Original Research: Nurses' Knowledge and Attitudes Regarding the Sustainable Development Goals: A Global Study.

BACKGROUND: Nurses have a critical role to play in achieving the United Nations' 17 Sustainable Development Goals (SDGs). While Goal 3 (good health and well-being) is of particular importance to nursing, every SDG contributes to the advancement of universal health and well-being. Yet many nurses are unfamiliar with the SDGs and how they relate to everyday nursing practices. PURPOSE: The purpose of this study was to examine RNs' knowledge of and attitudes toward the SDGs. METHODS: This study used a descriptive correlational cross-sectional design. A convenience sample of RNs from multiple countries completed an anonymous online survey that included eight demographic items and 25 items exploring participants' knowledge of and attitudes toward the SDGs. Descriptive, parametric, and nonparametric statistics were used to analyze the data. RESULTS: The majority of nurses in this study perceived themselves as lacking knowledge of the SDGs. Most wanted to know more, including how they could take action to help achieve the goals. Overall, participants agreed that the SDGs are relevant to nursing practice and that nurses are integral to their advancement. Participants who were younger than age 50, those living in the United States, and those who practiced primarily in a clinical or community setting were more likely than others to self-report lower SDG knowledge scores. CONCLUSIONS: The study findings contribute to our collective understanding of RNs' knowledge and attitudes regarding the SDGs. They can assist nurse educators and leaders worldwide in developing targeted strategies to better inform nurses and prepare them for actions that will advance these goals. Increasing nurses' knowledge of the SDGs, especially as these goals relate to daily clinical practice, may lead to greater nursing engagement and impact.

Genomics-informed nursing strategies and health equity: A scoping review protocol.

OBJECTIVE: The objective of this scoping review is to map the available evidence on strategies that nurses can use to facilitate genomics-informed healthcare to address health disparities. INTRODUCTION: Advancements in genomics over the last two decades have led to an increase in the delivery of genomics-informed health care. Although the integration of genomics into health care services continues to enhance patient outcomes, access to genomic technologies is not equitable, exacerbating existing health disparities amongst certain populations. As the largest portion of the health workforce, nurses play a critical role in the delivery of equitable genomics-informed care. However, little is known about how nurses can help address health disparities within the context of genomics-informed health care. A review of the literature will provide the necessary foundation to identify promising practices, policy, and knowledge gaps for further areas of inquiry. INCLUSION CRITERIA: We will include papers that explore strategies that nurses can undertake to facilitate genomics-informed care to address health disparities. METHODS: This review will be conducted using JBI methodology for scoping reviews. We will search electronic databases including MEDLINE (OVID), EMBASE, Cochrane Library, PsychInfo, and CINAHL for quantitative and qualitative studies, systematic reviews and grey literature. Theses, books, and unavailable full-text papers will be excluded. The search will be limited to papers from 2013 and beyond. Two reviewers will screen titles and abstracts followed by full-text and disagreements will be resolved by a third reviewer. We will use a data extraction tool using Microsoft Excel and analyse data using descriptive statistics and conventional content analysis. Findings will be presented in the form of evidence tables and a narrative summary. We will report findings using the Preferred Reporting Items for Systematic reviews and Meta-Analyses extension for Scoping Reviews (PRISMA-ScR). DISCUSSION: Genomics will continue to transform all aspects of health care across the wellness continuum from prevention, assessment, diagnosis, management, treatment, and palliative care. The identification of nursing strategies to address health disparities will build the foundation for policy and practice to ensure that the integration of genomic technologies benefits everyone.

Asian Healthcare Workers and Their Experiences of Racism in North America: A Scoping Review.

