Journal of Nursing Scholarship

Publisher: Sigma Theta Tau International, Blackwell Publishing


Reaching health professionals, faculty and students in 90 countries, the Journal of Nursing Scholarship is focused on health of people throughout the world. It is the official journal of the Honor Society of Nursing, Sigma Theta Tau International, and reflects the honor society's dedication to providing the tools necessary to improve nursing care globally.

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    Journal of nursing scholarship (Online), Journal of nursing scholarship
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Blackwell Publishing

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Publications in this journal

  • Journal of Nursing Scholarship 01/2015; 47(1):3-4.
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    ABSTRACT: Background Up to 4 million people in Tanzania are at risk for the parasitic disease onchocerciasis. A treatment program, Community-Directed Treatment with Ivermectin (CDTI), has made significant gains in prevention and treatment. Understanding factors affecting participation could help boost treatment coverage and sustain gains made in controlling onchocerciasis in endemic areas.PurposeTo explore community-perceived factors related to participation in and sustainability of the CDTI program in southwest Tanzania.Methods Multilevel triangulation design using surveys, focus group discussions (FGDs), and semistructured interviews to collect data in two villages in the Morogoro Rural District of Tanzania. In total, 456 villagers participated in the survey and 42 in FDGs. Five community-directed distributors (CDDs) and three community health workers were interviewed.FindingsHigh levels of awareness of onchocerciasis (90%) and methods of prevention and treatment (95%) were reported. Over 75% of participants knew how ivermectin was distributed and 74% have taken the drug. Over 90% of villagers knew that distribution of the drug was for treatment and prevention. Only 43% knew the cause of onchocerciasis. Through FGDs, villagers reported barriers to participation, including lack of comprehensive understanding of the disease, fears of medication, distrust of the method determining dose, lack of health education materials, insufficient CDD-resident communication, and inflexible drug distribution mechanisms.Conclusions Sustaining programs without supporting growth of CDDs and reinforcing education of communities could lead to a decrease in treatment and an increase in the public health threat. This research uncovered a need for more effective community education and sensitization.Clinical RelevanceUnderstanding barriers to participation in community-based programs can assist public health and community health nurses and key stakeholders including Ministries of Health and local and regional health systems in the development of education and support materials to enhance health literacy and encourage program participation.
    Journal of Nursing Scholarship 01/2015; 47(1).
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    ABSTRACT: PurposeThe purpose of this study was twofold: (a) to determine the prevalence of compassion satisfaction, compassion fatigue, and burnout in emergency department nurses throughout the United States and (b) to examine which demographic and work-related components affect the development of compassion satisfaction, compassion fatigue, and burnout in this nursing specialty.Design and Methods This was a nonexperimental, descriptive, and predictive study using a self-administered survey. Survey packets including a demographic questionnaire and the Professional Quality of Life Scale version 5 (ProQOL 5) were mailed to 1,000 selected emergency nurses throughout the United States. The ProQOL 5 scale was used to measure the prevalence of compassion satisfaction, compassion fatigue, and burnout among emergency department nurses. Multiple regression using stepwise solution was employed to determine which variables of demographics and work-related characteristics predicted the prevalence of compassion satisfaction, compassion fatigue, and burnout. The α level was set at .05 for statistical significance.FindingsThe results revealed overall low to average levels of compassion fatigue and burnout and generally average to high levels of compassion satisfaction among this group of emergency department nurses. The low level of manager support was a significant predictor of higher levels of burnout and compassion fatigue among emergency department nurses, while a high level of manager support contributed to a higher level of compassion satisfaction.Conclusions The results may serve to help distinguish elements in emergency department nurses’ work and life that are related to compassion satisfaction and may identify factors associated with higher levels of compassion fatigue and burnout.Clinical RelevanceImproving recognition and awareness of compassion satisfaction, compassion fatigue, and burnout among emergency department nurses may prevent emotional exhaustion and help identify interventions that will help nurses remain empathetic and compassionate professionals.
