The Journey and Experiences of Female Hispanic Nurse Leaders.

OBJECTIVE: This study aimed to understand the experience of female Hispanic nurses in formal leadership roles. BACKGROUND: Research has identified that a diverse nursing leadership workforce is essential to providing optimal patient care. Little is known about the phenomenon of minority nurse leaders, particularly female Hispanic nurses in leadership roles. METHODS: Ricoeur's hermeneutic phenomenology guided the interviews of 15 female Hispanic nurses in leadership roles. RESULTS: Three themes were generated that described the environment in which leaders lived: family, culture, and healthcare organization. Four phenomenological themes were identified: weaving my life fabric, my inner dialogue, weight on my shoulders, and paving the way. CONCLUSION: The study findings highlight the importance of a diverse and inclusive nursing leadership workforce. By proactively addressing equal opportunities, reducing barriers to career advancement, and developing strategies to support and encourage minority nurses, organizations and communities can recruit and retain qualified underrepresented minority nurse leaders.

Validation of the Mirror Image Comfort and Avoidance Scale in a General Population.

Background and Purpose: Mirror viewing is a central concept in body image, as many feelings and thoughts about one's body originate in the mirror. The Mirror Image Comfort and Avoidance Scale (MICAS) is a self-reported instrument to assess the experiential aspects of mirror viewing. The development of this instrument is grounded in the nursing mid-range Neurocognitive Mirror Comfort and Avoidance theory. This study aimed to validate the MICAS in a general population, explore its subscales, and note demographic differences. Methods: Waltz, Strickland, and Lenz's instrument validation framework guided the process. A survey website was used to recruit adult participants (n = 205). Convergent validation was established by assessing the relationships between mirror comfort and avoidance scores and measures of anxiety, depression, stress, self-esteem, and body appreciation. Results: Validity was obtained, and the subscales were reliable. Cronbach's α score was satisfactory for comfort at .90 and avoidance at .92. Significant associations were found between mirror comfort and avoidance and all psychological variables, indicating that mirror comfort and avoidance play a role in body image and overall well-being. Conclusions: MICAS is a nurse-developed instrument designed for research purposes to enhance our understanding of mirror viewing and formulate supportive nursing interventions to improve the mirror viewing experience.

Identifying Holistic Nursing Research Priorities for 2023-2026.

The primary goal of holistic nursing research is to develop and expand the knowledge base of holism and healing for nursing praxis. This article provides an overview of the process used to identify the research priorities for holistic nursing research over the next 3 to 5 years. A mixed method design using Appreciative Inquiry and surveys revealed five research priorities and the holistic philosophical foundation for these priorities. Additionally, new challenges in the environment, person, health, and nursing will undoubtedly emerge, requiring nurses to discern the research needs beyond 2026. This work seeks to inspire holistic nurses to consider research related to the American Holistic Nurses Association's five key research priorities.

Demystifying the experience of participating in a root cause analysis: A hermeneutic phenomenological study.

AIM: This study aimed to explore registered nurses' experience participating in a root cause analysis (RCA) meeting because of their involvement in an adverse event. BACKGROUND: An RCA is the most common strategy used by organizations for adverse event investigations. Nursing healthcare professionals directly involved in an adverse event may be asked to participate in the RCA. However, no studies were found in the literature on their experience. METHODS: Semi-structured audio-taped interviews were held with 13 registered nurses who participated in an RCA. Ricoeur's hermeneutic phenomenology guided data analysis. RESULTS: Two structural elements represented the world of the nurses: 1) Learning about an RCA, and 2) being on the other side of the RCA table. Three phenomenological themes emerged: 1) anticipatory and embodied fear, 2) to speak or not to speak, 3) the aftermath. CONCLUSION: Nurses desire RCA education to assist in understanding and support from nurse leaders throughout the process. Healthcare organizations must create a safe and collaborative environment to empower nurses to speak up and have their voices heard during the RCA process. IMPLICATIONS FOR NURSING LEADERS: Nurses want to participate in RCA meetings. However, leaders must demystify the RCA process for nurses through education and training.

