Nursing Commons^™

Predictors Of Opioid Misuse And Abuse Among Pregnant Women In The Us, Henry Ofori Duah, Diane Von Ah, Ethan Morgan

College of Nursing Faculty Research and Publications

Introduction

Opioid misuse and abuse during pregnancy can adversely affect maternal and infant outcomes. Factors that drive the burden of opioid misuse and abuse are multifaceted and understudied. This study sought to explore predictors of opioid misuse and abuse among pregnant women in the United States.

Methods

Secondary data analysis of the National Survey on Drug Use and Health (NSDUH) data from 2015-2019 was performed. The primary outcomes were past-year opioid misuse, past-month misuse, and past-year opioid abuse. Data analysis included weight-adjusted univariate, bivariate, and multivariable logistic regression.

Results

The pooled weighted sample comprised 2,258,599 pregnant women. The prevalence of …

Dna Methylation Of Slc6a4 And Nr3c1 In Term And Preterm Infants: A Pilot Study Of Nicu-Associated Stress, Kathryn J. Malin, Yvette P. Conley, Aleigha Barry, Rosemary White-Traut

College of Nursing Faculty Research and Publications

Background: Preterm infants requiring prolonged hospitalization in the neonatal intensive care unit (NICU) are often exposed to early-life stress, which may contribute to long-term health consequences. Epigenetic markers, particularly DNA methylation (DNAm) of stress-related genes such as SLC6A4 and NR3C1, have been identified as potential biomarkers of early-life stress. Limited research has compared DNAm patterns between term and preterm infants or examined associations between NICU-related stress and DNAm in preterm populations. Objectives: This pilot study aimed to (1) compare DNAm patterns between preterm and term infants, (2) examine relationships between NICU-related stress and DNAm alterations in preterm infants, and …

Educating To Exhaustion: Intention To Leave Among Us Full-Time Nursing Faculty, Jacqueline Christianson, Kathryn J. Malin, Jessica Leiberg, Lisa M. Grabert, Stephanie E. Moser, Jessica Zemlak, Jessica L. Zemlak

College of Nursing Faculty Research and Publications

AIM 

The aim of this study was to examine the relationships between work efforts and rewards with intention to leave and burnout among full-time nurse educators.

BACKGROUND 

The nursing faculty shortage is a contributor to the nursing shortage. Poor balance between work efforts and rewards may contribute to intention to leave.

METHOD 

A cross-sectional survey of US nurse faculty examined work efforts, rewards, burnout, and intention to leave. Structural equation modeling was used to evaluate the relationships among variables.

RESULTS 

Among 588 participants, efforts and rewards both had significant effects on burnout. Burnout and rewards had significant effects on intention …

Comparing Us Medicare Coverage Options As A Contributing Mechanism To Sticking Or Switching To An Insurance Plan, Lisa M. Grabert, Brian J. Miller, Kathryn L. Wagner

College of Nursing Faculty Research and Publications

Background

In 2025, the US Medicare program is expected to spend over $1.1 trillion taxpayer dollars. A growing trend in the US Medicare program is more beneficiaries electing a private insurer, referred to as Medicare Advantage (MA), to manage their care. Since 2023, a slight majority of Medicare beneficiaries have elected to enroll in MA, yet little is understood about the mechanisms that drive beneficiaries toward their choices.

Methods

Our objective was to examine the association between comparing coverage options and ‘switching’ or ‘sticking’ with Fee-for-Service (FFS) Medicare or Medicare Advantage (MA). We conducted a panel study, using data from …

From The Goodness Of Our Hearts: A Scoping Review Of Qualitative Literature On Altruism As A Reward Mechanism For Nursing, Jacqueline Christianson, Madaline Mccarthy, Bonnie Sommers-Olson, Emily Horner, Norah L. Johnson

College of Nursing Faculty Research and Publications

Introduction

Altruism, the desire to help others, is a common motivation for choosing a career in nursing. Improved understanding of the role of altruism as a reward or motivation for currently-practicing nurses may inform future interventions to improve effort-reward balance among practicing nurses. Therefore, the purpose of this study was to collect, examine, and present literature on how altruism has been described as a reward mechanism or motivation for engaging in professional nursing.

