Psychometric Properties of Instruments That Measure Vaping Outcome Expectancies: A Systematic Review.

INTRODUCTION: Vaping is a growing public health concern. Interventions that address vaping must build upon rigorous research that uses psychometrically sound instruments to measure vaping-associated outcome expectancies. AIMS AND METHODS: The primary aim was to appraise the reporting of psychometric properties of instruments used to measure vaping outcome expectancies. Secondary aims were to distinguish the different types of outcome expectancies assessed across the measures, the conceptual underpinnings, and the evidence explaining e-cigarette use etiology. This systematic review was guided by an adapted version of the COnsensus-based Standards for the selection of health Measurement INstruments (COSMIN) guideline and Risk of Bias Checklist. Five electronic databases were searched for peer-reviewed studies, dissertations, and theses that psychometrically evaluated instruments that measure vaping outcome expectancies. Studies that met the inclusion criteria were appraised based on their reporting of nine psychometric properties outlined in the COSMIN checklist. RESULTS: The review included 11 studies that described eight instruments and reported on two to five of nine predetermined psychometric properties. Structural validity, construct validity, and internal consistency were the most commonly reported properties. No studies reported test-retest, intrarater, or interrater reliability, measurement error, or responsiveness. Content validity and measurement invariance were only reported by two and four studies, respectively. The most commonly included subscales in the instruments were affect regulation, positive sensory experience, and negative health consequences. Many of the outcome expectancy subscales were associated with e-cigarette behaviors. CONCLUSIONS: There is limited reporting of psychometric testing of instruments that measure vaping outcome expectancies; however, utilization of the COSMIN guideline could enhance the quality of such reporting. IMPLICATIONS: Appraising the reporting of psychometric properties of instruments that measure vaping outcome expectancies is a first step to ensuring valid and reliable instruments are used to support rigorous research and build evidence-based knowledge. Future research should focus on testing for responsiveness, measurement error, and reliability, and on quality appraisal of the instruments. Studying vaping outcome expectancies may improve understanding of factors that influence and deter vaping. This may contribute to the development of effective interventions aimed at vaping cessation and prevention.

Nursing students' understanding of the Fundamentals of Care: A cross-sectional study in five countries.

AIM AND OBJECTIVE: To explore the accuracy with which nursing students can identify the fundamentals of care. BACKGROUND: A challenge facing nursing is ensuring the fundamentals of care are provided with compassion and in a timely manner. How students perceive the importance of the fundamentals of care may be influenced by the content and delivery of their nursing curriculum. As the fundamentals of care play a vital role in ensuring patient safety and quality care, it is important to examine how nursing students identify these care needs. DESIGN: Cross-sectional descriptive design. METHODS: A total of 398 nursing students (pre- and postregistration) from universities in Sweden, England, Japan, Canada and Australia participated. The Fundamentals of Care Framework guided this study. A questionnaire containing three care scenarios was developed and validated. Study participants identified the fundamentals of care for each of the scenarios. All responses were rated and analysed using ANOVA. RESULTS: The data illustrate certain fundamentals of care were identified more frequently, including communication and education; comfort and elimination, whilst respecting choice, privacy and dignity were less frequently identified. The ability to identify all the correct care needs was low overall across the pre- and postregistration nursing programmes in the five universities. Significant differences in the number of correctly identified care needs between some of the groups were identified. CONCLUSIONS: Nursing students are not correctly identifying all a patient's fundamental care needs when presented with different care scenarios. Students more frequently identifying physical care needs and less frequently psychosocial and relational needs. The findings suggest educators may need to emphasise and integrate all three dimensions. RELEVANCE TO CLINICAL PRACTICE: To promote students' ability to identify the integrated nature of the fundamentals of care, practising clinicians and nurse educators need to role model and incorporate all the fundamental care needs for their patients.

A concept analysis of abductive reasoning.

