Perceived Balance, Balance Performance, and Falls Among Community-Dwelling Older Adults: A Retrospective, Cross-Sectional Study.

Objectives: To examine the extent to which older adults' perceived balance, a balance performance test, and fear of falling (FOF) were associated with falls in the last month. Methods: The Health Belief Model served as the theoretical framework. A retrospective, cross-sectional, secondary analysis using data from the National Health and Aging Trends Study was conducted (N = 7499). Results: Multiple logistic regression analysis revealed that the odds of reporting a fall in the past month were 3.3 times (p < .001) greater for participants who self-reported having a balance problem compared to those who did not. The Short Physical Performance Battery and FOF were not uniquely associated with falls. Discussion: Our findings support limited evidence suggesting that older adults' perceived balance is a better predictor of falls than balance performance. Assessing older adults' perceived balance may be a new way to assess older adults' fall risk to prevent future falls.

A pilot resiliency course for Doctor of Nursing Practice (DNP) students: Lessons learned.

Graduate nursing students can face varied and significant stressors during their programs of study. The need for interventions to promote nursing student resiliency has been reported in the literature, by accrediting bodies, and in previous research conducted with students at the same university. Thus, the purpose of this project was to pilot a resilience course for Doctor of Nursing Practice (DNP) students. The theoretical frameworks guiding the design and implementation of the resiliency pilot program were andragogy (the science of adult learning) and rapid cycle quality improvement. The course included eleven monthly modules addressing resiliency content with written material, original videos, and online discussions and meetings. The first module overviewed the resiliency skills (Belief, Persistence, Trust, Strength, and Adaptability), five modules were dedicated to a specific resiliency skill, two modules addressed recent and anticipated challenges, two modules concentrated on the application (clinical and academic) of the resiliency skills, and the last module focused on reflection. Results of this pilot program indicate that DNP students can benefit from receiving resiliency content during their studies, especially from faculty involvement and increased peer support; however, future resiliency content may be more accepted and effective if embedded into nursing program curriculum and activities.

Methodology for Analyzing Qualitative Data in Multiple Languages.

BACKGROUND: Translation strategies are commonly used for qualitative interview data to bridge language barriers. Inconsistent translation of interviews can lead to conceptual inequivalence, where meanings of participants' experiences are distorted, threatening scientific rigor. OBJECTIVES: Our objective is to describe a systematic method developed to analyze multilingual, qualitative interview data while maintaining the original language of the transcripts. METHODS: A literature review of translation strategies, cross-language, and multilingual qualitative research was conducted. Combined with criteria for qualitative content analysis and trustworthiness, the methodology was developed and used for a qualitative descriptive study. RESULTS: The study had interview data in both English and Spanish. The research team consisted of both native Spanish and English speakers, who were grouped based on language. Verbatim transcription of data occurred in the original languages. All codes were kept in English, allowing the research team to view the data set as a whole. Two researchers within each group coded each transcript independently before reaching a consensus. The entire research team discussed all transcripts, and finally, major themes were determined. Participants' quotes remained in the original language for publication, with an English translation included when needed. DISCUSSION: Analyzing transcripts in the original language brought forth cultural themes that otherwise may have been overlooked. This methodology promotes conceptual equivalence and trustworthiness that is paramount in cultural, linguistic, and social determinants of health research to advance health equity.

Overcoming waves of helplessness: The meaning of experiencing fear of falling.

Fear of falling (FOF) is prevalent among older adults. While the phenomenon has been conceptually defined and the factors associated with FOF are evident in the nursing literature, the deeply personal experience of this fear from the perspective of older adults is often overlooked. The aim of this study was to explore the meaning of experiencing FOF among older adults (N = 4). Each participant was interviewed twice using van Manen's interpretive phenomenological methodology. Four major interpretive themes emerged: Loss of Self, Part of my Existence, Remaining Safe Within the Boundaries of Fear, and The Exhausting Appraisal of Relationships. While the older adults struggled to manage their FOF, a deeper meaning was expressed during a relentless striving for self-preservation. While FOF can be an experience of overwhelming helplessness, the older adults in this study demonstrated personal resiliency, a perspective that is often lacking in the current literature.

