Building Family Interventions for Scalability and Impact.

Family nursing researchers are charged with addressing the conceptual and methodological underpinnings of family research when developing family-focused interventions. Step-by-step guidance is needed that integrates current science of intervention development with family science and helps researchers progress from foundational work to experimental work with policy integration. The purpose of this manuscript is to provide pragmatic, evidence-based guidance for advancing family intervention research from foundational work through efficacy testing. Guidance regarding the development of family interventions is presented using the first three of Sidani's five-stage method: (a) foundational work to understand the problem targeted for change; (b) intervention development and assessment of acceptability and feasibility; and (c) efficacy testing. Each stage of family intervention development is described in terms of process, design considerations, and policy and practice implications. Examples are included to emphasize the family lens. This manuscript provides guidance to family scientists for intervention development and implementation to advance family nursing science and inform policy.

Career Cartography: From Stories to Science and Scholarship.

PURPOSE: To present four case scenarios reflecting the process of research career development using career cartography. ORGANIZING CONSTRUCTS: Career cartography is a novel approach that enables nurses, from all clinical and academic settings, to actively engage in a process that maximizes their clinical, teaching, research, and policy contributions that can improve patient outcomes and the health of the public. METHODS: Four early-career nurse researchers applied the career cartography framework to describe their iterative process of research career development. They report the development process of each of the components of career cartography, including destination statement, career map, and policy statement. CONCLUSIONS: Despite diverse research interests and career mapping approaches, common experiences emerged from the four nurse researchers. Common lessons learned throughout the career cartography process include: (a) have a supportive mentorship team, (b) start early and reflect regularly, (c) be brief and to the point, (d) keep it simple and avoid jargon, (e) be open to change, (f) make time, and (g) focus on the overall career destination. CLINICAL RELEVANCE: These four case scenarios support the need for nurse researchers to develop their individual career cartography. Regardless of their background, career cartography can help nurse researchers articulate their meaningful contributions to science, policy, and health of the public.

Family Presence During Resuscitation After Trauma.

The purpose of this study was to examine the effects of family presence during resuscitation (FPDR) in patients who survived trauma from motor vehicle crashes (MVC) and gunshot wounds (GSW). A convenience sample of family members participated within three days of admission to critical care. Family members of 140 trauma patients (MVC n = 110, 79%; GSW n = 30, 21%) participated. Family members ranged in age from 20-84 years (M = 46, SD = 15, Mdn = 47). The majority were female (n = 112, 80%) and related to the patient as spouse (n = 46, 33%). Participating in the FPDR option reduced anxiety (t = -2.43, p =.04), reduced stress (t = -2.86, p = .005), and fostered well-being (t = 3.46, p = .001). Results demonstrate the positive initial effects of FPDR on family members of patients surviving trauma injury.

Career cartography: a conceptualization of career development to advance health and policy.

PURPOSE: The purpose of this article is to propose a conceptualization of career development that emphasizes the interdependence between research, practice, and policy. ORGANIZING CONSTRUCT: Career cartography applies three decades of career development experience to lay out a systematic, comprehensive, and iterative approach for planning and communicating the outcomes of science at any career stage. To inform practice and policy, nurse researchers must be clear on the intended destination and trajectory of the science, and be skilled in communicating that science and vision to diverse stakeholders. Career cartography builds on the science of cartography, is developed within the context of public and health policy, and is composed of several components, including a destination statement, career mapping, a supportive career cartography team, and use of communication and dissemination strategies. CONCLUSIONS: The successful utilization of career cartography may accelerate advancement of individual careers, scientific impact, and the discipline as a whole by guiding nurse researchers to be deliberative in career planning and to communicate successfully the outcomes of research across a wide variety of stakeholders. Career cartography provides a framework for planning a nurse researcher's program of research and scholarship to advance science, policy, and health of the public. CLINICAL RELEVANCE: Career cartography guides nurse researchers to realize their full potential to advance the health of the public and inform public and health policy in academic and practice environments.

Measuring Transition Readiness: A Correlational Study of Perceptions of Parent and Adolescents and Young Adults with Sickle Cell Disease.

Adolescents and young adults (AYAs) often transfer from pediatric to adult care without adequate preparation, resulting in increased morbidity and mortality. The purpose of this descriptive research study of parent/AYA dyads was to measure perceptions of transition readiness. Factors that were found to be associated with perceptions of increased readiness to transition included AYA age, the amount of responsibility AYAs assume for their healthcare and the degree of parent involvement. More attention should be focused on these aspects of care to improve transition from pediatric to adult care for AYAs with sickle cell disease.

Strategies for establishing an endowed chair in a service setting.