AIM: To describe an analysis of the concept of abductive reasoning. BACKGROUND: In the discipline of nursing, abductive reasoning has received only philosophical attention and remains a vague concept. In addition to deductive and inductive reasoning, abductive reasoning is not recognized even in prominent nursing knowledge development literature. Therefore, what abductive reasoning is and how it can inform nursing practice and education was explored. DESIGN: Concept analysis. DATA SOURCES: Combinations of specific keywords were searched in Web of Science, CINAHL, PsychINFO, PubMed, Medline and EMBASE. The analysis was conducted in June 2012 and only literature before this period was included. No time limits were set. METHODS: Rodger's evolutionary method for conducting concept analysis was used. RESULTS: Twelve records were included in the analysis. The most common surrogate term was retroduction, whereas related terms included intuition and pattern and similarity recognition. Antecedents consisted of a complex, puzzling situation and a clinician with creativity, experience and knowledge. Consequences included the formation of broad hypotheses that enhance understanding of care situations. Overall, abductive reasoning was described as the process of hypothesis or theory generation and evaluation. It was also viewed as inference to the best explanation. CONCLUSION: As a new approach, abductive reasoning could enhance reasoning abilities of novice clinicians. It can not only incorporate various ways of knowing but also its holistic approach to learning appears to be promising in problem-based learning. As nursing literature on abductive reasoning is predominantly philosophical, practical consequences of abductive reasoning warrant further research.

Comparative Analysis of External Validity Reporting in Non-randomized Intervention Studies.

This article describes a comparative analysis of external validity reporting in non-randomized behavioural and public health intervention studies that used and did not use the TREND (Transparent Reporting of Evaluations with Non-randomized Designs) statement. The search resulted in 14 non-randomized intervention studies that were rated based on Green and Glasgow's criteria for external validity reporting. Studies that used the TREND statement demonstrated improved external validity reporting when compared with studies that did not use the TREND statement. The implication is that the TREND statement and Green and Glasgow's criteria can improve external validity reporting of non-randomized behavioural and public health interventions.

Cet article présente une analyse comparative d'établissements de rapports de validité externe dans le cadre d'études d'interventions non aléatoires en matière de comportements et de santé publique faisant usage et ne faisant pas usage de l'énoncé TREND (Transparent Reporting of Evaluations with Non-randomized Designs). La recherche a relevé 14 études d'interventions non aléatoires, lesquelles ont été évaluées selon les critères de Green et Glasgow quant à l'établissement de rapports de validité externe. Les études ayant utilisé l'énoncé TREND ont démontré la présence de rapports de validité externe améliorés, en comparaison avec les études n'ayant pas fait usage de l'énoncé TREND. En conclusion, l'énoncé TREND et les critères de Green et Glasgow peuvent améliorer les rapports de validité externe d'interventions non aléatoires en matière de comportements et de santé publique.

Consequences of COVID-19 Vaccine Hesitancy Among Healthcare Providers During the First 10 Months of Vaccine Availability: Scoping Review.

BACKGROUND: Throughout the COVID-19 pandemic, healthcare providers (HCPs)-including nurses-have played important roles in the vaccination effort. It is expected that COVID-19 vaccine hesitancy among HCPs has numerous consequences; however, the scope of these consequences and their impacts on providers, patients, and the broader healthcare system remained unclear. PURPOSE: To identify existing and emerging evidence to understand the state of knowledge of the consequences of COVID-19 vaccine hesitancy among HCPs. METHODS: A scoping review was completed based upon the JBI scoping review methodology. The databases searched included OVID Medline, EBSCOhost CINAHL, ProQuest Nursing and Allied Health Source, ProQuest APA PsycInfo, and ProQuest Dissertations and Theses. The final literature search was completed on June 2, 2022. Studies were screened and retrieved based on predefined inclusion and exclusion criteria using Covidence reference management software. Data extraction followed criteria recommended in the JBI scoping review framework with additional relevant variables identified by the authors. RESULTS: A total of 33 sources were included in the review. Consequences of HCP COVID-19 vaccine hesitancy were grouped under three themes and seven subthemes. Consequences affecting HCPs included health-related, psychosocial, and employment-related consequences. Consequences affecting patients pertained to COVID-19 vaccination communication and COVID-19 vaccination practices of HCPs. Consequences to the healthcare system involved consequences to coworkers and employment/attendance/staffing-related consequences. CONCLUSIONS: Healthcare provider COVID-19 vaccine hesitancy was found to have numerous consequences. By understanding the scope and extent of these consequences, healthcare leaders, researchers, and HCPs can work together to protect providers, patients, and healthcare systems.

The complex nature of transportation as a key determinant of health in primary and community care restructuring initiatives in rural Canada.

