Dual Collegiate Roles-The Lived Experience of Nursing Student Athletes.

BACKGROUND: Teamwork and communication, characteristics learned through playing college sports, can precipitate a sense of wonder in the lived experiences of nursing students who played a college sport. METHOD: A phenomenological study was conducted to understand the meaning of the collegiate roles of the nursing student and the student athlete. These roles carry different sets of responsibilities, social contacts, and physical and emotional demands. Thirteen practicing nurses who played a college sport during their nursing program were interviewed. RESULTS: Data analysis revealed four essential themes that described the meaning of their experience: athletic identity, perseverance, advocates and adversaries, and belongingness. Results suggest participation in college sports creates a sense of belonging that assists in the transition into college. CONCLUSION: Although nursing students may be deterred from coordinating academics and athletics, this study indicates it is possible and may even have benefits, both academically and during students' transition into practice. [J Nurs Educ. 2022;61(3):117-122.].

Douching practices among women in the Bolgatanga municipality of the upper east region of Ghana.

BACKGROUND: Vaginal douching is a common practice among women all over the world. Women douche for various reasons, despite evidence indicating the harmful health effects of the practice. There is lack of data on the practice in Ghana but health behaviors like vaginal douching may be influenced by differences in culture and geography. Therefore, this study sought to assess prevalence and predictors of vaginal douching practices among women of the Bolgatanga Municipality of Ghana. METHODS: This cross-sectional study was conducted among 200 women from January to March 2016. RESULTS: Sixty-seven percent of the women practiced vaginal douching, from which a similar proportion did it daily. Over two-thirds (67.7%) of the women used water for douching. The reasons for douching were cleansing the vagina (67.7%), therapeutic effects (12.8%) and tightening of the vaginal muscles (19.5%). The majority (87.2%) of women who douched were unaware of the harmful health effects associated with the practice. The educational level of the women (p = 0.025) and having knowledge of the dangers associated with douching (p <  0.001) were then significantly associated with douching practices. CONCLUSION: Vaginal douching is commonly practiced by women in the Bolgatanga Municipality. Most of these women douche because they did not know that there are health problems associated with the practice. Health education on the issues of women health is very vital for the improvement of women's health.

The Voices of Older African American Women Living with HIV Disease.

African American women are disproportionately affected by HIV. We used a phenomenological approach to understand the experiences of living with HIV in a group of older African American women. Approvals were obtained, and a criterion sample of 10 participants who self-identified as African American were recruited. Data were collected using unstructured interviews. The emergence of seven essential themes resulted in a textual interpretative statement that indicated that the meaning of living with HIV disease for this group of older African American women was (a) the dynamic interrelated patterning processes of transcending adversity and becoming as they responded to their emotional ebbs and flows, (b) being always hypervigilant to HIV stigma, and (c) managing the paradoxical process of concealing while revealing aspects of their lives with HIV. The women used knowledge as empowerment and strove to maintain relationality by caring for others while they, themselves, were being cared for.

Cancer Worry Among Urban Dominican Women: A Qualitative Study.

BACKGROUND: Two thirds of respondents of a recent survey, primarily self-identified urban immigrant Dominican females, indicated that cancer was the health problem they worried about the most. PURPOSE: The purpose of this qualitative study was to gain a greater understanding of the cancer worry experienced by Dominican women. DESIGN: Giorgi's descriptive existential phenomenological framework and methodology guided the study. SETTING: Washington Heights/Inwood community, New York City, New York. PARTICIPANTS: Thirty-eight urban Dominican immigrant women were included in the study. METHOD: Data were gathered using focus group interviews. All interviews were digitally recorded, transcribed verbatim from Spanish to English. The transcripts were analyzed using Giorgi's existential phenomenological data analysis process. FINDINGS: Four essences unfolded: Cancer as Destiny, Faith, Influential Relationships, and Knowledge Acquisition. CONCLUSION: New knowledge was generated on the contextual factors that influence cancer worry among a major Hispanic subgroup. Implications for nursing research and practice are described.

Grieving the Loss of Self: Challenges in Type 2 Diabetes Mellitus Self-Management.

