Gloria Duke

Pain Management Knowledge and Attitudes of Baccalaureate Nursing Students and Faculty

Pain affects approximately 76 million adults in the US. Though pain management has been targeted as a top priority, it continues to be inadequately addressed. Nursing faculty are in a unique position to significantly address the problem through facilitating the acquisition and utilization of knowledge by student nurses. The purpose of this study was to determine the knowledge of and attitudes toward pain in baccalaureate nursing students and faculty to establish a foundation for a systematic and comprehensive integration of pain content in the curricula. The descriptive design included a sample of 162 junior and senior students enrolled in a baccalaureate nursing program in Texas and 16 nursing faculty. The Knowledge and Attitudes Survey Regarding Pain (KASRP) was used to measure knowledge and attitudes toward pain. A direct correlation was found between the level of education and the percentage correct score. Differences found in knowledge and attitudes among the three levels of students and faculty were significant (df = 3.173; F = 14.07, p < .001). Senior students nearing graduation scored only 68% (SD = 6.8) with faculty scoring only slightly better with a mean of 71% (SD = 13). Significant differences also were found in assessment of pain through case scenarios of a patient who was smiling and talking as compared to a patient who was lying quietly and grimacing (X2 = 37.13, p < .05 (df = 24). Reevaluation of the way pain assessment and treatment are taught is indicated. Further studies are needed to assess changes in knowledge and attitudes toward pain as curricular revisions are made.

How animal-assisted therapy affects discharge teaching: a pilot study.

ANIMAL-ASSISTED THERAPY (AAT) has been shown to benefit patients who need critical care nursing. Under direction of health services and education professionals, animal-assisted therapy can also provide physical, emotional, and cognitive benefits to people with special needs. In AAT, a goal-directed intervention, an animal that meets specific criteria is integral to the treatment process. The health care professional who specializes in AAT identifies physical, psychological, and cognitive goals for each patient. She then develops a treatment plan that incorporates the therapy animal as the tool to help achieve those goals and evaluates and documents the patient’s progress.

Journal Editor Survey: Information to Help Authors Publish

Faculty are expected to publish but often do not know how to write a manuscript that avoids major reasons for subsequent rejection. The authors share the results of a survey of 63 journal editors who reported journal characteristics and reasons for rejection of manuscripts. Suggestions to improve the acceptance rate of faculty publications are offered.

The Patient Self-Determination Act: 20 Years Revisited

Evidence exists that the goals of the Patient Self-Determination Act (PSDA), which went into effect December 1991, have fallen significantly short of their achievement. The purpose of this paper is to explore the outstanding and controversial issues that continue to impact both health care providers

Child Sex-Trafficking Recognition, Intervention, and Referral: An Educational Framework for the Development of Health-Care-Provider Education Programs

ABSTRACT Purpose: The purpose of this Delphi study was to obtain consensus among an international, multidisciplinary panel of child sex-trafficking experts and child sex-trafficking survivors on the most important elements needed in a comprehensive, interdisciplinary health-care-provider education program on the recognition, intervention, and referral of child sex-trafficking victims and survivors. Methods: A two-round Delphi method was utilized to identify the most important elements of a child sex-trafficking health-care-provider education program. A content validity index score was utilized to determine consensus and order importance of each element. Results: Eight content areas including 63 subcontent areas were identified by an international panel of 23 subject-matter experts representing clinical professions, law enforcement, academia, and community support organizations as important for inclusion in comprehensive health-care-provider education programs. Three content areas and 19 subcontent areas were identified by 10 survivors as important for inclusion in comprehensive health-care-provider education programs. The Individual Content Validity Index (I-CVI) was utilized to determine consensus and rank importance. Conclusion: The findings of this Delphi study provide the first scientifically based framework to guide the development of comprehensive, interdisciplinary education programs for health care providers on the recognition, intervention, and treatment and referral of child sex-trafficking victims and survivors. The use of the I-CVI allows the program developer to tailor the education-program components to the time and scope of the program under development.