It is well recognized that transportation is a barrier to healthcare access for rural-dwelling residents, particularly older adults. Healthcare restructuring initiatives seldom take into consideration the complexity of transportation, which acts as a barrier to appropriate and timely access to healthcare services for older adults in rural communities. This article presents findings of a qualitative research study that explored the complex nature of transportation challenges that rural-dwelling older adults experience in Western Canada when trying to access primary and community care services. Data were derived from a larger study of service user views on a healthcare restructuring initiative intended to facilitate aging-in-place. We conducted 15 focus groups and 9 interviews with a diverse sample of 83 older adults living in one urban centre and nine rural and small rural towns in British Columbia (BC)'s interior. We used content analysis to determine codes and derive themes. Study findings showed that transportation was a top priority for improving primary and community care. Older adult participants identified a range of transportation challenges in trying to get to healthcare services and care providers getting to them. Transportation was a social determinant of health (SDOH) for all participants, regardless of whether they lived in the urban centre or in a rural or small rural town. Our study provides more evidence to support that transportation is a key SDOH for rural-dwelling older adults. As such, transportation should be specifically addressed in healthcare restructuring initiatives that aim to support aging-in-place. Service providers need to advocate for system-wide solutions such as integrating transportation into the healthcare system, while it is imperative that decision-makers act on these solutions.

Towards Equitable Health Care Access: Community Participatory Research Exploring Unmet Health Care Needs of Homeless Individuals.

Community and health services often overlook health care needs of persons experiencing homelessness, which leads to deterioration in health and increased utilization of emergency services. Since homeless people are underrepresented in health service research, little is known about their unmet health care needs, particularly in smaller cities where resources are limited. This community-based participatory research explored the experiences of small-city homeless service users (HSUs) with unmet health care needs and community service providers (CSPs) who work with them to determine barriers to health care access affecting them. Structured interviews were conducted with 65 HSUs and 15 CSPs in interior British Columbia, Canada. These interviews were audio-recorded, and the retrieved data were analyzed thematically. The three themes uncovered included: a lack of access to health care and risk of stigma, a lack of trust and fear of discrimination, and a need for community navigation and social support. The findings indicate that HSUs do not receive equitable care and face challenges in accessing appropriate and timely foot care, which contributes to increased foot-related emergency visits, loss of trust in the health care system, and disabilities due to worsening foot conditions. Various social determinants of health also impact HSUs, such as low socioeconomic status, lack of housing, decreased social support, unhealthy behaviors, and inequitable access to health services. By collaborating with HSUs, community and health services need to develop innovative outreach programs that provide better community resources as the first step toward equitable access to health care.

Older Adults' Views on the Repositioning of Primary and Community Care.

Older adults are rarely consulted on health care restructuring. To address this gap, our study explored older adults' views on "repositioning", a restructuring initiative to support independent living for older adults with complex chronic disease (CCD). We collected and analysed data from 83 older adults living in one small city and nine rural small towns where "repositioning" of primary and community care was occurring. Average participant age was 75 years; 56 (67%) were women, 44 (53%) had CCD, and 20 (24%) identified as Indigenous or South Asian. The four themes were: unfamiliarity with repositioning; optimism versus skepticism; improving primary and community care (through better home care, improved transportation, and more doctors); and, playing an active role to effect change. For repositioning to be successful, diverse service users must be fully included; rural-dwelling older adults' priorities for primary and community care need to be addressed, rather than using a "cookie-cutter" approach.

Development of a foot care model to determine the risk of foot problems among homeless adults in Canada.

Foot care is a common problem for homeless adults in cities, who often receive fragmented foot care services, resulting in increased foot problems, health complications, hospitalisation, limb removal and disabilities. Among the health factors that negatively affect the homeless, foot health is essential, but often neglected. This study employed a descriptive, cross-sectional research design to assess the foot care of homeless people and develop recommendations for clinical practice. Using Inlow's 60-s foot screening method, the foot conditions of a purposive sample of 65 homeless adults were examined in British Columbia, Canada, in 2019-2020. Descriptive and inferential statistics were used to analyse the data. Determinants, such as sex and years of homelessness significantly contributed to homeless individuals' risk of developing foot problems. Differences in perceived and observed foot problems were influenced by equitable access to social health and healthcare services. Foot assessment is not well-covered by homeless health services and should be implemented as part of the standard medical review of homeless patients. Furthermore, foot assessment should be conducted by healthcare professionals, rather than relying on the standard practice of service users' self-report. Finally, foot care should be based on tailoring assessments and interventions for the individualised needs of homeless service users. Future research must seek ways to integrate homeless individuals' voices in the development, implementation and evaluation of foot care services.