The aim of this study was to understand and describe the experience of diabetes self-management among patients not meeting glycemic control (A1C > 9). Type 2 diabetes mellitus (T2DM) is a complex chronic disease process. Diabetes self-management is equally complex and critical to patient outcomes and quality of life. The components for self-management include: knowledge, skills/abilities, and support. Few studies have reported on the experiences of self-management for patients with T2DM to reach and sustain glycemic control. This study used a qualitative descriptive design. Semistructured interviews were conducted with 13 patients receiving care at a diabetic clinic at a major health-care system in New York City. An interview guide was developed based on diabetes self-management which guided the interviews. All data were analyzed using qualitative content analysis. Initially, three themes that describe each component of diabetes mellitus self-management (DMSM) and impact the patients' reaching the desired outcome were identified: acceptance of knowledge, motivation for skills and abilities, and variability and vulnerability of support. Further analysis of the three themes led to the identification of an overarching, theme: loss of self. This overarching theme helped to explain the stages of grief illustrated across the themes in the participants DMSM experiences. The participants in this study identified loss of self, and the accompanying grief and grieving process related to the loss of self in response to their T2DM diagnosis. Participants were "stuck" in a stage of loss of self, which presented challenges to acceptance of their diagnosis, barriers to DMSM, and optimizing glycemic control.

Evaluation of Healthy Living Wellness Program With Minority Underserved Economically Disadvantaged Older Adults.

The purpose of this Roy adaptation model-guided study was to test the effectiveness of a student registered nurse intern-led nursing intervention entitled the Healthy Living Wellness Program. A one-group pretest/posttest preexperimental design was used. The intervention was imparted to minority, underserved, economically disadvantaged older adults ( N = 30). Significant findings pre- and postintervention were reported for body mass index, waist circumference, self-reported blood glucose, and weight. The findings supported the effectiveness of the nursing intervention, the Healthy Living Wellness Program, guided by the Roy adaptation model.

No Rush to Motherhood: The Lived Experience of African American Never Pregnant Sexually Active Female Teens.

PURPOSE: The aim of this study was to gain a deeper understanding of the lived experiences of underserved minority sexually active teenaged girls' successful avoidance of unwanted pregnancy. DESIGN AND METHOD: Merleau-Ponty's methodology and van Manen's method of doing phenomenological research guided and facilitated the process of the study. 7 participants were eligible and all of them were interviewed for this study. RESULTS: Six main themes were identified: sense of emotional safety; sense of being free from a potential pregnancy; feeling supported by family and friends; connections built on trust and communication; regard for self through self-esteem and self-confidence; and sense of having life goals. CONCLUSION: The interpretive statement of 'these teen-agers experienced a sense of emotional safety, support by family and friends, trust and connection with family, friends and healthcare providers, and self-confidence resulting in the opportunity to develop life goals and feel strongly motivated to be free from pregnancy' was developed after further reflection upon the study themes. PRACTICE IMPLICATIONS: Healthcare providers, primarily nurses, can use the findings of this study to improve their interactions with sexually active never pregnant female teens.

Effect of Expectation of Care on Adherence to Antihypertensive Medications Among Hypertensive Blacks: Analysis of the Counseling African Americans to Control Hypertension (CAATCH) Trial.

Novel ideas are needed to increase adherence to antihypertensive medication. The current study used data from the Counseling African Americans to Control Hypertension (CAATCH) study, a sample of 442 hypertensive African Americans, to investigate the mediating effects of expectation of hypertension care, social support, hypertension knowledge, and medication adherence, adjusting for age, sex, number of medications, diabetes, education, income, employment, insurance status, and intervention. Sixty-six percent of patients had an income of $20,000 or less and 56% had a high school education or less, with a mean age of 57 years. Greater expectation of care was associated with greater medication adherence (P=.007), and greater social support was also associated with greater medication adherence (P=.046). Analysis also showed that expectation of care mediated the relationship between hypertension knowledge and medication adherence (P<.05). Expectation of care and social support are important factors for developing interventions to increase medication adherence among blacks.

Análisis evolutivo del concepto de adaptación a la diabetes tipo 2 / Evolutionary Analysis of the Concept of Adaptation to Type 2 Diabetes / Análise evolutiva do conceito de adaptação à diabete tipo 2

El concepto de adaptación tiene diferentes aplicaciones y acepciones. En personas que viven con diabetes tipo 2 (DT2) se asocia con la observancia del tratamiento y el control glucémico. Es utilizado frecuentemente en la literatura de salud, pero no está claro qué significa en personas que viven con esta enfermedad, por lo que el propósito de esta investigación fue analizar el concepto de adaptación a la DT2. Metodología: se utilizó el método de análisis evolutivo de concepto de Rodgers. Los datos se codificaron por autor, 16 en total, palabras clave, hallazgos, antecedentes, atributos y consecuencias, conceptos relativos y sustitutos. La guía del análisis respondió a tres preguntas: ¿cómo define el concepto el autor? ¿Qué características o atributos se establecen? ¿Qué idea da el autor acerca del concepto? Resultados: el concepto de adaptación muestra atributos que permiten definirlo como un proceso que se presenta en tres fases: reacción, asimilación y respuesta. Los antecedentes corresponden a conductas previas al proceso, los resultados incluyen desafíos y cambios. Conclusiones: los atributos, los antecedentes y las consecuencias ofrecen guías para la investigación; es necesario ampliar el estudio en el contexto del hogar, la familia, el trabajo y el hospital.

