Cassandra D. Ford

The mock trial: a collaborative interdisciplinary approach to understanding legal and ethical issues.

To provide high-quality, safe, patient-centered care, RNs must exhibit a strong understanding of legal and ethical issues. The authors describe an interdisciplinary teaching learning strategy, the premock, actual, and postmock trial, to augment student retention of legal and ethical concepts and enhance the development of their personal accountability.

Psychosocial Factors Are Associated With Blood Pressure Progression Among African Americans in the Jackson Heart Study.

BACKGROUND Research that examines the associations of psychosocial factors with incident hypertension among African Americans (AA) is limited. Using Jackson Heart Study (JHS) data, we examined associations of negative affect and stress with incident hypertension and blood pressure (BP) progression among AA. METHODS Our sample consisted of 1,656 normotensive participants at baseline (2000-2004) (mean age 47±12; 61% women). We investigated associations of negative affect (cynical distrust, anger-in, anger-out, and depressive symptoms) and stress (perceived stress, weekly stress inventory (WSI)-event, WSI-impact, and major life events) with BP progression (an increase by one BP stage as defined by JNC VII) and incident hypertension by examination 2 (2005-2008). Poisson regression analysis was utilized to examine the prevalence ratios (PRs; 95% confidence interval (CI)) of BP tracking and incident hypertension with psychosocial factors, adjusting for baseline age, sex, socioeconomic status (SES), and hypertension risk factors. RESULTS Fifty-six percentage of the sample (922 cases) had BP progression from 2005 to 2008. After adjustment for age, sex, and SES, a high anger-out score was associated with a 20% increased risk of BP progression compared to a low anger-out score (PR 1.20; 95% CI 1.05-1.36). High depressive symptoms score was associated with BP progression in the age, sex, and SES-adjusted model (PR 1.14; 95% CI 1.00-1.30). High WSI-event scores were associated with BP progression in the fully adjusted model (PR 1.21; 95% CI 1.04-1.40). We did not observe significant associations with any of the psychosocial measures and incident hypertension. CONCLUSIONS Psychosocial factors were associated with BP progression, with the strongest evidence for number of stressful events that occurred.

Psychosocial Factors and Behaviors in African Americans: The Jackson Heart Study

INTRODUCTION There are limited reports on the association of psychosocial factors with unhealthy behaviors, which are key mediators in the psychosocial-cardiovascular disease pathway. The Jackson Heart Study was used to examine the associations of multiple psychosocial factors with behaviors among African Americans. METHODS The Jackson Heart Study is a prospective, cohort study of cardiovascular disease among African Americans recruited from the Jackson, MS, metropolitan area between 2000 and 2004. Between 2015 and 2016, multivariable regression was used to analyze the cross-sectional associations of baseline negative affect (cynicism, anger-in, anger-out, and depressive symptoms) and stressors (global stress, Weekly Stress Inventory-event, Weekly Stress Inventory-impact, and major life events) with the odds of current smoking and mean differences in dietary fat intake, physical activity, and hours of sleep. RESULTS Men were more likely to smoke than women (p<0.001) and had higher physical activity scores (p<0.001). Women reported more hours of sleep (p=0.001). In fully adjusted models, each negative affect and stress measure was significantly associated with an increased odds of current smoking. For example, the odds of smoking increased by 14% for each 1-SD increase in cynical distrust score (OR=1.14, 95% CI=1.01, 1.27) in the fully adjusted model. Further, each negative affect and stress measure (except anger-out) was significantly associated with fewer hours of sleep in fully adjusted models. CONCLUSIONS Using a large sample of African Americans, this study found that multiple psychosocial risk factors were associated with unhealthy behaviors that are prevalent among this population.

A Qualitative Examination of Barriers for Urban and Rural Custodial Grandparents

Extant grandparent-grandchild research identifies numerous attributes of “ideal” grandparents. To date, however, intergenerational communication researchers have not been able to adequately operationalize grandchildren’s perceptions of their grandparents as ideal. As such, the purpose of this study was to develop the Ideal Grandparent Scale (IGS) by (a) assessing its concurrent and construct validity and (b) examining its reliability. First, the IGS items were derived deductively. Second, American grandchildren (N—171) completed the IGS along with several established instruments. The results of partial Pearson correlational analyses provided support for the hypotheses, which established initial evidence of the IGS’s concurrent and construct validity. Similarly, a split-half reliability test followed by a Feldt test and a Fisher z test provided strong support for the IGS’s reliability.

Live Versus DVD Mock Trial: Are Cognitive and Affective Changes Different?