    Journal of Nursing Scholarship 01/2015;
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    ABSTRACT: To describe novel and emerging strategies practiced globally in research to improve longitudinal data collection. In research studies, numerous strategies such as telephone interviews, postal mailing, online questionnaires, and electronic mail are traditionally utilized in longitudinal data collection. However, due to technological advances, novel and emerging strategies have been applied to longitudinal data collection, such as two-way short message service, smartphone applications (or "apps"), retrieval capabilities applied to the electronic medical record, and an adapted cloud interface. In this review, traditional longitudinal data collection strategies are briefly described, emerging and novel strategies are detailed and explored, and information regarding the impact of novel methods on participant response rates, the timeliness of participant responses, and cost is provided. We further discuss how these novel and emerging strategies affect longitudinal data collection and advance research, specifically nursing research. Evidence suggests that the novel and emerging longitudinal data collection strategies discussed in this review are valuable approaches to consider. These strategies facilitate collecting longitudinal research data to better understand a variety of health-related conditions. Future studies, including nursing research, should consider using novel and emerging strategies to advance longitudinal data collection. A better understanding of novel and emerging longitudinal data collection strategies will ultimately improve longitudinal data collection as well as foster research efforts. Nurse researchers, along with all researchers, must be aware of and consider implementing novel and emerging strategies to ensure future healthcare research success. © 2014 Sigma Theta Tau International.
    Journal of Nursing Scholarship 12/2014;
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    ABSTRACT: The purposes of this study were (a) to evaluate self-care, symptom burden, and reported infections among individuals with lower-extremity primary lymphedema; (b) to examine the differences in self-care, symptom burden, and reported infections between individuals with unilateral and those with bilateral lower-extremity primary lymphedema; and (c) to examine the associations among self-care status, symptom burden, and reported infections in individuals with lower-extremity primary lymphedema. A secondary data analysis was used. Data were collected from a cross-sectional survey study supported by the National Lymphedema Network from March 2006 through January 2010. The surveys were available both online and in hard copy in order to increase accessibility. Descriptive statistics were conducted and associations between variables were assessed using Mann-Whitney tests and chi-square tests of independence. Multiple logistic regression was used to test for associations while controlling for potentially confounding variables. A total of 803 participants reported having lower-extremity primary lymphedema. The majority of the participants were female (82.9%), White (74.2%), and from the United States (90.7%). Approximately two thirds of the respondents conducted some home daily lymphedema self-care. Over half of the respondents reported experiencing symptom burden and 44.8% reported at least one episode of infection. Compared to individuals with unilateral lower-extremity primary lymphedema, individuals with bilateral lower-extremity lymphedema were more likely to conduct skin care (p = .004), use alternative medications (p = .005), more frequently reported symptoms (p < .05), and more likely to report at least one episode of infection (p = .002). Respondents who reported use of compression garments also were less likely to have self-reported pain (p = .002), poor range of motion (p = .026), and numbness (p = .001). Participants who reported exercising also were less likely to have self-reported pain (p = .003). Participants who reported at least one episode of infection also reported experiencing more symptoms (p < .001). Individuals with lower-extremity primary lymphedema experienced substantial symptom burden and infection episodes. Significant associations were identified among self-care, symptom burden, and reported infections. The findings support the need for clinicians to educate patients with lower-extremity primary lymphedema regarding the importance of self-care, symptom management, and infection control. It is critically important for clinicians to evaluate symptom burden and reduce infections in individuals with lower-extremity primary lymphedema. © 2014 Sigma Theta Tau International.
    Journal of Nursing Scholarship 12/2014;
  • Journal of Nursing Scholarship 12/2014;
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    ABSTRACT: PurposeThe incidence of sexually transmitted infections (STIs) and human immunodeficiency virus (HIV) is high among young Chilean women, and there are no STI or HIV prevention interventions available to them that incorporate technology. The purpose of this study was to investigate the preliminary efficacy of an Internet-based STI and HIV prevention intervention (I-STIPI) for Chilean young women on measures of STI- and HIV-related information, motivation, behavioral skills, and preventive behaviors.DesignThis is a pretest-posttest study. Forty young Chilean women between 18 and 24 years of age participated in an investigation of the I-STIPI's preliminary efficacy on STI and HIV prevention-related outcomes between baseline and a postintervention assessment. The intervention consisted of four online modules. Data collection was conducted in Santiago, Chile. Paired-samples t test analysis was used to determine whether there were significant differences in each of the outcome variables.FindingsAfter receiving I-STIPI, women reported a significant increase in levels of STI- and HIV-related knowledge, attitudes toward the use of condoms and perceived self-efficacy, and a reduction of risky sexual behaviors with uncommitted partners.Conclusions The I-STIPI showed promise as an Internet-based intervention that can reduce barriers to accessing preventive interventions and increase STI and HIV preventive behaviors in young Chilean women.Clinical RelevanceThe study provided important information about the ability of an Internet-based intervention to reduce young women's risk factors and to provide positive preliminary efficacy on STI- and HIV-related outcomes. Internet-based interventions can eliminate many barriers to receiving prevention interventions and may prove to be cost effective.
