A study on the reliability and validity of the Korean version of the parenting outcome expectancy scale for parents of elementary school students.

Introduction: Many parents do not engage in active discussions with their children about sexuality. This can contribute to negative sexual and reproductive health outcomes among youth. To foster a healthy environment for sexual activity, it is crucial for parents to provide comprehensive sex education to their children at home. This study aims to cross-culturally adapt and evaluate the psychometric properties of a Korean version of the Parenting Outcome Expectancy Scale to measure the sexual communication abilities of parents of elementary school students in South Korea. Method: The study participants were parents of elementary school students between 6 to 13 years old. We used exploratory and confirmatory factor analyses to examine the reliability and validity of the 23-item Korean version of the Parenting Outcome Expectancy Scale. Results: The study confirms the reliability and validity of the scale, comprising five factors and 22 items, for the evaluation of the outcome expectancy of communication about sex between parents and their children. Results also demonstrate that talking about sex is still a challenge for many parents. Discussion: This instrument can help parents prepare for sex communication with their children and for sexual education, potentially yielding a positive effect on children's sexual health and parental satisfaction.

Predictors of patient self-advocacy among patients with chronic heart failure.

The purpose of this study was to examine predictors of self-advocacy among patients with chronic heart failure (HF) as they were unknown. A convenience sample of 80 participants recruited from one Midwestern HF clinic completed surveys related to relationship-based predictors of patient self-advocacy including trust in nurses and social support. Self-advocacy is operationalized using the three dimensions of HF knowledge, assertiveness, and intentional non-adherence. Hierarchical multiple regression was used showing that trust in nurses predicted HF knowledge (ΔR2 = 0.070, F = 5.91, p < .05), social support predicted advocacy assertiveness (ΔR2 = 0.068, F = 5.67, p < .05), and ethnicity predicted overall self-advocacy (ΔR2 = 0.059, F = 4.89, p < .05). These findings suggest that support from family and friends can give the patient the needed encouragement to advocate for what they need. A trusting relationship with nurses impacts patient education so that patients not only understand their illness and its trajectory but also use that understanding to speak up for themselves. African American patients, who are less likely to self-advocate than their White counterparts, could benefit from nurses recognizing the impact of implicit bias so that these patients do not feel silenced in their care.

Predictors of Advance Care Planning Engagement Among Muslim Americans.

Advance care planning (ACP) enables people to discuss their physical, psychological, social, and spiritual needs before nearing death. Most literature examining the determinants of ACP engagement is limited and does not include minority faith communities in the United States, including Muslim communities. The purpose of this cross-sectional correlational study was to examine ACP engagement determinants among Muslims in the United States. Using the Social Ecological Model, we conceptualized the determinants of ACP engagement into intrapersonal, interpersonal, and community factors. The study self-administered questionnaires were distributed using convenience and snowball techniques. Multiple linear regression was used to predict ACP engagement. The total sample was 148 Muslim adults. The age range was 18 to 79 years. Among all tested factors, being Asian American, knowing a deceased person who had received aggressive or minimal medical treatments near death, being born in the United States, having knowledge and awareness about ACP, and being accepting of the American culture were the determinants of ACP engagement. Engagement in ACP is a multifactorial behavior. Several intrapersonal and interpersonal factors, but none of the community factors, were associated with ACP engagement among Muslim adults. Future ACP interventions targeted toward Muslim Americans should be planned with an understanding of the multifactorial nature of ACP engagement.

Educating Nursing Students About Female Genital Cutting/Mutilation Using a Standardized Patient in a Virtual Dramatization Simulation.

INTRODUCTION: Female genital cutting/mutilation (FGC/M) is a ritual to remove any or all of the external female genitalia. Educational strategies regarding the teaching of FGC/M for nursing students are scarce. The focus of this article is to describe the development, implementation, and evaluation of a virtual, FGC/M-related dramatization simulation with a standardized patient (SP). METHODS: This educational intervention used an East African immigrant woman as the SP with 35 undergraduate nursing students in two nursing schools in the Midwest United States. RESULTS: Participants appraised the simulation as an effective way to teach and learn about FGC/M. Debriefing was a key part of the simulation. DISCUSSION: Students felt the simulation was novel and engaging for a highly sensitive topic. The SP thought the virtual setting made it more comfortable for her to reveal sensitive facts. The researchers confirmed that the simulation required extensive time commitment to develop, critique, and implement.

Nursing students' knowledge gained about female genital cutting/mutilation through dramatization simulation with a standardized patient: A quasi-experimental study.

