Obesity is one of the fastest growing health concerns impacting all racial, ethnic, gender, and socioeconomic groups in the United States of America. More than one-third of the U.S. adult population is classified as being obese (Obesity Society, 2021). Obesity has reached epidemic proportions in all races and genders within the US with African American women comprising a majority of those impacted by this chronic health condition. Obesity rates are well documented within the literature but what is lacking is the role spirituality may play in obese African American women and their health behaviors. The purpose of this qualitative, phenomenological study was to explore and describe the lived experiences of obese African American women with attention and focus on weight, health behaviors, and spirituality. This study consisted of participant recruitment from various social organizations, beauty salons, and faith-based organizations. A naturalistic setting with a descriptive approach was taken to interview the participants and all recorded interviews were transcribed and utilized for data analysis. The analysis method for this study was the qualitative content analysis process. Upon completion of data analysis, the identification of three themes, who I am, the weight I bear, and power struggles, assisted with recognizing the gaps and concerns that supported the researcher in painting a picture of the lived experiences of obese African American women. Recommendations included diversifying healthcare providers, implementing community based interventions and research, and completing knowledge assessments before education.

Obesity is one of the fastest growing health concerns impacting all racial, ethnic, gender, and socioeconomic groups in the United States of America. More than one-third of the U.S. adult population is classified as being obese (Obesity Society, 2021). Obesity has reached epidemic proportions in all races and genders within the US with African American women comprising a majority of those impacted by this chronic health condition. Obesity rates are well documented within the literature but what is lacking is the role spirituality may play in obese African American women and their health behaviors. The purpose of this qualitative, phenomenological study was to explore and describe the lived experiences of obese African American women with attention and focus on weight, health behaviors, and spirituality. This study consisted of participant recruitment from various social organizations, beauty salons, and faith-based organizations. A naturalistic setting with a descriptive approach was taken to interview the participants and all recorded interviews were transcribed and utilized for data analysis. The analysis method for this study was the qualitative content analysis process. Upon completion of data analysis, the identification of three themes, who I am, the weight I bear, and power struggles, assisted with recognizing the gaps and concerns that supported the researcher in painting a picture of the lived experiences of obese African American women. Recommendations included diversifying healthcare providers, implementing community based interventions and research, and completing knowledge assessments before education.

Abstract This article describes the result of an academic-practice partnership between a School of Nursing (SON) and a University Medical Center (UMC) for the purpose of promoting BSN education in response to the Institute of Medicine’s recommendation that 80% of RNs hold a baccalaureate degree or higher by 2020. The mutually beneficial partnership worked together to offer a pilot online RN-BSN nursing program, increase the number of BSNs in the workforce, and to collect information from RN-BSN students returning to school about their challenges, recommendations for future programs, and why they were interested in returning to school. The BSN graduates reported a renewed interest in nursing, opportunities for advancement, and the importance of a support system for RNs planning to return to school. The BSN graduates identified barriers for returning to school included finances, lack of knowledge related to technology, and challenges of maintaining work-life balance.

Type 1 diabetes [T1D] is an autoimmune disease that presents in a pathophysiological disorder as insulin deficiency. Managing this illness during childhood is a constant challenge of maintaining blood glucose levels within a healthy range, resulting in increased stress for children and caregivers. School attendance is one factor that may result in increased stress. Studies have highlighted the fact that teachers of students with T1D may receive little education regarding management of the disease and may be required to make accommodations which can result in confusion, miscommunication, and increased psychosocial stress. The goal of this research was to learn about the experiences of teachers of students with T1D, what is expected of them, what resources they have, and factors which they perceive as barriers or facilitators to education for students with T1D. Semi-structured interviews were conducted with two high school teachers in East Tennessee who had experience teaching students with T1D. The results of the interviews showed that teachers receive limited education, that they are expected to make accommodations such as having snacks on hand and allowing extra access to phones, and that there are perceived barriers to education of individuals with T1D due to the possibility of life-threatening events. The teachers reported that school nurses are involved in the care of students with T1D. Limitations include that only two teachers were interviewed, and while the results are important to take into consideration, saturation was not reached. Future research could include more in-depth interviews or surveys with school nurses.