    Journal of Nursing Scholarship 11/2014;
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    ABSTRACT: PurposeTo report on approaches that were used to assist with implementation of family systems nursing (FSN) at a university hospital level in Northern Europe.Design and MethodsA quasi-experimental research design was used for the first phase of the study. For the second phase, a cross-sectional research design was used. Data were collected in the first phase of the study from 457 nurses in all except one of the divisions of the hospital regarding their attitudes towards involving families into their care before and after having participated in the education and training intervention (ETI) program in FSN. Furthermore, in the second phase, data were collected from 812 nurses, after FSN had been implemented in all divisions at Landspitali University Hospital, regarding the nurses’ knowledge of FSN and their evaluation of the quality of the ETI program (i.e., theoretical lectures on FSN as well as the benefit of the skill lab training regarding applying FSN into their clinical practices). Graham and colleagues’ Knowledge to Action framework was used as the conceptual framework for the research.ResultsNurses who had taken a course in FSN reported a significantly more positive attitude towards involving families in their care after the ETI program compared to those who had not taken such a course. Furthermore, a majority of the nurses who participated in the ETI program reported that the program was a favorable experience and indicated readiness for applying FSN in clinical practice.Conclusions Further research is needed regarding the benefits of offering FSN at an institutional level, but focusing international attention on effective strategies to implement FSN into nursing practice may result in better health care for individuals and families around the globe.Clinical RelevanceProviding clinically meaningful education and training in family nursing through programs such as the ETI program for practicing nurses at a university hospital is essential in supporting nurses applying new knowledge, when providing evidence-based health care services, to individuals and their family members. Such training can facilitate integration of new and needed information in clinical practice.
    Journal of Nursing Scholarship 11/2014;
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    ABSTRACT: PurposeMoral distress is a phenomenon affecting many professionals across healthcare settings. Few studies have used a standard measure of moral distress to assess and compare differences among professions and settings.DesignA descriptive, comparative design was used to study moral distress among all healthcare professionals and all settings at one large healthcare system in January 2011.Methods Data were gathered via a web-based survey of demographics, the Moral Distress Scale-Revised (MDS-R), and a shortened version of Olson's Hospital Ethical Climate Scale (HECS-S).FindingsFive hundred ninety-two (592) clinicians completed usable surveys (22%). Moral distress was present in all professional groups. Nurses and other professionals involved in direct patient care had significantly higher moral distress than physicians (p = .001) and other indirect care professionals (p < .001). Moral distress was negatively correlated with ethical workplace climate (r = -0.516; p < .001). Watching patient care suffer due to lack of continuity and poor communication were the highest-ranked sources of moral distress for all professional groups, but the groups varied in other identified sources. Providers working in adult or intensive care unit (ICU) settings had higher levels of moral distress than did clinicians in pediatric or non-ICU settings (p < .001). Providers who left or considered leaving a position had significantly higher moral distress levels than those who never considered leaving (p < .001). Providers who had training in end-of-life care had higher average levels of moral distress than those without this training (p = .005).Conclusions Although there may be differences in perspectives and experiences, moral distress is a common experience for clinicians, regardless of profession.Clinical RelevanceMoral distress is associated with burnout and intention to leave a position. By understanding its root causes, interventions can be tailored to minimize moral distress with the ultimate goal of enhancing patient care, staff satisfaction, and retention.
    Journal of Nursing Scholarship 11/2014;
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    ABSTRACT: To identify the prevalence and perpetrators of workplace violence against nurses and to examine the relationship of work demands and trust and justice in the workplace with the occurrence of violence.
    Journal of Nursing Scholarship 10/2014;
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    ABSTRACT: PurposeThe aim of this study was to develop, implement, and evaluate a theory-based intervention designed to promote increased health empowerment for marriage migrant women in Taiwan. The rapid increase of international marriage immigration through matchmaking agencies has received great attention recently because of its impact on social and public health issues in the receiving countries.Design and MethodsA participatory action research (PAR) and in-depth interviews were adopted. Sixty-eight women participated in this study. Eight workshops of the health empowerment project were completed.FindingsThrough a PAR-based project, participants received positive outcomes. Four outcome themes were identified: (a) increasing health literacy, (b) facilitating capacity to build social networks, (c) enhancing sense of self-worth, and (d) building psychological resilience.ConclusionsPAR was a helpful strategy that enabled disadvantaged migrant women to increase their health literacy, psychological and social health, and well-being.Clinical RelevanceThe findings can be referenced by the government in making health-promoting policies for Southeast Asian immigrant women to increase their well-being. Community health nurses can apply PAR strategies to plan and design health promotion intervention for disadvantaged migrant women.