BACKGROUND: Female genital cutting is a culture bound ritual involving excision of the female genitalia. Little is known about nursing students' knowledge and perceptions of female genital cutting and no studies using simulation to teach this topic exist. OBJECTIVE: The aim of this study was to examine the impact of a dramatization simulation on nursing students' knowledge about and perceptions of female genital cutting. DESIGN: A quasi-experimental pretest posttest study with a convenience sample. SETTING: Two Bachelor of Nursing schools in Northeast Ohio, United States. PARTICIPANTS: 35 third year undergraduate students. METHODS: Students were divided into an intervention group (n = 14) and a wait list control group (n = 21). The intervention group took a pre-test, did a reading assignment and then attended a virtual, dramatization simulation session with a standardized patient; a Muslim woman with a personal history of female genital cutting. They took the posttest within the next week. The control group took the pretest, did the reading assignment, and then took the posttest, followed by the simulation. The survey instrument used for pretest and posttest was the Knowledge, Perceptions, and Practice Questionnaire on Female Genital Cutting for Healthcare Professionals in the United States. Debriefing was a critical part of the simulation. RESULTS: The knowledge of female genital cutting of the nursing students in the intervention group increased more than that of the students in the control group (change score 3.57 and 2.05 respectively). Students' perceptions of female genital cutting were not significantly changed by intervention type. CONCLUSION: This study was the first of its kind to measure nursing students' knowledge and perceptions about female genital cutting before and after a dramatization simulation. A standardized patient dramatization simulation including focused debriefing may be an effective education strategy to teach nursing students about female genital cutting.

Psychological Distress, Post-Traumatic Stress, and Suicidal Ideation Among Resettled Nepali-Speaking Bhutanese Refugees in the United States: Rates and Predictors.

INTRODUCTION: Bhutanese refugees may exhibit psychological distress (PD), post-traumatic stress (PTS), and suicidal ideation (SI), but little is known about predictors of these mental health problems. PURPOSE: To examine rates and predictors of PD, PTS, and SI among Bhutanese refugees. METHODS: Cross-sectional correlational study of 209 Bhutanese refugees in Midwestern United States. Data were collected using the Hopkins Symptom Checklist/Nepali version and Refugee Health Screener-15/PTS subscale and then analyzed using simultaneous multiple regression. RESULTS: Rates of PD, PTS, and SI were 18.7%, 8.1%, and 7.7%, respectively. Significant predictors of PD were a history of mental health treatment (p<.001) and fewer years of schooling (p = .032). Predictors of PTS were history of mental health treatment (p<.001), female gender (p = .016), fewer years of schooling (p = .012), and being single/previously married (p = .004). PTS predicted SI (ρ<.001). DISCUSSION: Health providers should routinely assess Bhutanese refugees' mental health status for timely further assessment and treatment.

Validation of the Hopkins Symptom Checklist-25/Nepali Version Among Bhutanese Refugees in the United States.

BACKGROUND: Bhutanese refugees' mental problems are relatively high. The Hopkins Symptom Checklist-25 (HSCL-25) has been used widely in examining refugees' mental health, but its psychometric properties in Nepali version is unknown. PURPOSE: To examine psychometric properties of the HSCL-25/Nepali version. METHODS: Bhutanese refugees (n = 209) responded to demographic questionnaire, the HSCL-25/Nepali, and the Refugee Health Survey-15. Exploratory factor analysis (EFA), convergent validity, and internal consistency were performed. RESULTS: After three rounds of EFA, item 14 was deleted resulting in HSCL-24/Nepali with good construct validity and excellent internal consistency (α = .94). CONCLUSIONS: The HSCL-24/Nepali version is reliable and valid and can be used to culturally, appropriately assess psychological distress of Bhutanese refugees as it omits item 14 that captures individual's sexual interest.

Opioid epidemic and prescribing in hospice and palliative care: a review of the literature.

BACKGROUND: Rising rates of opioid abuse worldwide have led to the implementation of policies to curb opioid prescribing. It is unknown what impact these policies have on prescribing within the setting of hospice and palliative care. OBJECTIVES: To determine the current state of the science of opioid prescribing in hospice and palliative care in relation to the opioid epidemic and associated policies. METHODS: A systematic integrative literature review was conducted using the Cumulative Index of Nursing and Allied Health Literature (CINAHL), PubMed, ProQuest Central and SCOPUS. RESULTS: Most of the existing literature examines physician perspectives related to opioid prescribing in primary care settings. Ample evidence exists that policies can and do affect rates of opioid prescribing in specialties outside of hospice and palliative care. There is limited evidence to suggest how these policies affect opioid prescribing in hospice and palliative care. However, the available evidence suggests that opioids are necessary in hospice and palliative care in order to manage pain. CONCLUSION: Further research is necessary to examine the possible negative impact of the opioid epidemic on opioid prescribing in hospice and palliative care.