BACKGROUND: The rising rates of anti-Asian sentiments has recently been called into question by several community activists and scholars. While this collective work has heightened awareness to address anti-Asian racism, the experiences of Asian healthcare workers in particular remains limited. PURPOSE: To map the existing literature on anti-Asian racism experienced by Asian healthcare workers in North American healthcare settings, identify gaps in the current literature base, and inform future areas of anti-Asian racism research. METHODS: A scoping review following Arksey and O'Malley's (2005) methodology with updated guidance by Levac et al. (2010) and Peters et al. (2020) was undertaken. FINDINGS: A total of 3565 articles from database searches were identified from eight databases, with 64 full text articles screened and 15 articles included in this review. Anti-Asian racism amongst healthcare workers has been conceptualized, studied, and understood in three broad categories: levels of racism, descriptions of anti-Asian racism, and the impact of racism. In 60% of the included articles, interpersonal level of racism was solely studied, while 40% articles simultaneously studied interpersonal and institutional levels of racism. Anti-Asian racism was described through three key perspectives: otherness, inferior professional status, and general racial discrimination. Lastly, the impact of Asian healthcare workers' experiences of anti-Asian racism was studied by exploring the impact on mental health and barriers to career advancement. CONCLUSION: Despite the presence of anti-Asian racism, the limited literature examining the complexities of the experiences of anti-Asian racism for Asian healthcare workers is concerning. Future scholarship requires further investigation that comprehensively explores the multiple pathways of anti-Asian racism, the contestation of monolithic stereotypes, and how Asian healthcare workers negotiate both hypervisibility and invisibility within healthcare spaces.

Advancing Nursing Policy Advocacy Knowledge: A Theoretical Exploration.

Nursing policy advocacy continues to be recognized as a key part of a nurse's role by educators, professional associations, and regulators. Despite normative calls on nurses to engage in political action and advocacy, limited theories, models, and frameworks exist to support this practice within nursing. Using Walt and Gilson's Health Policy Triangle Framework, this article explores the theoretical underpinnings of policy advocacy to enhance nursing's contemporary role in advancing social justice. Specific consideration is placed on the type of nursing and policy knowledge and perspectives required to understand policy content, contexts, processes, and actors.

Source of Social Support and Caregiving Self-Efficacy on Caregiver Burden and Patient's Quality of Life: A Path Analysis on Patients with Palliative Care Needs and Their Caregivers.

Few studies have explored the inter-relationships of sources of social support and caregiving self-efficacy with caregiver burden and patient's quality of life among patients with palliative care needs and their caregivers. This study tested the associations of two sources of social support (family and friends) and the mediating role of caregiving self-efficacy on caregiver burden and patient's quality of life. A convenience sample of 225 patient-caregiver dyads recruited between September 2016 and May 2017 from three hospitals in Hong Kong was included in the current analysis. Results showed that the final model provided a satisfactory fit (SRMR = 0.070, R-RMSEA = 0.055 and R-CFI = 0.926) with the data, as good as the hypothesized model did (p = 0.326). Significant associations were detected. Family support had a significant negative indirect effect on caregiver burden and a significant positive indirect effect on patient's quality of life through caregiving self-efficacy, whereas friend support had a significant positive direct effect on caregiver burden but a minimal effect, if any, on patient's quality of life. These findings emphasized (1) the importance of caregiving self-efficacy in improving caregiver burden and patient's quality of life and that (2) sources of social support may be an important dimension moderating the associations of caregiving self-efficacy with caregiver burden and patient's quality of life.

Charting a Research Agenda for the Advancement of Nursing Organizations' Influence on Health Systems and Policy.

Nursing organizations across Canada play a significant role in influencing and shaping public policy. 2020, the Year of the Nurse and the Midwife, is an opportune time not only to support nurses in building policy leadership but also to explore opportunities to better understand and strengthen the policy advocacy work of nursing organizations. Given various social, political, and economic forces, the nature of organized nursing across Canada is changing significantly. We draw on recent key national and global events including our systematic inquiry into Canada's 2019 federal election, the Year of the Nurse and Midwife, and the Coronavirus pandemic to examine how Canadian nursing organizations respond in highly complex and evolving contexts. We use our observations to offer a vision and chart a research agenda for the advancement of nursing organizations' influence on health systems and policy. Specifically, we focus on three key areas including examining nursing organizations' policy agendas and spheres of influence; nursing organizations' decision-making around policy advocacy tactics and engagement approaches; and the impact of policy advocacy coalitions and networks on nursing organizations' influence.