Webcam as a new invigilation method: students' comfort and potential for cheating.

The purpose of this descriptive survey study was to determine the comfort of nurse practitioner (NP) students with webcam invigilation of online examinations and the effectiveness of webcam invigilation in preventing students from cheating. An online questionnaire was developed for NP students currently enrolled in Ontario's Primary Health Care Nurse Practitioner program, in which online examinations are invigilated through a webcam. All students were contacted via e-mail and invited to participate in the online questionnaire. The response rate was 77%. Data were collected and analyzed. Results demonstrated that webcam invigilation can be an uncomfortable experience and that cheating on webcam-invigilated examinations is possible. The results will contribute to the scarce literature available on webcam invigilation of online examinations, but research with a larger sample is needed if results are to be generalized to the webcam invigilation process.

Simulated patient scenario development: A methodological review of validity and reliability reporting.

INTRODUCTION: Some healthcare scholars (educators and researchers) develop their own simulated patient scenarios to address specific learning objectives. Clear processes of validity and reliability are needed in the development of simulated scenarios for the purpose of replication and the transfer of findings to other contexts. METHODS: This paper reports a methodological review of CINAHL to determine how valid and reliable simulated patient scenarios are developed. We reviewed 375 abstracts based on specific inclusion and exclusion criteria to yield 17 qualifying records. Data about the discipline, population, type of simulation, and validity and reliability processes were extracted. RESULTS: Selected records were from nursing, medicine, and paramedicine. While some studies used high-fidelity simulations, some used low-fidelity or a combination of high- and low-fidelity simulations. Scholars validated scenarios by using personal experience, consulting experts, or requesting participant feedback. They also examined different types of validity (face, content, construct). Most studies did not address how reliability of scenarios was determined. To ensure consistency in scenario delivery, some studies piloted scenarios with participants, or examined performance through video-tapes or virtual patients. CONCLUSIONS: This review shows that scholars use inconsistent processes to develop valid and reliable simulated patient scenarios, often overlooking evidence-based approaches to determining validity and reliability. Future practices pertaining to scenario development should use systematic processes in determining validity and reliability so simulation exercises can be replicated in other contexts.

Usefulness of Abductive Reasoning in Nursing Education: A Pilot Study.

BACKGROUND: Hypothetico-deductive reasoning used by novice nurses could limit their ability to explain a presenting care situation in its entirety. Hence, scholars recommend the use of abductive reasoning as an alternative approach. PURPOSE: This study explored the effects of abductive reasoning training on baccalaureate nursing students' hypothesis generation abilities. METHOD: Through a pretest-posttest study, we delivered educational training on abductive reasoning and examined hypothesis accuracy, expertise, and breadth. Participants generated scenario-specific hypotheses before and after the training. Academic content experts validated the scenarios, and 2 independent raters scored participants' hypotheses. RESULTS: Twenty first- and second-year nursing students participated in this pilot study. Posttest scores showed a significant improvement in participants' hypothesis generation abilities: accuracy (P < .001), expertise (P < .001), and breadth (P = .006). CONCLUSION: Abductive reasoning training in nursing education may improve students' hypothesis generation abilities.

Practice readiness of new nursing graduates: A concept analysis.

Practice readiness is not well defined in the literature and its conceptualization fluctuates from one practice setting to the next. The lack of common perception of what it means to be "practice ready" across sectors (academia, practice, regulatory) creates difficulty in identifying the boundaries of the concept and promotes varying expectations. This paper reports a concept analysis on practice readiness using Rodgers' evolutionary method of concept analysis. Through searching CINAHL, PubMed, EBM Systematic Reviews, and ProQuest Dissertations and Theses, fifteen records were found and included in the analysis. Prominent surrogate terms included job readiness and readiness for practice while related terms included transition to practice and entry into the workplace. Attributes of practice readiness focused on cognitive, professional, and clinical capabilities, as well as self-efficacy. While antecedents comprised of maturity, clinical practice experience, and socialization to the discipline; consequences encompassed provision of safe care, performance confidence, and transitioning into the nursing role. This analysis highlights the technicalities of the nursing role pertaining to practice readiness, but overlooks the humanistic characteristics essential for providing quality care. There is a need for further development of the concept through intersectoral collaboration and exploration of humanistic characteristics as they relate to practice readiness.