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1.  The Staff Nurse Clinical Leader at the Bedside: Swedish Registered Nurses' Perceptions 
Nursing Research and Practice  2016;2016:1797014.
Registered nurses at the bedside are accountable for and oversee completion of patient care as well as directly leading and managing the provision of safe patient care. These nurses have an informal leadership role that is not associated with any given position. Leadership is a complex and multifaceted concept and its meaning is unclear, especially in the staff nurse context. The aim was to describe registered nurses' perceptions of what it entails to be the leader at the bedside in inpatient physical care. A phenomenographic approach was employed. Interviews were performed with Swedish registered nurses (n = 15). Five descriptive categories were identified: demonstrating clinical knowledge, establishing a good atmosphere of collaboration, consciously structuring the work in order to ensure patients' best possible nursing care, customized presence in the practical work with patients according to predetermined prerequisites, and monitoring coworkers' professional practice. Registered nurses informal role as leader necessitates a social process of deliberate effort to attain and maintain leader status and authority. Participants used deliberate communicative approaches and interactive procedures. Leader principles grounded in the core values of the nursing profession that ensure nursing values and person-centered attributes were a key aspect.
doi:10.1155/2016/1797014
PMCID: PMC5164887  PMID: 28044103
2.  Assessing Nurses Knowledge of Glasgow Coma Scale in Emergency and Outpatient Department 
Nursing Research and Practice  2016;2016:8056350.
Assessment of level of consciousness using the Glasgow Coma Scale (GCS) is a tool requiring knowledge that is important in detecting early deterioration in a patient's level of consciousness. Critical thinking used with the skill and knowledge in assessing the GCS is the foundation of all nursing practice. This study aims to explore the knowledge and competence in assessing the GCS among staff nurses working in the Emergency and Outpatient Departments. This is a quantitative descriptive cross-sectional study design using the GCS Knowledge Questionnaire. Convenience sampling method was used. Nurses in these Departments were asked to partake in the survey. Data collected was analyzed using the Statistical Package of Social Sciences (SPSS) version 20. Descriptive and Pearson's chi square was used. Result showed that 55.56% of nurses had poor knowledge followed by 41.48% and 2.96% with satisfactory knowledge and good knowledge, respectively. The result on the association between knowledge and education level showed a significant association between the two variables (X2 = 18.412, df = 3, n = 135, and p < 0.05). There was also a significant correlation between knowledge and age group (X2 = 11.085, df = 2, n = 135, and p < 0.05). Overall, this study supports that good knowledge and skill are important in assessing GCS level.
doi:10.1155/2016/8056350
PMCID: PMC5156803  PMID: 28044104
3.  Caregivers Lack of Disclosure Skills Delays Disclosure to Children with Perinatal HIV in Resource-Limited Communities: Multicenter Qualitative Data from South Africa and Botswana 
Nursing Research and Practice  2016;2016:9637587.
To promote the appropriate implementation of procedures for health disclosure to children, it is important to understand the reasons why caregivers delay the disclosure of healthcare information to children. This paper explored the views of caregivers on what makes disclosure to children with perinatal acquired HIV (PAH) difficult and what could make disclosure in these cases easier. Data were collected using focus group interviews with caregivers who were purposely selected from a multicenter study conducted in Botswana and South Africa. Forty-seven nondisclosed caregivers of children between 5 and 18 years who were receiving ART were interviewed. Caregivers felt that children should be told of their HIV-positive status despite the fact that none had disclosed this information to the children. The caregivers reported lack of disclosure skills but believed they were primarily responsible for disclosure to children and required support from healthcare workers (HCWs) during the disclosure process. They believed that counseling on how to approach disclosure and training on when and how to disclose will make the disclosure process easier. HCWs have a crucial role to play in promoting disclosure to perinatally infected children. The development of appropriate disclosure guidelines and training for HCWs will facilitate disclosure to children.
doi:10.1155/2016/9637587
PMCID: PMC5149670  PMID: 28018673
4.  Breastfeeding among Latino Families in an Urban Pediatric Office Setting 
Nursing Research and Practice  2016;2016:9278401.
