Examining the Qualitative Experiences of Latinx Nurses During the First Wave of COVID-19.

Introduction: The world has been impacted by the coronavirus disease 2019 (COVID-19) pandemic since March of 2020. Latinx nurses have been some of the most underrepresented in being studied during this time and have been greatly affected by it. To the best of our knowledge, there are no published studies that focus on the qualitative experiences of Latinx nurses during the first wave of the pandemic. Methods: Data analysis included thematic analysis to identify main themes experienced by Latinx nurses. A qualitative descriptive study design was employed to conduct a parent study with 100 nurses across the United States reflecting on their experiences during the first wave of the COVID-19 pandemic, data collected from May to September 2020. Formal coding of the interview data was conducted utilizing Dedoose cloud-based software. Results: Five main themes emerged, including (1) connection to patients' personal touch and empathy, (2) connection to Latinx nurses, (3) connection to family and friends, (4) connection to food as care, and (5) coping. Within the theme of coping, subthemes of (5.1) faith, (5.2) maladaptive behaviors, and (5.3) self-care activities emerged. Conclusion: These experiences can help shape the pathway to be better prepared for any emergency or future pandemic.

Barriers and Challenges Experienced by Latina Nurse Leaders.

Introduction: Leadership reflecting and representing the diversity of the workforce and patient population has been an ongoing challenge for healthcare institutions. As hospitals strategically plan to improve diversity, equity, and inclusion within their intuitions, especially in executive and other leadership roles, it must be acknowledged that only about 5.3% of the nursing workforce is Latinx and few serve in leadership positions. This study aims to learn about the barriers and challenges Latina nurse leaders have experienced in their ascension into leadership roles. Methods: Using a qualitative descriptive study approach, Latina nurse leaders were interviewed one-on-one about their nursing journey and the challenges experienced. A conventional thematic content analysis approach was used to identify common themes. Results: Seventeen Latina nurse leaders shared their experiences. The themes that emerged included: imposter syndrome being the only one, the need to work harder to be seen, age discrimination, racism and racial discrimination, lack of mentorship, and motherhood. Conclusion: Findings from this study help to highlight barriers to leadership development and success of Latina nurses. The findings can be used to encourage, mentor, and support Latina nurses throughout their careers, so they are provided with opportunities for advancement and nurtured as they become leaders.

Motivators and Barriers to COVID-19 Vaccination in Young Adults Living in the USA.

High rates of COVID-19 infection and lower vaccination rates among young adults aged 18 to 26 in the United States prompted this study to examine motivating factors and barriers to COVID-19 vaccination and identify preferences in COVID-19 vaccine education. Three focus group discussions were completed. Transcribed data were analyzed using thematic analysis. Three key themes were identified including (1) motivating factors to vaccination, (2) barriers to vaccination, and (3) COVID-19 vaccination educational intervention design recommendations. Motivating factors included five relevant subthemes: civic duty, fear related to the disease process; fear related to emerging variants and breakthroughs; fear regarding the suffering of others; and freedom. Barriers included four subthemes: lack of trust, misinformation, politics, and pressure. Attempts to further educate young adults about the COVID-19 vaccine should consider strategies that target motivating factors and barriers while also making accurate information accessible through social media.

Moral Distress Experienced by US Nurses on the Frontlines During the COVID-19 Pandemic: Implications for Nursing Policy and Practice.

Introduction: The ongoing COVID-19 pandemic represents the largest contemporary challenge to the nursing workforce in the 21st century given the high stress and prolonged strain it has created for both human and healthcare supply resources. Nurses on the frontlines providing patient care during COVID-19 have faced unrivaled psychological and physical demands. However, no known large-scale qualitative study has described the emotions experienced by nurses providing patient care during the first wave of the COVID-19 pandemic in the US. Objective: Therefore, the purpose of this study was to qualitatively describe the emotions experienced by US nurses during the initial COVID-19 pandemic response. Methods: One hundred individual interviews were conducted with nurses across the United States from May to September of 2020 asking participants to describe how they felt taking care of COVID-19 patients. All interviews followed a semi-structured interview guide, were audio recorded, transcribed, verified, and coded by the research team. Results: Participants narratives of the emotions they experienced providing patient care during COVID-19 unequivocally described (1) moral distress, and moral distress related (1.1) fear, (1.2) frustration, (1.3) powerlessness, and (1.4) guilt. In sum, the major emotional response of nurses across the US providing patient care during the pandemic was that of moral distress. Conclusion: Investments in healthcare infrastructures that address moral distress in nurses may improve retention and reduce burnout in the US nursing workforce.

