Nursing

Transitions in care have been a national priority for decades to promote the safe and timely passage of patients between levels of healthcare and across care settings. Improving hospital discharge processes is an important quality improvement initiative to reduce adverse outcomes, and thirty-day readmission rates and increase patients’ satisfaction after discharge. This qualitative design study explored the perceptions, experiences, and gaps in understanding the needs of the resident and family in the transition from a hospital to a skilled nursing facility (SNF). It is essential to understand the perspective of the residents, families, and healthcare professionals who experience this transitional process to inform future research, and practice initiatives and to effectively prepare the residents and families for this transition. The purposive sample included 15 residents, 13 family members, and 12 SNF staff. The setting was a SNF within a continuing care residential community with an 89-licensed-bed capacity in Palm Beach County, FL. This doctoral research applied a descriptive qualitative methodology to capture the essence of the perceptions of residents, families, and staff participants transitioning from acute care to a skilled nursing facility. Interviews were qualitatively analyzed with an interactive model utilizing open, pattern, and thematic coding, and data (network) display to help organize, inform, and justify conclusions and explanations. Overall, 53% of residents, and 62% of families expressed confusion, frustration, concern, uncertainty, disappointment, and stress.

Infant feeding is a universally recognized practice yet, it is profoundly influenced by culture. While it is well accepted that breast milk is the gold standard for infant feeding in the United States, the persistence of breastfeeding disparity among minorities, particularly among Black women in the U.S. is not well understood. According to the literature, Black mothers in the U.S. remain among the least likely to both initiate and exclusively breastfeed. Although infant feeding research related to African American women's practices has been widely explored, there is a paucity of knowledge related to the experiences and practices of foreign-born Black women in the United States. More studies are needed to examine factors influencing the infant feeding practices of foreign-born Black women. This research may identify new strategies for addressing breastfeeding disparity among Black populations. This ethnographic research employs Leininger's Cultural Care Diversity and Universality Theory and Bronfenbrenner’s (1994) Social-Ecological Model to explore influencing factors on Black Jamaican women’s infant feeding practices during the first six months of life. By applying these theories as a guide for inquiry, this study seeks to identify influencing factors on Jamaican women’s infant feeding practices in the United States. Data collection involved conducting semi-structured interviews and focus groups with 14 participants aged between 30 and 40 years. Five themes emerged from the data: (1) It’s What I Saw, It’s What I Know, (2) Me Personally, (3) Riding Out The Storm, (4) During the Storm, (5) On De Road and Outta Door. The findings highlight the need for culturally competent nursing care to promote infant health within this growing population in the United States.

Background: Almost seven million persons in Saudi Arabia are diagnosed with Type 2 Diabetes Mellitus (T2DM). Lack of knowledge regarding T2DM among Saudi caregivers may impact T2DM management and disease outcomes, yet established educational programs for their caregivers are scant. There is a need to discover T2DM informal caregivers’ knowledge and its relation to patients' T2DM management, prior to designing educational interventions.
Purpose: The purpose of this quantitative, correlational study was to measure disease knowledge among informal caregivers for patients with T2DM in Saudi Arabia, and to compare findings to the patient-health status presented by HbA1C level. This study was conceptualized within nursing caring science, using Nursing as Caring Theory (Boykin & Schoenhofer, 2001), and the Individual and Family Self-Management Theory (Ryan & Sawin, 2009).

The purpose was to study the results Professional Certified Nurse Coaches (PCNCs) potentially have in mutually patterning the human energy field toward a higher wave frequency pattern of power as measured by the power as knowing participation in change tool and reflected in the narrative pattern profiles obtained from in-depth interviews. Participants were nurses working during the COVID-19 pandemic. Using Barrett’s (1986, 2020) power as knowing participation in change theory an explanatory convergent parallel mixed method using a single group with repeated measures (pre/post) and qualitative directed content analysis was used. A method for apprehending pandimensional awareness of unity and a mutual rhythmic-frequency process of-analysis-synthesis and were developed for the synthesis of numeric and textual data within a unitary perspective. Findings included a statistically significant effect for the total and four interrelated dimensions with a large effect size, except for the dimension involvement, which had a medium effect size. The results were the same when controlling for years of experience indicating that regardless of years of experience, professional nurse coaching appears to be beneficial. Six essences were identified and articulated as a group, as individuals, and across time. Joint displays show the synthesis. These findings have implications for nursing research, caring sciences, nursing education, nursing practice, policy, and professional nurse coaching.

The purpose of this qualitative research study was to explore the lived experience of families who donated their neonate’s organs at the end of life. The experiences of five mothers and one father were elicited from those who experienced this phenomenon. Heideggerian hermeneutic phenomenology served as the methodology as well as the guiding philosophy for this research study. Watson’s theory of Unitary Caring Science and the Caritas Processed provided the caring lens through which the research was completed. Deikelmann’s seven stage process for analysis was employed and through which four relative themes emerged: Enhancing the Fullness of the Baby, Celebrating the Ongoing Presencing of the Baby Within the Family, Ameliorating Grief through the Hope of Donation, and Being Embraced Within a Healing Environment. The four relational themes are represented with an aesthetic interpretation of the experience.

