Introducing Mindfulness Practices for Self-Care: Outcomes of a Brief Education Session.

Nurses' self-reported lack of self-care and work-related stress prompted professional educators to offer a 15-minute mindfulness experiential learning session during the facility's annual professional development forums. Nurses were taught and practiced mindfulness (e.g., meditation, imagery), designed to empower them to be present in the moment with a sense of clarity and compassion. Outcomes measured were nurses' self-reported practice benefit and interest in learning about and using mindfulness practices. Five hundred forty-five nurses attended the session. Most nurses (71%) reported benefit/great benefit from the session. Guided imagery and the mindful moment were the most frequently selected practices nurses would use and learn. Nursing professional development practitioners can incorporate mindfulness experiential learning opportunities into their existing education offerings.

Using Research Findings to Design an Evidence-Based Practice Curriculum.

Evidence from a system-wide research study highlighted strengths and weaknesses in evidence-based practice (EBP) implementation, beliefs, and organizational readiness. To address this evidence, a curriculum was developed within the context of the shared governance and EBP models for nursing practice. The curriculum, Evidence-Based Practice: Clinical Applications in Professional Nursing Practice, consists of five modules that provide the knowledge, skills, and abilities relative to each step of EBP. The learning approach incorporates classroom- and unit-based education, facilitated by EBP curriculum mentors. Each module is rolled out quarterly for a 15-month curriculum cycle. Outcome data include pre- and post-learning assessments, in addition to EBP projects. This seamless approach to nursing education, based on research findings and established shared governance and EBP models, can be undertaken by community hospital systems. J Contin Nurs Educ. 2017;48(4):184-189.

Development, Implementation, and Evaluation of a Nurse Anesthesia Program in Belize.

Because of a critical shortage of anesthesia providers in Belize, the Belize Ministry of Health initiated support for the creation of a nurse anesthesia education program. Developed in collaboration with Health Volunteers Overseas and the University of Belize, the nurse anesthesia education program graduated 10 nurse anesthetists. This article describes the 24-month nurse anesthesia education program's design, implementation, and evaluation. Challenges and opportunities experienced during the program are outlined as lessons learned for planning similar programs.

Does pilates-based exercise improve postural alignment in adult women?

A randomized, controlled trial was conducted to determine the effect of Pilates-based exercise on postural alignment. Seventy-four adult women (mean age ± SD, 34.9 ± 16.4 years) were randomized to a Pilates-based mat class (n = 40) or a control group (n = 34). Pilates-based exercise participants were taught the Initial Mat of Body Control Pilates for 6 months, twice a week, for 60 minutes per session; the control group received no exercise intervention. Repeated measurements were performed at baseline, 3 months, and 6 months of the frontal alignment of the thoracolumbar spine, shoulder, and pelvis, and sagittal alignment of the head and pelvis. No differences were found in either group, over time, on frontal alignment of the thoracolumbar spine and pelvis. The experimental group showed significant improvements in frontal alignment of the shoulder and sagittal alignment of the head and pelvis at 6 months. The Pilates-based exercise enhanced some parameters of the postural alignment of women, as measured by frontal alignment of the shoulder and sagittal alignment of the head and pelvis. The significant improvement in sagittal alignment of the head may imply that 6 months of Pilates-based exercise enhances sagittal alignment of the cervical or thoracic spine.

Effects of Pilates-based exercise on life satisfaction, physical self-concept and health status in adult women.

The objective of this study was to determine the effect of Pilates-based mat exercises on life satisfaction, perception of appreciation by other people, perception of physical appearance, perception of functionality, total physical self-concept, and perception of health status in healthy women. A randomized controlled trial was conducted in Evora, Portugal, in 2008, in which 62 healthy adult women were randomized to a Pilates-based mat (experimental group) (n = 38, mean age ± SD, 41.08 ± 6.64 years) or a control group (n = 24, mean age ± SD, 40.25 ± 7.70 years). Experimental group participants performed the Initial Mat of Body Control Pilates twice per week, 60-minutes per session. Repeated measurements were performed at baseline, 3 months and 6 months. No significant differences between the two groups were observed in life satisfaction, perception of appreciation by other people, perception of physical appearance, perception of functionality, total physical self-concept, and perception of health status at three time point measures (baseline, after 3 months, and after 6 months). No significant differences were observed in the control group over time. The experimental group showed significant improvements between baseline and six months in life satisfaction (p = .04), perception of appreciation by other people (p = .002), perception of physical appearance (p = .001), perception of functionality (p = .01), total physical self-concept (p = .001), perception of health status (p = .013) and between three and six months in life satisfaction (p = .002), perception of appreciation by other people (p = .05), perception of physical appearance (p = .001), perception of functionality (p = .02), and total physical self-concept (p = .001). Life satisfaction, perception of appreciation by other people, perception of physical appearance, perception of functionality, total physical self-concept and perception of health status may improve after 6 months of Pilates-based mat exercise.