Objective. To determine the breastfeeding rate of Latino infants at an urban pediatric clinic in the first six months of life and to identify factors associated with breastfeeding. Methods. Investigators conducted a retrospective chart review of infants seen at the clinic in 2014 as part of a mixed methods study. Topics reviewed included demographics, infant health data, and feeding methods at 5 points in time. Bivariate correlations and cross-tabulations explored associations between variables. Results. Most of the mothers (75%) fed their newborns with both breastfeeding and formula (las dos). At 6 months, a majority were formula-fed only (55.9%). Approximately 10% of mothers exclusively breastfed their newborns, and the trend of exclusive breastfeeding remained steady through the 6-month visit. Over time, the number of mothers who exclusively bottle-feed their infants steadily rises. There were no statistical differences among the feeding method groups with regard to birth order of child, number of adults or children in the household, vaccination rate, number of sick visits, or infants' growth. Conclusions. More targeted attention to this population and other immigrant populations with culturally tailored interventions spanning the prenatal to early infancy periods could increase exclusive breastfeeding and ultimately improve child health.
doi:10.1155/2016/9278401
PMCID: PMC5131241  PMID: 27980866
5.  Real-Time Reporting of Small Operational Failures in Nursing Care 
Nursing Research and Practice  2016;2016:8416158.
Addressing microsystem problems from the frontline holds promise for quality enhancement. Frontline providers are urged to apply quality improvement; yet no systematic approach to problem detection has been tested. This study investigated a self-report approach to detecting operational failures encountered during patient care. Methods. Data were collected from 5 medical-surgical units over 4 weeks. Unit staff documented operational failures on a small distinctive Pocket Card. Frequency distributions for the operational failures in each category were calculated for each hospital overall and disaggregated by shift. Rate of operational failures on each unit was also calculated. Results. A total of 160 nurses participated in this study reporting a total of 2,391 operational failures over 429 shifts. Mean number of problems per shift varied from 4.0 to 8.5 problems with equipment/supply problems being the most commonly reported category. Conclusions. Operational failures are common on medical-surgical clinical units. It is feasible for unit staff to record these failures in real time. Many types of failures were recognized by frontline staff. This study provides preliminary evidence that the Pocket Card is a feasible approach to detecting operational failures in real time. Continued research on methodologies to investigate the impact of operational failures is warranted.
doi:10.1155/2016/8416158
PMCID: PMC5118534  PMID: 27895940
6.  The Impact of Perceived Stress and Coping Adequacy on the Health of Nurses: A Pilot Investigation 
Nursing Research and Practice  2016;2016:5843256.
Stress and coping abilities influence the health and work performance of nurses. However, little is known about the combined influence of stress perception and perceived coping adequacy and its impact on the health of nurses. This study examined the relationship between stress, coping, and the combined influences of perceived stress and coping abilities on health and work performance. A valid and reliable questionnaire was completed by 120 nurses in a Midwestern hospital in the USA. In general, the nurses were not healthy: 92% had moderate-to-very high stress levels; 78% slept less than 8 hours of sleep per night; 69% did not exercise regularly; 63% consumed less than 5 servings of fruits and vegetables per day; and 22% were classified as binge drinkers. When confronted with workplace stress, 70% of nurses reported that they consumed more junk food and 63% reported that they consumed more food than usual as a way of coping. Nurses in the “high stress/poor coping” group had the poorest health outcomes and highest health risk behaviors compared to those in other groups. The combined variables of perceived stress and perceived coping adequacy influenced the health of nurses. Therefore, worksite health promotion programs for nurses should focus equally on stress reduction, stress management, and the development of healthy coping skills.
doi:10.1155/2016/5843256
PMCID: PMC5108847  PMID: 27882246
7.  The NPs Role of Assessing and Intervening with Older Adult Drivers 
Nursing Research and Practice  2016;2016:3254857.