Predictors associated with new nursing faculty's intent to leave nursing academia: teaching preparation in doctoral program, institutional supports, and job satisfaction.

OBJECTIVES: The purpose of this study was to examine the relationships among demographics, doctoral teaching preparation, nurse faculty institutional support, faculty job satisfaction, and intent to leave current nursing academic position in PhD- and DNP-prepared faculty. METHODS: Using a survey research design, invitations to a Qualtrics survey were emailed to nursing program directors. Independent samples t-tests and logistic regression models were used to determine the nature of the relationships. RESULTS: In total, 149 participants completed the survey. Degree type, age, and job satisfaction were significant predictors related to intent to leave nursing academia. Doctoral program teaching preparation and institutional support were not statistically associated with intent to leave nursing academia. CONCLUSIONS: Findings suggest older age, PhD-prepared faculty, and job dissatisfaction were significant factors influencing decisions to leave nursing academia among the doctoral prepared new nursing faculty. Efforts to retain or increase the number of nurse faculty must be prioritized.

Barriers to Dialysis Home Therapy Utilization: A Systematic Review.

Barriers to the utilization of home therapy among patients with chronic kidney disease (CKD) impact progression to kidney failure and access to treatment options. The impact of health disparities on home therapy utilization receiving kidney replacement therapy requires investigation. A systematic review utilizing the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) guidelines was conducted to examine health disparity barriers to home therapy utilization among patients with kidney failure. Twelve articles published from 2010-2020 identified relationships between health disparities and home dialysis utilization among adults receiving kidney replacement therapy. Findings included association between the utilization of home therapy and the barriers of race/ethnicity (n = 5), economic barriers (n = 4), and insurance type (n = 3). Implications of findings are provided.

Recruitment Strategies to Optimize Participation by Diverse Populations.

The authors describe the methodological strategies used to effectively recruit a diverse sample of nurses in a qualitative study. Adequate representation of diverse populations is necessary to advance science and health equity. A multimodal research approach (research team composition, flyers, social media, and purposive sampling) was used. When undertaking research with underrepresented groups, recruitment efforts should begin in the early phases of study planning with research team development that can assist in employing multiple recruitment strategies accordingly.

The Mediating Role of Spirituality on Depression, Alcohol Use Disorder, and Problem Gambling Among Korean College Students: A Multiple-Mediation Analysis.

ABSTRACT: Excessive alcohol use and gambling problems among Korean college students in Korea have been recognized as significant public health issues. The purpose of this study was to identify the direct, indirect, and total influence of depression on alcohol use disorder and problem gambling to determine relative magnitudes of the specific mediating effects of spirituality. A cross-sectional correlational survey was conducted in South Korea with 239 college students. Study variables included the Center for Epidemiological Studies Depression Scale, a Spirituality Scale for Koreans, the Alcohol Consumption Questions, and the Korean version of the Canadian Problem Gambling Severity Index. Multiple-mediation analyses were performed. The results found that depression has a negative effect on each of the six subgroups of spirituality. In terms of the effects of spirituality on alcohol use disorder and problem gambling, spirituality was found to have a positive effect only on alcohol use disorder. The relationship between depression and those two addictive behaviors was significantly mediated by spirituality. Bootstrapping revealed that transcendence and connectedness were significantly mediating the relationship between depression and alcohol use disorder. For problem gambling, compassion and connectedness were found to be mediators affecting the relationship between depression and problem gambling. The finding suggests that spirituality's subscales affect two specific addiction problems in different ways. College students' excessive drinking and problem gambling can be prevented by developing and applying an intervention program that strengthens the connectedness of spirituality's subscales.