Self-esteem and optimism in rural youth: gender differences.

AIM: To identify and describe gender-related differences in the self-esteem and optimism levels of rural adolescents. BACKGROUND: Self-esteem and optimism have been broadly examined and are associated with health-practices, social interaction, attachment, resiliency, and personal identity. Information describing the relationship of self-esteem and optimism as it relates to gender is limited. METHODS: Using a cross-sectional survey design, students (N = 193) from three high-schools in rural Pennsylvania, USA completed the Rosenberg Self-Esteem Scale and the Optimism Scale-Life Orientation Test-Revised as part of a National Institute of Health, National Institute of Nursing Research funded study. RESULTS: Both instruments' mean scores were in the range of average for this population, with females scoring lower than males in both self-esteem (p < 0.0001) and optimism (p < 0.0001). The results of this study have nursing implications for evidenced based interventions that target self-esteem and optimism. Attention to self-esteem and optimism in female youth is recommended.

Self-reported exercise during breast cancer treatment: results of a national survey.

BACKGROUND: Exercise during treatment for early-stage breast cancer is helpful to mitigate fatigue and promote health. Little is known about the experiences of and preferences for exercise during treatment from a national perspective. OBJECTIVE: The purpose of this descriptive survey was to explore women's experiences with and preferences for exercise during breast cancer treatment. METHODS: An online survey was conducted through a national survey company to their eligible subscribers. This researcher-created, 1-time survey included forced-choice and open-ended questions about exercise participation and preferences during treatment for breast cancer. RESULTS: One hundred sixty women who completed treatment for early-stage breast cancer in the previous year completed the survey. Walking was the most frequent form of exercise reported and preferred by the participants. Most participants did not meet current national guidelines for daily physical activity. CONCLUSION: Walking and exercises specific to women with breast cancer were most frequently performed and preferred among a national sample of women during their treatment for breast cancer. This finding supports previous studies. IMPLICATIONS FOR PRACTICE: Oncology nurses can encourage their patients to participate in exercise and physical activities that they enjoy and can self-pace, while meeting daily physical activity recommendations. The results from this survey can help oncology nurses appreciate the exercise experience in this population of women.

Continuing education for youth obesity prevention: lessons learned.

To enhance school nurses' knowledge, skills and abilities to impact youth overweight and obesity, we designed, implemented and evaluated three on-site continuing education workshops. These workshops were converted to an on-line learning management system. Suggestions for how school nurses can replicate our processes for delivery of continuing education are discussed.

Sex differences in self-reported anxiety in rural adolescents.

An anxiety disorder affects 13 out of every 100 children. The purpose of this paper is to determine if there are differences in self-reported anxiety between male and female rural adolescents. In total, 193 students aged 14-17 years in three western Pennsylvania rural high schools, USA, were surveyed. The majority of participants were Caucasian (86.5%, n = 167), female (53.4%, n = 103), and aged 15.57 years (SD = 0.93). The females' mean self-reported anxiety score was higher than the males' score (P < 0.0001). The females' mean score was 25.09 (SD = 13.83; a score > or =25 may indicate the need for further evaluation for the presence of a potential anxiety disorder), while the males' mean score was 16.88 (SD = 10.81). Of interest, all the five factor (specific types of anxiety) scores were significantly different between males and females at P < 0.05. Evidence-based implications for the mental health nurse's practice will be discussed. Anxiety screening is promoted to identify adolescents who may need mental health treatment and referrals, especially rural female adolescents.

Adolescent coping across time: implications for psychiatric mental health nurses.

This article compares rural adolescents' coping responses before and after the behavioral intervention Teaching Kids to Cope with Anger (TKC-A). A quasi-experimental design was used, that included 94 (intervention) and 85 (control) students who were enrolled in three high schools in rural southwestern Pennsylvania. Results showed no statistically significant differences between the intervention and control groups' coping responses following the TKC- A intervention. The majority of youth in this study demonstrated healthy coping skills. In the future, the TKC-A needs to be integrated into the high school curriculum as a health promotion effort that is tailored to adolescents.

THE RELATIONSHIP BETWEEN WEIGHT PERCEPTION, GENDER, AND DEPRESSIVE SYMPTOMS AMONG RURAL ADOLESCENTS.

