Western Journal of Nursing Research

Exposure to suffering can lead to compassion fatigue in undergraduate nursing students.

Guided by resilience theory, a cross-sectional, correlational design was used to investigate the potential moderating effect of positive thinking skills on the relationships between views of suffering, compassion fatigue, and compassion satisfaction.

In 157 undergraduate nursing students, multiple regressions revealed that views of suffering and positive thinking explained 23.8% of the variance in compassion satisfaction (F_11,145 = 4.121, P < .001), and 21.9% of the variance in burnout (F_11,144 = 3.786, P < .001). The Suffering God view, which stresses the presence of a compassionate deity amid suffering, and positive thinking had significant main effects on compassion satisfaction (β = 0.349, P = .025; and β = 0.309, P < .001, respectively). Positive thinking, the Suffering God view, and the Random view, in which the occurrence of suffering is random and purposeless, had significant main effects on burnout (β = −0.280, P < .001; β = −0.392, P = .014; and β = −0.206, P = .014, respectively). The Unorthodox view, in which a deity exists that allows suffering, had a significant main effect on secondary traumatic stress (β = 0.232, P = .027). Positive thinking did not moderate any of the relationships between the views of suffering and the dependent variables.

Knowledge of these relationships can aid in the assessment of nursing students at risk for poor outcomes and guide intervention development to promote professional quality of life.

There is limited research on how fatalism influences risky health behaviors that are linked to higher cancer risks. This study investigates the relationship between risky health behaviors (tobacco smoking, electronic cigarette use, and heavy alcohol drinking) and fatalistic cancer beliefs while controlling for health care–related self-efficacy and sociodemographic and clinical factors among adults without a history of cancer.

We used cross-sectional data from the 2020 Health Information National Trends Survey (HINTS) 5 Cycle 4. The study sample included noninstitutionalized adults (aged ≥18 years without a self-reported cancer history (n = 2464). The outcome variable was risky health behaviors comprised of tobacco smoking, electronic cigarette use, and heavy alcohol drinking. We combined these 3 risky behaviors into a binary variable (0, not having risky health behavior; 1, having ≥1 risky health behavior). The key independent variable was cancer fatalistic beliefs. We used descriptive statistics and multivariate logistic regression analyses.

Overall, 50% of the sample were women, 64.7% of participants self-identified as non-Hispanic White, 16.4% as Hispanic, and 10.6% as non-Hispanic Black. About 43% of participants reported having at least one risky health behavior. While holding all other factors constant, each unit increase in cancer fatalism score was associated with 30.0% higher odds of increased risky health behaviors (odds ratio = 1.30, 95% confidence interval 1.04-1.62, P = .021) among adults without a history of cancer.

By understanding the relationship between cancer-related fatalistic beliefs and risky health behaviors, cancer prevention outreach programs can be personalized to suit the unique needs of specific individuals and communities.

It is unclear how family factors affect health care utilization among youth with persistent or recurrent pain, despite potential relevance to interventions targeting treatment barriers.

We aimed to examine health care utilization among young adolescents with persistent or recurrent pain and family factor influences toward higher health care utilization.

We analyzed longitudinal data from the Adolescent Brain Cognitive Development Study and coded pain as none, infrequent (present 1-2 years), or persistent/recurrent pain (present 3-4 years). Higher health care utilization was coded as nonroutine or emergency department visit at ≥2 years. Parent-reported education, pain status, family income, and insurance status were recorded. Logistic regression examined the contributions of the child’s pain and family factors toward higher health care utilization.

Among 5960 youth, 1908 (32%) had persistent/recurrent pain and 2199 (37%) had infrequent pain. Youth with persistent/recurrent pain were more likely to have higher health care utilization compared to those without pain (adjusted odds ratio [OR]: 2.39) or those with infrequent pain (OR: 1.79). Higher health care utilization was associated with parents’ pain (adjusted OR: 1.22) and higher education (adjusted OR: 1.44), and family income below the poverty line (adjusted OR: 1.26), controlling for child characteristics and pain status.

Findings show how youths’ persistent/recurrent pain, parental, and family socioeconomic factors affect health care utilization among young adolescents, emphasizing a need for family-centered care and economic policies.

Most individuals with lower extremity peripheral artery disease (PAD) experience symptoms other than claudication and live with undiagnosed PAD yet no tools exist to detect atypical PAD symptoms. The purpose of this study was to identify discriminating PAD symptom descriptors from a community-based sample of patients with no current diagnosis of PAD.

Symptoms descriptors were obtained in a sample of 22 participants with persistent lower extremity symptoms pre/post exercise. An ankle brachial index with exercise was used to classify participants as “PAD” or “No PAD.”

