A quasi-experimental design was used to examine the differences in myocardial infarction (MI) patients' self-care behaviors, satisfaction, knowledge, and feelings of security after participation in a structured cardiac teaching program presented by one designated patient educator. Thirty subjects diagnosed with first time uncomplicated MIs were randomly assigned to the experimental group (n = 15) or the control group (n = 15) which received conventional unstructured teaching. Four self-report questionnaires were developed and used. Patient satisfaction with teaching was greater for the experimental group (t = -2.65; df = 28; p ≤ 0.05). No differences were found between groups regarding information retained at time of discharge from the hospital or two weeks later, or in readiness for post-hospital self-care. Self-care behaviors were improved clinically in both groups, but somewhat more in the experimental group. The findings suggest this structured cardiac teaching program presented by one designated patient educator enhanced patient satisfaction and may have improved self-care.

<p> Leaders within the long-term care industry face a myriad of challenges as the U.S. population ages at exponential rates. Long term care is an industry that requires strong, well-developed leaders; yet, while Directors of Nursing (DONs) are viewed as key leaders in the long term care setting, few studies have focused on their leadership styles. The goal of this quantitative, non-experimental research was to determine if a relationship existed between leadership styles, personnel retention, and job satisfaction. Based on findings from this study, the `PST2 Leadership Model' was developed. This model is unique as it conceptualized various leadership theories and offers suggestions for implementation of specific leadership styles. This model may prove useful as an important teaching instrument within the long term care arena. As healthcare leaders and stakeholders continue to evaluate salient matters within the long term care community, it is prudent to utilize research such as this and comparable studies to guide the decision making process as this evidence may contribute to the viability of a challenged long term care system.</p>

<p>Abstract The purpose of this study was to examine the relationship of work stressors and perceived organizational support on front line nurse manager work engagement. A non-experimental descriptive, cross sectional design examined the relationship in a convenience sample of 97 front line nurse managers from the New York tri-state area and members of the American Organization of Nurse Executives. Instruments used to measure work engagement, work stressors and perceived organizational support, were: (1) the Utrecht Work Engagement Scale (UWES); (2) Challenge-Hindrance Stressor Scale and (3) Survey of Perceived Organizational Support (SPOS). Pearson's correlation and linear regression analyses indicated support for the relationship between all variables. There was a negative direct relationship between work engagement and work stressors and a positive significant relationship between perceived organizational support and work engagement. The conceptual framework of Kahn's work engagement and the Job Demands-Resources Model revealed that organizational support is needed to promote front line nurse manager work engagement. Work engagement, perceived organizational support and work stressors are professional environmental factors that impact the leadership and well-being of FLNM. These factors, properly promoted and implemented, lead to FLNM's success, retention and job performance.

<p> The elderly population, defined as 65 and older, is the fastest growing demographic group in the United States. As baby boomers' reliance on healthcare systems increase, housing with medical accessibility becomes a vital need in today's economy. As the market appears to signal an increase in the need and desire for home and community based services, important questions arise about how assisted living executives' leadership styles affects his/her entrepreneurial orientation. This study analyzed the relationship between the full range of leadership model as measured by the multifactor leadership questionnaire and entrepreneurial orientation (innovativeness, proactiveness, and risktaking) of executives within the licensed assisted living facility industry in Indiana. The researcher used the multifactor leadership questionnaire and the entrepreneurial orientation questionnaire to determine whether assisted living executives were innovative, proactive, and risk-taking based on their leadership style. </p>

<p> The American Academy of Pediatrics (AAP) delineated four criteria for management of perinatal care and discharge (DC) of high-risk neonates: 1) physiological stability, 2) tracking and surveillance of growth and development for each infant, 3) active parental involvement with the infant's care, and 4) follow-up care arranged with experienced primary care provider. Registered Nurses in California Neonatal Intensive Care Units (NICUs) were surveyed about NICU DC transitioning programs to 1) identify current common standards of care used in DC transitioning and 2) define the nature and extent of additional criteria and procedures used in DC transitioning. Useable surveys were obtained from 32 of the 79 facilities queried (41%): 17 (53%) Level II, 10 (31%) Level III, and 5 (16%) Level IV. All responding facilities were located in communities of 100,000 people or more. All but one of the facilities (97%) used all four AAP criteria for determining readiness for DC. Facilities differed in whether they also used weight, corrected gestational age, or both as criteria for DC. They differed in the definition of active parental involvement with care, the degree to which parents participated in DC planning, who arranged for post-DC primary care, and how outcomes of DC planning practices were evaluated. Profiles derived from these data can be used to expand procedures, guidelines, and policies for DC transitioning of the NICU graduate.</p>