Methods

This scoping review of literature used the Arksey & O’Malley method, PRISMA-ScR reporting checklist, and Rayyan review management platform. PubMed, Web of Science, and CINAHL were …

An Educational Intervention On Mutual Goal Setting For Hospital Nurses: A Mixed-Methods Study, Teresa Jerofke-Owen, Kristi Opper, Joseph Beiler, Maharaj Singh

College of Nursing Faculty Research and Publications

Background:

Including patients in mutual goal setting is one mechanism to personalize care delivery and improve patient outcomes.

Objective:

The purpose of this study was to examine the impact of a nurse educational intervention about mutual goal setting on nurse engagement and self-efficacy for goal setting and the nurse/patient experience of goal setting.

Methods:

During this explanatory, sequential mixed-methods study, nurse engagement in goal setting and goal quality was assessed through chart audits 1-month pre-intervention (n = 173) and 1 and 3-months (n = 144, n = 137) post-intervention. Nurse self-efficacy was measured with the Appraisal Inventory Tool. Patient experience …

Beyond Numbers: Bridging Statistical Significance And Clinical Relevance In Healthcare Research, Maharaj Singh, Waheeda Khan, Mehreen Fatima

College of Nursing Faculty Research and Publications

Objective: This study aims to bridge the gap between statistical significance and clinical relevance using rigorous statistical methodologies applied to simulated healthcare data, thereby enhancing the translational value of research outcomes for patient‑centered care. Methods: A synthetic dataset representing 10,000 patients was generated, and descriptive statistics were applied to compare two treatment groups. Binary outcomes were predicted using both a logistic regression model and a neural network. Two‑tailed tests with a significant level of 0.05 were employed, utilizing SAS version 9.4 and IBM SPSS Statistics, Version 29.0 (IBM Corp., Armonk, New York, United States of America). Results: The simulated dataset …

The Performance Of Machine Learning Algorithms In Predicting Under-Five Anaemia In Tanzania, Henry Ofori Duah, Derrick Nyantakyi Owusu, Godwin G. Duah, Paul Shidende

College of Nursing Faculty Research and Publications

Aim

Anaemia in children under five remains a major public health concern, contributing significantly to global child morbidity and mortality. With the rise of machine learning (ML), novel opportunities exist to model and predict anaemia more effectively. This study aimed to evaluate and compare the performance of five ML algorithms in predicting anaemia among under-five children in Tanzania.

Methods

We conducted a secondary data analysis using the 2017 Tanzania Malaria Indicator Survey (TMICS). The dataset (n = 5906) was randomly split into training (70%) and test (30%) sets. Five ML algorithms, Linear Discriminant Analysis (LDA), Logistic Regression, Random Forest (RF), …

Artificial Intelligence And Mental Health: Promise, Pitfalls And Ethical Priorities, Maharaj Singh

College of Nursing Faculty Research and Publications

Mental health conditions are prevalent across the lifespan, yet workforce shortages, long waiting times, and fragmented systems mean many people never receive timely, evidence‑based care. Artificial intelligence (AI), including machine‑learning classifiers and large language models (LLMs), is being explored to support earlier detection, closer symptom monitoring and scalable psychoeducation. Early studies suggest AI can surface risk signals from language, sleep/activity traces and clinical notes; summarise complex records for clinicians; and deliver structured self‑help at scale. At the same time, safety, bias, privacy and accountability concerns remain salient.

Glp-1 Medications For Kids: Do They Work, And At What Price?, Sylvia Peña, Marilyn Frenn

College of Nursing Faculty Research and Publications

Context

Childhood obesity continues to increase along with the numbers of children with severe obesity and related comorbidities. This meta-analysis1 sought to determine whether or not glucagon-like peptide-1 receptor agonist (GLP-1 RA) medications are safe and effective for children and adolescents.

Methods

Appropriate search and abstraction approaches were used in the meta-analysis of randomised controlled trials making it the highest level of evidence. Included studies were those with participants younger than 18 years with obesity, overweight, pre-diabetes or type 2 diabetes (T2D) assessing GLP-1 RAs alone or with lifestyle modification versus placebo published between 2023 and 2025. Most participants …

Black Women’S Experiences Accessing Health Care And Law Enforcement After Intimate Partner Violence: A Qualitative Pilot Study, Kaylen M. Moore, Linda M. Wesp, Jeneile Luebke, Peninnah M. Kako

College of Nursing Faculty Research and Publications

Background:

Intimate partner violence (IPV) is a global public health issue impacting millions of people each year. Black women constitute 14% of the US population but alarmingly comprise 31% of homicides resulting from IPV. African American women survivors of IPV experience intersecting impacts of racism, sexism, and historical mistrust. This research aimed to raise awareness about their experiences of violence and perceptions of institutional support.