"My body, my choice": A qualitative study of women's mastectomy with flat closure experiences.

This qualitative study aimed to describe and explore the pre and post-mastectomy experiences of women choosing flat closure after a breast cancer diagnosis. Aesthetic flat closure creates a flat contoured chest wall after a mastectomy. There is limited research on women's flat closure experiences. To fill this gap, we interviewed 19 women (Mage = 53, range 31-72) with breast cancer who underwent a bilateral mastectomy with flat closure, examining decision-making, mirror-viewing, and flat closure experiences. Using a hermeneutic phenomenological design, we generated seven themes. Broadly, women choosing flat closure experienced pressure from their clinicians to undergo breast reconstruction. We found flat closure information to be consistently lacking. Mirror-viewing experiences of women obtaining suboptimal flat closure outcomes led to shattered expectations, mirror avoidance, psychological distress, and body image disturbances. Women negotiated their new reality by discovering ways to feel comfortable with their flat bodies. Regardless of surgical outcome, decision satisfaction was high. These findings illustrate the importance of bodily autonomy and supportive healthcare environments for women making flat closure decisions. Providing comprehensive information on all surgical options and addressing post-operative expectations can improve women's decision-making and mirror-viewing experiences and assist women in adapting to their new body image.

The mirror viewing experience of women undergoing a mastectomy: An integrative review.

AIMS: To appraise the current literature on the mirror viewing experience of women undergoing a mastectomy. DESIGN: Whittemore and Knafl's approach to integrative reviews, Braun and Clarke's thematic analysis, and PRISMA guidelines were utilized for this review. DATA SOURCES: A systematic search of primary peer-reviewed articles from April 2012 to 2022 was conducted using PubMed, CINAHL, Academic Search Complete and Google Scholar databases. REVIEW METHODS: Eighteen studies met the inclusion criteria (15 qualitative and 3 quantitative) and were appraised using the Johns Hopkins evidence-based practice appraisal instrument. RESULTS: Five themes describing the mirror viewing experience were revealed: Mirror viewing motives, mirror viewing preparedness, mirror viewing experience, mirror comfort/avoidance and women's mirror viewing recommendations. CONCLUSION: The review findings were found to align with Freysteinson's Neurocognitive Mirror Viewing Model highlighting the occurrence of short-term memory disruptions and an autonomic nervous system response that can lead women to experience a flight/fright or faint response, mirror trauma and mirror avoidance when looking at themselves in the mirror after a mastectomy. IMPACT: Women reported feeling unprepared to look at themselves in the mirror, with some experiencing shock and emotional distress, which led to mirror avoidance behaviours as a way to cope with their new body image. Nursing interventions aimed at improving women's mirror viewing experiences may help mitigate this autonomic nervous system response and minimize mirror trauma and mirror avoidance. Preparing women to view themselves in the mirror for the first time may help reduce psychological distress and body image disturbances in women undergoing a mastectomy. NO PATIENT OR PUBLIC CONTRIBUTION: This integrative review did not involve patient or public contributions. The authors reviewed currently published peer-reviewed literature in writing this manuscript.

Development and validation of the mirror image comfort and avoidance scale (MICAS).

