Are We Missing the Mark? Understanding Health Literacy in A Rural-Border Hospital.

Low health literacy (LHL) significantly impacts patients' ability to participate actively in their healthcare. Registered nurses (RNs) play a crucial role in identifying LHL and addressing patient knowledge gaps and skill deficits. This correlational study examined the relationship between RNs' predictions of patients' health literacy levels (HLL) and the actual HLL of a predominately Hispanic patient population. In addition, personal factors (i.e., demographics) were analyzed to determine their influence on the nurse's predictions and patients' HLL. Data were collected from 84 participant patient-nurse couplets admitted to a medical-surgical unit in a rural setting located on the United States-Mexico border. In addition to demographic information collected via survey, RNs were asked to predict their patient's health literacy abilities while the Newest Vital Sign, a health literacy assessment tool, was deployed to determine the actual HLL of patients participating in the study. Data were analyzed using descriptive statistics, t-tests, and chi-square tests while a Spearman correlational model was used to examine the relationship between predicted HLL and actual HLL. Finally, a logistic regression model was used to analyze the relationship between personal factors and HL data for RNs and patients. Analysis of the data revealed that RNs consistently overestimated patients' abilities, as evidenced by the disparity between patients' actual HLL (mean 1.71) and predicted HLL (mean 4.26) by RNs, with a moderately strong positive relationship (rs = .418). Notably, higher academic preparation and years of experience did not enhance the RNs' ability to identify LHL while the highest level of education completed was the only statistically significant predictor of adequate health literacy in the patient population sampled. These findings emphasize the need to prioritize effective health literacy education in RN academic preparation and clinical practice to support the detection of LHL when a standardized health literacy assessment tool is not utilized in the clinical setting. By recognizing the presence of LHL, healthcare professionals can better support patients' needs and bridge the knowledge gap, ultimately improving patient outcomes.

The Effects of Augmented Reality on Prelicensure Nursing Students' Anxiety Levels.

BACKGROUND: Prelicensure nursing students experience high anxiety as they enter the clinical setting, which can have a negative impact on learning care performance and critical thinking. This study explored the viability of an innovative technological teaching strategy, augmented reality (AR), as a platform to prepare students and decrease their anxiety levels when entering a new environment. METHOD: A pretest/posttest quasiexperimental design was used to assess the effect of AR 360 photosphere on preli-censure nursing students' anxiety levels as they entered a new clinical environment compared with anxiety levels of prelicensure nursing students who participated in the traditional faculty-led orientation method. RESULTS: Students from three midwestern colleges of nursing completed the State-Trait Anxiety Inventory before and after completing the AR 360 photosphere orientation or a faculty-led orientation. An independent t test revealed no difference in students' anxiety levels between the two methods of orientation. CONCLUSION: Although there were no significant differences in nursing students' anxiety levels between the two methods of clinical orientation, the AR 360 can be a valuable method of orientation that saves faculty time and ensures more consistent and uniform content compared with the traditional faculty orientation method. [J Nurs Educ. 2020;59(3):142-148.].

Predicting success in nurse anesthesia programs: an evidence-based review of admission criteria.

Nurse anesthesia programs strive to minimize attrition due to academic reasons and maximize student success. The authors examined the evidence for evaluating applicants to nurse anesthesia programs that may help predict success in the program and on the National Certification Examination for Nurse Anesthetists. A search strategy guided gathering of evidence from peer-reviewed journals. Evidence from non-anesthesia graduate nursing programs was included because of the suspected lack of evidence specifically examining nurse anesthesia programs. Eight sources involved solely graduate nurse anesthesia programs, 9 involved graduate nursing programs without stu-graduate nursing programs with student registered Nurdent registered nurse anesthetists, and 2 pertained to nurse anesthetists. Most of the evidence sources were descriptive studies. The evidence overall supports current commonly used admissions criteria such as undergraduate grade point averages. The requirement for applicants to take the Graduate Record Examination should be examined closely. Programs should also consider the length of time the applicant has been out of a formal educational setting. Based on these findings, programs may cautiously explore revising the admission policy. Further investigations are proposed to explore the predictive value of various admission criteria.