Objective:

This study sought to explore African American women’s experiences with IPV and navigation of health care and law enforcement after experiences of violence.

Method:

Critical ethnography was used as an approach for this qualitative …

Cultural Humility In Patient Education: Development Of A Nutrition-Related Simulation For Nursing Students, Theresa G. Schnable, Sylvia Peña, Juanita T. Garcia, Marilyn Frenn

College of Nursing Faculty Research and Publications

Introduction:

The Latinx community is disproportionately impacted by social and structural inequities such as food insecurity and culturally and linguistically appropriate resources. To address a gap in culturally appropriate nutrition education with Latinx individuals among baccalaureate nursing students, a simulation learning experience (SLE) was developed.

Methodology:

The SLE was designed using best practice standards by faculty experts and reviewed by consultants. After the SLE, students and faculty provided feedback regarding simulation design and implementation.

Results:

Participants reported improved knowledge and confidence when providing culturally appropriate nutrition education and valued working with an interpreter.

Discussion:

This innovative strategy using simulation offers …

Supporting Discharge Preparation For Children With Medical Complexity: A Scoping Review, Emily Moore, Mia Waldron, Darlene Acorda, Cara Gallegos, Barbie Giambra, Stacee M. Lerret, Christine R. Platt, Danielle A. Sarik, Zara Sajwani-Merchant, Nesibe Sumeyye Kutahyalioglu, Pamela Gampetro, Susan Groshong, Marianne Weiss, Teri L. Hernandez, Sandra Staveski

College of Nursing Faculty Research and Publications

Background

The transition from hospital to home is a critical period for children with medical complexity (CMC) and their caregivers, often associated with increased risks and stress. Both registered nurses and advanced practice nurses play a pivotal role in facilitating this transition through discharge preparation, including planning, coordination, and teaching. However, best practices for optimizing discharge processes for CMC remain unclear. The need for a comprehensive understanding of hospital discharge during this crucial time is apparent as adverse events following discharge are common and are often attributed to insufficient preparation and communication. This scoping review aims to identify key nursing …

Noise-Optimized Cone-Beam Computed Tomographic Imaging Of Different Post Materials With Multiple Settings: A Comparative Analysis, Solaleh Shahmirzadi, Dilek Helvacioglu-Yigit, Umut Seki, Maharaj Singh, Sarang Saadat, Husniye Demirturk Kocasarac

College of Nursing Faculty Research and Publications

Purpose The aim of this study was to evaluate the effect of 4 different post materials on the contrast-to-noise ratio (CNR) in various tooth regions using multiple cone-beam computed tomography (CBCT) imaging settings and metal artifact reduction (MAR) algorithms. Materials and Methods Forty single-rooted teeth with 4 different post materials were mounted in a skull and scanned using the Planmeca ProMax 3D Max under different conditions: 90 and 96 kVp; no, medium, and high MAR settings; and voxel sizes of 100 and 200 μm. Image analysis was performed with ImageJ software to calculate CNR. The dose-area product (DAP) was recorded, …

Botulinum Neurotoxin Light Chain/A1 Uses Fast Synaptic Vesicle Cycling To Cleave Plasma Membrane Bound Snap-25, Alexander Gardner, Molly Sneller, William H. Tepp, Joseph T. Barbieri, Sabine Pellett

College of Nursing Faculty Research and Publications

Botulinum neurotoxins (BoNT) are the most potent protein toxins for humans, yet how BoNT-Light Chain/A1 (LC/A1) journeys to cleave intracellular SNAP-25 is understudied. Here we use a cell-based assay to measure cytosolic EGFP-LC/A1 intracellular trafficking and SNAP-25 cleavage in Neuro-2A cells. Intracellular LC/A1 associated on microtubules and co-localized with Rab GTPases involved in fast synaptic vesicles and endosome recycling. Multiple Dominant Negative (DN) Rabs GTPases involved in fast synaptic vesicles or endosome recycling inhibited LC/A1 trafficking to the intracellular plasma membrane and SNAP-25 cleavage. A cytosolic LC/A1 variant that bound the plasma membrane from the cytosol was insensitive to DNRab …