As the silver tsunami continues, assessing and intervening with older adult drivers are becoming an essential aspect of the comprehensive geriatric exam. The current lack of time efficient clinical guidelines is a concern and barrier for NPs. The purpose of this study was to identify strategies currently used by NPs. The critical incident technique was used to obtain data from a convenience sample of NPs. A total of 89 incidents were collected. The perspective of the NP can provide important information for developing clinical guidelines to promote individual and community safety.
doi:10.1155/2016/3254857
PMCID: PMC5097816  PMID: 27843646
8.  Mentoring Nurses in Political Skill to Navigate Organizational Politics 
Nursing Research and Practice  2016;2016:3975634.
Objective. The aim of this study was to describe and analyze the correlations between mentoring functions and political skill development among nurses who have earned or are candidates for a Ph.D. or doctorate of nursing practice (DNP) degree. Background. The healthcare system is in flux; future generations of Ph.D. and DNP nurse leaders will be required to demonstrate political acumen. Political skill to navigate organizational politics has had limited research within nursing. Methods. A cross-sectional research design using a web-based survey of 222 nurses who have earned or are candidates for a Ph.D. or DNP. This study utilized two validated tools to measure mentoring functions and political skill. Results. The response rate was 52% (n = 115) of which 86 were Ph.D. and 29 were DNPs. An informal mentoring relationship was described by 62% of the respondents and formal mentoring by 35% of the protégés; only 25% (n = 74) established a mentoring contract. Mentoring score showed significance for total political skill and moderate effect on the networking ability. The mentoring functions of advocacy, career development facilitation, learning facilitation, and friendship were found to correlate significantly with total political skill scores. Conclusions. This study established a benefit for nurses who have earned or are candidates for a Ph.D. or DNP from mentoring to support political skill development.
doi:10.1155/2016/3975634
PMCID: PMC5061956  PMID: 27777798
9.  Relatives to Critically Ill Patients Have No Sense of Coherence: A Quality Improvement Article Using Mixed Methods 
Nursing Research and Practice  2016;2016:6195894.
Aims and Objective. To investigate the relatives' satisfaction and involvement on a general surgery ward regarding the critically ill patient. Introduction. Relatives to critically ill patients are affected both physically and mentally during the hospitalization of a family member. Research has shown that relatives do not always receive the attention they need from health professionals. There is a lack of studies that focus on relatives' satisfaction and involvement during their family members' hospitalization. Design. A mixed methods design was chosen. Methods. A quantitative study was conducted with 27 relatives to critically ill patients. All participated in a questionnaire and out of the 27 relatives, six participated in qualitative in-depth interviews. Results. The questionnaire revealed that relatives were dissatisfied with care and involvement. For further exploration of the dissatisfaction, a qualitative approach was used and the in-depth interviews revealed three themes: lack of continuity and structure, responsibility of coordination, and relatives feeling left on their own with no guiding and support. Conclusion. Health professionals' key role in relation to relatives must be guidance and support. Thereby, relatives can gain a sense of coherence during the hospitalization of a critically ill patient, which can lead to a greater satisfaction and thereby better support for the patient.
doi:10.1155/2016/6195894
PMCID: PMC5040810  PMID: 27703810
10.  An Exploratory Study Using Cortisol to Describe the Response of Incarcerated Women IPV Survivors to MAMBRA Intervention 
Nursing Research and Practice  2016;2016:7068528.
Objective. To determine if incarcerated women survivors of IPV had a physiological response to the Music and Account-Making for Behavioral-Related Adaptation (MAMBRA) intervention, as measured by cortisol levels. Methods. A single-group repeated measures designed exploratory study was used to pilot-test MAMBRA. A convenience sample (n = 33) was recruited in a Midwestern women's correctional facility. Serving as their own control, participants provided demographics and pre-/post-MAMBRA salivary samples while attending four MAMBRA sessions. Baseline data were compared to participants' data collected over the remaining 3 MAMBRA sessions. Data were analyzed with descriptive and univariate statistics with an alpha of .05 and post-hoc power of .65. Results. Participants were predominantly White (52%), single (80%), and early middle-aged (x-AGE=38.7±9.4), with a history of physical/nonphysical spousal abuse. Using a subsample (n = 26), salivary cortisol decreased between the pre-/post-MAMBRA over the sessions (F(3,75) = 4.59, p < .01). Conclusion. Participants had a physiological response to the MAMBRA intervention as evidenced by the decreased cortisol between the pre-/post-MAMBRA. This is the first step in examining MAMBRA's clinical utility as an intervention for female IPV survivors. Future longitudinal studies will examine MAMBRA's effectiveness given this change in cortisol.
