How Can Framed Mammography Screening Messages Be Optimally Persuasive for Foreign-Born Chinese American Women?

BACKGROUND: Foreign-born Chinese American women (FBCAW) have the lowest mammography rates compared with other racial groups despite the overwhelming evidence of the benefits of screening. Message framing based on the prospect theory has shown significant but inconsistent effects on mammogram screening among ethnic minority groups. OBJECTIVE: Using data from a randomized controlled trial, this secondary analysis aims to identify factors that interact with message framing to improve mammography screening in FBCAW. METHODS: In the parent study, participants were randomized to receive either a gain- or loss-framed brochure that encouraged mammography screening. Data were collected at baseline and 2 months using validated questionnaires. For this secondary analysis, ordinal logistic regression was performed to identify moderation effects using both per-protocol and intention-to-treat principles. RESULTS: Participants predominantly had low income, a low level of English proficiency, and no insurance. Lack of access to mammography services, knowledge of making a mammogram appointment, knowledge of insurance coverage for breast cancer treatment, education levels, and mammogram history were significant moderators of the framing effects. Overall, the moderation effects were larger when using per-protocol analysis. Some moderation results under intention-to-treat analysis were different from those using per-protocol analysis. CONCLUSIONS: The persuasive effects of the loss- or gain-framed messages depend on the characteristics of FBCAW. Future studies can identify algorithms to select tailored messages that match individual FBCAW's characteristics to optimize the effects of framed messages. IMPLICATIONS FOR PRACTICE: Findings of this study can guide healthcare providers, especially nurses, to choose different wording when communicating with their clients.

"It Was Never Enough": The Meaning of Nurses' Experiences Caring for Patients during the COVID-19 Pandemic.

This study's aim was to understand nurses' caring experiences during the recent pandemic in the United States. Using an interpretive phenomenological approach, 15 participants provided the meaning of the care they provided. Five major themes were interpreted: If not us, then who?; Accepting uncertainty; It was never enough; Finding self and our voices in a new role; and Believing it was worth it. The study results have implications for psychiatric-mental health nurse clinicians as they identify and meet the needs of individuals of this vulnerable group. Research that uncovers the meaning of the caring experiences of front line nurses can illuminate the discipline's current understanding of this phenomena.

A Phenomenological Study of Nurse Managers' and Assistant Nurse Managers' Experiences during the COVID-19 Pandemic in the United States.

AIM: To understand the experiences of hospital nurse managers and assistant nurse managers during the COVID-19 pandemic in the United States. BACKGROUND: Little research has been published about the experiences of nurse managers during the COVID-19 pandemic. Experiences of front-line nurses have been well documented. This is the first phenomenological study to date in the United States on experiences of hospital nurse managers during the COVID-19 pandemic. DESIGN: Phenomenological qualitative approach. METHODS: Thirteen managers, seven nurse managers and six assistant nurse managers were interviewed about their experiences using audio-video teleconferencing and a semi-structured interview guide. Consolidated Criteria for Reporting Qualitative Research criteria for reporting qualitative research were used. RESULTS: The four major themes that emerged were as follows: being there for everyone; leadership challenges; struggles, support and coping; and strengthening my role. There were 11 subthemes. CONCLUSIONS: A major focus of nurse managers during the pandemic was psychosocial support of front-line nurses while at the same time experiencing stress and exhaustion themselves. IMPLICATIONS FOR NURSING MANAGEMENT: More attention on the psychosocial needs of nurse managers, interventions to allay their exhaustion and provisions for readily available support are warranted.

Stumbling toward Vulnerability: Recovery from Substance Use Disorders and Co-Occurring Mental Illness.

This study investigated the recovery process for individuals engaged in treatment for substance use disorders (SUDs) who had co-occurring anxiety and depression. The participants were eight individuals engaged in treatment. The results of a Grounded Theory design and methods revealed the core category and substantive theory, Stumbling toward Vulnerability. Four phases in which the participants progressed in a linear way emerged. The study results have implications for the role of the advance practice psychiatric-mental health nurse in the early assessment of mental illness for clients with SUDs by providing integrated treatment for these individuals, and focusing on health and wellness as a recovery outcome. Based on the findings, hypotheses for further research are recommended.

The relationship amongst ethical position, religiosity and self-identified culture in student nurses.