Mixed methods appraisal tool: strengthening the methodological rigor of mixed methods research studies in nursing / Mixed methods appraisal tool: fortalecimiente del rigor metodológico de investigaciones de métodos mixtos en enfermería / Mixed methods appraisal tool: fortalecimento do rigor metodológico de pesquisas de métodos mistos na enfermagem

ABSTRACT Objective: to describe the use of the Mixed Methods Appraisal Tool to appraise and to strengthen the methodological rigor of mixed methods studies in nursing. Method: a theoretical essay was used to describe the application of Mixed Methods Appraisal Tool to support the development and assessment of mixed methods research in nursing. Four mixed methods articles in nursing were purposely chosen and evaluated based on the Mixed Methods Appraisal Tool criteria. Results: Mixed Methods Appraisal Tool is a tool for evaluating primary mixed methods studies based on five evaluation criteria: 1) justification for adopting mixed methods methodology; 2) integration between the quantitative and qualitative components; 3) interpretation of integrated findings of quantitative and qualitative data; 4) presentation of divergences between quantitative and qualitative results; and 5) compliance with the methodological rigor of each individual approach in mixed methods research. Conclusion: Mixed Methods Appraisal Tool is an instrumental resource that can be used to appraise mixed methods research and strengthen the methodological rigor in planning and conducting future mixed studies in nursing research.

RESUMEN Objetivo: describir el uso de la Mixed Methods Appraisal Tool para evaluación y fortalecimiento del rigor metodológico de estudios de métodos mixtos en enfermería. Método: se utilizó un ensayo teórico para describir la aplicación de la Mixed Methods Appraisal Tool para apoyar el desarrollo y evaluación de la investigación de métodos mixtos en enfermería. Se eligieron y evaluaron intencionalmente cuatro artículos de enfermería de métodos mixtos con base en los criterios del instrumento. Resultados: la Mixed Methods Appraisal Tool es una herramienta para evaluar estudios primarios seleccionados a partir de revisiones de literatura mixta, que evalúa cinco modalidades / categorías metodológicas, incluida la investigación de métodos mixtos. En la evaluación de estudios vinculados al paradigma de investigación mixta, se emplean cinco criterios de evaluación: 1) justificación de la adopción de métodos mixtos; 2) integración entre los componentes cuantitativo y cualitativo; 3) interpretación de la integración entre datos cuantitativos y cualitativos; 4) presentación de divergencias entre resultados cuantitativos y cualitativos; y 5) cumplimiento del rigor metodológico de cada enfoque de investigación mixta, de modo particular. Conclusión: la Mixed Methods Appraisal Tool es un recurso instrumental que puede fortalecer el rigor metodológico en la planificación y realización de estudios mixtos de investigación en Enfermería.

RESUMO Objetivo: descrever o uso da Mixed Methods Appraisal Tool para avaliação e fortalecimento do rigor metodológico de estudos de métodos mistos em enfermagem. Método: foi utilizado um ensaio teórico para descrever a aplicação da Mixed Methods Appraisal Tool no desenvolvimento e avaliação da pesquisa de métodos mistos em enfermagem. Quatro artigos de métodos mistos em enfermagem foram intencionalmente escolhidos e avaliados com base nos critérios do instrumento. Resultados: a Mixed Methods Appraisal Tool é uma ferramenta para avaliar estudos de métodos mistos primários com base em cinco critérios de avaliação: 1) justificativa para a adoção da metodologia de métodos mistos; 2) integração entre os componentes quantitativos e qualitativos; 3) interpretação de resultados integrados de dados quantitativos e qualitativos; 4) apresentação de divergências entre resultados quantitativos e qualitativos; e 5) conformidade com o rigor metodológico de cada abordagem individual na pesquisa de métodos mistos. Conclusão: a Mixed Methods Appraisal Tool é um recurso instrumental que pode ser usado para avaliar a pesquisa de métodos mistos e fortalecer o rigor metodológico no planejamento e na condução de futuros estudos mistos na pesquisa em enfermagem.

