The Psychology of Coronavirus Behavioral Health Mindset, Vaccination Receptivity, Customer Orientation and Community Public Service.

Three studies were conducted to explore the psychological determinants of COVID-deterrent behaviors. In Study 1, using data collected and analyzed both before and after the release of COVID-19 vaccines, mask-wearing, other preventative behaviors like social distancing, and vaccination intentions were positively related to assessments of the Coronavirus Behavioral Health Mindset (CVBHM); belief in the credibility of science; progressive political orientation; less use of repressive and more use of sensitization coping; and the attribution of COVID-19 safety to effort rather than ability, powerful forces, fate, or luck. In Study 2, favorable COVID-19 vaccination intentions were related to greater willingness to work, lower emotional distress, and greater customer experience mindset. Study 3 examined the personality and motives of individuals who volunteered to help deliver COVID-19 inoculations to the local community. The vaccine-giving volunteers, especially those with prosocial motives, had high CVBHM scores, belief in the credibility of science, low use of repressive coping, greater attribution of COVID-19 protection to effort, low likelihood of voting conservative, were older, and had more education than others. The majority of public health volunteers expressed prosocial motives to help people or join a cause (60.7%), but many (39.3%) expressed the personal motives of getting the COVID-19 vaccination for themselves, conveying a public image of compassion, or structuring time. Based on the three research studies, a COVID-19 Mindset Hierarchy model is proposed to integrate the results.

Elevated Blood Pressure in Women of Childbearing Age in the United States.

PURPOSE: Elevated blood pressure is frequently associated with adverse health issues among women during and after childbirth in the United States. The purpose of this study was to describe incidence of and determine predictors of prehypertension and hypertension among women of childbearing age in the United States. STUDY DESIGN AND METHODS: Using secondary data analysis, existing data from the National Health and Nutrition Examination Survey (NHANES; 2013-2018) were used to address study aims. Inclusion criteria were women in the age range commonly considered to be of childbearing age, 15 to 44 years of age. Simple random sampling was to select subjects from the 2,932 women in the NHANES dataset who met inclusion criteria. We calculated a sample size as adequate for the statistical group comparison to be significant with a power of 95% to detect a difference among groups. An ordinal logistic regression model was created to discriminate predictors of normotensive blood pressure, prehypertension, and hypertension. RESULTS: The sample (n = 393) included 300 women with normal blood pressure, 46 women with prehypertension, and 47 with hypertension. Older women (within childbearing age range), women with high body mass index, and African American women are highly likely to have prehypertension and hypertension. CLINICAL IMPLICATIONS: Contrary to previous research, poverty income ratio was not associated with prehypertension and hypertension. Future research should test interventions that include promoting heathy lifestyles and address elevated body mass index. Interventions should be tailored to be culturally appropriate for African American women and older women within this age range.

Acceptability of Using a Robotic Nursing Assistant in Health Care Environments: Experimental Pilot Study.

BACKGROUND: According to the US Bureau of Labor Statistics, nurses will be the largest labor pool in the United States by 2022, and more than 1.1 million nursing positions have to be filled by then in order to avoid a nursing shortage. In addition, the incidence rate of musculoskeletal disorders in nurses is above average in comparison with other occupations. Robot-assisted health care has the potential to alleviate the nursing shortage by automating mundane and routine nursing tasks. Furthermore, robots in health care environments may assist with safe patient mobility and handling and may thereby reduce the likelihood of musculoskeletal disorders. OBJECTIVE: This pilot study investigates the perceived ease of use and perceived usefulness (acceptability) of a customized service robot as determined by nursing students (as proxies for nursing staff in health care environments). This service robot, referred to as the Adaptive Robotic Nurse Assistant (ARNA), was developed to enhance the productivity of nurses through cooperation during physical tasks (eg, patient walking, item fetching, object delivery) as well as nonphysical tasks (eg, patient observation and feedback). This pilot study evaluated the acceptability of ARNA to provide ambulatory assistance to patients. METHODS: We conducted a trial with 24 participants to collect data and address the following research question: Is the use of ARNA as an ambulatory assistive device for patients acceptable to nurses? The experiments were conducted in a simulated hospital environment. Nursing students (as proxies for nursing staff) were grouped in dyads, with one participant serving as a nurse and the other acting as a patient. Two questionnaires were developed and administrated to the participants based on the Technology Acceptance Model with respect to the two subscales of perceived usefulness and perceived ease of use metrics. In order to evaluate the internal consistency/reliability of the questionnaires, we calculated Cronbach alpha coefficients. Furthermore, statistical analyses were conducted to evaluate the relation of each variable in the questionnaires with the overall perceived usefulness and perceived ease of use metrics. RESULTS: Both Cronbach alpha values were acceptably high (.93 and .82 for perceived usefulness and perceived ease of use questionnaires, respectively), indicating high internal consistency of the questionnaires. The correlation between the variables and the overall perceived usefulness and perceived ease of use metrics was moderate. The average perceived usefulness and perceived ease of use metrics among the participants were 4.13 and 5.42, respectively, out of possible score of 7, indicating a higher-than-average acceptability of this service robot. CONCLUSIONS: The results served to identify factors that could affect nurses' acceptance of ARNA and aspects needing improvement (eg, flexibility, ease of operation, and autonomy level).