PURPOSE: The purpose of this study was to develop an instrument to measure the experience of viewing one's reflection in the mirror for use in rehabilitation, nursing, psychology, and in research studies designed to improve the mirror-viewing experience for those who have suffered psychological or bodily trauma. A secondary purpose was to explore demographic differences in each subscale of the instrument. METHODS: The developed items went through content expert validation, exploratory and confirmatory factor analyses, and internal consistency reliability testing. RESULTS: Using an exploratory factor analysis (n = 137) and a confirmatory factor analysis (n = 142), we validated a 17-item instrument for two distinct populations: veterans (n = 108) and individuals with upper and lower limb loss (n = 210). The mirror viewing comfort subscale (9 items; α = 0.90) and the mirror avoidance subscale (8 items, α = 0.94) were deemed reliable. Strong, significant correlations between pre-and post-comfort scores (r = 0.81, p < 0.001), as well as pre-and post-avoidance scores (r = 0.94, p < 0.001) provide evidence of test-retest reliability. Demographic differences were noted in the subscales. CONCLUSIONS: This instrument contributes to a greater understanding of the experience of mirror-viewing in clinical practice. In interventional research studies to improve the mirror-viewing experience, this instrument can act as a manipulation check or outcome measure.Implications for rehabilitationIndividuals who suffer actual or perceived body disfigurement due to surgery or trauma may suffer mirror discomfort or mirror trauma when viewing their bodies in a mirror. This reaction is due to a pre-frontal cortex neurological disruption and autonomic nervous system fright/flight or faint. Psychological disorders (e.g., devastation, shame, self-revulsion, decreased body image) may ensue.Falls have occurred due to mirror trauma due to an autonomic nervous system disturbance (faint) and may result in ongoing mirror avoidance. When mirrors are needed for incision visualization, mirror avoidance has led to severe surgical site infections.Although there were many scales available in the literature to measure several aspects of the effects of actual or perceived body disfigurement, there were no scales that measured the mirror-viewing experience.Clinicians and researchers can use the Mirror Comfort and Avoidance Scale (MICAS) to assess mirror comfort and avoidance.

A concept analysis of decision regret in women with breast cancer.

The aim of this article is to understand the components of decision regret for women making breast cancer treatment decisions. Patient-centered care models encourage women to become more active in the decision-making process, inadvertently exposing them to the risk of experiencing decision regret. Enhancing the understanding of the concept of decision regret can offer insight into ways to mitigate this phenomenon. The Walker and Avant method was used to analyze this concept. Using PubMed, CINAHL, ERIC, Academic Search Complete, PsychINFO, SocINDEX, Joanna Briggs Institute of EBP Database, and an online dictionary, articles from 2011 to 2021 were analyzed to identify concept uses, attributes, antecedents, and consequences. Decision regret in women making breast cancer healthcare decisions is a negative cognitive-emotional response to a treatment decision that involves counterfactual thinking with three targets of regret: outcome regret, chosen option regret, and process regret. Experiencing decision regret can reduce a woman's quality of life, inflict psychological distress, and impact future decision-making. Unfavorable outcomes, decision uncertainty, and breakdowns in the decision-making process can lead to decision regret. Findings provide information on identifying women experiencing decision regret and illustrate opportunities to address causative factors through patient education and support to promote optimal patient outcomes.

Factors Associated With African American Mothers' Perceptions of Human Papillomavirus Vaccination of Their Daughters: An Integrated Literature Review.

PROBLEM IDENTIFICATION: African American (AA) women have a higher mortality rate for cervical and other cancers and are less likely to have received the human papillomavirus (HPV) vaccine than White women. Mothers play a significant family role and have a unique relationship with their daughters. Mothers' positive views on HPV vaccination may enhance the HPV vaccination rate among their daughters. LITERATURE SEARCH: The review was conducted by searching literature in PubMed®, CINAHL®, ScienceDirect, Ovid MEDLINE®, and ProQuest databases. The search was limited to studies conducted in the United States and published since the inception of the HPV vaccine in 2006. DATA EVALUATION: Of 10,566 publications retrieved, 28 articles were included in the final sample. SYNTHESIS: Factors associated with HPV vaccination were approval and disapproval of HPV vaccination from physicians, family, and friends; HPV knowledge; attitude and belief about HPV vaccination; benefits of vaccination; and challenges of and barriers to HPV vaccination. IMPLICATIONS FOR PRACTICE: Understanding factors related to HPV vaccination decisions among AA mothers will inform healthcare providers of the best approach to improving vaccination rates among this high-risk population.

Experiences of viewing self in the mirror for men and women with dementia as perceived by their caregivers: A phenomenological study.