Educating nurses to provide safe, ethical patient care while being socialized into the professional role requires active learning Personal, affective growth and professional transformation occur over the course of the nursing program as a result of the synthesis of cognitive knowledge, psychomotor skills, and ethical standards into a professional identity (Benner, Sutphen, Leonard, & Day, 2010). The end result is a nurse who demonstrates ethical comportment by keeping the good of the patient at the forefront, and continually acting to protect patient safety and dignity (Benner et al.). All faculty are challenged to present didactic material while using best practices. Encouraging the internalization of content while being prudent regarding financial and faculty resources requires creativity. We decided to revisit one creative strategy for teaching ethical patient care to nursing students, that is, the mock trial and explore how viewing a live trial versus a DVD affected cognitive knowledge and changed affective learning. The purpose of this study was twofold: a) to explore how presenting didactic information, followed by experiential learning with a mock trial, enhanced the cognitive and affective domains of the learner, and b) to investigate the effectiveness of a live mock trial versus a DVD of the same trial in producing the desired changes. METHOD This mixed-methods, quasi-experimental study involved 192 generic baccalaureate nursing students at a public university in the United States. The students had completed all general education credits, including an ethics course. The mock trial took place during the first upper division semester in a professional concepts course. One cohort of 96 students experienced a live mock trial; the second cohort, also 96 students, experienced the DVD version of the same trial. Focus groups with each cohort provided insight into thoughts regarding the events of the trial and its perceived effectiveness as a teaching method. Sample Most student participants were female (89.5 percent). The race/ ethnicity membership of the total cohort was 92 percent Caucasian, 6.5 percent African American, and 1.5 percent other. All students attended focus groups. Three students did not complete both the pretest and the posttest, resulting in a final sample of 189 students. Data Collection and Analysis Cohorts completed identical learning modules covering ethical content and legal issues. After finishing the modules, students completed a pretest to determine baseline knowledge about legal concepts as discussed in The Essentials of Baccalaureate Education for Professional Nursing Practice (American Association of Colleges of Nursing, 2008) as well as current affective status. Identical pre-/posttests consisted of 17 questions, assessing three faculty-identified constructs: knowledge, responsibility, and accountability. Knowledge questions measured cognitive change. Responsibility and accountability questions assessed affective change. This level of assessment was appropriate for newly promoted undergraduate students who are just beginning to interact with patients, as they were likely to be in one of the first two steps of the affective taxonomy, receiving and responding (Kirkpatrick & DeWitt, 2012). The test was a course-specific exam, and face validity was confirmed by faculty experts. The live trial took place in a courtroom and was recorded for future use. The case was a scripted scenario developed by nursing faculty and a circuit court judge. It was loosely based on a real-life case and involved a nurse who gave a miscalculated overdose of digoxin and did not record the administration of the medication. Mock trial participants playing various roles included students and faculty from law, nursing, and the drama department (March, Ford, Adams, Cheshire, & Collins, 2011). Immediately following the intervention, students participated in focus groups to determine how the mock trial affected them and to assess the acceptability and effectiveness of the strategy. …

Using data from the internet to teach ethical principles for critiquing research studies.

Qualitative researchers are increasingly using the Internet to conduct their studies; however, they need to adhere to the same ethical principles used when conducting traditional research studies. Students also must be aware of these ethical principles and know how to critique research reports for adherence to them. The authors describe selected ethical principles as they relate to Internet qualitative research, what students need to know, what faculty must teach them to critique those studies, and what decisions students must make once the critique is completed.

Family health history and future nursing practice: Implications for undergraduate nursing students

• A complete and accurate family health history is an integral part of providing comprehensive care.

An Innovative Academic/service Partnership to Increase Bsn-prepared Rns in a Rural Hospital

Developing innovative ways to increase BSN-prepared nurses in hospitals in rural regions is a struggle. A partnership between 1 hospital and a local university to support the associate-degree new graduates to progress toward their BSN is proving to be a success.

Perceptions of Community Resources and Insights for Program Development from Southern, Rural Hypertensive Women

Background. Hypertension affects millions of Americans each year and is a significant contributor to the development of cardiovascular disease. African Americans, especially those living in rural locations, experience greater disparities in the incidence and prevalence rates of hypertension and cardiovascular disease. Methods. This study utilizes qualitative descriptive methodology. Focus groups involving African American women reporting hypertension were conducted in a rural community in Alabama. Results. The mean age was 60.3 years of age (SD = 10.3). Most were married and half were college educated. The majority reported an overweight or obese status. Most were aware that they had hypertension for more than five years, all were nonsmokers, and the majority had a family history of heart disease, hypertension, and/or heart attack or stroke. Key themes emerging from the focus groups included strengths of the community, support for the community, support for a healthy lifestyle, and intervention development. Conclusion. Hypertension is a treatable and preventable disease that not only causes disability, but also significantly decreases the quality of life in affected individuals. Findings from this study provide insight into the unique needs and perceptions of African American women residing in rural Alabama as they relate to community resources.