Medicine and Health Sciences Commons^™

The Efficacy Of High-Fidelity Simulation On Knowledge And Performance In Undergraduate Nursing Students: An Umbrella Review Of Systematic Reviews And Meta-Analysis, Celeste Marie Alfes

Faculty Scholarship

Objectives: This umbrella review aimed to consolidate the evidence base on the impact of high-fidelity simulation on knowledge and performance among undergraduate nursing students. Design: Umbrella review with meta-analyses of pooled effect sizes, followed by an additional meta-analysis of primary studies from the included systematic reviews, excluding overlapping results. Data sources: Systematic searches were performed up to August 2023 in PubMed, Embase, and Cochrane Library. We included reviews that compared high-fidelity simulation against other learning strategies. Review methods: The risk of bias was assessed for each included systematic review (ROBIS tool) and primary study (RoB 2 or ROBINS-I as appropriate). …

Lived Experiences: Growing Up With A Seriously Mentally Ill Parent, Deborah Lindell, Elliane Irani

Faculty Scholarship

Introduction: Individuals with serious mental illness often have persistent and disruptive symptoms. These can profoundly affect their children's lives, exposing them to adverse social and psychological conditions. Such conditions can result in traumatic lived experiences during childhood, which can carry over into adulthood, influencing their self-perceptions and shaping their attitudes toward themselves and society. To gain insights into this phenomenon, this study explored the lived experiences of adults who grew up with a parent with serious mental illness and their perceptions of their lives in adulthood. Design: This study used an interpretive phenomenological design. Methods: Participants were invited to voluntarily …

Historic Redlining And Health Outcomes: A Systematic Review, Noa T. Kraus, Sarah Connor, Krista Shoda, Scott Emory Moore, Elliane Irani

Faculty Scholarship

Objective: The purpose of this systematic review was to synthesize the existing literature on the associations between historic redlining and modern-day health outcomes across the lifespan. Method: This review searched PubMed and CINAHL for peer-reviewed, data-based articles examining the relationship between historic redlining and any health outcome. Articles were appraised using the JBI critical appraisal checklist. The results were synthesized using a narrative summary approach. Results: Thirty-six articles were included and focused on various health outcomes, including cardiovascular outcomes, breast cancer incidence and mortality, firearm injury or death, birth-related outcomes, and asthma outcomes. Most of the included articles (n = …

Social Activity Restriction And Psychological Health Among Caregivers Of Older Adults With And Without Dementia, Elliane Irani, Kylie Meyer, Scott Emory Moore, Kedong Ding

Faculty Scholarship

Objectives: We examined associations between social activity restriction and psychological distress and well-being for caregivers of older adults with and without dementia, and if the identified associations are different for the two groups. Methods: Using data from the 2017 National Study of Caregiving, we identified caregivers of older adults with (N = 541) and without (N = 1701) dementia. Linear regression models were estimated, adjusting for caregivers’ age, gender, race, education, relationship to care recipient, and self-rated health. Results: Restriction in visiting friends and family and attending religious services were associated with higher distress in dementia caregivers. Restriction in visiting …

Use Of Electronic Ecological Momentary Assessment Methodologies In Physical Activity, Sedentary Behavior, And Sleep Research In Young Adults: Systematic Review, Kimberly R. Hartson, Luz Huntington-Moskos, Clara G. Sears, Gina Genova, Cara Mathis, Wessly Ford, Ryan E. Rhodes

Faculty Scholarship

Background: Recent technological advances allow for the repeated sampling of real-time data in natural settings using electronic ecological momentary assessment (eEMA). These advances are particularly meaningful for investigating physical activity, sedentary behavior, and sleep in young adults who are in a critical life stage for the development of healthy lifestyle behaviors.

Objective: This study aims to describe the use of eEMA methodologies in physical activity, sedentary behavior, and sleep research in young adults.