Community end-of-life care among Chinese older adults living in nursing homes.

AIM: The aim of the present study was to investigate the preference and willingness-to-pay (WTP) of older Chinese adults for community end-of-life care in a nursing home rather than a hospital. METHODS: A total of 1540 older Chinese adults from 140 nursing homes were interviewed. Four hypothetical questions were asked to explore their preferences for end-of-life care. Using a discrete choice approach, specific questions explored acceptable trade-offs between three attributes: availability of doctors onsite, attitude of the care staff and additional cost of care per month. RESULTS: Approximately 35% of respondents preferred end-of-life care in the nursing home, whereas 23% of them would consider it in a better nursing home. A good attitude of staff was the most important attribute of the care site. Respondents were willing to pay an extra cost of US$5 (HK$39) per month for more coverage of doctor's time, and US$49 (HK$379) for a better attitude of staff in the nursing home. The marginal WTP for both more coverage of doctor's time and better attitude of staff amounted to US$54 (HK$418). Respondents on government subsidy valued the cost attribute more highly, as expected, validating the hypothesis that those respondents would be less willing to pay an additional cost for end-of-life care. CONCLUSIONS: Older Chinese adults living in nursing homes are willing to pay an additional fee for community end-of-life care services in nursing homes. Both the availability of the doctor and attitudes of nursing home staff are important, with the most important attribute being the staff attitudes. Geriatr Gerontol Int 2013; 14: 273-284.

Mortality and health services utilisation among older people with advanced cognitive impairment living in residential care homes.

OBJECTIVES: To study the demography, clinical characteristics, service utilisation, mortality, and predictors of mortality in older residential care home residents with advanced cognitive impairment. DESIGN: Cohort longitudinal study. SETTING: Residential care homes for the elderly in Hong Kong West. PARTICIPANTS: Residents of such homes aged 65 years or more with advanced cognitive impairment. RESULTS: In all, 312 such residential care home residents (71 men and 241 women) were studied. Their mean age was 88 (standard deviation, 8) years and their mean Barthel Index 20 score was 1.5 (standard deviation, 2.0). In all, 164 (53%) were receiving enteral feeding. Nearly all of them had urinary and bowel incontinence. Apart from Community Geriatric Assessment Team clinics, 119 (38%) of the residents attended other clinics outside their residential care homes. In all, 107 (34%) died within 1 year; those who died within 1 year used significantly more emergency and hospital services (P<0.001), and utilised more services from community care nurses for wound care (P=0.001), enteral feeding tube care (P=0.018), and urinary catheter care (P<0.001). Independent risk factors for 1-year mortality were active pressure sores (P=0.0037), enteral feeding (P=0.008), having a urinary catheter (P=0.0036), and suffering from chronic obstructive pulmonary disease (P=0.011). A history of pneumococcal vaccination was protective with respect to 1-year mortality (P=0.004). CONCLUSION: Residents of residential care homes for the elderly with advanced cognitive impairment were frail, exhibited multiple co-morbidities and high mortality. They were frequent users of out-patient, emergency, and in-patient services. The development of end-of-life care services in residential care homes for the elderly is an important need for this group of elderly.

Financial abuse in a mentally incapacitated old man.

A mentally incapacitated 82-year-old man with no relatives was managed by a geriatrician-led multidisciplinary team when medical staff realised he was at risk of being exploited. They initiated a series of protective measures including an emergency guardianship application. The Guardianship Board appointed the Director of Social Welfare as his public guardian. This case illustrates that hospital staff should be alert to potential elder abuse to ensure timely protection of potential victims.