doi:10.1155/2016/7068528
PMCID: PMC5031832  PMID: 27672452
11.  Eliciting Challenges on Social Connectedness among Filipino Nurse Returnees: A Cross-Sectional Mixed-Method Research 
Nursing Research and Practice  2016;2016:9187536.
This cross-sectional study utilized a nested concurrent design to determine the association of Filipino nurse returnees' length of stay since they returned and their social connectedness as well as the essence of communication from their perspective. The respondents, who are Filipino nurses (n = 107) who worked abroad and returned to the Philippines for good, were employed from June to July of 2015 via referrals from colleges and institutions in Metro Manila and Bulacan areas in the Philippines. The quantitative results revealed, in one hand, significant but weak correlation between the respondent's length of stay and social connectedness (r = 0.224, p = 0.021, α = 0.05). On the other hand, three themes were generated from the qualitative analysis, namely, (1) Taking-In, (2) Taking-Hold, and (3) Letting-Go. The Social Connection System (SCS) provides a visual depiction of the social connectedness of a person. This research is geared towards the understanding of the interesting phenomenon of migration and social coherence of Filipino professionals.
doi:10.1155/2016/9187536
PMCID: PMC4985577  PMID: 27563462
12.  Experiences of African Students in Predominantly White Institutions: A Literature Overview 
Nursing Research and Practice  2016;2016:5703015.
The objective of this paper is to examine research conducted on the experiences of African health sciences students in predominantly white higher education institutions/environments. The main elements of cross-cultural adaptation models were adopted to discuss the amalgamated themes under the auspices of adjustment, integration, and conditioning. The overview revealed that African students encounter unique experiences, with isolation and “feeling different” being commonly mentioned. Recommendations for future research are presented, including programmatic implications for higher education and student affairs professionals.
doi:10.1155/2016/5703015
PMCID: PMC4971327  PMID: 27525115
13.  Using Multidisciplinary Focus Groups to Inform the Development of mI SMART: A Nurse-Led Technology Intervention for Multiple Chronic Conditions 
Nursing Research and Practice  2016;2016:7416728.
Used as integrated tools, technology may improve the ability of healthcare providers to improve access and outcomes of care. Little is known about healthcare teams' preferences in using such technology. This paper reports the findings from focus groups aimed at evaluating a newly developed primary care technology platform. Focus groups were completed in academic, outpatient, and community settings. Focus groups were attended by 37 individuals. The participants included professionals from multiple disciplines. Both prescribing (N = 8) and nonprescribing healthcare team members (n = 21) completed the focus groups and survey. The majority were practicing for more than 20 years (44.8%) in an outpatient clinic (62%) for 20–40 hours per week (37.9%). Providers identified perceived obstacles of patient use as ability, willingness, and time. System obstacles were identified as lack of integration, lack of reimbursement, and cost. The positive attributes of the developed system were capability for virtual visits, readability, connectivity, user-friendliness, ability to capture biophysical measures, enhanced patient access, and incorporation of multiple technologies. Providers suggested increasing capability for biophysical and symptom monitoring for more common chronic conditions. Technology interventions have the potential to improve access and outcomes but will not be successful without the input of users.
doi:10.1155/2016/7416728
PMCID: PMC4967683  PMID: 27504199
14.  Mind-Body Exercises for Nurses with Chronic Low Back Pain: An Evidence-Based Review 
Nursing Research and Practice  2016;2016:9018036.