    Journal of Nursing Scholarship 10/2014;
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    ABSTRACT: PurposeTo identify and examine the expert panelists’ visions on the future implementation of the clinical nurse specialist (CNS) role in Finland.Design and MethodsA policy Delphi design was conducted in 2013. A purposive sampling method was used to recognize expert panelists in the areas of advanced practice nursing (APN), healthcare management, and advanced practice nurse education. Three iterative Web-based survey rounds were conducted (n = 25, n = 22, n = 19). Both qualitative and quantitative methods were used to analyze the data.FindingsThe expert panelists envisioned the future of the CNS role in Finland. This study portrayed the CNS role in Finland as generally consistent with the international role. CNS have comprehensive skills and knowledge that they use to guide and develop nursing practice; however, several threats may affect their role achievement. The existing national consensus, contradiction, and ambivalence related to CNS roles were revealed through the examination of the results, thus pointing out the areas for consideration when further developing these roles and role policies.Conclusions This is the first national study to examine the implementation of the CNS role in Finland. Expert panelists’ views regarding the CNS role will be valuable in the forthcoming national policy formulation process. Although the policy Delphi design is not often utilized, this study reveals that it is very well suited to guide and inform national and international APN policy development.Clinical RelevanceThis study contributes to CNS role development and describes the methods facilitating the essential policy formulation process.
    Journal of Nursing Scholarship 10/2014;
  • Journal of Nursing Scholarship 10/2014;
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    ABSTRACT: PurposeTo compare skills acquired by undergraduate nursing students enrolled in a medical-surgical course. To compare skills demonstrated by students with no previous clinical practice (undergraduates) and nurses with clinical experience enrolled in continuing professional education (CPE).DesignIn a nonrandomized clinical trial, 101 undergraduates enrolled in the “Adult Patients 1” course were assigned to the traditional lecture and discussion (n = 66) or lecture and discussion plus case-based learning (n = 35) arm of the study; 59 CPE nurses constituted a comparison group to assess the effects of previous clinical experience on learning outcomes.Methods Scores on an objective structured clinical examination (OSCE), using a human patient simulator and cases validated by the National League for Nursing, were compared for the undergraduate control and intervention groups, and for CPE nurses (Student's t test).FindingsControls scored lower than the intervention group on patient assessment (6.3 ± 2.3 vs 7.5 ± 1.4, p = .04, mean difference, -1.2 [95% confidence interval (CI) -2.4 to -0.03]) but the intervention group did not differ from CPE nurses (7.5 ± 1.4 vs 8.8 ± 1.5, p = .06, mean difference, -1.3 [95% CI -2.6 to 0.04]). The CPE nurses committed more “rules-based errors” than did undergraduates, specifically patient identifications (77.2% vs 55%, p = .7) and checking allergies before administering medication (68.2% vs 60%, p = .1).Conclusions The intervention group developed better patient assessment skills than the control group. Case-based learning helps to standardize the process, which can contribute to quality and consistency in practice: It is essential to correctly identify a problem in order to treat it. Clinical experience of CPE nurses was not associated with better adherence to safety protocols.Clinical RelevanceCase-based learning improves the patient assessment skills of undergraduate nursing students, thereby preparing them for clinical practice.
    Journal of Nursing Scholarship 10/2014;
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    ABSTRACT: PurposeTo examine differences in spirituality, purpose in life, and attitudes toward organ donation between people who signed and those who did not sign an organ donor card.DesignA descriptive cross-sectional survey conducted in Israel with a sample of 312 respondents from the general population, of whom 220 (70.5%) signed an organ donor card. Data were collected during April–June 2013.Methods Participants completed a paper questionnaire and a Web-based questionnaire consisting of four sections: spiritual health, purpose in life, attitudes toward organ donation, and social-demographic questions. Descriptive statistics, t test, chi-square test, and a logistic regression analysis were performed.FindingsDifferences in mean scores between respondents who signed an organ donor card and those who did not were indicated in transcendental spirituality (p < .01), purpose in life (p < .05), and attitudes toward organ donation (p < .01). No statistically significant difference was found between the groups in the overall spirituality mean score. The spiritual transcendental dimension, individual's purpose in life, and attitudes toward organ donation explained 34.3% of the variance of signing an organ donor card.Conclusions Signing an organ donor card was found to be correlated with high purpose in life, positive attitudes toward organ donation, and low level of transcendental spirituality.Clinical RelevanceNurses should assess the patient's spiritual needs in order to construct appropriate programs for promoting signing an organ donor card. Nurses who signed an organ donor card should be encouraged to share this information with their patients.