The purpose of this study was to explore older adults’ perception of relational empathy in their healthcare providers and its relationship to medication adherence. In addition, the study examined whether older adults’ perception of relational empathy in their healthcare providers was associated with medication adherence, beyond predictive factors including medication beliefs, gender, and level of education. The sample consisted of 72 participants in a community-based program in an adult day center setting in South Florida. Correlation and linear regression analysis were used to test the two research questions. The results indicated that there was no statistically significant relationship between older adults’ perception of relational empathy in their healthcare provider and medication adherence (p = .344) and no significant predictor variables of change in medication adherence, with all p values in the regression model greater than .202. Although present study findings were inconclusive in supporting the association between relational empathy and medication adherence, secondary findings or considerations related to the low perception of relational empathy with healthcare providers and moderately low medication adherence provided a context for a thoughtful consideration of the implications of this study. Ideas for designing future research initiatives, specifically initiatives that promote a framework for understanding and practice of empathy during the clinical encounters with older adults are also discussed.

Although there appears to be heightened awareness of the alarming rise in adolescent mental health concerns, treatment initiation and adherence to traditional therapies remains low. Nurses are at the forefront of exploring innovative youth-friendly therapeutic options that engage adolescents who otherwise may be reluctant to care. Human-animal interactions (HAIs) are alternative approaches where animals are integrated as therapeutic partners to help break down barriers, build trust, uncover meaning, and foster transformation. Equine-assisted learning (EAL), a type of HAI, was the focus of this research. This study explored the lived experience of adolescents who participated in an equine-assisted learning program guided through the lens of the theory of unitary caring and the hermeneutic-phenomenological unitary-caring research method. Eleven participants between the ages of 11-19 were interviewed. The outcomes of improved self-confidence, better mood, healthier relationships, and an optimistic outlook were supported by the literature. Six essences evolved from the narratives: troubled by turbulent connections; embracing uncertainty and vulnerability; awakening to the shared human-horse condition; attuning as one; engaging harmonically; and cultivating peace and joy. These essences, blended with the theory of unitary caring, led to the discovery of the antecedents of transformational change defined in the conceptual representation of the Unitary Caring Relatedness Model. These findings contribute to nursing and HAI literature and suggest a model that may be implemented in adolescent practice.

Global research on family caregivers’ experiences with individuals who have serious mental illnesses has increased in different cultures. However, less research has been conducted on caregivers’ experiences within cultural contexts by using transcultural theory. Further, limited studies explored family caregivers’ lived experiences of people with serious mental illnesses in Saudi Arabia. The purpose of this hermeneutic phenomenological study was to explore the lived experiences of family caregivers of persons with serious mental illnesses in Saudi Arabia in a home environment. Guided by Ray’s (2016) Transcultural Caring Dynamics in Nursing and Health-Care Model and Diekelmann’s seven-stage analysis, this study interpreted the meaning of the family caregivers’ lived experiences for individuals with serious mental illness within Saudi Arabia. Data were collected through in-depth interviews and demographic data with participants. Participants included 10 males and 5 females, who ranged in age from 24 to 53 years. Fourteen of the participants were siblings. The meaning of families’ lived experiences was interpreted as a multidimensional process within Saudi culture in the constitutive pattern of the dynamic of an endless cycle of care. Three relational themes and 11 sub-themes were categorized to capture the multidimensional nature of the phenomenon: (a) development of caring experiences (formation of knowledge and Allah/spirituality); (b) living culture values and beliefs (societal views, caregivers’ beliefs and attitudes, caregiver in family, impact of social media, caregiver as financially supportive, and mental health care services); and (c) meaning of care ( being available, expressing love, and being present). This study's findings offer implications for nursing education, nursing practice, health policy, and future research recommendations.

Stroke is a major health problem in Saudi Arabia that impacts the health outcomes of adults and elderly persons. No matter its severity, stroke is a stressful life event not only for the survivors but their family caregivers as well. Uncertainty is one of the major problems facing family caregivers caring for persons with a stroke. Uncertainty affects overall health outcomes and the quality of life of family caregivers caring for persons with strokes. Current research has not yet identified the meaning of the uncertainty of family caregivers of persons with strokes during hospitalization in Saudi Arabia. The purpose of this study was to gain an in-depth understanding of the meaning of uncertainty experienced by family caregivers of persons in the hospital who have survived strokes.
This study used a phenomenological design. Data were collected through in-depth face-to-face and online semi-structured interviews with 15 family caregivers using openended questions. Participants were recruited from inpatient medical units and stroke care units in multi acute care hospitals in Saudi Arabia. The interviews were recorded, transcribed verbatim, translated, and analyzed using the hermeneutic phenomenological unitary caring research method. NVivo software (Version 12) was used to manage the qualitative data.

The purpose of this qualitative study was to explore the process of complex healthcare decision-making by parents for their children within the milieu of a pediatric palliative care team. As healthcare has advanced, the number of children living with complex chronic conditions has increased. Decision-making by parents for their children referred to palliative care has not, up to this point, been widely explored by nursing. A purposeful sample of 22 participants, parents of children in life-limiting or life-threatening situations were asked: What matters most during the process of complex healthcare decision-making?
A constant comparative method was used to analyze data collected from semistructured interviews and the theory of embodying parenting in the midst of conflicting complexity emerged. J. Watson’s (2020) theory of human caring grounded the researcher in living caritas processes throughout the study. All participants experienced a disruption of their expected parenting and family normal. Through constant comparative data analysis, the core category of embodying parenting was identified. Feeling respected as the parent, thoughtfully making right decisions, and maintaining presence support embodying parenting. The basic social process identified was finding a unique path. The process of finding a unique path included connecting with a supportive community, claiming decisional authority, moderating negative thoughts and feelings, and adjusting expectations. Living in peace was achieved by finding a unique path to embodying parenting in the midst of conflicting complexity. For the participants in this study, accepting circumstances, feeling gratitude, and perceiving life differently led to living in peace.