Background. Chronic low back pain (CLBP) among nurses is a growing health concern. The multimodal nature of mind-body exercises has potential to impact physiological and psychological processes associated with chronic pain, affording possible advantages over conventional unimodal therapies. This paper summarizes the prevalence of and risk factors for CLBP among nurses, reviews the effectiveness in treating pain and disability of mind-body exercises (yoga and tai chi) for CLBP among the general and nursing population, and describes implications. Methods. Articles, published during or prior to 2015, were systematically identified through the PubMed/MEDLINE, Web of Science, and ScienceDirect databases using the following search terms: nurses, mind-body, integrative, biopsychosocial, yoga, tai chi, back pain, and/or risk factors. Results. Prevalence estimates of CLBP among nurses ranged from 50% to 80%. Associated risk factors for CLBP included lifestyle and physical, psychological, psychosocial, and occupational factors. No published studies were identified that evaluated yoga or tai chi for nurses with CLBP. Studies in the general population suggested that these interventions are effective in reducing pain and disability and may improve factors/processes predictive of CLBP. Conclusion. This review suggests that evaluating the impact of multimodal interventions such as yoga and tai chi for nurses with CLBP warrants investigation.
doi:10.1155/2016/9018036
PMCID: PMC4947504  PMID: 27446610
15.  Relationship-Building Skills of Child-Rearing Mothers in Japanese Communities 
Nursing Research and Practice  2016;2016:9091039.
This study elucidated the skills of mothers who used to build positive interpersonal relationships with people they met through child-rearing. The research method was qualitative descriptive study. The participants were 24 mothers who had children between ages of one and four years. These participants were recruited at child-rearing salons and childcare centers located in various municipalities in Japan. The survey period was from September 2013 to July 2014. The mothers' interpersonal relationship-building skills were described by six categories: “ability to strive for new encounters,” “ability to try to interact socially with others,” “ability to choose compatible people,” “ability to continuously maintain good relationships,” “ability to take action suitable to a situation,” and “ability to build positive relationships with parents-in-law.” Cognitive aspects of assessing and understanding the interactions that occur during exchanges and behavioral aspects guided by these cognitions were identified within these skills. This study contributed to providing a framework to understand mothers' interpersonal relationship-building skills for public health nurses involved in child-rearing support.
doi:10.1155/2016/9091039
PMCID: PMC4939190  PMID: 27429804
16.  Improving Outcomes for Infants with Single Ventricle Physiology through Standardized Feeding during the Interstage 
Nursing Research and Practice  2016;2016:9505629.
Congenital heart disease is identified as the most common birth defect with single ventricle physiology carrying the highest mortality. Staged surgical palliation is required for treatment, with mortality historically as high as 22% in the four- to six-month period from the first- to second-stage surgical palliation, known as the interstage. A standardized postoperative feeding approach was implemented through an evidence-based protocol, parent engagement, and interprofessional team rounds. Five infants with single ventricle physiology preprotocol were compared with five infants who received the standardized feeding approach. Mann-Whitney U tests were conducted to evaluate the hypotheses that infants in the intervention condition would consume more calories and have a positive change in weight-to-age z-score (WAZ) and shorter length of stay (LOS) following the first and second surgeries compared to infants in the control condition. After the protocol, the change in WAZ during the interstage increased by virtually one standard deviation from 0.05 to 0.91. Median LOS dropped 32% after the first surgery and 43% after the second surgery. Since first- and second-stage palliative surgeries occur within the same year of life, this represents savings of $500,000 to $800,000 per year in a 10-infant model. The standardized feeding approach improved growth in single ventricle infants while concurrently lowering hospital costs.
doi:10.1155/2016/9505629
PMCID: PMC4893427  PMID: 27313883
17.  Physiological Evaluation of Childcare-Associated Muscle Load on the Neck and Shoulder Region in Japanese Women 
Nursing Research and Practice  2016;2016:1757094.