To advance care for patients and families requires that providers and administrators in clinical settings place a high priority on the scientific domain of nursing. New knowledge intended to benefit nursing care is most effectively and efficiently achieved when a vibrant and well-supported nursing research program is embedded within a health care system. An endowed chair in nursing research is an esteemed strategy acknowledging the contributions of nursing science, providing credibility to a researcher and research programs, and demonstrating commitment to the infrastructure for nursing research. Organizational readiness through leadership; systems thinking; relationship development; and knowledge of the dynamics, process, and expectations of philanthropy are essential to establishing an endowed chair. Philanthropic endeavors can be used to strategically develop a high-impact campaign that resonates across public and private sectors to secure funding to solidify and advance nursing research. By actively engaging stakeholders including system leaders, frontline nurses, and other care providers and development leaders, a successful campaign can establish and sustain an endowed chair in nursing research. This article describes the stakeholders, processes, structure, and outcomes for the first endowed chair in nursing research at Children's National Health System in Washington, DC.

A blueprint for genomic nursing science.

PURPOSE: This article reports on recommendations arising from an invitational workshop series held at the National Institutes of Health for the purposes of identifying critical genomics problems important to the health of the public that can be addressed through nursing science. The overall purpose of the Genomic Nursing State of the Science Initiative is to establish a nursing research blueprint based on gaps in the evidence and expert evaluation of the current state of the science and through public comment. ORGANIZING CONSTRUCTS: A Genomic Nursing State of the Science Advisory Panel was convened in 2012 to develop the nursing research blueprint. The Advisory Panel, which met via two webinars and two in-person meetings, considered existing evidence from evidence reviews, testimony from key stakeholder groups, presentations from experts in research synthesis, and public comment. FINDINGS: The genomic nursing science blueprint arising from the Genomic Nursing State of Science Advisory Panel focuses on biologic plausibility studies as well as interventions likely to improve a variety of outcomes (e.g., clinical, economic, environmental). It also includes all care settings and diverse populations. The focus is on (a) the client, defined as person, family, community, or population; (b) the context, targeting informatics support systems, capacity building, education, and environmental influences; and (c) cross-cutting themes. It was agreed that building capacity to measure the impact of nursing actions on costs, quality, and outcomes of patient care is a strategic and scientific priority if findings are to be synthesized and aggregated to inform practice and policy. CONCLUSIONS: The genomic nursing science blueprint provides the framework for furthering genomic nursing science to improve health outcomes. This blueprint is an independent recommendation of the Advisory Panel with input from the public and is not a policy statement of the National Institutes of Health or the federal government. CLINICAL RELEVANCE: This genomic nursing science blueprint targets research to build the evidence base to inform integration of genomics into nursing practice and regulation (such as nursing licensure requirements, institutional accreditation, and academic nursing school accreditation).

The perfect storm: patient safety and nursing shortages within the context of health policy and evidence-based practice.

Dr. Ada Sue Hinshaw stepped down from her deanship at the University of Michigan School of Nursing, leading to a conference in honor of her legacy held in May 2006. The topic of the conference highlighted Dr. Hinshaw's accomplishments in the area of health policy and patient safety. The proceedings of the afternoon included four presentations. The common themes of the presentations incorporated the importance of public policy for patient safety, the need for health systems reforms, and the use of appropriate evidence-based practice to advance the nursing sciences. These and other perspectives of the speakers are discussed within the context of the broad categories of system reform, contributions from nursing research, and health policy focus. Finally, recommendations were given for the preferred future.

Evaluating a multiple-family group access intervention for refugees with PTSD.

The purpose of this study was to analyze the effects of a multiple-family group in increasing access to mental health services for refugees with posttraumatic stress disorder (PTSD). This study investigated a nine-session multiple-family group called Coffee and Families Education and Support with refugee families from Bosnia-Herzegovina in Chicago. Adults with PTSD (n = 197) and their families were randomly assigned to receive either the intervention or a control condition. The results indicated that a multiple-family group was effective in increasing access to mental health services and that depression and family comfort with discussing trauma mediated the intervention effect. Further well-designed studies of family interventions are needed for developing evidence-based interventions for refugee families.

A family beliefs framework for socially and culturally specific preventive interventions with refugee youths and families.

To assist in designing socially and culturally specific preventive interventions for refugee youths and families, this study identified the processes by which refugee families adapt and apply family beliefs concerning youths. A grounded-theory model constructed with ATLAS/ti for Windows and named the family beliefs framework describes (a) family beliefs concerning refugee youths, (b) contextual factors interacting with these family beliefs, (c) adaptation of family beliefs concerning refugee youths, and (d) the interplay of adapting family beliefs and behaviors concerning refugee youths. Preventive interventions for refugee youths and families would be more socially and culturally specific if they addressed the specific processes of adapting family beliefs experienced by refugee youths and their families amid transitions and traumas.

Genomic-based health care in nursing: a bidirectional approach to bringing genetics into nursing's body of knowledge.

