A Structural Equation Modeling Analysis to Explore Diabetes Self-Care Factors in a Rural Sample

Diabetes is a public health problem that requires management to avoid health sequelae. Little is known about the determinants that influence diabetes self-care activities among rural populations. The purpose of this analysis was to explore the relationships among diabetes self-care activities, diabetes knowledge, perceived diabetes self-management, diabetes fatalism, and social support among an underserved rural group in the southern United States. A diabetes health promotion program was tested during a cluster randomized trial that tested a disease risk reduction program among adults living with prediabetes and diabetes. A structural equation model was fit to test psychosocial factors that influence diabetes self-care activities using the Information–Motivation–Behavioral Skills Model of Diabetes Self-Care (IMB-DSC) to guide the study. Perceived diabetes self-management significantly predicted self-care behaviors, and there was also a correlation between perceived diabetes self-management and diabetes fatalism. Perceived diabetes self-management influenced diabetes self-care activities in this rural sample and had an association with diabetes fatalism. The findings of this study can facilitate clinical care and community programs targeting diabetes and advance health equity among underserved rural groups

Knowledge, Beliefs, and Attitudes of Emergency Nurses Toward People With Chronic Pain

More and more people suffering from chronic pain (CP) utilize the emergency department (ED). However, their needs are not properly addressed. Stigmatization toward people with CP can partially explain this gap. Most studies in the ED have been focused on measuring nurses’ pain management knowledge in general, not negative attitudes toward CP. Hence, understanding of the determinants of the stigma related to CP is needed. The objectives of this study were to (a) describe the knowledge, beliefs, and attitudes of ED nurses toward people suffering from CP and (b) identify nurses’ characteristics associated with these perceptions. A cross-sectional web-based survey design was conducted using the KnowPain-12 questionnaire and the Chronic Pain Myth Scale. A total of 571 participants from 20 different states across the United States were recruited among whom 482 completed the entire survey. The sample included about one third of the ED nurses suffering from CP. Negative beliefs and attitudes toward people with CP were present in a considerable proportion of participants (up to 64%), even in nurses suffering from CP (up to 47.5%). Nevertheless, our results suggest that higher levels of education and suffering from CP were associated with better beliefs and attitudes toward people with CP. The ED presents an increased risk of stigmatization of people with CP as compared with the general population. Identifying determinants of the stigma associated with CP is crucial, as it will help tailoring awareness and educational campaigns. In addition, CP patients utilizing the ED often have complex needs which are difficult to address in this clinical environment. This situation can contribute to negative beliefs and attitudes. Given the scarcity of specialized care clinics for this population, health-care stakeholders should devise solutions to improve continuity of care in primary care settings and between the latter and ED

College Students’ eMental Health Literacy and Risk of Diagnosis with Mental Health Disorders

Background: This study investigated college students’ eMental health literacy (eMHL), knowledge of common mental disorders and risk of being diagnosed with a mental health disorder and compared their knowledge of mental disorders and concurrent risk of diagnosis with high and low eMHL; Method: A total of 123 college students completed an online survey through Amazon’s Mechanical Turk (MTurk). Data were analyzed using descriptive statistics and chi-square tests; Results: eMental health literacy scores were higher when students had a history of prior mental health problems, were female, and graduate students. College students with high eMHL were more likely to recognize symptoms, recommend professional help, and be at lower risk for common mental health disorders compared to low eMHL students; Conclusions: eMHL was associated with mental health status and demographic variables. Level of eMHL was associated with knowledge of mental disorders and risk of diagnosis. Implications: The results highlight the need for targeted interventions to enhance eMHL of college students, support mental health resilience and prevent mental health disorders

Cross-Cultural Validation of the English Chronic Pain Myth Scale in Emergency Nurses

Background. Utilization of the emergency department (ED) by patients seeking relief from chronic pain (CP) has increased. These patients often face stigmatization, and the ED is no exception. The French-Canadian Chronic Pain Myth Scale (CPMS) was developed to evaluate common societal misconceptions about CP including among healthcare providers. To our knowledge, no tool of this nature is available in English. Objectives. This study thus aimed at determining to what extent a new English adaptation of the CPMS could provide valid scores among US emergency nurses. The internal consistency, construct validity, and internal structure of the translated scale were thus examined. Methods. After careful translation of the scale, the English CPMS was administered to 482 emergency nurses and its validity was explored through a web-based cross-sectional study. Results. Acceptable reliability α>0.7 was reported for the first and third subscales. The second subscale’s reliability coefficient was below the cutoff (α=0.67) but is still considered adequate. As expected, statistically significant differences were found between nurses suffering from CP vs nurses not suffering from CP, supporting the construct validity of the scale. After exploratory factor analysis, similar internal structure was found supporting the 3-factorial nature of the original CPMS. Conclusion. Our results provide support for the preliminary validity of the English CPMS to measure knowledge, beliefs, and attitudes towards CP among emergency nurses in the United States

Nurses’ Perception of a Tailored Web-Based Intervention for the Self-Management of Pain After Cardiac Surgery

Background Cardiac surgeries rank among the most frequent surgical procedures and present a risk of chronic postsurgical pain (CPSP). A continuum approach is required to prevent the development of CPSP. As a first step, a tailored web-based intervention was developed and successfully tested to tackle pain management during hospitalization. Before proceeding to further development, preliminary acceptability of the intervention including the postdischarge phase must be evaluated. Purpose The purpose of this study was to examine nurses’ perception of a tailored Web-based intervention for pain management in the early recovery phase. The objectives were to evaluate intervention’s acceptability and to identify ways to enhance its acceptability. Methods A parallel mixed methods approach was used to assess the acceptability of the intervention in the early recovery phase (first month after surgery). Results In total, 249 participants completed the online survey and 10 participants were individually interviewed. Overall, the intervention was rated as acceptable. No difference was found in acceptability ratings by demographics. The intervention was rated as appropriate to very much appropriate by 79% of participants. Although nurses seemingly would recommend it to their patients, they did not perceive that their patients would be as highly willing to use it. Interviews highlighted several strengths of the intervention, such as postoperative pain awareness, customization of content, and flexible dosage and schedule. However, the main weakness was related to patient adherence. Opting for a hybrid format and integrating individual preferences could enhance the coaching experience. Conclusion The innovative intervention was judged as acceptable for pain management in the early recovery phase. Considering that the intervention has demonstrated positive effects on the pain experience in the first week after cardiac surgery, it seems logical to explore its potential impact after discharge on the transition to CPSP