The awkward movements and postures associated with childcare activities can lead to musculoskeletal symptoms in the neck and shoulders. “Dakko” is a method for carrying a child in Japan, and recently it has been reported to cause shoulder stiffness. To our knowledge, the relationship between childcare activities and the physical load on the neck and shoulders is poorly understood. The present study aims to clarify the muscle load on the neck and shoulder region through dakko simulations. First, the association between dakko movements and trapezius muscle activity is clarified by image and electromyogram analyses. Based on this clarification, the distributions and intensity of the muscle load from repetitive dakko movements are clarified using myogenic potential topography. During dakko movements, trapezius muscle activity was observed when lifting up and setting down the child, but not when holding the child. For the repetitive movements, myogenic electrical potentials were observed in the trapezius region after movement load, and individual characteristics of participants were revealed in both the load distributions and the recovery process. Repetitive dakko movements likely induced sustained muscle tonus in the trapezius, which may be a factor related to shoulder stiffness.
doi:10.1155/2016/1757094
PMCID: PMC4811619  PMID: 27064421
18.  Recent Clinical Characteristics of Labors Using Three Japanese Systems of Midwife-Led Primary Delivery Care 
Nursing Research and Practice  2016;2016:9101479.
Objective. The objective of this study was to describe the recent clinical characteristics of labor using 3 systems of Japanese midwife-led primary delivery care, as follows: (1) those intending to give birth at home managed by midwives who do not belong to our hospital, (2) those planning to give birth in our hospital managed by the same midwives, and (3) those planning to give birth managed by midwives who belong to our hospital. Methods. A retrospective cohort study was performed. Results. There were no significant differences in the obstetric or neonatal outcomes among the 3 groups. The rate of transfers during labor with the system involving midwives belonging to our hospital was higher than those with the other 2 systems. In addition, the timing of transfers in the system with the midwives belonging to our hospital was earlier than with the other 2 systems. Among the 3 groups, there were no significant differences in the rate of the main 2 indications for transfers: fetal heart rate abnormality and failure to progress. Conclusion. There were no significant differences in perinatal outcomes among the 3 systems; however, there were some differences in the status of transfers to obstetric shared care.
doi:10.1155/2016/9101479
PMCID: PMC4789428  PMID: 27034827
19.  Cognitive Behavioral Therapy in Psychiatric Nursing in Japan 
Nursing Research and Practice  2015;2015:529107.
Psychiatric nurses have played a significant role in disseminating cognitive behavioral therapy (CBT) in Western countries; however, in Japan, the application, practice, efficiency, and quality control of CBT in the psychiatric nursing field are unclear. This study conducted a literature review to assess the current status of CBT practice and research in psychiatric nursing in Japan. Three English databases (MEDLINE, CINAHL, and PsycINFO) and two Japanese databases (Ichushi-Web and CiNii) were searched with predetermined keywords. Fifty-five articles met eligibility criteria: 46 case studies and 9 comparative studies. It was found that CBT took place primarily in inpatient settings and targeted schizophrenia and mood disorders. Although there were only a few comparative studies, each concluded that CBT was effective. However, CBT recipients and outcome measures were diverse, and nurses were not the only CBT practitioners in most reports. Only a few articles included the description of CBT training and supervision. This literature review clarified the current status of CBT in psychiatric nursing in Japan and identified important implications for future practice and research: performing CBT in a variety of settings and for a wide range of psychiatric disorders, conducting randomized controlled trials, and establishing pre- and postqualification training system.
doi:10.1155/2015/529107
PMCID: PMC4698669  PMID: 26798512
20.  The Significance of Asthma Follow-Up Consultations for Adherence to Asthma Medication, Asthma Medication Beliefs, and Asthma Control 
Nursing Research and Practice  2015;2015:139070.