Examining effective communication in nursing practice during COVID-19: A large-scale qualitative study.

AIM: The aim of this study was to conduct a primary examination of the qualitative communication experiences of nurses during the first wave of the COVID-19 pandemic in the United States. BACKGROUND: Ambiguity in ever-evolving knowledge on how to provide care during COVID-19. Remaining safe has created a sense of urgency, which has in turn created the need for organizations to quickly alter their operational plans and protocols to support measures that increase capacity and establish a culture of safe care and clear communication. However, no known study has described communication in nursing practice during COVID-19. METHODS: Utilizing qualitative descriptive methodology, semi-structured interviews were conducted with 100 nurse participants from May to September 2020 and recorded for thematic analysis. The consolidated criteria for reporting qualitative studies (COREQ), a 32-item checklist, were used to ensure detailed and comprehensive reporting of this qualitative study protocol. FINDINGS: Study participants shared descriptions of how effective communication positively impacted patient care and nursing practice experiences during the first wave of the COVID-19 pandemic. The thematic network analyses identified the importance of effective communication across three levels: (1) organizational leadership, (2) unit leadership and (3) nurse-to-nurse communication. Within this structure, three organizing themes, essential to effective communication, were described including (a) presence, (b) education and (c) emotional support. CONCLUSION: Examining existing crisis communication policies and procedures across healthcare organizations is imperative to maintain highly relevant, innovative, and data-driven policies and strategies that are fundamental to preserving quality patient care and supporting optimal nursing practice. IMPLICATIONS FOR NURSING POLICY AND HEALTH POLICY: Effective communication is critical to support nurses through extended periods of crisis. COVID-19 represents a unique contemporary challenge to the nursing workforce given the high stress and prolonged strain it has created for both human and healthcare supply resources. There is value in nurses' presence at local, unit level and organizational leadership levels to convey critical information that directly informs leadership decision-making during unprecedented emergencies such as the COVID-19 pandemic.

Case Report: Systemic lupus erythematous associated with thrombotic thrombocytopenic purpura, a diagnostic challenge.

Thrombotic thrombocytopenic purpura (TTP) is an uncommon microangiopathic disease and sometimes is associated with systemic lupus erythematous (SLE). However, this probable causal relationship has not been completely proven. The diagnostic differentiation of both diseases is difficult in the first instance because they share similar characteristics that may overlap. We present a case of a 32-year-old woman with antecedents of epileptic seizures since she was 12 years old. The patient was admitted to the emergency room with a clinical picture of headaches, fever, paleness in the skin and mucosa, confused state, paresthesia, and transient spasticity of the extremities. The laboratory results revealed direct Coombs negative hemolytic anemia, severe thrombocytopenia, significant elevation of lactate dehydrogenase, and presence of schistocytes ++ in the peripheral film. In addition, positive antinuclear antibodies and positive anti-native DNA in titers of 1/320 and 1/160, respectively, were found. Urinalysis showed that serum creatinine was in normal range. Because of limited hospital resources, ADAMTS13 was not evaluated. However, based on clinical, hematological, and biochemical findings, we concluded that it was a case of TTP associated with SLE and indicated treatment with plasmapheresis and methylprednisolone pulses, obtaining a satisfactory response (normalization of biomarker levels, health condition) after the second session of plasmapheresis. Diagnosis of both SLE and TTP is often difficult to achieve; however, adequate correlation of clinical manifestations and laboratory tests, along with the help of partial therapeutic interventions, may lead to good clinical response.

Culturally Congruent Health Care of COVID-19 in Minorities in the United States: A Clinical Practice Paper From the National Coalition of Ethnic Minority Nurse Associations.