BACKGROUND/PURPOSE: Research from other disciplines demonstrates that ethical position, idealism, or relativism predicts ethical decision-making. Individuals from diverse cultures ascribe to various religious beliefs and studies have found that religiosity and culture affect ethical decision-making. Moreover, little literature exists regarding undergraduate nursing students' ethical position; no studies have been conducted in the United States on students' ethical position, their self-identified culture, and intrinsic religiosity despite an increase in the diversity of nursing students across the United States. PARTICIPANTS AND RESEARCH CONTEXT OBJECTIVES: The study's two aims were to determine the relationship of self-identified culture, religiosity, and ethics position of undergraduate nursing student and whether students' level of education and past ethics courses taken related to idealism. Two hundred and twelve volunteer undergraduate students participated. RESEARCH DESIGN: A descriptive cross-sectional study was designed for participants who completed the Ethical Position Questionnaire, The intrinsic subscale of the Religious Orientation Scale, and a Demographic, Cultural, Ethnicity Form. To test the five hypotheses, analyses included t-tests, correlations, and ANOVA. ETHICAL CONSIDERATIONS: The study was approved by the Institutional Review Board at Adelphi University. RESULTS: Idealism and intrinsic religiosity were significantly related. Differences were observed for intrinsic religiosity and idealism for cultural identity and cultural dimensions such as parents' place of birth, and if participants were US born. Students' level of education or participation in past courses on ethics did not influence idealism. CONCLUSIONS: The study's findings were similar to most of the research from other disciplines on culture, ethics position, and religiosity. Generic courses on ethics taken prior to clinical work may not assist nursing students in integrating principles into complex ethical dilemmas. Self-identified culture, religion, and intrinsic religiosity related to ethics position; completing ethics courses and level of education, juniors compared with seniors, did not influence idealism. Faculty should consider integrating students' culture, religious orientation, and ethics position into teaching ethics for all levels of nursing education.

Transforming Nursing Education and the Formation of Students: Using the Humanbecoming Paradigm.

Transforming nursing education is a current focus across the country, the result of recent national reports that have made significant contributions for evaluating and changing curricula and ways students are taught. However, the need to ground these strategies for change within our discipline's ontological foundation through nursing theory must be addressed. The purpose of this article is to use Parse's Humanbecoming Paradigm to provide educators with exemplars of discipline-specific theory-based changes across educational levels. The exemplars are situated within the important tensions that educators face today in undergraduate, advanced practice, and doctoral programs. Conclusions are drawn regarding continuing efforts to ensure that nurse educators incorporate discipline-relevant theories when transforming nursing education.

Emergency room psychiatric services: a qualitative study of nurses' experiences.

Emergency nurses working in general emergency divisions (EDs) are primarily trained to assess and treat acute physical problems. However, ED nurses often care for psychiatric patients and the perceptions of nurses in EDs regarding their experiences with psychiatric patients have not been well-studied. Using focus groups, the purpose of this study was to explore and describe ED nurses' experiences, and feelings caring for patients with mental illness. Krueger and Casey's qualitative analysis for focus groups was utilized to code and categorize phrases and identify themes from transcribed interviews. Four themes emerged; powerlessness best captured the overarching and substantive experience of the participants. Based on the findings, implications for emergency room care of psychiatric patients are described.

School Health Initiatives and Childhood Obesity: BMI screening and reporting.

The prevalence of childhood obesity has reached an epidemic status especially in the United States. Agencies such as the Institute of Medicine, Surgeon General's Office, and the American Academy of Pediatrics have called for action. Schools have been provided with guidelines to address obesity prevention. School-based body mass index screening and parent reporting programs have received a significant amount of attention in the literature. Intended to raise awareness for parents and provide a first step toward intervention for children who are overweight, there is to date limited outcomes of their success. However, one state, Arkansas, with mandated screening has reported success in that following screening in its schools, obesity rates were not increased. A significant concern with screening in schools is its potential harm to children around teasing, body image sensitivity, and possible unhealthy dieting. These controversial issues are explored, and recommendations are suggested for nursing's role in obesity prevention especially in schools.

Valuing autonomy, struggling for an identity and a collective voice, and seeking role recognition: community mental health nurses' perceptions of their roles.

Leaders in this community mental health system approached the problem of job frustration, morale issues, and turnover concerns of their Community Mental Health Nurses (CMHNs) by designing a qualitative study using Participant Action Research (PAR) methodology based on the philosophy of Habermas. Six focus groups were conducted to address the nurses' concerns. The themes of Valuing Autonomy, Struggling for an Identity and Collective Voice, and Seeking Role Recognition best explained the participants' concerns. The study concluded with an action plan, the implementation of the plan, and a discussion of the plan's final outcomes.

Competencies and roles of community mental health nurses.

Community mental health nurses practice in a range of behavioral health care settings, including community mental health centers, detoxification centers, group homes for individuals with mental retardation or serious mental illnesses, and residential substance abuse treatment programs. As the population for whom they care grows and ages and with an increase in comorbid conditions, different skills may be needed or different roles may require emphasis. This can present challenges related to role competencies and nursing preparation and to the allocation of their time. The overall purposes of this project were to compare the competencies of basic and advanced practice nurses with accepted psychiatric-mental health nursing competencies and to assess the nurses' roles and division of work time among various roles. The findings support the need for changes related to nursing roles and job descriptions. Specific recommendations have been implemented based on the findings.

The American Psychiatric Nurses Association responds to the September 11 tragedy.

This article describes how the American Psychiatric Nurses Association (APNA) responded to the September 11 tragedy, as an organization. Also included are anecdotes from APNA members who participated individually in the aftermath of this tragedy. Because such a traumatic event can result in psychiatric disorders, a brief synopsis of these disorders is included. The economic effects of emotional difficulties for our nation are explored, especially those related to the most serious disorder resulting from such a traumatic event, Post Traumatic Stress Disorder. Strategies that APNA is focusing on for the future, as a result of this tragedy, are presented.