Nurses can expect to become partners with patients and their families as genomic-based health care brings decisions involving gene-based diagnostics and therapeutics into commonplace practice. All health professionals need genetic literacy to continue competence in clinical practice in the future. This article explores the efforts nursing has undertaken during the past decade to integrate human and clinical genetics into practice and scholarship. Genetics nursing education literature in the second half of the 20th century was analyzed. A focused survey of 15 genetics nurses and nursing leaders regarding key national initiatives, genetics research training programs, and genetics education models was conducted. Nursing has taken a bidirectional approach (through grass roots and top-down initiatives) to implementing change and advancing genetics in nursing practice, research, and education. For optimal leadership in genetics education for nursing and other disciplines, bidirectional efforts must continue and concentrate on bringing genetics into clinical practice and scholarship as genomic-based health care spreads worldwide. Evidence of nursing's interdisciplinary leadership is recognized. Recommendations and strategies for continued nursing leadership and programs that build on previous work are presented.

Creating a nursing vision for leadership in genetics.

Today, an increasing number of nurses are applying new genetic knowledge in their practice, research, and educational activities. Just as the evolving precepts of biology, psychology, sociology, medicine, public health, and economics are integral to the practice of quality patient care, so too are those of genomics. The International Society of Nurses in Genetics (ISONG) has taken up the challenge of educating nurses about genetics and about ways such knowledge might be integrated into practice.

A review of diabetes mellitus-specific family assessment instruments.

Family dynamics and attributes are increasingly recognized as affecting management of diabetes mellitus (DM); however, little research has been done on the validity and usefulness of family assessment instruments (FAIs). This article reviewed the literature that employs DM-specific FAIs and evaluates whether the instruments comprehensively captured family attributes/processes and were robust enough to be useful in understanding the relationship between family attributes/issues and DM-related health care. Studies using eight instruments were identified through a search of literature published from 1982 to 2010 and were analyzed with criteria derived from the measurement and family literatures. The findings of this study revealed that DM-specific FAIs yield useful data about family-related phenomenon; however, some domains of DM-specific care, such as family dynamics/functioning, were not overtly measured. Suggestions for improving DM-specific FAIs are provided and a rationale for why DM-specific and non-DM-specific FAIs is needed to fully measure family issues related to family dynamics/attributes on DM patient care.

Autism spectrum disorder: parenting stress, family functioning and health-related quality of life.

The prevalence of Autism Spectrum Disorder (ASD) is 1 in 110 persons in the U.S. Both parents of children with ASD are under stress that may impact their health-related quality of life (HRQL) (physical and mental health). The purpose of the current study was to explore the relationship of parenting stress, support from family functioning and the HRQL (physical and mental health) of both parents. Female (n = 64) and male (n = 64) parents of children with ASD completed Web-based surveys examining parenting stress, family functioning, and physical and mental health. Results of a Wilcoxon signed-ranks test showed that female parent discrepant (D) scores between "what is" and "should be" family functioning were significantly larger than male parents, p = .002. Results of stepwise linear regression for the male-female partners showed that (1) higher female caregiving stress was related to lower female physical health (p < .001), (2) a higher discrepancy score in family functioning predicted lower mental health (p < .001), accounting for 31% of the variance for females and (3) male parent personal and family life stress (p < .001) and family functioning discrepant (D) score (p < .001) predicted poor mental health, with the discrepancy score accounting for 35% of the variance. These findings suggest that there may be differences in mothers' and fathers' perceptions and expectations about family functioning and this difference needs to be explored and applied when working with families of children with ASD.

Acculturation, social alienation, and depressed mood in midlife women from the former Soviet Union.

Level of acculturation has been linked to depressed mood in studies across culturally diverse immigrant groups. The purpose of this study was to determine the effects of acculturation, social alienation, personal and family stress, and demographic characteristics on depressed mood in midlife immigrant women from the former Soviet Union. Structural equation modeling showed that higher acculturation scores, measured by English language and American behavior, were indirectly related to lower scores for depressed mood. Higher acculturation levels promoted mental health indirectly by reducing social alienation and, subsequently, lowering family and personal stress, both of which had direct relationships to symptoms of depression. These findings support the ecological framework that guided our research and point to the importance of focusing on contextual factors in developing interventions for new immigrants.

Nursing leadership in genomics for health and society.

PURPOSE: This article is part of the series regarding genomics and nursing practice, science, education, and policy. Issues in genetic testing, genetic information and the lessons learned through applications of genetic and genomic science are analyzed and discussed. FRAMEWORK: Scientists, scholars, and members of the public have articulated a vision to guide genomics research and scholarship. The three overarching themes of this conceptual framework are genomes to biology, genomes to health, and genomes to society. CONCLUSIONS: Nurses can promote the use of genomic research technologies and information in the context of health, biology, and society, as well as in nursing research, practice, education, and policy.