Advance Care Planning Engagement Among Muslim Community-Dwelling Adults Living in the United States.

Advance care planning (ACP) is a cornerstone of self-determination for the type of care provided at the end of life. Despite many national efforts to improve American adults' engagement in ACP, statistics indicate low engagement. Low engagement, especially among racial and ethnic minority populations, immigrants, people with lower socioeconomic status, young adults, rural residents, or non-English speakers, is common. Advance care planning engagement among Muslims living in the United States has been minimally studied. The purpose of this study was to explore Muslims' engagement in ACP. A cross-sectional descriptive design was used. Participants were recruited from Islamic organizations through convenience and snowball sampling. Engagement in ACP was measured by the Advance Care Planning Engagement Survey. A sample of 148 Muslims (18-79 years of age) participated in the study. The average engagement scores ranged from 1.97 to 2.09, with about two-thirds in the precontemplation stage. Significant differences in engagement scores were found according to health condition and end of life experiences. Results suggest a need for further collaborative efforts by health care providers, policymakers, and researchers to mitigate the disparities in ACP engagement in the American Muslim community.

Post-Traumatic Stress, Depression, and Quality of Life in Women with Peripartum Cardiomyopathy.

PURPOSE: Peripartum cardiomyopathy, a traumatic life-threatening type of heart failure, occurs in the last trimester of pregnancy or shortly after childbirth. Little is known about psychological or emotional conditions women experience with peripartum cardiomyopathy. The purpose of this study was to examine relationships among post-traumatic stress, depression, and quality of life in women with peripartum cardiomyopathy. DESIGN AND METHODS: This cross-sectional, correlational survey study included 28 participants recruited via public notice on Facebook. Participants completed the Horowitz Impact of Events Scale, the Center for Epidemiology Scale-Depression 20, and the Ferrans & Powers Quality of Life Index-Cardiac Version-IV. RESULTS: Post-traumatic stress correlated significantly and positively with depression (r = .809, p < .001). Post-traumatic stress and depression correlated significantly and inversely with quality of life (r = -.455, p = .015), (r = -.544, p = .003), respectively. All participants measured positive for depression. Participants with lower education scored higher on post-traumatic stress and depression, whereas those unemployed or disabled registered a lower quality of life. CLINICAL IMPLICATIONS: Nurses, midwives, and physicians caring for women with cardiomyopathies must be vigilant for evidence of post-traumatic stress, depression, and poor quality of life. Targeted antenatal and postnatal support could be vital to emotional and psychological recovery.

Systemic assessment of depressive symptoms among registered nurses: A new situation-specific theory.

BACKGROUND: A mentally-healthy nursing workforce is vital to providing quality healthcare. While there has been research conducted internationally on depressive symptoms in nurses, most studies have lacked a theoretical framework. PURPOSE: The purpose of this article is to describe the development of a situation-specific theory, the Systemic Assessment of Depressive Symptoms among Registered Nurses (SAD-RN). METHODS: The SAD-RN was developed through theory synthesis using the Roy's Adaptation Model (RAM) as a framework. Sixty-four research articles were selected to abstract relevant concepts based on a priori RAM concepts. FINDINGS: Using depressive symptoms as the anchor concept, related emergent concepts of SAD-RN include context, stressors, protective factors, negative health outcomes, and low patient care quality. DISCUSSION: SAD-RN is an evidence-based comprehensive model that offers researchers a guiding theory to be used in their future research on depressive symptoms among RNs.

Social Pressure for Pregnancy Scale: Its Development, Psychometric Properties, and Potential Contributions to Infertility and Depression Research.

BACKGROUND: Women with infertility in different cultures, especially those in West African countries, are viewed as inferior. They tend to experience discrimination and have suboptimal mental health outcomes. However, recent evidence shows that social pressure for pregnancy, not infertility, is a significant predictor of depression. Yet, instruments that measure social pressure for pregnancy are scarce. Existing instruments to measure social pressure for pregnancy show no evidence of psychometric properties. PURPOSE: To assess the psychometric properties of a new tool, the Social Pressure for Pregnancy Scale (SPPS), among Malian women in West Africa. METHODS: Exploratory factor analysis, and analyses of convergent validity, discriminant validity (known-groups technique), and reliability. RESULTS AND CONCLUSION: The SPPS has good psychometric properties and can be used in future infertility studies especially in relation to depression.

Seasonality of birth defects in West Africa: could congenital Zika syndrome be to blame?