Childhood Obesity Body Mass Index And Gut Microbiome: A Cluster Randomized Controlled Pilot Feasibility Study, Marilyn Frenn, Nita Salzman, Vy Lam, Mary Holtz, Andrea Moosreiner, Mauricio Garnier-Villarreal, Maharaj Singh

College of Nursing Faculty Research and Publications

Background:

Prebiotic fiber has been examined as a way to foster gut bacteria less associated with obesity. Tests of prebiotic fiber in reducing obesity have occurred mainly in animals, adults, and Caucasians when the highest obesity rates are in African American and Latinx youth. Response to prebiotic fiber is determined by the pre-existing intestinal microbiota. The type of microbiota varies based on diet and physical activity (PA), so it is important to examine acceptability and response to prebiotic fiber in those most at risk for obesity.

Methods:

This cluster randomized controlled feasibility trial included an online program designed to improve …

Using Meta-Analysis: What Exercise Helps Kids With Excess Weight The Most?, Marilyn Frenn

College of Nursing Faculty Research and Publications

No abstract provided.

The State Of The Science Of Natural Family Planning: A Report From Nfp Scientists’ Meeting Held In Orlando, Fl, September 4, 2024, Michael D. Manhart, Richard J. Fehring

College of Nursing Faculty Research and Publications

A one-day meeting was held as a pre-conference to the Catholic Medical Association Annual Educational event in 2024. A panel of eighteen physicians, scientists, and researchers involved in NFP work was convened to review the available evidence in four topical areas: (i) evidence for effectiveness of NFP methods to postpone and achieve pregnancy, (ii) evidence for effectiveness in the postpartum and perimenopause transition periods, (iii) evaluate the current state of technology in NFP (specifically app and quantitative hormone monitoring), and (iv) evidence examining the impact of NFP on marital relations. In each topical area, the panel worked to reach a …

Engaging A Community-Academic Partnership To Implement Community-Driven Solutions, Abiola O. Keller, Lindsey St. Arnold Bell, Kristin Haglund

College of Nursing Faculty Research and Publications

Community engagement is a pivotal public health tool for addressing population health challenges and advancing health equity. Community–academic partnerships that use community-engaged approaches can prioritize community strengths and ensure that resources and interventions match local needs. In 2021–2022, a community-academic partnership, guided by the principles of community engagement, collaborated with residents of Milwaukee’s Near West Side (NWS) to identify strengths and assets and prioritize actions to improve health and quality of life. To inform the development of a planned community resource center, residents were invited for group concept mapping (GCM).

Pediatric Respite Homes: A Call To Action, Amy S. Porter, Jennifer M. Snaman, Jonathan Cottor, Kim Whitmore, Joanne Wolfe

College of Nursing Faculty Research and Publications

Approximately 1 million children with medical complexity (CMC) live in the United States, and although their health care needs comprise 40% of child health costs, most of their care is provided at home by their parents and other family caregivers. Around-the-clock care encompasses direct medical care, including administration of medications and nutrition, care coordination and supplies management, emotional work of vigilance and worry, financial planning, and more. This intensive caregiving offers meaning and joy for many of those parents, yet its constancy can threaten their emotional well-being, physical health, and financial security, presumedly negatively influencing their capacity to provide care …

Polypharmacy And Pharmacogenomics In High-Acuity Behavioral Health Care For Autism Spectrum Disorder: A Retrospective Study, Sheldon R. Garrison, Sophie A. Schweinert, Matthew W. Boyer, Maharaj Singh, Sreya Vadapalli, Jeffery M. Engelmann, Rachel A. Schwartz, Madeline M. Hartig

College of Nursing Faculty Research and Publications

Background

This study evaluated pharmacogenomic (PGx) testing in children and adolescents with autism spectrum disorder (ASD). ASD frequently presents with co-occurring depression and anxiety. This complex phenotype often results in psychotropic medication polypharmacy. Incorporating PGx testing into the medical work-up may reduce polypharmacy and improve quality of life with symptom reduction.

