Healthcare interprofessional team members' perspectives on human caring: A directed content analysis study

Objectives: As Watson's Human Caring Theory continues to evolve and guide the discipline of nursing, the challenge is to find ways to integrate it into practice. The purpose of this study is to describe interprofessional team members' perspectives on human caring based on the Ten Caritas Processes®/Caritas-Veritas Literacy of Watson's Human Caring Theory within the Unitary Caring Science. Methods: This is a qualitative directed content analysis study, taking place in a Children's Hospital in the United States between November 2017 and April 2018. Information redundancy was utilized to guide the recruitment. Data were collected via a one-time face-to-face individual interview. A qualitative directed content analysis was conducted using Watson's Ten Caritas Processes®/Caritas-Veritas Literacy as a coding framework. Results: Twenty-seven healthcare professionals participated in the study. Interprofessional human caring, based on the Ten Caritas Processes®/Caritas-Veritas Literacy, was referred to as performing loving-kindness to patients, each other, and self; maintaining faith-hope in teamwork; valuing inter-subjective interactions and building trust among team members; cultivating heart-centered-caring relations; acknowledging and processing positive and negative feelings non-judgmentally; applying all ways of knowing in caring; encouraging reciprocal teaching-learning; developing caring-healing environments collaboratively; respecting human dignity of patients and each other; and being open-minded to the unknowns and believing in miracles. Conclusions: Watson's Human Caring Theory can be an underlying guide to enrich human-to-human relations and create a caring-healing environment. When human caring is applied in interprofessional teams, healthcare professionals find a caring consciousness to care for oneself and each other and promote patient care

A Systematic Literature Review of the Current State of Knowledge Related to Interventions for Bereaved Parents

Aims: The purpose of this systematic literature review is to describe the interventions for bereaved parents, evaluate intervention effectiveness through study methodology rigor, replicability, and theoretical foundations. Methods: We searched MEDLINE via PubMed (1966-2018), CINAHL (1937-present), PsycINFO (1887-present), and Embase (1947-present) using various search words and MeSH terms related to the study purpose. A blinded screening of title/abstract was performed, with conflicting inclusion decisions resolved through group discussions. Matrices for remaining articles were created and discussed among the team. The levels of evidence of the 9 records were rated from very low to high based on the Grading of Recommendations Assessment, Development, and Evaluation guidelines. Results: Our initial pool included 1025 articles. After the screening of titles/abstracts, 63 articles were retained for full-text reviews. Evaluated based on the inclusion/exclusion criteria, 9 records met the review criteria. Of the 9 records, 1 was graded as very low, 3 low, and 5 low to moderate. The interventions for bereaved parents varied from using single-model interventions such as expressive arts therapy and telephone support to multimodal interventions that combined resources (ie, peer support, resource packets, and health-care support). Only 1 study explicitly illustrated how its bereavement intervention was designed based on the proposed theoretical model. Conclusions: This review highlights the need for individualized, well-tested, and effective bereavement care interventions to support bereaved parents. In summary, the state of the science on interventions for bereaved parents is poor and much work needs to be done to effectively address the needs of bereaved parents, including both their physical and emotional health needs

The impacts of faculty caring on nursing students’ intent to graduate: A systematic literature review