Introduction: Race and ethnicity along with social determinants of health have been identified as risk factors for COVID-19. The purpose of this clinical paper is to provide an overview of the National Coalition of Ethnic Minority Nurse Associations (NCEMNA), present COVID-19 epidemiological data on five racial-ethnic groups, identify culturally congruent health care strategies for each group, and provide directions for practice and research. Method: NCEMNA collaborated to provide a clinical paper that addresses information about COVID-19 and culturally congruent health care in five racial-ethnic groups. Results: Every organization presented common themes across the different groups and unique perspectives that each group is faced with during this challenge. Discussion: This article provides an introduction to the issues that minority groups are facing. It is imperative that data are collected to determine the extent of the impact of COVID-19 in diverse communities in the country.

Lack of Diagnosis and Screening for Pediatric Obesity in the Retail Health Setting: Implications for Quality Improvement Measures.

INTRODUCTION: Pediatric obesity has reached an epidemic status. The purpose of this study was to examine the prevalence of overweight and obesity in patients and how often and how accurately a diagnosis was coded. The population for this study included children aged 3-18 years. This cohort presented to retail health clinics in a large urban health system for school or sports physicals from June 1, 2017, to November 30, 2017. METHOD: A retrospective chart review was conducted. Statistical analysis was performed to determine if there was a relationship between obesity and age, ethnicity, race, and sex. RESULTS: The study identified that 15.9% of patients were overweight and 16.5% were obese. In practice, 99% of patients lacked a formal diagnosis of overweight or obesity; in addition, appropriate screening measures reflecting nutrition and physical activity were found to be lacking in 99% of cases. DISCUSSION: Strategies are needed to improve efforts to diagnose and manage overweight and obesity in pediatric population in the retail health setting. Organizational recommendations for change are suggested based on guidelines for childhood obesity.

Exploring the Need of HPV Education Programs in Korean American Communities.

Given the significantly higher cervical cancer risks faced by Korea Americans (KA), the aim of this study was to explore cultural influences and barriers affecting human papillomavirus (HPV) vaccination decisions and preferred educational methods to effectively deliver HPV information. Focus groups included 20 KA parents. This study found a lack of knowledge about HPV and the vaccine, along with negative perceptions about the vaccine, affects HPV vaccination decision-making. Ineffective conversations and a lack of HPV vaccine recommendations by health care providers influenced by cultural beliefs were found to be another major barrier. These findings reveal new insights to guide the development of HPV education programs.

The impact of burnout on doctorate nursing faculty's intent to leave their academic position: A descriptive survey research design.

BACKGROUND: Despite the fact that the great demands placed on many nursing faculty put them at high risk for job burnout; there are limited studies exploring the relationship between burnout and leaving their academic positions. OBJECTIVE: The objective of this study is to address the national nursing faculty shortage by examining demographics, teaching preparation in the doctoral program, and burnout to determine intent to leave nursing academia among PhD and DNP-prepared nursing faculty. DESIGN: A descriptive survey research design was used to identify the most significant factors related to faculty intent to leave their academic position. SETTINGS: An online national survey of doctorate faculty throughout the U.S. was administered. PARTICIPANTS: Full-time nursing faculty who had earned a PhD or DNP degree in nursing with four or less years ofteaching experience after doctoral program graduation were recruited. METHODS: Data was collected from an the online survey posted on Qualtrics. Logistical regression models were used to interpret data significance. RESULTS: A total of 146 nursing faculty responded to the online survey. 51.4% of the respondents (n = 75) had a DNP degree and 48.6% (n = 71) had a PhD degree. 61% of the respondents were over the age of 50 with the remaining 39% of the respondents between ages 20 and 49. PhD-prepared faculty reported higher emotional exhaustion compared to DNP-prepared faculty. Findings revealed that degree type (PhD versus DNP), age, and emotional exhaustion and depersonalization in burnout were significant predictors related to intent to leave nursing academia. CONCLUSIONS: To address the nursing faculty shortage issue, it is critical to create supportive and positive working environments to promote the well-being of nursing faculty, provide additional emotional support for the specific PhD-prepared faculty needs that contribute to burnout, and encourage nurses to begin an academic career earlier to help retain nursing faculty in academic settings.