<p> There is an increasing demand for more baccalaureate- and graduate-prepared registered nurses in the United States, to face the healthcare challenges of the 21st century. As a strategy to meet this need, educational institutions are expanding electronic learning in nursing education; however, technology acceptance in education continues to be a concern for educational institutions. In this context, the goal of the study was to investigate factors that potentially influence registered nurses&rsquo; intentions to adopt e-learning systems. A theoretical model was used to determine whether perceived value, attitude toward e-learning systems, and resistance to change influence registered nurses&rsquo; intentions to use e-learning systems. </p><p> A web-based survey was used to assess the effect of the aforementioned constructs on registered nurses&rsquo; intentions to use e-learning systems. The web-survey instrument was developed as a multi-item questionnaire using Likert-type scales. A 35-item survey instrument was developed using previously validated measurable items. The target population of this study was registered nurses in South Florida. The sample for this study was 323 (over 21% response rate) registered nurses at two hospitals in South Florida. </p><p> Multivariate analysis was conducted using structural equation modeling and robust standard errors with the Satorra-Bentler adjustment. The results revealed that perceived value, attitude toward e-learning systems, and resistance to change influence registered nurses&rsquo; intentions to use e-learning systems. Findings from this investigation may be of interest to educational institutions preparing to make investments in e-learning systems. The information provided in the study will allow administrators in higher educational institutions to make decisions on ways to address the challenges that may be affecting e-learning acceptance by registered nurses.</p>

<p> Many advanced cancer patients receive intensive treatment near the end of life (EOL). Intensive treatment near the EOL is often associated with worse outcomes, such as worse quality of life (QOL), greater distress in patients and caregivers, and higher health care costs. For cancers typically unresponsive to chemotherapy such as lung and gastro-intestinal (GI), the side effects of intensive treatment are endured without increasing survival time. To date, research on EOL care in advanced cancer patients has focused on patient prognostic understanding, physician communication, and patient distress. These factors do not fully explain why many patients receive intensive treatment near the EOL when there is no hope for cure. Hence, there is a need to better understand the factors that influence EOL treatment in order to improve patient and caregiver outcomes. Self-Regulation Theory (SRT) provides a framework that may help explain motivations and care decisions in this population. This study had two aims: 1) to examine the associations between EOL clinical encounters (i.e., EOL conversations with a physician) and treatment intensity in advanced cancer patients near the EOL; and 2) to examine the associations between important SRT constructs (i.e., goal flexibility, hope, and optimism) and treatment intensity in advanced cancer patients near the EOL. A sample of 76 advanced lung and GI cancer patients was recruited from Indiana University Simon Cancer Center. Hope predicted receiving chemotherapy closer to death (&beta; = -.41, t (66) = -2.31, <i>p</i> = .025), indicating more intensive treatment near EOL. Other predictor variables were not significantly associated with intensive treatment. Implications and methodological limitations are discussed. </p>

<p> The suicide rate among post-9/11 veterans has become a national crisis. At a staggering number of 22 suicides per day, our wounded warriors are in dire need of psychological assistance. Currently, the treatment interventions used in the rehabilitation of veterans suffering from mental health disorders are limited. Furthermore, these therapy options available to veterans are not realizing adequate improvements in the management of their symptoms. </p><p> This business proposal advocates the utilization of psychiatric service dogs as an alternative intervention to help veterans manage their PTSD symptoms. Rescues for Warriors (RFW), a nonprofit 501(c)(3) organization, aims to pair task trained service dogs with veterans in need of a rehabilitative canine companion. Using evidence-based selection tools, RFW rescues dogs from local animal shelters and uses comprehensive techniques to train them to patient-specific symptoms. This service will be free of charge for all veteran participants, and therefore, marketing and funding will be very important aspects of this business. While this plan does acknowledge the potential challenges in opening charitable organizations, RFW is rigorously committed to increase the quality of life of our nation&rsquo;s heroes and rescue dogs alike.</p>

<p> This critical analysis of the literature is a comprehensive collection and review of the literature on the strengths-based perspective as it is applied to the treatment of substance use disorders. Literature was collected, analyzed, and critically evaluated to consolidate the existing research on strengths-based treatment approaches, identify ways in which the strengths-based perspective is congruent with culturally competent practice, and to identify strengths, weaknesses, and gaps in the literature. Analyses reveal that there are numerous components of the strengths-based perspective that are congruent with culturally competent practice and that strengths-based treatment approaches may serve as an effective adjunct or alternative to traditional treatment approaches for substance use disorders. While additional research is needed to further our understanding of the effectiveness of this approach, preliminary results indicate that there are numerous therapeutic advantages associated with the strengths-based perspective and its use with substance abusing populations. </p>

<p> Recent changes in the ethnic composition of the population of the United States pose great challenges for healthcare institutions and healthcare providers. In recent years, policy statements on nursing education indicated that nursing educators recognized the need to increase the cultural caring of the nursing workforce (Swanson, 2012). Salimbene (2014) discussed the importance of considering clients&rsquo; culture as an integral part of assessing their healthcare needs and planning culturally appropriate nursing care to meet those needs. Currently, there is a paucity of information regarding patients&rsquo; perceptions of culturally competent care. The purpose of this qualitative study was to identify culturally sensitive caring behaviors of professional nurses from the perspective of Hispanic American maternity patients two to four weeks post-discharge in a WIC program in rural Georgia. Utilization of a phenomenological research design included interviews with 15 Hispanic American women. Data analysis was conducted using phenomenological analysis methods with the aid of the software program Nvivo 11. Themes that were identified were: Better Future, Better Medical Care, Treatment of Patients, Customs and Practices, and Meaning of Care. This information may aid in creating a culturally competent maternity care curriculum.</p>