Methods: The PubMed, CINAHL, PsycINFO, Embase, and Web of Science electronic databases were searched through August 2022. Inclusion criteria were use of eEMA; sample of young adults …

Resilience As A Moderator Of Role Overload And Sleep Disturbance Among Caregivers Of Persons With Dementia, Elliane Irani, Fei Wang, Stephanie Griggs, Ronald L. Hickman

Faculty Scholarship

The purpose of this study was to examine if resilience moderates the association between role overload and sleep disturbance among caregivers of persons with dementia. This was a secondary analysis of data on 437 informal caregivers (mean age=61.77 years, SD=13.69) of persons with dementia in the United States. Data from the 2017 wave of the National Study of Caregiving were analyzed using multiple regression with interaction terms to evaluate the moderation effect of resilience, while controlling for caregivers’ age, race, gender, education, self-rated health, caregiving hours, and primary caregiving status. Higher role overload was associated with greater sleep disturbance and …

The Mediating Effect Of Caregiving Relationship Quality On The Association Between Caregiving Stressors And Mental Health Problems Among Older Spousal Caregivers, Fei Wang, Elliane Irani

Faculty Scholarship

Providing care to a spouse can be especially challenging for older adults given their compounding stressors resulting from aging and caregiving. This cross-sectional study examines the relationships between caregiving stressors and caregiver mental health problems and the potential mediator (i.e., caregiving relationship quality) of these associations. A total of 431 Americans (≥65 years) were selected from the National Study of Caregiving. Path analysis shows that care assistance was positively associated with caregiver mental health problems, and this association was mediated by negative relationship quality (Indirect effect =.14, p =.016). Moreover, role overload was positively associated with caregiver mental health problems, …

Socioeconomic Deprivation And Cardiometabolic Risk Factors In Individuals With Type 1 Diabetes: T1d Exchange Clinic Registry, Stephanie Griggs, Sadeer Al-Kindi, Heather Hardin, Elliane Irani, Sanjay Rajagopalan, Ronald L. Hickman Jr.

Faculty Scholarship

Aims: Social determinants of health (SDOH) influence cardiovascular health in the general population; however, the degree to which this occurs in individuals with type 1 diabetes (T1D) is not well understood. We evaluated associations among socioeconomic deprivation and cardiometabolic risk factors (hemoglobin A1c, low-density lipoprotein, blood pressure, body mass index, physical activity) in individuals with T1D from the T1D Clinic Exchange Registry. Methods: We evaluated the association between the social deprivation index (SDI) and cardiometabolic risk factors using multivariable and logistic regression among 18,754 participants ages 13 – 90 years (mean 29.2 ± 17) in the T1D Exchange clinic registry …

Examining How Congruence In And Satisfaction With Dyadic Care Type Appraisal Contribute To Quality Of Life In Heart Failure Care Dyads, Elliane Irani, Seunghee Margevicius

Faculty Scholarship

AIMS: Given the complexity of heart failure (HF) management, persons with HF and their informal caregivers often engage in dyadic illness management. It is unknown how congruent appraisal of dyadic HF care type is associated with dyadic health. Our aim was to examine how congruence in and satisfaction with appraisal of dyadic HF care type contribute to quality of life (QOL) for dyads. METHODS AND RESULTS: This is a secondary analysis of cross-sectional data on 275 HF care dyads (patients 45.1% female, caregivers 70.5% female). Congruent appraisal and satisfaction were assessed using the Dyadic Symptom Management Type instrument. Quality of …

The Lived Experiences Of Intensive Care Nursing Students Exposed To A New Model Of High-Fidelity Simulation Training: A Phenomenological Study, Celeste Marie Alfes

Faculty Scholarship

Background: In postgraduate intensive care nursing courses, high-fidelity simulation is useful to prepare students to guarantee safe and quality care of critically ill patients. Surprisingly, this issue has not attracted sufficient attention in the literature, and it is not clear whether the linear application of the traditional high-fidelity simulation method based on prebriefing, the simulation session and debriefing, can serve as empirical reference in postgraduate students’ education. The aim of this study was to investigate the lived experiences of postgraduate students receiving multiple exposures to an innovative high-fidelity simulation design based on Kolb’s Experiential Learning Theory. Methods: A phenomenological study …

A Pilot Randomized Clinical Trial Of A Teamwork Intervention For Heart Failure Care Dyads, Elliane Irani, Atsadaporn Niyomyart, Mary A. Dolansky, John Paul Stephens, Richard A. Josephson, Ronald L. Hickman Jr.

