Engaging nurses in health policy in the era of COVID-19.

Nurses have a unique place in redesigning the future of healthcare, particularly after experiencing health policy failures with the coronavirus disease 2019 pandemic. Nurses consistently outperform other professions to enjoy a decades-long reputation as the most trusted profession. Nevertheless, the nursing voice is missing at a public level; representation in governments and boardrooms negligible. While nurses carry out health policy, rarely are they involved informing policy. While substantial dialog on health system reform, regulatory changes, care coordination, and health information technology occurs, nursing's presence is absent. The barriers are many: a lack of political sophistication, family, and work demands limiting time, and a lack of confidence. Using the Yoder-Wise Framework for Planned Policy Change, opportunities for engagement at each step in the process are made clear. Workplace opportunities provide entry-level representation and exposure to the machinations of governance. Nursing professional associations provide similar opportunities. For many nurses, social media, while not without its risks, offers a familiar and accessible platform by which to engage patients, the public, and policymakers in planned, strategic steps to create policy change and improve healthcare for patients.

Place of residence modifies the association between acculturation and dietary tools knowledge among Latina WIC participants: a multi-state study.

This cross-sectional study assessed: (a) awareness and knowledge of federal dietary tools (MyPyramid, Food Guide Pyramid (FGP), and food labels (FL)), and (b) the influence of acculturation and state of residence on FGP knowledge (FGPK) indicators among low-income Latina WIC participants (N = 479) living in Connecticut, Ohio, Texas, and California. Participants were familiar with FGP but only 37% recognized MyPyramid. FGPK was highest for fruits (71%) and lowest for the 'breads and cereals' group (12%). Less than half (47%) used FL's when grocery shopping. Living in OH, was associated with the lowest FGPK. Multivariate analyses showed that more acculturated individuals living in CT/CA had better FGPK than participants living in TX and their less acculturated counterparts in CT/CA. The forthcoming revised federal dietary tools need to be adequately disseminated among Latinos, with special emphasis on those with lower acculturation levels, living in rapid emerging Latino communities or in the US-Mexico border.

A health survey of a colonia located on the west Texas, US/Mexico border.

Little is known about how health disparities affect the health status and general health perceptions of Hispanics living in Texas colonias. The purpose of this study was to conduct a health survey of residents (n = 216) of a colonia community on the border between El Paso, Texas and Juarez, Mexico. Instruments used in this study included a researcher developed demographic questionnaire, the Short Acculturation Scale for Hispanics (SASH), Cutting down, Annoyance by criticism, Guilty feeling and Eye-openers (CAGE) for alcohol consumption, and the Short Form version 2 (SF36v2) health survey. Study findings show the average participant was approximately 42 years old, attained an average of 9.6 years of education, earned an average annual household income of $17,575 and had an average SASH score of 25.4. SASH scores range from 12 to 60, with higher scores suggesting higher levels of American acculturation. Findings from this health survey suggest the average resident of the colonia may have health disadvantages when compared to residents from other parts of El Paso and Texas. Binge drinking was self-reported by 13.4% of all participants; with 5.6% having a CAGE score greater than 2 (indicating an increased propensity towards problems with alcohol). The self-report rates of diabetes, depression and anxiety were 15.3%, 20.4% and 16.7% respectively. The SF36v2 composite functional health status scores mirrored the national norms.

Diabetes prevalence and treatment adherence in residents living in a colonia located on the West Texas, USA/Mexico border.

Little is known about how diabetes affects the health status of Hispanic people living in colonias located along the USA/Mexico border. The purpose of this report is to describe the demographic factors, prevalence of diabetes, and the health status of the residents living in a colonia on the border between El Paso, Texas, USA, and Juarez, Mexico, and to report the residents' adherence to the Behavioral Risk Factor Surveillance System (BRFSS) protocols for the management of type 2 diabetes. This study included 188 participants. The instruments used included a demographic questionnaire, the Short Acculturation Scale for Hispanics, "Cutting Down, Annoyance by Criticism, Guilty Feelings, and Eye-openers", BRFSS, and the Short Form-36 (v2). The prevalence of diabetes was 15.4% and 41.3% of the residents had a Body Mass Index score > 30. The rate of hypertension, elevated cholesterol, and depression for those reporting diabetes was significant. The SF-36 v2 physical score for the diabetic residents was 42.9 and it was 52.4 for the non-diabetic residents. The average resident of the colonia who reports diabetes has many health disadvantages when compared to those in other parts of Texas and the USA generally.