The link between Zika virus infection during pregnancy and microcephaly and other neurodevelopmental defects in infants, referred to as congenital Zika syndrome (CZS), was recently discovered. One key question that remains is whether such neurodevelopmental abnormalities are limited to the recently evolved Asiatic ZIKV strains or if they can also be induced by endemic African strains. Thus, we examined birth registries from one particular hospital from a country in West Africa, where ZIKV is endemic. Results showed a seasonal pattern of birth defects that is consistent with potential CZS, which correspond to a range of presumed maternal infection that encompasses both the peak of the warm, rainy season as well as the months immediately following it, when mosquito activity is likely high. While we refrain from definitively linking ZIKV infection and birth defects in West Africa at this time, in part due to scant data available from the region, we hope that this report will initiate broader surveillance efforts that may help shed light onto mechanisms underlying CZS.

Infertility, Psychological Distress, and Coping Strategies among Women in Mali, West Africa: A Mixed-Methods Study.

Relatively little is known about infertility and its consequences in Mali, West Africa where the context and culture are different from those of previously studied settings. This study therefore aimed to specifically examine infertility induced psychological distress and coping strategies among women in Mali. A convergent mixed-methods design-correlational cross-sectional and qualitative descriptive-guided the study. Fifty-eight infertile Malian women participated: 52 completed the Psychological Evaluation Test specific for infertility and a question on general health status, and 26 were interviewed in-depth. Over 20% scored above the cut-off point for psychological distress, and 48% described their general health as poor. There was no significant difference between women with primary vs. secondary infertility. The study found that infertile women lived with marital tensions, criticism from relatives, and stigmatization from the community. They experienced sadness, loneliness, and social deprivation. Coping strategies included traditional and biomedical treatments, religious faith and practices, and self-isolation. Health care professionals should provide holistic care for infertile women to meet their physical, spiritual, psychological, and social needs.

Psychometric properties of the Chinese version of the Dutch Eating Behavior Questionnaire in a sample of Taiwanese parents.

The Dutch Eating Behavior Questionnaire (DEBQ) appraises overeating styles that may contribute to weight gain in adults. The purpose of this analysis was to assess the psychometric properties of a Chinese version of the DEBQ (C-DEBQ) in a sample of parents of school-age children in Taiwan. The C-DEBQ encompassing three subscales that including emotional eating, external eating, and restrained eating. Each subscale's reliability was assessed with Cronbach's alpha internal consistency. Confirmatory factor analysis (CFA) was conducted to validate the model fit. A total of 340 normal weight and overweight parents of school-age children from various geographical locations in Taiwan participated in the study. Each subscale, emotional, external, and restrained eating, displayed good-to-excellent internal consistency (Cronbach's alphas: .94, .81, and .89, respectively). CFA showed that the three-factor solution had close goodness-of-fit to the data for supporting the factorial validity (x2=1239.03, df=488, p<.001, x2/df=2.54, root mean square error of approximation=.067, comparative fit index=.879, Tucker-Lewis index=.869). Findings suggest that the C-DEBQ is a psychometrically reliable and valid instrument with the potential to assess overeating styles in Taiwanese parents of school-age children. Replication studies with more age- and gender-diverse populations are needed to provide further evidence of construct validity for the Chinese version of the DEBQ.

Liderança em enfermagem e qualidade do cuidado em ambiente hospitalar: pesquisa de métodos mistos / Nursing leadership and quality of care in a hospital setting: mixed methods research

Objetivo: examinar e descrever a relação entre liderança em enfermagem e qualidade do cuidado no ambiente hospitalar. Métodos: estudo concomitante e convergente de métodos mistos que incorporou um delineamento correlacional transversal e teoria fundamentada. Os dados quantitativos foram coletados por meio da subescala Liderança do Brazilian Nursing Work Index-Revised, com 105 enfermeiros de um hospital e analisados por meio de estatística descritiva e inferencial. Os dados qualitativos foram coletados por meio de entrevistas com 64 participantes e analisados pelo método de Charmaz. Posteriormente, os achados foram integrados para gerar os resultados dos métodos mistos. Resultados: os resultados qualitativos apoiaram os quantitativos e mostraram que a liderança de enfermagem eficaz gerou qualidade de atendimento por meio de colaboração com a equipe de enfermagem, incentivo à advocacia do paciente e melhoria do atendimento. Conclusão: o uso de métodos mistos possibilita uma compreensão mais profunda do fenômeno. As implicações também são discutidas. (AU)