Faculty Scholarship

Background: Dyadic heart failure (HF) management can improve outcomes for patients and caregivers and can be enhanced through eHealth interventions. Objective: To evaluate the feasibility, acceptability, and preliminary efficacy of an eHealth dyadic teamwork intervention, compared to an attention control condition. Methods: We recruited 29 HF patient-caregiver dyads from inpatient units and randomized dyads to an intervention or a control group. We calculated enrollment and retention rates, described acceptability using interview and questionnaire data, and computed intervention effect sizes. Results: 37% of eligible dyads agreed to participate and 93% of randomized participants completed follow-up questionnaires. Participants found both study conditions …

Testing The Effects Of Two Field-To-Fork Programs On The Nutritional Outcomes Of Elementary School Students From Diverse And Lower-Income Communities, Kimberly R. Hartson, Kristi M. King, Carol O'Neal, Aishia Brown, Toluwanimi Olajuyigbe, Shakeyrah Elmore, Angelique Perez

Faculty Scholarship

The purpose of this quasi-experimental study was to evaluate the effects of two farm-to-school programs, specifically the Field-to-Fork Multi-visit Program (N  =  264) and the Field-to-Fork After-school Club (N  =  56), on nutritional outcomes of elementary school students (third to fifth grade) from urban, diverse, and lower-income communities. Data were collected via self-report surveys measuring: (a) knowledge of recommendations for daily fruit and vegetable intake; (b) fruit and vegetable consumption; (c) knowledge of cooking a healthy recipe using vegetables; and (d) desire for farm fresh foods at school. Statistical analyses included McNemar’s and Wilcoxon signed rank tests. The …

Stressors And Resilience Are Associated With Well-Being In Young Adult College Students, Kimberly R. Hartson, Lynne A. Hall, Sara A. Choate

Faculty Scholarship

Objective: The purposes were to describe stressors and resilience behaviors of college students and examine the relationships among stressors, resilience, and well-being. Hypothesis: Resilience will modify the relationship between stressors and well-being. Participants: The sample included 1,010 college students, ages 18–26, from an urban Midwestern university. Methods: A secondary analysis of cross-sectional data from an anonymous survey was conducted using multiple regression and simple slopes analysis. Results: Resilience did not modify the relationship between stressors and well-being. Stressors (β = −.44, p < .0001) and resilience (β = .33, p < .0001) accounted for 42% of the variance in well-being (adjusted R2 = .42, F2,999 = 365.98, p < .0001). The most frequently endorsed stressors were sleep problems, anxiety, and relationships. Conclusions: Stressors and resilience …

Caregiving Stress And Self-Rated Health During The Covid-19 Pandemic: The Mediating Role Of Resourcefulness, Elliane Irani, Atsadaporn Niyomyart, Jaclene A. Zauszniewski

Faculty Scholarship

Family caregivers faced unprecedented circumstances and experienced increased levels of stress during the COVID-19 pandemic. Resourcefulness can minimize the effect of stress on health outcomes. The purpose of this study was to examine the associations between caregiving stress during the pandemic, resourcefulness, and self-rated health and assess the mediating effect of resourcefulness. A convenience sample of 70 family caregivers of adults with chronic and/or disabling conditions was recruited using social media groups and professional networking platforms. Data were collected using an online survey and analyzed using linear regression. Mediation analysis was conducted using the PROCESS macro. Higher levels of caregiving …