Aim: The aim of this study was to examine if student nurse participation in root cause analysis has the potential to reduce harm to patients from medication errors by increasing student nurse sensitivity to signal and responder bias. Background: Schools of nursing have traditionally relied on strategies that focus on individual characteristics and responsibility to prevent harm to patients. The modern patient safety movement encourages utilization of systems theory strategies like Root Cause Analysis (RCA). The Patient Risk Detection Theory (Despins, Scott-Cawiezell, & Rouder, 2010) supports the use of nurse training to reduce harm to patients. Method. Descriptive and inferential analyses of the demographic and major study variables were conducted. Validity and reliability assessments for the instruments were performed. The Safe Administration of Medications-Revised Scale (Bravo, 2014) was used to measure sensitivity to signal. The Safety Attitudes Questionnaire (SAQ; Sexton et al., 2006) was used to assess responder bias; this was the first use of this instrument with nursing students. Results: The sample consisted of 125 senior-level nursing students from three universities in the southeastern United States. The SAQ was found to be a valid and reliable test of safety attitudes in nursing students. Further support for the validity and reliability of the SAM-R was provided. A significant difference in safety climate between schools was observed. There were no differences detected between the variables. Conclusion: The results of this study provide support for the use of the SAQ and the SAM-R to further test the PRDT, and to explore methods to improve nursing student ability to administer medications safely.

Background Each Emergency Room (ER) across the USA provides every patient with paperwork upon discharge, which commonly includes information about the patient’s diagnosis. This information will briefly describe the condition, provide information on treatment outside the ER, and possibly more, depending on the document and source. These documents are not made by hospital staff, but are generally purchased from outside providers who mass market such documents as resources for hospitals to use to educate patients. One issue with these documents lies in their mass usage, which is not necessarily designed to target the general population’s reading and educational levels. Purpose The purpose of this research was to investigate currently used discharge education materials and evaluate them for their readability and content. From this investigation, recommendations were made and adjustments to the documents were applied in order to increase understanding for the general population. Results The documents ranged in Flesch-Kincaid grade level rankings from 7.8 to 3.6, and with Flesch Reading Ease scores of 54.7 to 85.3. The entirety of the standard documents were ranked at a minimum of 7th grade equivalents, and are, at the hardest rank, ranked at a 54.7 by the Reading Ease score. In comparison, the ‘easy to read’ documents were ranked all below 5th grade level, and at the hardest rank, ranked at a 69.0 with the Flesch Reading Ease calculation. At a minimum, all documents included condition information and home care guidelines. The major obvious difference between the documents considered ‘easy to read’ and the standard documents are that those considered easy to read typically had sections found on the standard document removed, and have the same overall content as the standard version remaining, only in a simpler vocabulary. Conclusions In order to provide the best educational materials to the general public, it would be in the best interest of companies manufacturing these documents to produce only one version, which would be at a level around the 6th grade or below. A document slightly below the 6th grade level would be more ideal, as the simpler the document is, the more patients it will be accessible for overall, accounting for those who are below the national standards. It is not truly necessary to separate the documents into two forms, and it helps to prevent confusion or offense by doing so.

INTRODUCTION: Acute infusion reactions from antineoplastic agents can include hypersensitivity reactions, anaphylaxis, and cytokine release infusion reactions. Severe acute infusion reactions happen in about 5% of the oncology patient population and nurses are responsible for assessment and management of the reaction. This is a high-stress task for a nurse magnified by the lack of exposure. This project explores nursing knowledge and perceived comfort level of acute infusion reactions caused by antineoplastic agents. METHODOLOGY: An original survey was created to test nursing knowledge and assess comfort level. Nursing knowledge was broken down into six subscales: general knowledge of acute infusion reactions, signs and symptoms of hypersensitivity, anaphylaxis, and cytokine release infusion reaction, and drugs most likely to cause hypersensitivity and anaphylactic reactions and cytokine release infusion reactions. Comfort questions were asked on a 6-point Likert scale from extremely uncomfortable to extremely comfortable. There was an additional section in the survey related to nurses’ distress and support in situations with acute infusion reactions. The questions were presented using a 6-point Likert scale ranging from strongly disagree to strongly agree. There were two open-ended questions that were designed to allow the nurses to share any additional information about their experiences with acute infusion reactions. Oncology nurses working with adults and pediatric populations were invited to participate. Descriptive statistics were used to analyze the survey results. T tests were used to compare groups and Pearson R statistics were used to examine relationships between total knowledge, knowledge subscale score, and comfort level. RESULTS: 20 nurses completed the survey. 12 were from the adult nurse population and 8 were from the pediatric nurse population. The typical participant was forty-four years of age, had sixteen years experience as a Registered Nurse, and thirteen years experience in the oncology setting. The average total knowledge score was a 56% based on 84 possible points. The basic knowledge section and the anaphylactic signs and symptoms were the highest scoring subscales, both scoring a 62%. Cytokine release infusion reaction signs and symptoms was the lowest scoring subscale with a 45%. There were no significant differences in knowledge between groups. The nurses chose an overwhelming agree/strongly agree when asked to choose the signs and symptoms related to each type of infusion reaction. The total comfort level score indicated that nurses were very comfortable managing acute reactions. There was no significant difference between the adult and pediatric setting comfort level scores. There was no statistically significant relationship between total knowledge score and total comfort level score. DISCUSSION: The knowledge score showed knowledge deficits while the comfort score indicated confidence in management of acute infusion reactions. The high frequency of agree/strongly agree for all three subscales of signs and symptoms indicates that the nurses at least know what to look for even if they cannot assign the specific sign and symptom to the type of infusion reaction. Knowledge about signs of specific types of drug reactions may not be necessary as long as a basic understanding of what to look for and how to manage a reaction is present.