Objectives: To examine the current studies about the impacts of faculty caring on nursing students’ intent to graduate and provide recommendations. The nursing profession continues to face nursing shortages. One of the solutions recognized to alleviate the shortage is increasing the number of students graduating from nursing schools. It lacks a literature review synthesizing the current research about the impacts of faculty caring on nursing students’ intent to graduate and indicate areas for future research. Methods: This is a systematic literature review. The search of the literature was guided by the Preferred Reporting Items for Systematic reviews and Meta-Analyses (PRISMA). Databases searched included MEDLINE via PubMed, CINAHL, PsycINFO, and ProQuest Search. Search terms included ‘attrition,’ ‘dropouts,’ ‘graduation rate,’ ‘faculty,’ ‘instructor,’ ‘professor,’ ‘nursing,’ and ‘caring.’ Results: Ten articles met the inclusion criteria. The articles were conducted in the Associate Degree of Nursing and the Bachelor of Science in Nursing programs. Nursing faculties played a significant role in students’ intent to graduate by building students’ confidence, creating a compassionate learning environment, and promoting students’ competence. Faculties’ caring behaviors, including respecting students, showing empathy, and using caring communication skills, were essential characteristics to affect students’ learning environments. Conclusions: The findings indicate that students’ perceptions of faculty caring can affect their perceptions of the learning environment and sense of belonging, and therefore, impact their intent to graduate. Students’ perceptions of their instructors’ caring behaviors are instrumental in motivating them to continue learning. The capacity of faculty caring plays a significant role in students’ success

The Experiences and Care Needs of Parents whose Children are Born with Congenital Heart Disease

Congenital heart disease (CHD) is the most prevalent birth defect in the United States. Little research was found regarding parents’ experiences of having a child with CHD and their desires for providers’ actions in healthcare environments. The purposes of this dissertation were to synthesize research regarding the experiences of families of children with CHD; phenomenologically describe parents’ experiences of having a child with CHD; and explain parents’ perspectives on healthcare providers’ actions during their encounters. To achieve these purposes, four separate, but related, papers were written. They were: 1) a literature review synthesizing families’ experiences of having a child with CHD; 2) a methods paper detailing steps of conducting a phenomenological study; 3) a phenomenological study exploring parents’ experiences of having a child with CHD; and 4) a directed content analysis evaluating parents’ perceptions of healthcare providers’ actions guided by the Swanson’s Caring Theory. Four major foci were addressed in the published research on families of children with CHD in the last 15 years. The foci were: parents’ psychological health, impact on family life, parenting challenges, and family-focused interventions. The methods paper described the philosophy of phenomenology and strategies of choosing sample size, interviewing, and analyzing data using an interdisciplinary team. Examples were provided about the contribution of an interdisciplinary team to enhance the quality of a phenomenological research project. Parents experienced a “rollercoaster” of emotions as their child underwent surgery. Critical times were when parents received their child’s diagnosis, were informed that their child required heart surgery, handed their child over to the surgical team, and visited their child for the first time after surgery. Related stressors were the uncertainty of outcomes after surgery, the loss of parental control, the physical appearance of their child after surgery, and the fear of the technological atmosphere in the intensive care unit. Parents’ experiences moved from shocking to blessing. The five caring processes of the Swanson’s Caring Theory captured parents’ perspectives on providers’ actions. Providers’ caring actions carried parents through their critical times. This study suggested that future research was warranted to better understand how providers could best meet these parents’ caring needs.Doctor of Philosoph

Does the COVID-19 Pandemic Change Consumers’ Food Consumption and Willingness-to-Pay? The Case of China

Since COVID-19 was first detected in China in 2019, governments around the world have imposed strict measures to curb the spread of the coronavirus, which substantially impacted people’s life. Consumers’ food consumption behavior has also changed accordingly with reduced grocery shopping frequency, replaced in-person grocery shopping with online shopping, and increased valuation on food. In this paper, we aim to investigate the change in Chinese consumers’ food consumption and their willingness to pay (WTP) for vegetables and meat, using a dataset with 1206 online samples collected between February and March 2020. Consumers’ WTP for vegetables and meat is estimated using a double-bounded dichotomous contingent valuation design, and factors affecting their WTPs are also investigated. Results show that consumers have a higher WTP for these food products during the pandemic, and their WTP is positively affected by their anticipated duration of the COVID-19, their online shopping shares, their direct exposure to infected patients, their gender, and their income. These results imply that the food industry shall try to develop online market channels as consumers are willing to share the costs, while lower-income consumers may not be able to meet their food needs with prices increased beyond their WTP and thus may call for the government’s support