Family Caregivers’ Experiences And Changes In Caregiving Tasks During The Covid-19 Pandemic, Elliane Irani, Atsadaporn Niyomyart, Ronald L. Hickman

Faculty Scholarship

The purpose of this descriptive study was to describe family caregivers’ experiences and changes in caregiving tasks and approaches during the COVID-19 pandemic. Using web-based strategies, 69 family caregivers of adults with chronic or disabling conditions were recruited and completed an online survey about positive and negative caregiving experiences, and ways in which caregiving has changed. Data were analyzed using descriptive statistics (structured questions) and conventional content analysis (open-ended responses). Participants reported concerns about their loved one’s physical and mental health, the limited access to other caregiving sources, and the limited opportunities to maintain personal well-being. Caregiving tasks completed more …

Application Of The Ideas Framework In Adapting A Web-Based Physical Activity Intervention For Young Adult College Students, Kimberly R. Hartson, Lindsay J. Della, Kristi King, Sam Liu, Paige N. Newquist, Ryan E. Rhodes

Faculty Scholarship

User-centered developmental processes are critical to ensuring acceptability of e-health behavioral interventions, and yet physical activity research continues to be inundated with top-down developmental approaches. The IDEAS (Integrate, Design, Assess, and Share) framework outlines a user-centered process for development of e-health interventions. The purpose of this manuscript is to describe the application of the IDEAS framework in adapting a web-based physical activity intervention for young adult college students. Steps 1–3 emphasized integrating insights from users and theory and Steps 4–7 focused on iterative and rapid design with user feedback. Data were collected via repeat qualitative interviews with young adult college …

Negative Marital Interaction, Purpose In Life, And Depressive Symptoms Among Middle-Aged And Older Couples: Evidence From The Health And Retirement Study, Elliane Irani, Sumin Park, Ronald L. Hickman Jr.

Faculty Scholarship

Objective: Negative marital interaction and purpose in life have been associated with depressive symptoms. Yet, these associations have not been fully explored in a dyadic context. This study examines the actor (intra-individual) and partner (cross-spousal) effects of negative marital interaction on depressive symptoms in couples and the potential mediating role of purpose in life. Methods: Data came from 1186 heterosexual married couples who participated in the 2016 (T1) and 2018 (T2) waves of the Health and Retirement Study and completed the psychosocial questionnaire in 2016. Structural equation modeling was used to estimate the direct and indirect associations among T1 negative …

Detailed Data About A Forty-Year Systematic Review And Meta-Analysis On Nursing Student Academic Outcomes, Celeste Marie Alfes

Faculty Scholarship

Data were extracted from observational studies describing undergraduate nursing students’ academic outcomes that were included in a systematic review and meta-analysis conducted in 2019 and updated in 2020 [1]. Data were extracted by two researchers independently through a previously tested electronic spreadsheet; any disagreement about data extraction was discussed with a third author. Extracted data were studies’ general information, characteristics (i.e., country, study design, involved centers, number of cohort of students involved, duration (years) and denomination of the program attended, sample (N), sociodemographic characteristics of the sample, and methods utilized for data collection), and data related to the research question(s) …

Resilience, Moral Distress, And Workplace Engagement In Emergency Department Nurses, Paul Clark, Timothy Crawford, Brandonn Hulse, Barbara Polivka

Faculty Scholarship

This cross-sectional, correlational study’s purpose was to evaluate the effects of resilience and moral distress on workplace engagement in emergency department nurses providing direct patient care. Data were collected from 175 emergency department nurses using a Web-based survey. The higher the nurses’ resilience and the lower their moral distress, the greater their workplace engagement. Resilience and moral distress were not correlated; furthermore, moral distress did not mediate a relationship between resilience and workplace engagement. Resilience was higher with greater job satisfaction, increased age, and longer tenure as a nurse. Workplace engagement increased with higher job satisfaction and less time seeking …