Thirteen (59%) participants had a positive ankle brachial index (<0.9, ≥20% drop postexercise, or 30 mmHg drop postexercise). Symptoms do not disappear while walking, trouble keeping up with friends/family, positive response to pain or discomfort while sitting, and pain outside of the calves and thighs were associated with a positive ankle brachial index.

Atypical symptoms were common among study participants. Symptoms while sitting and symptoms outside of the calf and thigh were negatively associated with a positive ankle brachial index. More precise descriptions of symptom characteristics are needed to improve PAD symptom recognition.

Black pregnant women who experience racial discrimination are at an increased risk of psychological distress. Studies have not adequately addressed if social support may moderate the association between experiences of racial discrimination and psychological distress among Black pregnant women.

We sought to examine the moderating effect of social support on the association between experiences of racial discrimination and psychological distress among Black pregnant women.

We report findings based on cross-sectional data collected from 599 Black pregnant women enrolled in a prospective cohort study prior to the COVID-19 pandemic. Women completed questionnaires about experiences of racial discrimination (Experiences of Discrimination), social support (MOS Social Support Survey), and psychological distress (Psychological General Wellbeing Index).

Women had an average age of 26 ± 5 years and gestational age at data collection of 17 ± 6 weeks. Approximately 53% of women reported ever experiencing racial discrimination in at least one situation, and 54% reported psychological distress. After adjustment for covariates, racial discrimination was associated with a 2.2-fold increase in psychological distress (odds ratio [OR] = 2.24; 95% confidence interval [CI] 1.35-3.70; P = .002). Low social support (scores below the median) was associated with a 3.8-fold higher likelihood of psychological distress (OR = 3.84, 95% CI 2.27-6.48, P < .001). Social support did not moderate the association of lifetime experiences of racial discrimination with psychological distress.

Findings of the study contribute to evidence that lifetime experiences of racial discrimination and low levels of social support relate to psychological distress among Black pregnant women.

The Head and Neck Patient Symptom Checklist (HNSC) is a validated 2-part instrument used to ask patients with head and neck cancer about the nutrition impact symptoms they experience (part 1) and how these interfere with their eating (part 2).

The purpose of this work was to translate and culturally adapt the HNSC into Swedish in accordance with the guidelines of the International Society for Health Economics and Outcomes Research (ISPOR).

The ISPOR guidelines include 10 steps, and these were thoroughly followed. In step 7, 9 health care professionals from the field of head and neck cancer assessed the perceived relevance (content validity) of each item in the HNSC, as well as the full HNSC. A total of 522 participants with head and neck cancer were included and followed up on 7 occasions using the HNSC to assess internal consistency.

The HNSC was translated from English into Swedish, ensuring accuracy through forward and backward translation and harmonization in the research team. Content validity for each part of the HNSC was rated excellent (scale content validity index 0.96). Internal consistency demonstrated a good Cronbach’s alpha score (>0.8) across the 7 follow-up time points (from baseline [before the start of treatment] and up to 24 months posttreatment).

The HNSC has been successfully translated and culturally adapted into Swedish. The HNSC can be used in both clinical practice and research to screen for nutrition impact symptoms and symptoms that interfere with eating in patients with head and neck cancer.

ClinicalTrials.gov NCT03343236 (date of registration: November 17, 2017)

The relationship between recurrence risk perception, fear of progression, and health behaviors in patients with ischemic stroke is unclear.

To explore the effect of accuracy and level of recurrence risk perception on health behaviors and the mediating role of fear of progression.

We conducted a 2-wave survey. Patients with ischemic stroke (N = 261) were recruited from 2 hospitals in Guangzhou, China. Before discharge, demographic information, objective recurrence risk, perceived recurrence risk, fear of progression, and health behaviors were investigated. After 1 month, the patient’s health behaviors were followed up.

The median (quartiles 1-3) scores for recurrence risk perception and fear of progression were 43.0 (39.0-46.0) and 22.0 (18.0-28.0), respectively. Only 22.2% of the patients correctly perceived the risk of recurrence, 23.0% underestimated the risk, and 30.7% overestimated the risk. Patients who overestimated the risk of recurrence (β = 0.421, P = .002) or had a higher perceived level of recurrence risk (β = 0.446, P < .001) had a higher fear of progression, which contributed to better health behaviors at 1 month (β = 0.197, P = .001). Fear of progression played a partial and full mediating role, respectively. Patients who underestimated the recurrence risk had worse health behaviors than those who accurately perceived it (β = −0.296, P = .033).