The concept of adaptation has different applications and meanings. In persons who live with type 2 diabetes (T2D), it is associated with treatment adherence and glycemic control. It is used frequently in health literature, but it is unclear what it means to those living with the disease. Accordingly, the purpose of this study was to analyze the concept of adaptation to T2D. Method: Rogers' evolutionary concept analysis was the method used. The data were coded by author (16 in total), key words, findings, antecedents, attributes, consequences, and surrogate and relative concepts. The analysis guide answered three questions: How the author defines the concept? What features or attributes are established? What idea does the author provide about the concept? Findings: The concept of adaptation has attributes that enable it to be defined as a process that occurs in three phases: reaction, assimilation and response. The antecedents pertain to preprocess behavior, while the results include challenges and changes. Conclusions: The attributes, antecedents and consequences offer guidelines for research. It is necessary to broaden this research to include the context of home, family, work and the hospital.

O conceito de adaptação tem diferentes aplicações e acepções. Em pessoas que vivem com diabete tipo 2 (DT2), se associa com a observância do tratamento e o controle glicêmico. É utilizado frequentemente na literatura de saúde, mas não está claro o que significa em pessoas que vivem com essa doença; por isso, o propósito desta pesquisa foi analisar o conceito de adaptação à DT2. Metodología: utilizou-se o método de análise evolutiva de conceito de Rodgers. Os dados se codificaram por autor (16 em total), palavras-chave, antecedentes, atributos e consequências, conceitos relativos e substitutos. O guia da análise respondeu a três perguntas: como o autor define o conceito? Que características ou atributos são estabelecidos? Que ideia o autor dá sobre o conceito? Resultados: o conceito de adoção mostra atributos que permitem defini-lo como um processo que se apresenta em três fases: reação, assimilação e resposta. Os antecedentes correspondem a condutas prévias ao processo; os resultados incluem desafios e mudanças. Conclusões: os atributos, os antecedentes e as consequências oferecem guias para a pesquisa. É necessário ampliar o estudo no contexto do lar, da família, do trabalho e do hospital.

Oncology nurses and the experience of participation in an evidence-based practice project.

PURPOSE/OBJECTIVES: To illuminate the experiences of oncology nurses who participated in an evidence-based practice (EBP) project in an institution with an EBP organizational structure. RESEARCH APPROACH: A descriptive phenomenologic approach and in-depth interviews with each participant. SETTING: An oncology-focused academic medical center with an established organizational infrastructure for EBP. PARTICIPANTS: 12 RNs working in an oncology setting who participated in an EBP project. METHODOLOGIC APPROACH: Descriptive, qualitative phenomenologic approach through use of interviews and analysis of interview text. FINDINGS: Four essential themes (i.e., support, challenges, evolution, and empowerment) and 11 subthemes emerged that reflected nurses' professional and personal growth, as well as the creation of a culture of EBP in the workplace. CONCLUSIONS: The participants described the EBP project as a positive, empowering personal and professional evolutionary experience with supports and challenges that resulted in improvements in patient care. INTERPRETATION: To the authors' knowledge, the current study is the first qualitative study to demonstrate improved nursing outcomes (e.g., professional growth, improved nursing performance) and nurses' perception of improved patient outcomes (e.g., ongoing healthcare collaboration, evidence-based changes in practice).

Análisis de concepto: "decisión de cambio" para mejorar las conductas de salud en el contexto de las enfermedades crónicas en adultos / Analyzing "Decision to Change" in Order to Improve Health Care Behavior in Adult Chronic Disease: "decisão de mudança"para melhorar as condutas de saúde no contexto das doenças crônicas em adultos / Análise de conceito

Objetivo: a fin de contribuir con la clarificación y el desarrollo de conceptos útiles para la ciencia de enfermería en su práctica, este trabajo utilizó la metodología de Rodgers con el fin de proporcionar una definición del concepto "decisión de cambio" (DC) para el mejoramiento de conductas de salud en el contexto de las enfermedades crónicas (obesidad, hipertensión arterial y diabetes). Método: se realizó el análisis de evidencia empírica en bases de datos para identificar atributos, términos subrogados, antecedentes y consecuencias en relación con el concepto DC. De forma complementaria se aplicaron entrevistas semiestructuradas con codificación abierta. Resultados: la decisión de cambio es definida, entonces, como el proceso de elección que requiere de intención y actitud para comprometerse con responsabilidad en el mejoramiento de la conducta de salud, de manera efectiva y permanente respecto de las condiciones sociales y emocionales a las que una persona es sometida ante la presencia de una enfermedad crónica y que requiere de manera impostergable el apoyo familiar y profesional de salud. Conclusión: la decisión de cambio es un juicio de elección que requiere de voluntad permanente para cambiar las conductas de salud y resolver las posibles contingencias que pueda provocar una enfermedad crónica.