AIM: To explore and discuss the perceptions and experiences of caregivers who rendered care to persons with dementia who viewed themselves in the mirror. BACKGROUND: Considerations must be given to caring for those with dementia due to the steady rise of adults 65 and older living with dementia. A literature review revealed limited experiential knowledge concerning aspects of mirror-viewing for persons with dementia. METHODS: This phenomenological hermeneutic study was analyzed using Ricoeur's theory of interpretation. Eighteen participants who cared for individuals with dementia in the home, and long-term care facilities took part in the study. A semi-structured interview guide with open- ended questions facilitated an open dialogue about their experiences while caring for persons with dementia when they view themselves in the mirror. Two questions guiding the study were: 1) What are caregivers' perceptions of what they see and believe when they observe dementia patients whom they care view themselves in a mirror? 2) How do the caregivers' perceptions of that experience change over time as the dementia worsens? RESULTS: The structural analysis uncovered a considerable difference between the numbers of mirrors available in the homes as compared to the long-term care facilities. Two phenomenological findings were uncovered: 1) decision to look in the mirror and 2) viewing self in the mirror. Six subsequent subthemes; mirror as a tool, wanting to look presentable, self- recognition, self-confirmation seeing another and the latent stage were revealed. CONCLUSION: A mirror assessment is needed for individuals who have dementia.

The experience of nursing leadership in a crisis: A hermeneutic phenomenological study.

AIM: This study aimed to understand nursing leaders' experience during the pandemic. BACKGROUND: COVID-19 is a public health crisis that affects every nation in the world. METHODS: Purposeful sampling was used to recruit 28 leaders in a large health care system. Data were collected via semi-structured audiotaped interviews. Results were analysed using hermeneutic phenomenology. RESULTS: The structure in which leaders worked was described as: from the day-to-day grind to derailment and from manning the hospital to manning the frontlines. Five phenomenological themes were as follows: embodied leadership, navigating differently, trusting and earning trust, being the calm voice and envisioning the future. CONCLUSION: Disaster policies and procedures are needed that will alleviate leadership angst, maximize nursing resources, heighten trust and enhance communications. IMPLICATIONS FOR NURSING MANAGEMENT: In 2020, we witnessed a previously inconceivable media and public focus on the value of nursing care. Leaders can use this pivotal moment in time as a catalyst towards securing the support needed in planning for the next pandemic.

Educating Nurses on Supported Mirror Viewing for Patients After Amputation and Other Visible Disfigurements.

PURPOSE: The aim of our study was to test an educational intervention to improve nurses' confidence in supporting and frequency of offering a mirror to patients who have recently suffered visible body disfigurement. DESIGN/METHODS: Forty-eight registered nurses who worked in two acute care hospitals took part in a mixed-method one-group repeated-measures (pretest and posttest) research study. The educational intervention included a video, a presentation, and a recorded discussion. RESULTS: Study participants experienced a significant increase in confidence in supporting and frequency of offering mirrors to patients. An overarching theme from the qualitative analysis was that the nurse participants perceived assisting patients in viewing their changed bodies in mirrors as "an act of compassion." Four subthemes emerged: (a) seeing mirrors differently, (b) there is only one first time, (c) how can we do this better, and (d) "me too" stories of their own and patients' difficult mirror-viewing experiences. CONCLUSION: Education enhances nurses' frequency of offering mirrors and supporting patients in mirror viewing after visible disfigurement because of trauma or surgery. CLINICAL RELEVANCE: Education provides nurses with the necessary skills to assist patients in adapting to an altered body image.

The Language of Scholarship: Synthesis of the Literature.

The purpose of this article is to educate nurses and nursing students on the meaning and location of scholarly literature. Select resources are identified to assist with identifying high-quality evidence-based publications, which is a vital competency to enhance scholarship for evidence-based practice in professional nursing practice.

Demystifying the mirror taboo: A neurocognitive model of viewing self in the mirror.