Partnering with new mothers to develop a smart phone app to prevent maternal mortality after hospital discharge: A pilot study.

BACKGROUND: In the United States, approximately 700 women die annually from pregnancy-related complications in the first year after birth; a significant number of the deaths occur after hospital discharge. Although postpartum monitoring is important, the standard practice is for one healthcare evaluation at 6 weeks post-birth. Most women are not aware of signs of postpartum complications. AIM: The aim of the pilot study was to develop a prototype of a mobile app aimed at increasing a new mother's ability to monitor her own health after childbirth. DESIGN: The design used mixed methods and procedures from human-centred design in an iterative process. METHODS: Data were collected by the researchers from January - May 2019 in a hospital that serves primarily low income and underserved women in the southern US. Three groups of women provided data related to health education preferences or their reaction to a mock-up or prototype mobile app. Several women completed the Mobile App Rating Scale (MARS; N = 22). RESULTS: Themes from interviews indicated that women (N = 5) preferred electronic health education and that they used apps to monitor their pregnancies. Other new mothers (n-5) described their overall reaction to the proposed features of the app which was incorporated into the design of the app that was tested by the third group of new mothers (N = 22) who were positive about interactions with the app. The MARS scores for the app were positive. CONCLUSIONS: New mothers indicated that they would be willing to use an app to monitor their own postpartum health. IMPACT: Data from the pilot study informed the development of a prototype mobile app that can now be used in a clinical trial with new mothers to monitor their own health and report concerns to healthcare providers.

Self-Efficacy and Postpartum Depression Teaching by Perinatal Nurses in a Rural Setting: A Replication Study.

Perinatal nurses in rural hospitals can play an important role in providing postpartum depression education to new mothers. Guided by Self-Efficacy Theory, this replication study used a self-report instrument to survey perinatal nurses' self-efficacy in postpartum depression teaching, self-esteem, stigma and attitudes toward seeking help for mental illness. Thirty-eight perinatal nurses employed in a rural hospital participated in the study. The results indicated perinatal nurses' postpartum depression teaching behaviors were associated with: self-efficacy related to postpartum depression teaching; social persuasion by a supervisor; prior mastery of teaching on other postpartum care topics; and vicarious experiences of observing peers teach about postpartum depression. Perinatal nurses with positive attitudes toward receiving psychological help were more likely to provide postpartum depression education.

Patient Experience Factors and Health-Related Quality of Life in Hospitalized Individuals.

PURPOSE: To identify a relationship between patient satisfaction with the hospital experience and health-related quality of life (HRQOL), as well as determine predictors of each variable. PARTICIPANTS & SETTING: 50 patients with cancer in two adult oncology units in an academic health sciences center. METHODOLOGIC APPROACH: A descriptive, cross-sectional design was used. Patient satisfaction was measured by the Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) and HRQOL was assessed using the Quality of Life Patient/Cancer Survivor (QOL-CS) version. FINDINGS: Patients who were single, diagnosed for 6-10 years, and diagnosed for 11 years or longer had significantly lower patient satisfaction scores. Patients with public insurance, diagnosed for 6-10 years, and diagnosed for 11 years or longer had lower QOL-CS scores. Physical and social well-being scores were associated with higher HCAHPS scores. There was a positive relationship between patient satisfaction and physical and social functioning. Patient demographics were related to patient satisfaction and HRQOL. IMPLICATIONS FOR NURSING: Nurses should have measurable goals to provide high-quality care to patients with cancer, including satisfaction during hospitalization and promotion of HRQOL.

Screening for Postpartum Depression by Hospital-Based Perinatal Nurses.