    Journal of Nursing Scholarship 09/2014;
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    ABSTRACT: PurposeAfrican immigrants are one of the fastest growing immigrant groups to the United States; there is a crucial need to learn about African immigrants’ beliefs and lifestyle behaviors that may impact health. The purposes of this study were to (a) explore the perceptions and practices of Nigerian immigrants regarding healthy eating and physical activity in the United States; (b) assess the influence of cultural beliefs of Nigerian immigrants on eating and physical activity; (c) describe the role that healthcare providers can play in helping to promote healthy eating and physical activity; and (d) evaluate the feasibility and efficacy of using Photovoice to collect data on the perceptions and practices of Nigerian immigrants regarding healthy eating and physical activity.DesignQualitative visual ethnography using Photovoice.Methods Thirteen Nigerian immigrants were recruited. Data were collected using photography and focus group discussions at a church. Photovoice methodology and Leininger's four phases of qualitative analysis were used to analyze photographs, field notes, and focus group transcripts.FindingsFour overarching themes emerged from the data: moderation is healthy, Nigerian ways of living are healthy, acquiring American ways is unhealthy, and cultural context is important to promote healthy behaviors.Conclusions Photovoice was a feasible, effective methodology for collecting data on the perceptions and practices of Nigerian immigrants. Nigerian participants believed that adherence to traditional dietary and activity practices are healthy. Nurses and other healthcare providers must make concerted efforts to communicate with and educate Nigerian immigrants about healthful eating and activity behaviors within their cultural context.Clinical RelevanceThe number of African immigrants to the United States has increased dramatically. Photovoice is a creative method to learn about the health beliefs and behaviors of the Nigerian immigrant population.
    Journal of Nursing Scholarship 09/2014;
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    ABSTRACT: PurposePopulation data concerning smoking rates of adolescents and adults in the United States and Korea (South Korea) has highlighted the need for attention to this age group. This study compared the risk factors related to smoking and examined the gender differences with other risk factors in smoking among American and Korean adolescents between 2005 and 2011.Organizing Construct and Methods Participants were students in grades 9–11 selected from nationally representative surveys conducted in 2005 and 2011.FindingsIn 2011, similar risk factors for current smoking were identified in American and Korean adolescents. These included male gender, school grade, depression, experience of alcohol drinking, current use of alcohol, use of glue or other inhalants, and experience of sexual intercourse. Among Korean adolescents, weight perception and weight control were unique risk factors for current smoking. Interactions with gender and other risk factors in each nation were revealed.Conclusions These risk factors, their change from earlier years, and gender differences should be recognized in the screening of vulnerable individuals for smoking and formulating effective intervention programs.Clinical RelevanceThese results will provide information for the design and implementation of cessation programs for adolescents in these countries.
    Journal of Nursing Scholarship 09/2014;
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    ABSTRACT: PurposeTo explore nurses' perceptions of the nature of nursing work as a factor that contributes to attrition from the profession.DesignA nonpurposive sample of nurses from the Nurses and Midwives e-cohort Study in Australia, New Zealand, and the United Kingdom provided electronic responses about reasons for leaving the profession. Data were then subjected to qualitative content analysis.FindingsNurses at the “coal face,” that is, those who actually do the work of nursing, in real working conditions, express dissatisfaction in relation to hygiene factors relating to the nature of nursing work and attribute these to nurses leaving the profession: workload, shift work, violence, and financial remuneration.Conclusions Nurses’ satisfaction with work and motivation to work are being sorely tested. There is manifest tension between the core concepts of nursing—compassion and care—and a system of work that actively precludes nurses from being able to exhibit these virtues and fails to reward them. Workload, shift work, violence, and financial remuneration are drivers of attrition and need to be addressed.Clinical RelevanceImplications from this study are fourfold: determination of nursing workload, mitigating the impact of shift work, providing safe work environments, and adequate financial remuneration.
    Journal of Nursing Scholarship 09/2014; 46(5).
  • Journal of Nursing Scholarship 09/2014; 46(5).