Research has consistently demonstrated that viewing one's body in a mirror after an amputation or other perceived or visible body disfigurements can be a traumatic experience. Mirror viewing or mirroring is a taboo subject, which may be the reason this trauma has not been previously detected or acknowledged. Traumatic mirror viewing may lead to mirror discomfort, mirror avoidance, and a host of psychosocial concerns, including post-traumatic stress. As mirroring is complex, four qualitative mirror viewing studies, embodiment concepts, polyvagal theory, and memory theories were used to develop a model. In this article, foundational knowledge that led to the development of the model is shared. A neurocognitive model of mirror viewing is offered together with implications for nursing research, practice, and education.

The Language of Scholarship: How to Write an Abstract That Tells a Compelling Story.

This article is for nurses and nursing students who are writing abstracts for poster or oral presentations, journal articles, or grants. The use of storytelling principles for scholarly writing demonstrated how a potentially dreary abstract can be created to captivate a reader. [J Contin Educ Nurs. 2019;50(3):107-108.].

School and Community-based Nurse-led Asthma Interventions for School-aged Children and Their Parents: A Systematic Literature Review.

PROBLEM: Asthma is one of the most prevalent chronic diseases in the world. Lack of asthma knowledge can lead to asthma exacerbations, more emergency room visits, school absences, and decreased quality of life. This systematic review examines the effectiveness of educational intervention programs on asthma management for school-aged children and their parents beyond inpatient clinic settings. ELIGIBILITY CRITERIA: Educational asthma interventions for school-aged children and their parents with comparison with usual asthma care and the outcome related to asthma management. Studies included were peer-reviewed and published in English within the last five years. SAMPLE: The eight study articles were identified in ProQuest, Medline, CINAHL, and PubMed databases. RESULTS: The review demonstrated that educational asthma interventions for children and their parents significantly improved knowledge and skills related to asthma self-management. CONCLUSIONS: School and community-based asthma educational intervention programs are key components for good management of asthma condition. Well-planned asthma education programs are valuable and should go beyond inpatient clinic settings for promoting and maintaining health for children with asthma and their parents. IMPLICATIONS: School nurses are well-positioned to assume a more prominent role in asthma care to improve child health and academic outcomes. School nurses have an opportunity to establish a trusting relationship that is foundational for collaborating with parents and students for better asthma management.

A Synopsis of Ricoeur's Phenomenology of the Will: Implications for Nursing Practice, Research, and Education.

The will is a word that nurses may use to describe their patients' actions or inactions. This concept has been extensively addressed by religions, psychologists, and philosophers. Ricoeur offered a phenomenology of the will in which three overarching key concepts were uncovered: decision, action, and consent. In this article, Ricoeur's elaborative and exhaustive description of these three concepts is summarized. Examples as to how a phenomenology of the will may guide nurses in their day-to-day clinical practice in caring are provided. In research, Ricoeur's phenomenology of the will may be used as a heuristic to guide phenomenological studies. An introduction to the will may act as a bridge between the art and science of nursing, providing nursing students with a greater understanding of the meaning of and need to provide holistic care.

Body Image Perceptions of Women Veterans With Military Sexual Trauma.

The researchers were invited to a transitional home for homeless women veterans to help veterans with body image issues. Convenience sampling was used to recruit 12 veterans who perceived they had a physical difference due to military service. Data were obtained in focus groups where the veterans were invited to share stories. Ricoeur's hermeneutic phenomenology guided the study. The research team learned early in the data collection stage that 11 of the 12 participants suffered military sexual trauma (MST). Three structures emerged in the data: (a) to speak up or not to speak, (b) from military pride to shameful anguish, and (c) invisible scars versus visible scars. A phenomenological interpretation of these invisible scars uncovered that viewing self in a mirror was depicted as viewing a stranger. Being with others, including family, was described as wearing a fake face. The phrase I am broken defined intimate relationships which were non-existent or strained. Shame permeated all body image structures. As the veterans listened to each other, they began to see themes in their stories. There was a shared sense of identity and a movement toward greater self-understanding and resolving. In addition to the recommendations the participants had regarding prevention of MST and recovery care of those with MST, implications for research and practice are provided.