Methods

A retrospective electronic health record (EHR) review between January 2017 and May 2023. Individuals either received PGx testing or treatment as usual (TAU). The co-primary outcomes were instance of polypharmacy and the Pediatric Quality of Life Enjoyment and Satisfaction Questionnaire (PQ-LES-Q). Secondary outcomes included length of stay, average …

Building Health Policy Advocacy Expertise In Pediatric Nurse Practitioners Through Civic-Based Experiential Learning, Christine A. Schindler, Jill C. Kuester, Jennifer K. Pfister, Katie L. Mcdermott

College of Nursing Faculty Research and Publications

Background:

Many nurses work largely as policy implementers rather than policy developers. The literature posits several multifaceted reasons for this lack of policy acumen including interprofessional power dynamics, marginalization of nurses in policy making, and lack of formal training in public policy advocacy.

Purpose:

To evaluate the impact of a targeted teaching strategy on increasing political astuteness, perceived skill, and comfort in health policy advocacy among a cohort of acute care pediatric nurse practitioner students.

Methods:

Curriculum assessment data were collected using the Political Astuteness Inventory, pre- and postclass discussions, and written reflections.Results: This curriculum evaluation suggests that specific policy …

The Impact Of Covid-19 During The First Two Years: Giving Voice To Pediatric Nurses, Karen S. Gralton, Kathryn J. Malin, Eileen Sherburne, Danielle Smith, Stacy Wenner, Julie Averbeck, Amy Newman, Anita Norton, Genesee Hornung, Karen Kavanaugh

College of Nursing Faculty Research and Publications

Purpose

The purpose of this study was to describe the experiences of pediatric nurses providing direct care in a variety of settings during the first two years of the COVID-19 pandemic.

Design and methods

This was a qualitative descriptive study. Donabedian's Quality Framework for the Evaluation of Healthcare was used to guide the design. Purposive sampling was used to recruit 24 direct care nurses from inpatient and outpatient settings within one healthcare system. Semi-structured, audio-recorded interviews were conducted in-person or via a virtual platform from November 2021 through March 2022.

Results

Four major themes were determined across all settings and …

Participant Personal Characteristics And Adherence To Oral Capsules: A Secondary Analysis Of A Randomized Placebo-Controlled Trial Of Antenatal Probiotics, Lisa Hanson, Kathlyn Albert, Emily Malloy, Maharaj Singh, Mikala Kallay, Ava Brandt, Courtney Morris, Diana Kleber, Marie Forgie

College of Nursing Faculty Research and Publications

Background

Adherence to study interventions is critical to the conduct of randomized controlled trials (RCTs). The relationships between participant characteristics and intervention adherence are understudied in pregnant populations. The purpose of this study was to conduct a secondary analysis of adherence to study capsules in a double-masked, placebo-controlled RCT of a probiotic intervention to reduce antenatal Group B Streptococcus colonization, in relationship to participant characteristics.

Methods

We analyzed the relationship between capsule adherence rates and demographic characteristics among 81 RCT participants. Categorical variables were reported using counts and percentages, and continuous variables were expressed as means along with their standard …

The Importance Of Feedback With An Asynchronous Online Training Program When Learning Debriefing For Meaningful Learning, Aimee A. Woda, Brandon Kyle Johnson, Jamie Hansen, Kristina Chen, Kristina Thomas Dreifuerst

College of Nursing Faculty Research and Publications

Background

Despite knowing the importance of debriefing, there is insufficient evidence to guide the best way to train and provide formative feedback to develop competent debriefers.

Method

This multi-site, experimental, repeated measures study was used to test the impact of different intervals of expert feedback on a debriefer's competence implementing debriefing after participating in an asynchronous, online, distributed modular training program.

Results

Training and early feedback facilitated rapid improvements in a debriefer's ability to implement a debriefing method correctly. Regular feedback improved competence over time.

Conclusion

A well-developed, asynchronous online training program is an effective way to train debriefers.