The state of the science of nurse work environments in the United States: A systematic review

A healthy nurse work environment is a workplace that is safe, empowering, and satisfying. Many research studies were conducted on nurse work environments in the last decade; however, it lacks an overview of these research studies. The purpose of this review is to identify, evaluate, and summarize the major foci of studies about nurse work environments in the United States published between January 2005 and December 2017 and provide strategies to improve nurse work environments. Databases searched included MEDLINE via PubMed, CINAHL, PsycINFO, Nursing and Allied Health, and the Cochrane Library. The literature search followed the PRISMA guideline. Fifty-four articles were reviewed. Five major themes emerged: 1) Impacts of healthy work environments on nurses' outcomes such as psy- chological health, emotional strains, job satisfaction, and retention; 2) Associations between healthy work environments and nurse interpersonal relationships at workplaces, job performance, and pro- ductivity; 3) Effects of healthy work environments on patient care quality; 4) Influences of healthy work environments on hospital accidental safety; and 5) Relationships between nurse leadership and healthy work environments. This review shows that nurses, as frontline patient care providers, are the foun- dation for patient safety and care quality. Promoting nurse empowerment, engagement, and interper- sonal relationships at work is rudimental to achieve a healthy work environment and quality patient care. Healthier work environments lead to more satisfied nurses who will result in better job perfor- mance and higher quality of patient care, which will subsequently improve healthcare organizations' financial viability. Fostering a healthy work environment is a continuous effort

Tranquility rooms for team member well-being: Implementation during COVID-19 pandemic

In 2020, the COVID-19 global pandemic changed the landscape of healthcare delivery and with it the need to better address team member well-being. Aside from patients and their families, healthcare professionals were among the most affected and at high risk for suffering psychological distress, including increased stress, depression, anxiety, substance use, and post-traumatic stress disorder. Prior to COVID-19, healthcare workers were already experiencing a high rate of job burnout, depression, and suicide. The pandemic brought in sharp focus the essential and urgent need for healthcare facilities to acknowledge the importance of team member well-being and the provision of spaces such as tranquility rooms for use while at work. This case study shares one health system’s evidence-based implementation plan for tranquility rooms, what was learned, and how team members responded. More research is needed to better understand team member well-being and the impact of tranquility rooms. Experience Framework This article is associated with the Staff & Provider Engagement lens of The Beryl Institute Experience Framework (https://www.theberylinstitute.org/ExperienceFramework). Access other PXJ articles related to this lens. Access other resources related to this lens

The Feasibility of Imaging Myocardial Ischemic/Reperfusion Injury Using \u3csup\u3e99m\u3c/sup\u3eTc-labeled Duramycin in a Porcine Model