Objective: in order to clarify and develop useful concepts for nursing practice, this study used Rodger's methodology with the purpose of defining "Decision to Change" (DC) and thus improve health care behavior when dealing with chronic disease (obesity, hypertension, diabetes). Method: empirical evidence found in databases was analyzed in order to determine the attributes, subrogated terms, background and consequences in the DC concept. To complement this, semi-structured open coded interviews were also applied. Results: thus, the "Decision to Change" can de defined as electing an intention and an attitude to responsibly commit towards effectively and permanently improving behavior towards the social and emotional conditions surrounding a persona affected by chronic disease, who requires immediate support from family and health care providers. Conclusion: decision to change is a deliberate election that requires permanent determination to change health care behavior and solve eventual contingencies resulting from chronic illness.

Objetivo: a fim de contribuir com a classificação e o desenvolvimento de conceitos úteis para a ciência de enfermagem no contexto de sua prática, este trabalho utilizou a metodologia de Rodgers com o propósito de proporcionar uma definição do conceito "decisão de mudanças" (DM) para o melhoramento de condutas de saúde no contexto das doenças crônicas (obesidade, hipertensão arterial e diabetes). Métodos: realizou-se a análise de evidência empírica com bases de dados para identificar atributos, termos substitutos, antecedentes e consequências com relação ao conceito DM. De forma complementar, aplicaram-se entrevistas semiestruturadas com codificação aberta. Resultados: a DM é definida, então, como o processo de eleição que requer intenção e atitude para comprometer-se com responsabilidade no melhoramento da conduta de saúde, de maneira efetiva e permanente, com respeito às condições sociais e emocionais às quais uma pessoa é submetida na presença de doenças crônicas e que requer de maneira urgente o apoio familiar e profissional de saúde. Conclusão: a DM é um julgamento de escolha que requer vontade permanente para mudar as condutas de saúde e resolver as possíveis contingências que possa provocar uma doença crônica.

Chief nursing officer executive development: a crisis or a challenge?

The roles and responsibilities of nurses are expanding, as they become more involved in administration and leadership within their field. Nurses are taking on executive positions, which have become a crucial part of hospital organizations. With this expansion, an executive development program is necessary to provide nurses with the knowledge and competencies that these executive positions require. Their focus must evolve from singular bedside practice to the greater scope of health care administration. Leadership skills are extremely important, in addition to interpersonal, management, mentoring, and interprofessional skills. A number of nursing associations have worked to develop a set of curricula for nurse executive education, but a consistent and specific set of academic requirements has yet to be agreed upon. With the importance of the chief nursing officer's (CNO) role in the function of a hospital and the requirement of the knowledge of the changing health care system in the United States, it is essential that nurses are provided with proper education and training that will help them become successful nurse executives. Some suggestions include a dual MSN/MBA degree, a PhD in nursing, continuing education institutes, and mentoring programs. However, research must be done to clarify the best way to prepare CNOs for their roles.

Instruments used in Roy adaptation model-based research: review, critique, and future directions.

The purpose of this secondary analysis is to identify and critique the instruments most frequently used to measure concepts of the Roy adaptation model. Of the 123 instruments used in 231 studies over 30 years, 20 instruments met the criteria for secondary analysis. Based on established criteria, 14 were judged to have high usefulness, three have moderate usefulness, one has limited usefulness, and two are not recommended for use with the model. Recommendations include locating and developing instruments in key content areas including adaptation in groups, and particularly developing measurement strategies consistent with the philosophical assumptions of the model and multiple ways of knowing.

Developing a model of social capital: relationships in primary care.

We have developed a model of social capital to enhance relationships within primary care practices that promote organizational success and improve patient care outcomes. The model extends the meaning and the value of social capital by providing dimensions, attributes, and operational definitions that can be used to measure outcomes and guidelines to develop future interventions. Our model brings new insight and logic to understanding relationships to create resources to improve primary care practices. Furthermore, our model provides a preliminary focus on the value of integrating registered nurses into the work of primary care practices and as facilitators of social capital.

The Glass Menagerie as heuristic for explicating nursing theory.

Tennessee Williams' play, The Glass Menagerie, is interpreted through the lens of two different nursing theories, the Roy adaptation model and the human becoming theory. In the Roy adaptation model interpretation, adaptive levels of reality testing and stimuli that instigate withdrawal are explored, while in the human becoming theory interpretation, the themes of meaning, rhythmicity, and contranscendence are explicated.