Changing Intimate Partner Violence Screening And Intervention: Focus Group Perspectives, Colleen M. Galambos, Teresa Jerofke-Owen, Heidi Paquette, Linda B. Piacentine, Erin C. Schubert, Mychoua Vang, Erica Arrington, Nilanjan Lodh, Kimberly S. Gecsi

College of Nursing Faculty Research and Publications

Background: Many survivors of intimate partner violence (IPV) remain unconnected to professional help. Screenings in health settings may improve connections to support services.

Purpose: The purpose of this study was to gather data to help inform an IPV screening intervention in an obstetrics/gynecology health clinic.

Methods: A qualitative analysis was employed using a summative content analysis approach of the transcripts of 2 focus groups consisting of health care providers, advocates, and survivors of IPV.

Results: Four thematic categories and additional subcategories emerged from the analysis, including (1) current process (what is done); (2) need (what is not done); (3) concerns …

An Integrative Review Of The Use Of The Individual And Family Self-Management Theory In Research, Wendy S. Bauer, Rachel F. Schiffman, Julie L. Ellis, Jeanne M. Erickson, Michele Polfuss, Murad H. Taani, Kathleen J. Sawin

College of Nursing Faculty Research and Publications

The extent of the application of the Individual and Family Self-Management Theory (IFSMT) in research has yet to be determined. The purpose of this analysis was to review the use of the IFSMT in published research and evaluate posited constructs and relationships. Dimensions and categories of the IFSMT and the interrelationships were generally supported in the 77 articles reviewed. A majority focused on self-management of chronic conditions in the adult population. More research on the strength, direction, and interaction of relationships is needed. Defining and exploring social constructs, including race, ethnicity, and gender, should be prioritized in future IFSMT research.

To Address The Nursing Faculty Shortage, Start With The Salary Gap, Jacqueline Christianson, Christine A. Schindler, Lisa M. Grabert

College of Nursing Faculty Research and Publications

Nurses must advocate with policymakers for meaningful change.

There is a national shortage of nursing faculty to educate the future nurse workforce. The biggest barrier to recruiting and retaining nursing faculty is the salary gap between the faculty and clinical nursing roles. Many full-time nursing faculty earn a lower salary than the new graduate nurses they educate. According to our recent research (American Nurse, July 2024), NPs who have a comparable education level to nursing faculty take an average $43,000 pay cut if they leave clinical practice to teach full-time. Even the salaries of PhD-prepared faculty often lag …

Integrated Mental Health Care In Specialty Clinics For Children With A Diagnosis Of Asthma Or Diabetes: A Mixed Methods Study, Joan P. Totka, Maria Peña, Joshua A. Steinberg, Peter M. Wolfgram

College of Nursing Faculty Research and Publications

Introduction

Using patient-reported outcome measures (PROM) in a shared-space mental health-integrated specialty clinic, we explored the feasibility, acceptance, and experience of youth with asthma and diabetes, their families, and the healthcare team.

Method

Using mixed methods, we examined feasibility, acceptability, and experience of PROM inclusion in caring for youth with asthma (n = 7) and diabetes (n = 11), their families (n = 18), and healthcare providers (n= 13). Completion and receipt of PROM (feasibility), postvisit surveys (acceptance), and structured interviews (experience) between June 2019 and February 2020.

Results

Targeted PROM met feasibility goals (80%) …

Assessing Family Caregiver Readiness For Hospital Discharge Of Patients With Serious Or Life-Limiting Illness Using Electronic Health Record And Self-Reported Data, Joan M. Griffin, Diane E. Holland, Catherine E. Vanderboom, Brystana G. Kaufman, Allison M. Gustavson, Jeanine Ransom, Jay Mandrekar, Ann Marie Dose, Cory Ingram, Zhi Ven Fong, Ellen Wild, Marianne E. Weiss

College of Nursing Faculty Research and Publications

Objective

To assess how patient and caregiver factors influence caregiver readiness for hospital discharge in palliative care patients.

Study Setting and Design

This transitional care study uses cross-sectional data from a randomized controlled trial conducted from 2018 to 2023 testing an intervention for caregivers of hospitalized adult patients with a serious or life-limiting illness who received a palliative care consult prior to transitioning out of the hospital.

Data Sources and Analytical Sample

Caregiver readiness was measured with the Family Readiness for Hospital Discharge Scale (n = 231). Caregiver demographic, intra- and interpersonal factors were self-reported. Patient demographic, comorbidity score, …