When pathologically externalized, phosphatidylethanolamine (PE) is a potential surrogate marker for detecting tissue injuries. 99mTc-labeled duramycin is a peptide-based imaging agent that binds PE with high affinity and specificity. The goal of the current study was to investigate the clearance kinetics of 99mTc-labeled duramycin in a large animal model (normal pigs) and to assess its uptake in the heart using a pig model of myocardial ischemia–reperfusion injury. Methods The clearance and distribution of intravenously injected 99mTc-duramycin were characterized in sham-operated animals (n = 5). In a closed chest model of myocardial ischemia, coronary occlusion was induced by balloon angioplasty (n = 9). 99mTc-duramycin (10–15 mCi) was injected intravenously at 1 hour after reperfusion. SPECT/CT was acquired at 1 and 3 hours after injection. Cardiac tissues were analyzed for changes associated with acute cellular injuries. Autoradiography and gamma counting were used to determine radioactivity uptake. For the remaining animals, 99mTc-tetrafosamin scan was performed on the second day to identify the infarct site. Results Intravenously injected 99mTc-duramycin cleared from circulation predominantly via the renal/urinary tract with an α-phase half-life of 3.6 ± 0.3 minutes and β-phase half-life of 179.9 ± 64.7 minutes. In control animals, the ratios between normal heart and lung were 1.76 ± 0.21, 1.66 ± 0.22, 1.50 ± 0.20 and 1.75 ± 0.31 at 0.5, 1, 2 and 3 hours post-injection, respectively. The ratios between normal heart and liver were 0.88 ± 0.13, 0.80 ± 0.13, 0.82 ± 0.19 and 0.88 ± 0.14. In vivo visualization of focal radioactivity uptake in the ischemic heart was attainable as early as 30 min post-injection. The in vivo ischemic-to-normal uptake ratios were 3.57 ± 0.74 and 3.69 ± 0.91 at 1 and 3 hours post-injection, respectively. Ischemic-to-lung ratios were 4.89 ± 0.85 and 4.93 ± 0.57; and ischemic-to-liver ratios were 2.05 ± 0.30 to 3.23 ± 0.78. The size of 99mTc-duramycin positive myocardium was qualitatively larger than the infarct size delineated by the perfusion defect in 99mTc-tetrafosmin uptake. This was consistent with findings from tissue analysis and autoradiography. Conclusion 99mTc-duramycin was demonstrated, in a large animal model, to have suitable clearance and biodistribution profiles for imaging. The agent has an avid target uptake and a fast background clearance. It is appropriate for imaging myocardial injury induced by ischemia/reperfusion

Micro-Environment Causes Reversible Changes in DNA Methylation and mRNA Expression Profiles in Patient-Derived Glioma Stem Cells

In vitro and in vivo models are widely used in cancer research. Characterizing the similarities and differences between a patient\u27s tumor and corresponding in vitro and in vivo models is important for understanding the potential clinical relevance of experimental data generated with these models. Towards this aim, we analyzed the genomic aberrations, DNA methylation and transcriptome profiles of five parental tumors and their matched in vitro isolated glioma stem cell (GSC) lines and xenografts generated from these same GSCs using high-resolution platforms. We observed that the methylation and transcriptome profiles of in vitro GSCs were significantly different from their corresponding xenografts, which were actually more similar to their original parental tumors. This points to the potentially critical role of the brain microenvironment in influencing methylation and transcriptional patterns of GSCs. Consistent with this possibility, ex vivo cultured GSCs isolated from xenografts showed a tendency to return to their initial in vitro states even after a short time in culture, supporting a rapid dynamic adaptation to the in vitro microenvironment. These results show that methylation and transcriptome profiles are highly dependent on the microenvironment and growth in orthotopic sites partially reverse the changes caused by in vitro culturing

ROCK1 via LIM kinase regulates growth, maturation and actin based functions in mast cells

Understanding mast cell development is essential due to their critical role in regulating immunity and autoimmune diseases. Here, we show how Rho kinases (ROCK) regulate mast cell development and can function as therapeutic targets for treating allergic diseases. Rock1 deficiency results in delayed maturation of bone marrow derived mast cells (BMMCs) in response to IL-3 stimulation and reduced growth in response to stem cell factor (SCF) stimulation. Further, integrin-mediated adhesion and migration, and IgE-mediated degranulation are all impaired in Rock1-deficient BMMCs. To understand the mechanism behind altered mast cell development in Rock1-/- BMMCs, we analyzed the activation of ROCK and its downstream targets including LIM kinase (LIMK). We observed reduced activation of ROCK, LIMK, AKT and ERK1/2 in Rock1-deficient BMMCs in response to SCF stimulation. Further, loss of either Limk1 or Limk2 also demonstrated altered BMMC maturation and growth; combined deletion of both Limk1 and Limk2 resulted in further reduction in BMMC maturation and growth. In passive cutaneous anaphylaxis model, deficiency of Rock1 or treatment with ROCK inhibitor Fasudil protected mice against IgE-mediated challenge. Our results identify ROCK/LIMK pathway as a novel therapeutic target for treating allergic diseases involving mast cells