PURPOSE: The primary purpose of this study was to evaluate acceptability by new mothers of postpartum depression (PPD) screening and education about community resources by hospital-based perinatal nurses. A secondary purpose was to determine further screening for PPD that women received by community providers in the first few weeks after birth. METHODS: The study design was descriptive. As per standard practice on the unit, all new mothers were screened for depression the night before hospital discharge using the Edinburgh Postnatal Depression Scale (EPDS). New mothers identified as high risk for depression by EPDS scores greater than or equal to 10 (n = 75) and a comparison group of mothers at low risk for depression with EPDS scores less than 10 (n = 26) were recruited from an academic health sciences center. Participants were contacted by telephone 2 to 4 weeks later and asked about the acceptability of screening for depression and education about community resources by hospital-based perinatal nurses, as well as if they had received further screening for depression by community providers. Descriptive and correlational statistics were used to analyze data. RESULTS: The majority of new mothers found it acceptable to be screened for depression and educated about community resources by hospital-based perinatal nurses. Many new mothers were not asked about depressive symptoms by community providers. There was no significant correlation between demographics and depression risk. CLINICAL IMPLICATIONS: New mothers viewed depression screening and receiving information on community resources as a positive part of their care. Communication between inpatient and community caregivers should be improved so that new mothers can benefit from seamless depression assessment, evaluation, and treatment.

Intention to Seek Depression Treatment in Latina Immigrant Mothers.

BACKGROUND: Postpartum depression in Latina immigrant mothers can lead to adverse outcomes in both mothers and babies, yet depression treatment remains suboptimal. AIMS: The aims were to determine predictors of intention to seek depression treatment and to determine if intention to seek depression treatment differed in those with significant symptoms of depression. METHODS: Based upon the theory of planned behavior (TPB), a cross-sectional study design was used. A convenience sample of Latina immigrant mothers (n = 50) were interviewed in Spanish. Certified translation services were used to translate study instruments to Spanish. Descriptive analysis and multivariable logistic regression techniques were used for data analysis. RESULTS: While increases in attitudes were associated with intention to seek depression treatment, increased social support and perceived control were associated with a decrease in intention to seek treatment. CONCLUSIONS: The differing role of social support in Latina immigrant mothers should be explored.

Do New Mothers Understand the Risk Factors for Maternal Mortality?

PURPOSE: The purpose of this study was to describe new mothers' knowledge related to maternal mortality. STUDY DESIGN AND METHODS: Using a cross-sectional design, new mothers were recruited from a postpartum unit of an academic health sciences center where the population was predominately low-income women. Before hospital discharge, they answered questions on their knowledge of potential postpartum complications that could lead to maternal mortality. Questions were based on recommendations from an expert nursing panel. Descriptive statistics were used for data analysis. RESULTS: One hundred twenty new mothers participated. Results indicated that most new mothers knew that they should watch for heavy bleeding, a severe headache, and swelling after hospital discharge. However, fewer participants knew that a new mother could experience feelings that she could harm herself or her baby, have blood clots larger than a baby's hand, a temperature of 100.4 °F or higher, and odor with vaginal discharge. Courses of action new mothers would take if experiencing any of the warning signs included 18% of mothers would take no action, 76.7% would tell their boyfriend/husband/partner, 72.5% would inform their mother. Only 60% who would call the labor and delivery unit. Only 38% of the sample knew that pregnancy-related complications can occur for up to 1 year after birth, and 13% of mothers reported not knowing that complications can occur for up to 6 weeks postpartum. CLINICAL IMPLICATIONS: Our findings provide a foundation to enhance postpartum education for new mothers and their families and to potentially decrease rates of maternal mortality in the United States.

Contextual Factors Impacting a Pain Management Intervention.