Both accuracy and level of recurrence risk perception were independent predictors of future health behaviors, and fear of progression was mediating. Health care professionals should develop individualized risk education programs to help stroke patients properly understand and cope with the risk of recurrence.

Government programs—targeting chronic disease patients with high health care costs—focus on clinical conditions, factors internal to the health care system, and individual patient education, not on addressing modifiable social determinants of health to reduce health care utilization.

To evaluate differences in sociodemographic variables and health care utilization between patients with chronic obstructive pulmonary disease (COPD) who reported food insecurity and those who did not.

This descriptive retrospective cross-sectional study used data from the electronic health records of a convenience sample of 854 participants with a discharge diagnosis of COPD or COPD with acute exacerbation, admitted via the emergency department of participating hospitals in Southern California. Chi-square (or Fisher’s exact) tests and t tests were used to evaluate group differences, and multivariate (or Firth) logistic regression to identify factors that increased the odds of emergency department visits and hospitalizations.

Significant differences between groups were identified for food insecurity (sometimes or often vs never insecure) and age (P < .001), race (P = .022), medical insurance (P < .001), zip code (P = .022), homeless status (P < .001), smoking status (P < .001), and emergency department visits (P = .033). No significant differences were found for food insecurity and hospitalizations (P = .592).

This study contributes to the growing body of research supporting the association of upstream social factors (food insecurity, homelessness, zip code) and downstream health outcomes (repeated emergency room visits), and how existing programs can be effectively utilized to impact downstream health outcomes such as health care utilization.

Aging is a process inherent to the human condition that is characterized by various biological, psychological, and social changes that can lead to certain mental health problems.

This study aimed to understand and characterize how biological, psychological, and social factors influence mental health symptoms and neuropsychological function in the aging process.

A sample consisting of 616 participants (73.8% female) aged between 50 and 90 years, (mean [SD]: 69.6 [17.2] years). Data collection involved a neuropsychological assessment carried out by a psychologist in a clinical interview session and the self-completion of a questionnaire.

Regression models revealed that depressive symptoms are explained by anxiety, psychological and environmental quality of life, and sleep habits. Anxiety symptoms are explained by depression, physical quality of life, and sleep habits. Statistically significant differences were identified between participants with and without anxiety in neuropsychological terms at the level of agnosia and praxis. Statistically significant differences were identified between participants with and without depression in neuropsychological terms at the level of memory, language, agnosia and praxis, and executive function (eg, prefrontal tests).

Depression and anxiety symptoms are associated and could negatively influence the aging process. Aging should be understood in an ecological way taking into account the action of biological, psychological, social, and environmental factors, as well as the relationship and influence between the different levels and factors. This knowledge is important for diagnosis, for clinical practice, and for the development and definition of public policies to promote healthy aging.

While longitudinal designs can provide significant advantages compared to single measurement/cross sectional designs, they require careful attention to study infrastructure and the risk of attrition among the sample over multiple time points.

The strategies used to design and manage an appropriate infrastructure for a longitudinal study and approaches to retain samples are explored using examples from 2 studies, a 25-year study of persons living with multiple sclerosis and a 10-year longitudinal follow-up of breast cancer survivors.

Key strategies (developing appropriate infrastructure, minimizing costs to participants, and maximizing rewards of study participation) have helped address the serious threat of attrition in these longitudinal samples.

Implementation of these strategies can help mitigate some of the disadvantages and leverage the strengths of longitudinal research to produce reliable, insightful, and impactful outcomes.

Memorializing nurses’ experiences during the COVID-19 pandemic had the potential to allow scientists and policymakers to learn about the impact on the nursing profession and health care systems. Yet, nurses are considered a difficult population to recruit for research.

To describe an innovative qualitative data collection method for capturing current practice experiences among nurses working during the COVID-19 pandemic.

Guerilla theory served as the theoretical framework. Utilizing a qualitative descriptive design, a telephone voicemail messaging system was developed to capture nurses’ experiences.

Nurses were recruited with convenience and snowball sampling via social media and state listservs. The telephone voicemail messaging system, Twilio, was used. After listening to the recording of the consent form, the participants shared their experiences by leaving a voice message where they answered the prompt, “Tell us about your experiences working during the COVID-19 pandemic.” Seventy voicemails were included, and the voicemails were transcribed. After a nurse shared their experience via an email sent to the research team, emails were added to the data collection; 16 emails were received. Transcripts and emails were uploaded to the qualitative data analysis software program, Dedoose, and coded by 2 researchers using content analysis. Main themes were derived and discussed among the research team.

Allowing participants multiple modes of expressing their experiences promote inclusivity in data collection. Further development and standardization of this method is needed for future research.