Objective. The aim was to investigate adherence to asthma medication treatment, medication beliefs, and asthma control in relation to asthma follow-up consultations in asthmatics in the general population. A further aim was to describe associations between adherence, medication beliefs, and asthma control. Method. In the population-based West Sweden Asthma Study, data allowing calculation of adherence for 4.5 years based on pharmacy records were obtained from 165 adult asthmatics. Additional data were collected through questionnaires and structured interviews. Results. The mean adherence value for filled prescriptions for regular asthma medication was 68% (median 55.3%) but varied over the year under study. Adherence to combination inhalers with corticosteroids and long-acting beta2 agonists was higher than adherence to single inhalers with corticosteroids only. More than one-third of participants reported not having seen an asthma nurse or physician for several years. Regular asthma follow-up consultations were associated with both higher adherence and the belief that asthma medication was necessary but were not associated with asthma control. Conclusions. Adherence to asthma medication treatment was low and varied over the year under study. The current study suggests that quality improvements in asthma care are needed if adherence to asthma medication is to be improved.
doi:10.1155/2015/139070
PMCID: PMC4685132  PMID: 26770823
21.  Effectiveness of Facebook-Delivered Lifestyle Counselling and Physical Activity Self-Monitoring on Physical Activity and Body Mass Index in Overweight and Obese Adolescents: A Randomized Controlled Trial 
Nursing Research and Practice  2015;2015:159205.
Background. The aim was to evaluate the effects of a 12-week, Facebook-delivered lifestyle counselling intervention, with or without physical activity self-monitoring, on physical activity and body mass index (BMI) in overweight and obese 13–16-year-old adolescents. Methods. Three-arm randomized controlled trial. Participants (n = 46) were randomly assigned to intervention and control groups: one group received Facebook-delivered lifestyle counselling and monitoring of their physical activity (Fb + Act, n = 15), whereas a second experimental group received the same Facebook-delivered lifestyle counselling without self-monitoring (Fb, n = 16) and a third group served as the control group (n = 15). Objective and self-reported physical activity assessment were used. Nonparametric statistical tests were used. Results. There were no significant intervention effects in terms of changes in physical activity levels or BMI from baseline to the 12-week postintervention measurements between the intervention and control groups. The Fb + Act group had lower sedentary time on weekdays compared to the control group during postintervention measurements (p = 0.021), but there was no interaction between time and group. Conclusions. Interventions were not effective at increasing physical activity in overweight and obese adolescents. Before implementing such interventions, more evaluations on their effectiveness are needed. This trial is registered with ClinicalTrials.gov identifier NCT02295761 (2014-11-17).
doi:10.1155/2015/159205
PMCID: PMC4678089  PMID: 26697218
22.  Spousal Presence as a Nonpharmacological Pain Management during Childbirth: A Pilot Study 
Nursing Research and Practice  2015;2015:932763.
Background. Measures of spousal effect during parturient pain should take a tripartite approach involving the parturients, spouses, and midwives. Aim. To develop and validate three questionnaires measuring spousal presence in management of parturient pain in Nigeria. Methods. There are two phases: (1) development of questionnaires, Abuja Instrument for Midwives (AIM), Abuja Instrument for Parturient Pain (AIPP), and Abuja Instrument for Parturient Spouses (AIPS), utilizing literatures, Kuopio instrument for fathers (KIF) and expertise of health professionals, and (2) pilot study to validate the questionnaires which were administered in two hospitals in Nigeria: midwives (n = 10), parturients (n = 10), and spouses (n = 10).  Results. Internal consistency for the three questionnaires indicated Cronbach's alpha coefficient of 0.789 (AIM), 0.802 (AIPP), and 0.860 (AIPS), while test-retest reliability was r = 0.99 (AIM), r = 0.99 (AIPP), and r = 0.90 (AIPS). Conclusions. AIM, AIPP, and AIPS provide a means of investigating the effectiveness of spousal presence in management of parturient pain in Nigeria. However, further testing of each instrument is needed in a larger population to replicate the beneficial findings of AIMS, AIPP, and AIPS which can contribute rigor to future studies.
doi:10.1155/2015/932763
PMCID: PMC4670669  PMID: 26682066
23.  Symptomatology and Coping Resources Predict Self-Care Behaviors in Middle to Older Age Patients with Heart Failure 
Nursing Research and Practice  2015;2015:840240.