The quality of life of hospice patients: patient and provider perceptions.

The purposes of this study were to describe the quality of life (QOL) of terminally ill patients in a home-based hospice program and to examine the relationship between QOL data and patients' symptom distress, ability to function, interpersonal communication (support from family and friends), well-being (their affairs in order), and transcendence (religious comfort/support) as recorded in their charts. QOL was measured by the Missoula-Vitas Quality of Life Index (MVQOLI), an instrument designed specifically for use with terminally ill patients. The study was conducted over a three-year period with 129 terminally ill patients enrolled in a home-based hospice program of care. The MVQOLI was administered to patients within 20 days of their admission to hospice. A retrospective chart review was conducted to determine patients' levels of symptom distress, ability to function, social support, whether or not their affairs were in order, and religious comfort/support. The mean age of participants in this study was 67, with 54.3 percent male and 45.7 percent female. Cancer was the primary diagnosis for 92.2 percent of the sample, and 35 percent of these patients had a diagnosis of lung cancer. Of the 7.8 percent non-cancer diagnoses, five were diagnosed with AIDS, four with chronic obstructive pulmonary disease, and one with chronic heart failure. The results of this study revealed positive scores on the five dimensions of the MVQOLI QOL scale, indicating that within 20 days of admission to hospice, patients rated their QOL as good to very good. Data obtained from the chart review also indicated that patients did not experience a great deal of symptom distress (e.g., pain, nausea, shortness of breath, and restlessness). A significant correlation existed between age and QOL; number of interventions and pain levels; and marital status, well-being, interpersonal relationships, and transcendence. Shortness of breath and well-being were significantly correlated with QOL. There was no significant correlation between gender, race, or closeness to death and the five dimensions of the MVQOLI and chart review assessments.

Comparison of characteristics of heart failure by race and gender.

Heart failure (HF) affects almost 4.8 million Americans, occurring in men and women of all races. Half of those with HF are women; of the African American population, almost 3% are affected by HF. Although recent HF research has focused on women and minorities, information is still needed regarding differences by race and gender. The purpose of this study was to compare risk factors and physiologic differences by race (African American and Caucasian) and gender that exist in those with HF.

Sex-related differences in heart failure.

Heart failure (HF) is a complex syndrome that is generally defined as cardiac output not adequate to meet the circulatory demands of the body. HF is at the end of the continuum of cardiovascular disease and preceded by an initiating event such as myocardial infarction, untreated hypertension, idiopathic cause, congenital heart disease, or pulmonary hypertension. In recent years, research has revealed differences in various aspects of HF between men and women including risk factors, pathophysiology, clinical manifestations, and response to treatment. Therefore, the purpose of this review is to review these sex-related differences between men and women who live with HF.

Outpatient costs of medications for patients with chronic heart failure.

BACKGROUND: The outpatient costs of medications prescribed for chronic heart failure are high and are often borne by individual patients. Lack of financial resources may force noncompliance with use of medications. OBJECTIVE: To compare the outpatient costs of medications for patients with different New York Heart Association classifications of chronic heart failure. METHODS: The charts of 138 patients with chronic heart failure were reviewed retrospectively. Outpatient costs of medications were obtained from the Web sites of commercial pharmacies. Medications were classified by type according to the system of the American Heart Association. A mean cost for each classification of medication was used for analysis. RESULTS: The overall mean monthly cost of medications for chronic heart failure was $438. Patients with class II and class III chronic heart failure had the highest costs: $541 and $514, respectively. Analysis of variance indicated that the differences in monthly costs of medications between the patients with the 4 stages of chronic heart failure were significant (F = 4.86, P = .003). A post hoc Scheffé test revealed significant differences in costs between patients with class I and patients with class II heart failure (P = .02) and between patients with class I and those with class III heart failure (P = .02). CONCLUSIONS: The outpatient costs of medications for chronic heart failure are significant. Ability to pay for prescribed medications must be determined. Healthcare professionals must maintain an awareness of the costs of medications and patients' ability to pay.