In moderation, stress is a normal response to a perceived challenge which can motivate an individual to perform at their best. Nursing students consistently report a significant amount of stress which has been found to be greater than their non-nursing peers. The purpose of this study is to assess the level of stress reported by second-semester freshman and sophomore students who have declared nursing as a major, compared with the level of stress experienced by junior and senior students who are enrolled in the university's nursing program. Through this comparison, a conclusion can be drawn as to the level of stress experienced while enrolled in a nursing program, with the level of stress prior to being exposed to the challenges presented by the program. It is intended that the outcomes from this study can be utilized to address stress as it relates to a nursing student from pre-admission through graduation.

Women with gynecological (GYN) cancer experience a wide spectrum of physical, emotional and social effects after diagnosis and treatment of their cancer. The insufficient availability of local support groups, limited transportation for the rural Chinese population and a shortage of oncologists make it difficult to have face-to-face support groups for Chinese GYN cancer patients. However, the wide access of Internet has provided an opportunity for people to have online support groups. The purpose of this study was to observe and describe the types of support given to and by Chinese GYN cancer survivors in a QQ chat group. This was a qualitative study that used the directed content analysis approach. A QQ group was observed for two weeks between March 10th (12:01am) and March 24st (11:59pm) 2018 Beijing time. Observed online posts were copied and pasted into a WORD ™ document for analysis. There were 4 themes observed: sharing experience, information exchange, emotional support and Guardian Against Cancer group member benefits. The results of the study suggested that women supported each other but little evidence-based support was observed. Healthcare providers should be monitoring and engaging in conversations with group members. Well-planed and organized information sessions should also be beneficial for members. Further research on understanding members’ needs on online support groups and the effectiveness of intervention should be conducted.

Decision-making in healthcare is a complex and, at times, uncertain process. In the United States Certified Registered Nurse Anesthetists (CRNA) administer the majority of anesthesia. Nurse Anesthetists must draw on their educational background, clinical experience, and cognitive processes to make sound clinical judgments. To avoid errors understanding the relationship between cognitive preference and skill acquisition is critical. This study was designed to describe the cognitive preferences of Student Nurse Anesthetists (SRNAs) and CRNAs in the United States. The 2 cognitive preferences explored are rational (analytical) and experiential (intuitive) decision-making. The researcher used a quantitative, cross-sectional, descriptive correlational design. The researcher administered the Rational Experiential Inventory (REI-40) via electronic survey to enrolled SRNAs and practicing CRNAs. The REI-40 is a validated psychometric tool involving 40 questions. Twenty questions evaluate each decision-making style. Ten questions assess engagement (e.g., enjoyment and reliance), and 10 questions assess the ability (e.g., capability and use) of each style. The demographics (e.g., age, gender, clinical experience, setting, and education) were collected and compared with the cognitive preference. This study revealed that SRNAs’ and CRNAs’ dominant cognitive preference was rational thinking and experiential thinking was greater than mid-scale. There was no statistical difference in how SRNAs and CRNAs scored on the REI-40 Inventory. Furthermore, there were no strong correlations between years of experience and cognitive preferences. However, there was a statistically significant difference in experiential cognitive ability and engagement when compared by gender identity. Ideally how one feels, and thinks should be aligned when making clinical decisions. This is the art and science of the profession. Research has revealed that human factors such as cognitive biases, heuristics, personal experience, and emotions play a role in decision-making. The development and integration of experiential decision-making is essential to aligning clinical judgment and safe patient care. This study describes SRNAs’ and CRNAs’ cognitive preferences and the relationship to the level of skill acquisition. This knowledge contributes to the understanding of CRNAs’ decision-making processes. Furthermore, there are ramifications for developing continuing education and clinical support tools for the profession.