Background. Symptoms of heart failure (HF) and coping resources, such as social support and social problem-solving, may influence self-care behaviors. Research regarding the influence of HF symptomatology characteristics and components of social support and social problem-solving on self-care is limited. Objective. To identify predictors of HF self-care behaviors using characteristics of HF symptomatology, components of social support and social problem-solving, and demographic and clinical factors. Methods. Using a cross-sectional, correlational predictive design, a convenience sample (N = 201) of outpatients with HF answered self-report surveys. Multiple linear regression with stepwise variable selection was conducted. Results. Six predictors of HF self-care were identified: race, symptom frequency, symptom-related interference with enjoyment of life, New York Heart Association Class HF, rational problem-solving style, and social network (β = 34.265, R2 = 0.19, P = 0.001). Conclusions. Assessing the influence of race on self-care behaviors in middle to older age patients with HF is important. Clinical assessment that focuses on symptom frequency, symptom-related interference with enjoyment of life, and HF Class might also impact self-care behaviors in this population. Rational problem-solving skills used and evaluation of the size of and satisfaction with one's social network may be appropriate when assessing self-care.
doi:10.1155/2015/840240
PMCID: PMC4651789  PMID: 26618000
24.  Nurses' and Nursing Students' Knowledge and Attitudes regarding Pediatric Pain 
Nursing Research and Practice  2015;2015:210860.
Nursing staff spend more time with patients with pain than any other health staff member. For this reason, the nurse must possess the basic knowledge to identify the presence of pain in patients, to measure its intensity and make the steps necessary for treatment. Therefore, a prospective, descriptive, analytical, and cross-sectional study was conducted to investigate the knowledge and attitudes regarding pediatric pain in two different populations. The questionnaire, Pediatric Nurses Knowledge and Attitudes Survey Regarding Pain (PKNAS), was applied to 111 hospital pediatric nurses and 300 university nursing students. The final scores for pediatric nurses and nursing students were 40.1 ± 7.9 and 40.3 ± 7.5, respectively. None of the sociodemographic variables predicted the scores obtained by the participants (P > 0.05). There was a high correlation between the PKNAS scores of pediatric nurses and nursing students (r = 0.86, P < 0.001). It was observed that the degree of knowledge about pain and its treatment was very low in both groups. Due to this deficiency, pain in children remains inadequately managed, which leads to suffering in this population. It is necessary to increase the continued training in this subject in both areas.
doi:10.1155/2015/210860
PMCID: PMC4620320  PMID: 26543643
25.  Previous Education, Sociodemographic Characteristics, and Nursing Cumulative Grade Point Average as Predictors of Success in Nursing Licensure Examinations 
Nursing Research and Practice  2015;2015:682479.
Introduction. Success in the licensure examination is the only legal prerequisite to practice as a nurse in Ghana. However, a large percentage of nursing students who sit fail this examination for the first time. This study sought to unravel whether prior education, sociodemographic characteristics, and nursing Cumulative Grade Point Average (CGPA) could predict performance in the licensure examinations. Methods. The study was a descriptive cross-sectional survey conducted from November 2014 to April 2015 in the Kumasi metropolis, Ghana on 176 past nursing students. Data was collected using questionnaires and analyzed using SPSS version 22. A logistic regression model was fitted to look at the influence of the explanatory variables on the odds of passing the licensure examinations. All statistical significances were tested at p value of <0.05. Results. Majority, 56.3%, were females and 86.4% were between the ages of 25 and 31 years. Most of the students (88.6%) entered the nursing training colleges with a WASSCE qualification and 38% read general science. 73.9% passed the licensure examinations and the mean CGPA of the students was 2.89 (SD = 0.37). Sociodemographic characteristics and previous education had no influence on performance in the licensure examinations. CGPA had strong positive relationship with performance in licensure examinations (AOR = 15.27; 95% CI = 6.28, 27.11). Conclusion. Students CGPA could be a good predictor of their performance in the licensure examinations. On the other hand, students' sociodemographic and previous educational characteristics might not be important factors to consider in admitting students into the nursing training programme.
doi:10.1155/2015/682479
PMCID: PMC4617873  PMID: 26635975

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