PURPOSE: To determine if findings from our preliminary study related to patient and nursing satisfaction with a pain management intervention could be replicated in a changed environment, and if contextual factors could impact the effectiveness of a pain management intervention on patient satisfaction with nursing staff's management of pain. METHODS: A prospective, experimental design was used with six monthly assessments before, during, and after the intervention. Data were collected from 540 patients admitted to eight medical surgical and progressive care units and nurses that worked in these units at an academic health sciences center in the southern United States, from March to July 2015. The script-based, pain management communication intervention included three specific tactics: script-based communication, use of white boards, and hourly rounding. The Hospital Consumer Assessment of Healthcare Providers and Systems survey was used to assess two items: "pain is well controlled" and "staff did everything they could to help with pain." Contextual factors focused on the practice setting. FINDINGS: Both scores for "pain is well controlled" (ß = .028, p = 0.651) and scores for "staff did everything they could to help with pain" (ß = .057,p = .385) did not change initially but then increased significantly and were sustained over time. Nurses had high levels of satisfaction with the intervention (M = 7.9, SD = 2.1) and compliance with the intervention (M = 8.0, SD = 1.9), and had little difficulty in implementing the intervention (M = 8.3, SD = 1.4). In terms of contextual factors, the number of beds on the unit and the number of patients being discharged negatively impacted scores for "pain is well controlled" and "staff did everything they could to help with pain." Hospital length of stay positively impacted scores for "pain is well controlled" by staff. CONCLUSIONS: Despite challenging contextual variables, the study extended the findings of an early preliminary study in showing the effectiveness of pain management intervention on patient satisfaction with staff's management of pain. In evaluating the impact of an intervention, it is essential to examine the contextual environment. CLINICAL RELEVANCE: Using simple, clear, and consistent communication between patients and nurses related to pain can positively impact patient satisfaction with pain management over time. The health care environment can enhance nursing practice and patients' outcomes.

Nursing Empowerment, Workplace Environment, and Job Satisfaction in Nurses Employed in an Academic Health Science Center.

OBJECTIVE: The aim of this study was to test predictors of nursing empowerment and job satisfaction in nurses. BACKGROUND: Nursing professional development leaders and Magnet® coordinators need foundational data on which to build interventions that will support and empower nurses on the journey toward American Nurses Credentialing Center Magnet® designation. METHOD: Secondary data analysis methods were used. RESULTS: Overall, nurses perceived that they had moderate empowerment and were satisfied with their jobs. CONCLUSIONS: Study results support predicted relationships and can be used to guide interventions for, and development of, nurses.

Postsplenectomy vaccination guideline adherence: Opportunities for improvement.

BACKGROUND AND PURPOSE: Patients undergoing splenectomy for trauma are at life-long risk for rapidly progressive septicemia. The purpose of this study was to investigate long-term patient understanding and follow-up with recommendations regarding their asplenia. METHODS: Patients undergoing splenectomy for trauma January 2010-December 2014 were analyzed. Medical records were reviewed and telephone follow-up interviews were conducted in October-December 2015. Patients were asked a standard set of questions that included hospitalizations, awareness of infectious risks associated with asplenia, need for revaccination, and vaccines they had received since their index hospitalization. FINDINGS: Two hundred forty-four patients underwent splenectomy during the study period. A total of 95 patients (39%) were included in the study. Thirty (32%) had been hospitalized since their trauma admission. Only 46% were aware of the risks for sepsis and the need to revaccinate. Only 7% reported having rapid access to antibiotics. CONCLUSIONS: Despite uniform education prior to discharge, most patients undergoing splenectomy for trauma were unaware of the risks for sepsis and did not follow recommended guidelines for risk reduction. IMPLICATIONS FOR PRACTICE: Improvements that have direct implications for advanced practice included the need to refer for vaccination, educate regarding infection risks, and facilitate rapid access to antibiotic treatment.

Parent Education is Changing: A Review of Smartphone Apps.

PURPOSE: The purpose was to critique existing parenting apps using established criteria and health literacy guidelines. STUDY DESIGN: Descriptive methodology was used. METHODS: The Apple App Store was searched using the terms parenting, child health, and infant health. To be included, the apps had to have relevant content (parenting, child health, or infant health), be in English, and contain parent education. After eliminating apps that failed to meet inclusion criteria from the original 203 apps, 46 apps were reviewed. The Patient Education Materials Assessment Tool was used to evaluate the health literacy subscales called Understandability and Actionability. Content analysis included Authority, Objectivity, Accuracy, Timeliness, and Usability. RESULTS: The majority of the apps (70%) were in English only. The price ranged from free to $4.99. The purpose, target audience, and topics varied. Although all included apps were for parents, some were for more targeted groups of parents. The source of the information was not presented in 26% of the apps. Most apps took the user to a Web site or an article to read. Functionality of the apps was limited, with none of them providing a customized experience. CLINICAL IMPLICATIONS: Much development and research is needed before mobile health (mHealth) solutions can be recommended by nurses caring for new parents. It is critical that consumers and interdisciplinary professionals be involved in the early design phase of the product to ensure that the end product is acceptable and usable and that it will lead to healthy behaviors.