L’Utilizzo Del Tourniquet Nelle Emorragie Da Trauma In Ambito Civile: Una Revisione Narrativa Della Letteratura (Tourniquet In Traumatic Haemorrhage In Civilian Settings: A Narrative Literature Review), Celeste Marie Alfes

Faculty Scholarship

Introduzione: L’emorragia arteriosa è una delle principali cause di morte in ambito civile e militare. Nonostante la pressione manual diretta del sito emorragico sia ancora lo standard di riferimento per il controllo del sanguinamento, l’applicazione precoce, in ambito extra-ospedaliero di tourniquet si è dimostrata capace di ridurre le morti con bassi rischi di complicanze. L’obiettivo dello studio è quello di sintetizzare i metodi di utilizzo, le condizioni dei pazienti, gli esiti e le complicazioni relative alle applicazioni del tourniquet. Materiali e Metodi: È stata condotta una revisione narrativa della letteratura tramite PubMed. Risultati: Dieci articoli inclusi hanno fornito informazioni su …

Systematic Review Of Technology-Based Interventions Targeting Chronically Ill Adults And Their Caregivers, Elliane Irani, Atsadaporn Niyomyart, Ronald L. Hickman Jr.

Faculty Scholarship

The purpose of this systematic review is to synthesize the study design features as well as the attributes and outcomes of technology-based health interventions targeting chronically ill adults and their family caregivers. Twenty papers representing 19 studies met the inclusion criteria. Various theoretical foundations or approaches guided the interventions in 11 studies. Interventions either aimed to support patient self-management and improve patient outcomes or enhance shared illness management and improve patient and caregiver outcomes. The interventions included educational, behavioral, and support components and were delivered using various technologies ranging from text messaging to using the Internet. Overall, patients and caregivers …

The Role Of Social, Economic, And Physical Environmental Factors In Care Planning For Home Health Care Recipients, Elliane Irani

Faculty Scholarship

Social, economic, and environmental factors contribute to patients’ recovery following hospitalization. However, little is known about how home health nurses make decisions based on their assessment of these factors. The purpose of the current study was to explore the nonclinical factors that home health nurses evaluate and describe how these factors influence care planning decisions. Semi-structured inter-views conducted with 20 visiting nurses from three home health agencies were analyzed using conven-tional content analysis. Three nonclinical factor themes emerged: Social Support, Home Environment and Neighborhood, and Finances and Insurance Barriers. Nurses’ assessments guided them to include family caregivers in the plan …

A Psychometric Evaluation Of The Family Decision-Making Self-Efficacy Scale Among Surrogate Decision-Makers Of The Critically Ill, Grant A. Pignatiello, Elliane Irani, Sadia Tahir, Emily Tsivitse, Ronald L. Hickman Jr.

Faculty Scholarship

Objectives The purpose of this study was to report the psychometric properties, in terms of validity and reliability, of the Unconscious Version of the Family Decision-Making Self-Efficacy Scale (FDMSE). Methods A convenience sample of 215 surrogate decision-makers for critically ill patients undergoing mechanical ventilation was recruited from four intensive care units at a tertiary hospital. Cross-sectional data were collected from participants between days 3 and 7 of a decisionally impaired patient's exposure to acute mechanical ventilation. Participants completed a self-report demographic form and subjective measures of family decision-making self-efficacy, preparation for decision-making, and decisional fatigue. Exploratory factor analyses, correlation coefficients, …

Wearable Sensors For Monitoring The Internal And External Workload Of The Athlete, Dhruv R. Seshadri, James R. Rowbottom, Celeste Marie Alfes, Christian A. Zorman, Colin K. Drummond

Faculty Scholarship

The convergence of semiconductor technology, physiology, and predictive health analytics from wearable devices has advanced its clinical and translational utility for sports. The detection and subsequent application of metrics pertinent to and indicative of the physical performance, physiological status, biochemical composition, and mental alertness of the athlete has been shown to reduce the risk of injuries and improve performance and has enabled the development of athlete-centered protocols and treatment plans by team physicians and trainers. Our discussions in this review include commercially available devices, as well as those described in scientific literature to provide an understanding of wearable sensors for …