Barriers and facilitators for adopting a healthy lifestyle among Latina cancer survivors: A qualitative descriptive study.

PURPOSE: Cancer is the leading cause of death among Hispanics/Latinos in the USA. Latina cancer survivors experience higher symptom burden than other cancer survivors. A healthy lifestyle can decrease recurrent cancer risk, increase well-being, and may decrease symptom burden in cancer survivors. The purpose of this study was to explore the barriers and facilitators for adopting healthy lifestyle behaviors among Latina cancer survivors. METHODS: Using the Health Belief Model as the theoretical framework, qualitative descriptive methodology was used for secondary analysis of data from a previously conducted randomized clinical trial. Transcripts from the telephone health coaching calls, analyzed in the original language (English or Spanish), were used for this qualitative analysis. RESULTS: Intervention telephone call transcript data from Latina cancer survivors (n = 14) were analyzed. Major themes were as follows: Perceived susceptibility to other chronic illnesses, perceived benefits of a healthy lifestyle, and perceived barriers and facilitators of adopting a healthy lifestyle. Lack of knowledge about healthy lifestyle behaviors could prevent participants from adopting a healthy lifestyle; gaining new knowledge about healthy lifestyle behaviors was a facilitator for changing lifestyle. Family responsibility and wearable technology could both prevent and motivate the participants to adopt a healthy lifestyle. CONCLUSION: Developing culturally appropriate interventions for Latina cancer survivors is vital to decrease symptom burden and health risks, as well as improve health outcomes in this population.

Nurses' experiences of working while pregnant: A qualitative descriptive study.

BACKGROUND: Healthcare work environments are fraught with occupational hazards that can impact nurse health as well as patient care. However, little is known about how these hazards impact nurse health during pregnancy, and the experiences of nurses in the work environment during pregnancy and upon their return postpartum. OBJECTIVE: To describe registered nurses' (RNs') experiences of working while pregnant and returning to work postpartum. Specifically, their experiences related to the work environment and work-related hazards. DESIGN: A qualitative descriptive design was utilized to describe nurse experiences at work, occupational hazards during pregnancy, and experiences of returning to work after pregnancy. PARTICIPANTS AND SETTING: A convenience sample of twenty nurses working in direct patient care roles across the United States were recruited for virtual semi-structured interviews. METHOD: Participants were interviewed using a semi-structured question guide to explore nurse experiences, specifically occupational hazards at work during pregnancy and upon returning to work. Interview transcripts were analyzed using deductive and inductive content analysis. RESULTS: Deductive findings for occupational hazards and risks during pregnancy and postpartum included exposure to infectious diseases, imaging, physical tasks (e.g., lifting and performing CPR), cleaning products, patient violence, and medication administration. Inductive thematic findings included: support needed avoid occupational hazards and make necessary modifications; desire to be 'supernurses' and put the patient first even when it meant taking risks for our health and that of their child; and fear of the consequences of occupational hazards and exposures. CONCLUSIONS: Occupational hazards experienced by nurses during pregnancy that may impact their health and that of their baby were broader than previously studied. Pregnant nurses should receive education from their healthcare providers early in their pregnancies about the occupational hazards themselves and the potential modifications they should seek. Managers, occupational health and other health system leaders, and policymakers should be aware of occupational hazards for nurses, including pregnant nurses, and support workplace modifications. Future research should focus on assessing the prevalence of these hazards, the longitudinal impact of exposures that can lead to negative consequences for nurse and fetal health, and reducing the risk of exposure to these hazards for pregnant nurses. TWEETABLE ABSTRACT: RNs described a variety of occupational hazards of working while pregnant and postpartum. Inconsistent ability to modify work to protect self and baby leads to completing work demands known to be hazardous.