A Needs Assessment for Development of the TIME Anesthesia Handoff Tool.

Standardized handoff is critical to providing safe and effective patient care. Limited studies assess the need for developing a handoff tool for anesthesia providers. The purpose of this descriptive study was to assess the need for a standardized anesthesia handoff tool and to identify the most essential components to develop an anesthesia handoff tool. A descriptive survey design was used. Anesthesia providers were asked to complete an online survey. Fifty-three (64%) of 82 respondents did not currently use a systematic process during anesthesia handoff. Most (73%) believed they were given inadequate information, and 40 (48.8%) sometimes discovered information that was not shared by the prior anesthesia provider. The most frequently provided components by respondents were airway type, airway difficulty, analgesia, anesthetic type, invasive lines, patient medical history, procedure, and vital signs. The most frequently received were airway difficulty, invasive lines, medical history, and procedure. Most participants perceived that anesthesia providers currently provide inadequate handoff. Anesthesia providers indicated the most essential components for effective anesthesia handoff were airway difficulty, invasive lines, medical history, procedure and casespecific concerns, allergies, medications, and plan/ goals. The study findings guided the development of the concise and efficient TIME (transaction, induction, maintenance, emergence) anesthesia handoff tool.

Impacto en una comunidad terapéutica de las diferentes modalidades de sesiones grupales / Impact at a therapeutic community from different modalities of group sesions

Se aplicó una encuesta a pacientes ingresados en una comunidad terapéutica de atención a toxicomanías, con interés de conocer sus actitudes hacia cada una de las diferentes modalidades de trabajo grupal en que participan, acorde a criterios de preferencia, de aporte de conocimiento útil a los efectos de su rehabilitación, de libertad para expresar sus vivencias, ser mejor comprendidos e intercambiar con los demás; todo esto como formas directas de evaluación. Se incluyeron además, criterios acerca del grado de complacencia con relación a la frecuencia semanal de realización de tales sesiones, así como al tiempo dispuesto para cada una de estas, como formas indirectas de evaluación. Se encontró notable aceptación por todas las sesiones referidas, pero se evidenció especial preferencia por los grupos alternativos en cuanto al criterio de libertad mencionado, teniendo en cuenta la ausencia del profesional en esta modalidad de trabajo, así como una especial preferencia por la psicoterapia de grupo. La existencia además, de aspiraciones del grupo a que se incremente la frecuencia semanal de algunas sesiones grupales, o la duración del tiempo de ejecución, constituyen un indicador que ilustra el grado en que estas impactan a la comunidad terapéutica

Impacto en una comunidad terapéutica de las diferentes modalidades de sesiones grupales / Impact at a therapeutic community from different modalities of group sesions

Se aplicó una encuesta a pacientes ingresados en una comunidad terapéutica de atención a toxicomanías, con interés de conocer sus actitudes hacia cada una de las diferentes modalidades de trabajo grupal en que participan, acorde a criterios de preferencia, de aporte de conocimiento útil a los efectos de su rehabilitación, de libertad para expresar sus vivencias, ser mejor comprendidos e intercambiar con los demás; todo esto como formas directas de evaluación. Se incluyeron además, criterios acerca del grado de complacencia con relación a la frecuencia semanal de realización de tales sesiones, así como al tiempo dispuesto para cada una de estas, como formas indirectas de evaluación. Se encontró notable aceptación por todas las sesiones referidas, pero se evidenció especial preferencia por los grupos alternativos en cuanto al criterio de libertad mencionado, teniendo en cuenta la ausencia del profesional en esta modalidad de trabajo, así como una especial preferencia por la psicoterapia de grupo. La existencia además, de aspiraciones del grupo a que se incremente la frecuencia semanal de algunas sesiones grupales, o la duración del tiempo de ejecución, constituyen un indicador que ilustra el grado en que estas impactan a la comunidad terapéutica(AU)