Wearable Sensors For Monitoring The Physiological And Biochemical Profile Of The Athlete, Dhruv R. Seshadri, James R. Rowbottom, Celeste Marie Alfes, Christian A. Zorman, Colin K. Drummond

Faculty Scholarship

Athletes are continually seeking new technologies and therapies to gain a competitive edge to maximize their health and performance. Athletes have gravitated toward the use of wearable sensors to monitor their training and recovery. Wearable technologies currently utilized by sports teams monitor both the internal and external workload of athletes. However, there remains an unmet medical need by the sports community to gain further insight into the internal workload of the athlete to tailor recovery protocols to each athlete. The ability to monitor biomarkers from saliva or sweat in a noninvasive and continuous manner remain the next technological gap for …

Effects Of High-Fidelity Simulation Based On Life-Threatening Clinical Condition Scenarios On Learning Outcomes Of Undergraduate And Postgraduate Nursing Students: A Systematic Review And Meta-Analysis, Celeste Marie Alfes

Faculty Scholarship

Objective The purpose was to analyse the effectiveness of high-fidelity patient simulation (HFPS) based on life-threatening clinical condition scenarios on undergraduate and postgraduate nursing students' learning outcomes. Design A systematic review and meta-analysis were conducted based on the Cochrane Handbook for Systematic Reviews of Interventions and its reporting was checked against the Preferred Reporting Items for Systematic Reviews and Meta-Analyses checklist. Data sources PubMed, Scopus, CINAHL with Full Text, Wiley Online Library and Web of Science were searched until July 2017. Author contact, reference and citation lists were checked to obtain additional references. Study selection To be included, available full-texts …

The Use Of Videoconferencing For Qualitative Interviewing: Opportunities, Challenges, And Considerations, Elliane Irani

Faculty Scholarship

No abstract provided.

How Home Health Nurses Plan Their Work Schedules: A Qualitative Descriptive Study, Elliane Irani

Faculty Scholarship

Aims and objectives: To describe how home health nurses plan their daily work schedules and what challenges they face during the planning process. Background: Home health nurses are viewed as independent providers and value the nature of their work because of the flexibility and autonomy they hold in developing their work schedules. However, there is limited empirical evidence about how home health nurses plan their work schedules, including the factors they consider during the process and the challenges they face within the dynamic home health setting. Design: Qualitative descriptive design. Methods: Semi-structured interviews were conducted with 20 registered nurses who …

Home Health Nurse Decision-Making Regarding Visit Intensity Planning For Newly Admitted Patients: A Qualitative Descriptive Study, Elliane Irani

Faculty Scholarship

Despite patients referred to home health having diverse and complex needs, it is unknown how nurses develop personalized visit plans. In this qualitative descriptive study, we interviewed 26 nurses from three agencies about their decision-making process to determine visit intensity and analyzed data using directed content analysis. Following a multifactorial assessment of the patient, nurses relied on their experience and their agency’s protocols to develop the personalized visit plan. They revised the plan based on changes in the patient’s clinical condition, engagement, and caregiver availability. Findings suggest strategies to improve visit planning and positively influence outcomes of home health patients.

Simulation As A Clinical Remediation Strategy For Undergraduate Nursing Students, Sara Camp, Tammy Legge

Faculty Scholarship

Development of clinical competency is a critical component of undergraduate nursing education. However, often when students struggle in the clinical setting with skills such as critical thinking and clinical reasoning, evidence-based resources for remediation are lacking. Because simulation is a well-established nursing pedagogy, could it be a valuable tool in clinical remediation for such students? The aim of this integrative review of literature was to examine what was currently known about clinical remediation using simulation and how simulation contributes to clinical competency. A literature search of three data bases was conducted to identify pertinent research using keywords such as simulation, …