Research findings indicate a relationship between weight perception and depression in adolescents. This study explored the relationship between weight perception, gender, and depressive symptoms in rural adolescents. Among 623 rural adolescents who completed a health inventory and a depression scale, 75 participants (n = 62 females; n = 13 males) had depressive symptoms and were used in data analysis. A two-way ANOVA model was used to evaluate the effects of weight perception and gender on depressive symptoms in rural adolescents. Although the 2-way ANOVA was not significant, there was a statistical significant finding for females who reported perceived weight problems and depression. The interaction between gender and weight perception was of marginal statistical significance (p = 0.07). Females who perceived a problem with their weight had higher depressive scores compared to females who did not perceive a problem with their weight (p = 0.0002), however no difference was observed for males. Implications are for rural nurses to screen adolescents for depressive symptoms and their weight perception during health care visits, with emphasis on females.

The fast track back to registered nurses employment.

The registered nurse (RN) workforce continues to decline. One method to attract experienced RNs into the workforce is through RN refresher courses. To determine if our RN refresher program is successful in returning RNs to the workforce, we sought to measure the: characteristics of RNs who participate in our program; relationship among participants' employment and demographics; effect of high fidelity human simulation (HFHS) on participants' learning, and; program's ability to meet participants' preparation for employment. Seventy-three participants were surveyed to measure their demographics and employment; they ranked the HFHS experience and program experience on their learning and employment. Thirty-four (47%) surveys were returned. Thirty-three participants (97%) were female (mean age=50.44 years, SD=6.2). Their mean years of RN licensure was 24.93 years (SD=8.8), and their mean time out of nursing practice was 13.30 years (SD=8.0). Twenty-six (76.5%) were employed, with 20 (60.6%) employed as RNs at acute care facilities. Employed participants were licensed for less years than non-employed participants (p=0.047). Employed participants ranked their HFHS experience highly (p=0.04) and the program highly (p=0.04) on benefiting their current employment. Our refresher program appears to be successful in helping RNs re-enter the nursing workforce.

Anger correlated with psychosocial variables in rural youth.

Uncontrolled anger is a contributing force in the three leading causes of adolescent death: homicide, suicide, and injuries. Anger may be one of the early warning signs which could lead to violent behavior. The purpose of this study was to examine the relationship between anger experience and expression with the potential correlates of life events, perceived social support, self-esteem, optimism, drug use, anxiety, and depressive symptoms in rural adolescents. The participants (n = 193) were aged 14 to 17 years old in ninth through eleventh grades enrolled at three rural Western Pennsylvania public high schools. Participants completed nine questionnaires. Negative life events, anxiety, drug use, and depressive symptoms had significant positive correlations with anger. In addition, anger was found to have significant negative correlations with the adolescents' perceived family support, self-esteem, and optimism. With this knowledge, health promotion programs conducted by pediatric nurses can target anxiety, drug use, and depressive symptoms while bolstering family support, self-esteem, and optimism to promote anger management in adolescent health care.

Optimizing Medication Adherence in Older Patients: A Systematic Review.

OBJECTIVE: To review the literature on strategies to optimize medication adherence in community-dwelling older adults and to make recommendations for clinical practice. METHODS: A systematic literature search was conducted using the MEDLINE, CINAHL, PsycINFO, International Pharmaceutical Abstracts, and EMBASE databases for randomized controlled trials examining strategies to optimize medication adherence in patients aged 65 or older prescribed long-term medication regimens. Additional studies were found by examining the reference lists of systematic reviews and selected papers. 34 papers reporting on 33 studies met the eligibility criteria and were included in this review. RESULTS: Improvement in adherence was mixed across the studies examining educational interventions, with only 12 of the 28 studies showing improvement in adherence; most were delivered by pharmacists. Effect sizes for the statistically significant educational interventions ranged from Cohen's d = 0.14 to 4.93. Four of the 5 interventions using memory aids and cues, some in conjunction with newer technologies, improved adherence. Effect sizes for the statistically significant interventions using memory aids and cues ranged from Cohen's d = 0.26 to 2.72. CONCLUSION: The evidence from this review does not clearly support one single intervention to optimize medication adherence in older patients. Future studies should explore suggestive strategies, such as tailored interventions involving ongoing contact, and should endeavor to correct methodologic weaknesses found in the literature.

Mental health and academic achievement: role of school nurses.

PURPOSE: This article discusses how school nurses promote mental health and subsequent academic achievement by screening and referral for children demonstrating mental health problems. Nursing interventions are discussed at the individual, systems, and community levels. CONCLUSION: Mental health problems can affect school performance and academic achievement. When mental health problems are not recognized, students may be unable to reach their academic potential. School nurses are in a key position to provide interventions to address mental health and academic achievement. PRACTICE IMPLICATIONS: The role of school nurses and examples of mental health collaborative activities are provided.