social, and emotional well-being of undergraduate nursing students returning to campus after the coronavirus disease 2019 (COVID-19) pandemic. METHOD: A purposeful sample of 488 students was recruited to participate via an anonymous survey on the academic, social, and emotional aspects of acclimating back to campus life. RESULTS: A total of 121 undergraduate nursing students responded to the survey. The majority of students reported study groups (79%) and de-stressing events (86%) were the most helpful as they acclimated back to campus. Compared with the emotional and social areas of support, the academic area of support was of highest interest to the students. CONCLUSION: The "It's ASNAP!" program has been acculturated into the school of nursing to support students via study halls, tutoring, and social activities, as well as resilient threads and listening sessions during finals week. [J Nurs Educ. 2023;62(9):516-518.].

Navigating complex sample analysis using national survey data.

BACKGROUND: The National Center for Health Statistics conducts the National Health and Nutrition Examination Survey and other national surveys with probability-based complex sample designs. Goals of national surveys are to provide valid data for the population of the United States. Analyses of data from population surveys present unique challenges in the research process but are valuable avenues to study the health of the United States population. OBJECTIVE: The aim of this study was to demonstrate the importance of using complex data analysis techniques for data obtained with complex multistage sampling design and provide an example of analysis using the SPSS Complex Samples procedure. METHODS: Illustration of challenges and solutions specific to secondary data analysis of national databases are described using the National Health and Nutrition Examination Survey as the exemplar. RESULTS: Oversampling of small or sensitive groups provides necessary estimates of variability within small groups. Use of weights without complex samples accurately estimates population means and frequency from the sample after accounting for over- or undersampling of specific groups. Weighting alone leads to inappropriate population estimates of variability, because they are computed as if the measures were from the entire population rather than a sample in the data set. The SPSS Complex Samples procedure allows inclusion of all sampling design elements, stratification, clusters, and weights. DISCUSSION: Use of national data sets allows use of extensive, expensive, and well-documented survey data for exploratory questions but limits analysis to those variables included in the data set. The large sample permits examination of multiple predictors and interactive relationships. Merging data files, availability of data in several waves of surveys, and complex sampling are techniques used to provide a representative sample but present unique challenges. In sophisticated data analysis techniques, use of these data is optimized.

The implementation of a statewide bullying prevention program: preliminary findings from the field and the importance of coalitions.

Bullying in schools has become recognized as a significant public health problem. The Olweus Bullying Prevention Program (OBPP) has been identified as an effective means to reduce bullying behavior in schools. The goal of this large population-based initiative was to reduce bullying by producing a quantifiable change in school climate using an established program and standardized measurement tool. Program participants over a 2-year period included 56,137 students and more than 2,400 teachers from 107 schools in 49 counties across Pennsylvania. An age cohorts design was used, and data from two equivalent age cohorts of students were compared at two or more points in time. After 1 to 2 years of program implementation, across cohorts, there were reductions in student self-reports of bullying others, and improvements in student perceptions of adults' responsiveness, and students' attitudes about bullying. This study is the largest bullying prevention initiative to date in the United States. This initiative reaffirms the efficacy of the OBPP, emphasizes the importance of an identified coalition, and highlights several positive outcomes. It is recommended that the OBPP be implemented through the establishment of community partnerships and coalitions as consistent with the public health model.