Assessment of acutely mentally ill patients' satisfaction of care: there is a difference among ethnic groups.

The relationship between quality of care and patient satisfaction has been documented. The specific research aim related to this study is to determine if differences exist among Caucasians, Asians, and Pacific Islanders who are hospitalized for an acute mental illness with regard to their perceived satisfaction with the care. The results of the overall study have been reported elsewhere. The sample was composed of 138 patients, of whom 34.7% were Caucasian, 31.2% Pacific Islanders, and 34.8% Asians. Within 24 hours of discharge, patients completed the Perceptions of Care instrument. Caucasians were over-represented in our sample in comparison to their percentage in the general population of Hawaii. These patients were significantly more satisfied (p = .04) with their care than the other ethnic groups. No single variable was found to specifically indicate why they were more satisfied than Pacific Islanders and Asians.

Supporting faculty proposal development and publication.

The Hispanic Health Disparities Research Center, a collaborative venture between the University of Texas at El Paso and the University of Texas at Houston Health Sciences Center, supports the research capabilities of junior faculty through a variety of programs. Novice researchers often need practical help in conducting literature reviews, extracting data, evaluating the evidence, and formulating a research question of significant importance to be funded yet narrow enough to fit within the scope of the proposal. The authors discuss a successful proposal development program that includes mentoring by more senior faculty and structured sessions with a medical writer and editor.

Assessment of acutely mentally ill patient outcomes in an ethnically diverse population.

Hawaii's multi-ethnic population provides a special opportunity within the United States to examine relationships between ethnicity, mental illness, and psychiatric-mental health outcomes. Understanding such relationships is essential to facilitate the development of culturally sensitive intervention strategies. The aim of this study was to investigate if differences in patient outcomes exist between Caucasians, Asians and Pacific Islanders hospitalized for an acute psychiatric illness in Hawaii. A descriptive approach was used to examine the functional and mental health outcomes and perceptions of care of 138 subjects. The specific tools employed included the Brief Psychiatric Rating Scale (BPRS), Short Form 36 Health Survey Version 2 (SF-36v2), Perceptions of Care (POC), and the Psychiatric Records Abstract Instrument (PRAI). In terms of results, the BPRS scores showed an expected improvement at the time of discharge when compared to the admission assessment.

Assessment of patient satisfaction of mentally ill patients hospitalized in Thailand.

Psychiatric patients' satisfaction with their hospital care has not been reported in the Western literature. The concept of asking psychiatric patients about their perceptions of care is relatively new. The purpose of the present investigation was to assess the satisfaction of the care received by a group of acutely mentally ill hospitalized Thai patients. This post-test design examined a random sample of 182 persons hospitalized between 1 March 2000 and 31 July 2000. Using a validated Perception of Care instrument, research assistants assessed patient satisfaction. Patients rated the care as average with none of the items achieving a very good or excellent score. The lowest scoring items were receiving information about their rights, consistency of information provided, and the ease of obtaining information. Women tended to be more satisfied with care as were patients over the age of 55 years (P = 0.02). Patients with a diagnosis of schizophrenia were more satisfied with the care than other patients (P = 0.05). It is unknown if satisfaction levels are similar in other institutions in Thailand. None of the areas received excellent or very good ratings. The findings of this study were shared with the staff at the study site. There appears to be a need to develop performance improvement activities designed to address the areas identified as needing improvement. Replication of this study in other Thailand sites would provide an opportunity for agencies to benchmark their findings. By consenting to be a part of this study the staff and patients have taken a positive step forward to improve patient satisfaction with care.

Assessment of inpatient treatment of mentally ill patients in Thailand: implications for practice.

Given the demand for services, psychiatric facilities in Thailand, strive to provide quality care despite limited resources. Patient quality of care initiatives are limited. The purpose of this investigation is to assess the quality of inpatient treatment among a group of acutely mentally ill hospitalized Thai patients. This study presents important data on the standards of care provided to mentally ill patients at one inpatient facility in Thailand. This study is one of the first to look at the inpatient care for Thais with a diagnosis of an acute mental illness. Areas for improvement identfied in this research include master treatment planning and documentation of care, patient teaching, and management of aggressive behavior. This study provides an insight into the patient profile and major nursing problems facing Thai nurses. The article also highlights areas of concern such as the high use of ECT and mechanical restraint. How pervasive these deficiencies are in other settings is not known. The findings in this study were shared with the professional staff. It is hope that the nursing staff armed with the results of this study will develop performance improvement activities to improve the quality of care.