The Nature and Meaning of Insulin Pump Use in Emerging Adults With Type 1 Diabetes

Objective. The purpose of this study is to investigate the meaning of living with an insulin pump for the management of type 1 diabetes during the period of emerging adulthood. Through a phenomenological narrative, this study contributes to the reflective understanding of the everyday life experiences of this population. Methods. A hermeneutic phenomenological design was used for this study of nine emerging adults (aged 19–24 years). Data were generated through face-to-face interviews and analyzed using the phenomenological approach of Max van Manen. Results. Four themes represent the essence of the day-to-day experiences of these emerging adults: seeking control, becoming responsible, staying connected, and accepting me. Conclusions. An in-depth understanding of the meaning of daily experiences with insulin pump technology has the potential to promote a developmentally appropriate approach to this age-group. The human understanding gained through this study is essential to the development of evidence-based practice guidelines and resources for this vulnerable population.

Tai Chi, Yoga, and Qigong as Mind-Body Exercises

Mind-body interventions or exercises may improve body function and health since nervous system affects endocrine system and immune system while performing these mindbody (MB) exercises. Tai Chi, Yoga, and Qigong are considered themost popularMB exercises, ranked by the 2002–2012 National Health Interview Surveys as the top three of the 10 most common complementary health approaches in practice. Tai Chi is a healing/martial art combining martial art movement with Qi—vital energy circulation, breathing, and stretching techniques. Tai Chi exercise consists of a series of graceful movements with deep and slow diaphragmatic breathings performed while standing. Tai Chi exercise has been shown to have both physical and psychosocial benefits for the different populations. Yoga, a mind-body exercise, involves a combination of muscular activity and an internally directed mindful focus on awareness of the self, the breath, and energy. Yoga integrates an individual’s physical, mental, and spiritual components to improve physical and mental health, particularly stress related illnesses. Qigong exercise, similar to Tai Chi, consists of a series of breath practices with body movement and meditation to attain deep focus and relaxed state. Simply speaking, Qigong exercise is practiced/used to cultivate the balance and harmony of vital energy in the human body. Considerable scientific evidence supports the health benefits of practicing Tai Chi and Qigong in various populations with differing characteristics such as age, gender, and occupation in NIH Research Report. In this special issue, we have focused on Tai Chi, Yoga, and Qigong as mind-body exercises. Nine research articles including human experimental studies, clinical trials, and meta-analyses have been carefully reviewed, revised, and published. These research articles explore the efficacy and effectiveness of these mind-body exercises in improving, enhancing, or strengthening integrative health and wellbeing in relation to functional outcomes or clinical benefits on the human body. We hope you enjoy reading these research articles on this special issue.

Military Nurses Caring for the Enemy

Purpose: This phenomenological study described the lived experience and aftermath of U.S. military nurses assigned enemy detainees during Operation Iraqi Freedom/Operation Enduring Freedom. Two themes emerged: Insurgent Assignments (subthemes included identification of and interactions with insurgents; training, precautions, and ethical issues, thoughts and feelings, coping, and meanings of insurgent care) and The Aftermath (subthemes were mental, emotional, personal, professional, and positive). Conclusions: Insurgent assignments caused ethical dilemmas and challenged theoretical constructs related to caring. Formal training is needed to prepare nurses for the practicalities of and responses to insurgent assignments.

A Pilot Randomized Controlled Trial Examining the Effects of Tai Chi and Electronic Tablet Use on Older Adults’ Cognition and Health

Purpose: To evaluate the feasibility of Tai Chi (TC) and electronic tablet (ET) interventions on older adults’ cognition and health and to explore participants’ perceptions of intervention activities. Design: An emergent embedded experimental mixed methods design was used in which the qualitative strand helped explain intervention results. Method: Older adults who participate in TC classes will have improved cognition and health compared with older adults who participate in ET classes. Twenty-six participants from two assisted living residences were recruited and randomized to receive nine TC or ET classes. The Modified Mini Mental State Exam was used to measure cognition and the SF-12v2 assessed perceived health before and after the intervention. Participants were invited to share perceptions of the two interventions. Institutional review board approval was obtained and participants provided signed consent for both quantitative and qualitative strands. Findings: There was no significant difference within or between groups on cognition and health scores. Conclusions: TC and ET use are activities that can be delivered in the community and have the potential to promote compensatory scaffolding as described by the revised scaffolding theory of aging and cognition. Future research should involve larger samples and teaching methods that promote learning postures.