The Journey and Experiences of Female Hispanic Nurse Leaders

OBJECTIVE

This study aimed to understand the experience of female Hispanic nurses in formal leadership roles.

BACKGROUND

Research has identified that a diverse nursing leadership workforce is essential to providing optimal patient care. Little is known about the phenomenon of minority nurse leaders, particularly female Hispanic nurses in leadership roles.

METHODS

Ricoeur's hermeneutic phenomenology guided the interviews of 15 female Hispanic nurses in leadership roles.

RESULTS

Three themes were generated that described the environment in which leaders lived: family, culture, and healthcare organization. Four phenomenological themes were identified: weaving my life fabric, my inner dialogue, weight on my shoulders, and paving the way.

CONCLUSION

The study findings highlight the importance of a diverse and inclusive nursing leadership workforce. By proactively addressing equal opportunities, reducing barriers to career advancement, and developing strategies to support and encourage minority nurses, organizations and communities can recruit and retain qualified underrepresented minority nurse leaders.

Demystifying the experience of participating in a root cause analysis: A hermeneutic phenomenological study

AIM

This study aimed to explore registered nurses' experience participating in a root cause analysis (RCA) meeting because of their involvement in an adverse event.

BACKGROUND

An RCA is the most common strategy used by organizations for adverse event investigations. Nursing healthcare professionals directly involved in an adverse event may be asked to participate in the RCA. However, no studies were found in the literature on their experience.

METHODS

Semi-structured audio-taped interviews were held with 13 registered nurses who participated in an RCA. Ricoeur's hermeneutic phenomenology guided data analysis.

RESULTS

Two structural elements represented the world of the nurses: 1) Learning about an RCA, and 2) being on the other side of the RCA table. Three phenomenological themes emerged: 1) anticipatory and embodied fear, 2) to speak or not to speak, 3) the aftermath.

CONCLUSION

Nurses desire RCA education to assist in understanding and support from nurse leaders throughout the process. Healthcare organizations must create a safe and collaborative environment to empower nurses to speak up and have their voices heard during the RCA process.

IMPLICATIONS FOR NURSING LEADERS

Nurses want to participate in RCA meetings. However, leaders must demystify the RCA process for nurses through education and training.

Identifying Holistic Nursing Research Priorities for 2023-2026

The primary goal of holistic nursing research is to develop and expand the knowledge base of holism and healing for nursing praxis. This article provides an overview of the process used to identify the research priorities for holistic nursing research over the next 3 to 5 years. A mixed method design using Appreciative Inquiry and surveys revealed five research priorities and the holistic philosophical foundation for these priorities. Additionally, new challenges in the environment, person, health, and nursing will undoubtedly emerge, requiring nurses to discern the research needs beyond 2026. This work seeks to inspire holistic nurses to consider research related to the American Holistic Nurses Association's five key research priorities.

"My body, my choice": A qualitative study of women's mastectomy with flat closure experiences

This qualitative study aimed to describe and explore the pre and post-mastectomy experiences of women choosing flat closure after a breast cancer diagnosis. Aesthetic flat closure creates a flat contoured chest wall after a mastectomy. There is limited research on women's flat closure experiences. To fill this gap, we interviewed 19 women (Mage = 53, range 31-72) with breast cancer who underwent a bilateral mastectomy with flat closure, examining decision-making, mirror-viewing, and flat closure experiences. Using a hermeneutic phenomenological design, we generated seven themes. Broadly, women choosing flat closure experienced pressure from their clinicians to undergo breast reconstruction. We found flat closure information to be consistently lacking. Mirror-viewing experiences of women obtaining suboptimal flat closure outcomes led to shattered expectations, mirror avoidance, psychological distress, and body image disturbances. Women negotiated their new reality by discovering ways to feel comfortable with their flat bodies. Regardless of surgical outcome, decision satisfaction was high. These findings illustrate the importance of bodily autonomy and supportive healthcare environments for women making flat closure decisions. Providing comprehensive information on all surgical options and addressing post-operative expectations can improve women's decision-making and mirror-viewing experiences and assist women in adapting to their new body image.

The mirror viewing experience of women undergoing a mastectomy: An integrative review

AIMS

To appraise the current literature on the mirror viewing experience of women undergoing a mastectomy.

DESIGN

Whittemore and Knafl's approach to integrative reviews, Braun and Clarke's thematic analysis, and PRISMA guidelines were utilized for this review.

DATA SOURCES

A systematic search of primary peer-reviewed articles from April 2012 to 2022 was conducted using PubMed, CINAHL, Academic Search Complete and Google Scholar databases.

REVIEW METHODS

Eighteen studies met the inclusion criteria (15 qualitative and 3 quantitative) and were appraised using the Johns Hopkins evidence-based practice appraisal instrument.

RESULTS

Five themes describing the mirror viewing experience were revealed: Mirror viewing motives, mirror viewing preparedness, mirror viewing experience, mirror comfort/avoidance and women's mirror viewing recommendations.

CONCLUSION

The review findings were found to align with Freysteinson's Neurocognitive Mirror Viewing Model highlighting the occurrence of short-term memory disruptions and an autonomic nervous system response that can lead women to experience a flight/fright or faint response, mirror trauma and mirror avoidance when looking at themselves in the mirror after a mastectomy.

IMPACT

Women reported feeling unprepared to look at themselves in the mirror, with some experiencing shock and emotional distress, which led to mirror avoidance behaviours as a way to cope with their new body image. Nursing interventions aimed at improving women's mirror viewing experiences may help mitigate this autonomic nervous system response and minimize mirror trauma and mirror avoidance. Preparing women to view themselves in the mirror for the first time may help reduce psychological distress and body image disturbances in women undergoing a mastectomy.

NO PATIENT OR PUBLIC CONTRIBUTION

This integrative review did not involve patient or public contributions. The authors reviewed currently published peer-reviewed literature in writing this manuscript.

A concept analysis of decision regret in women with breast cancer

The aim of this article is to understand the components of decision regret for women making breast cancer treatment decisions. Patient-centered care models encourage women to become more active in the decision-making process, inadvertently exposing them to the risk of experiencing decision regret. Enhancing the understanding of the concept of decision regret can offer insight into ways to mitigate this phenomenon. The Walker and Avant method was used to analyze this concept. Using PubMed, CINAHL, ERIC, Academic Search Complete, PsychINFO, SocINDEX, Joanna Briggs Institute of EBP Database, and an online dictionary, articles from 2011 to 2021 were analyzed to identify concept uses, attributes, antecedents, and consequences. Decision regret in women making breast cancer healthcare decisions is a negative cognitive-emotional response to a treatment decision that involves counterfactual thinking with three targets of regret: outcome regret, chosen option regret, and process regret. Experiencing decision regret can reduce a woman's quality of life, inflict psychological distress, and impact future decision-making. Unfavorable outcomes, decision uncertainty, and breakdowns in the decision-making process can lead to decision regret. Findings provide information on identifying women experiencing decision regret and illustrate opportunities to address causative factors through patient education and support to promote optimal patient outcomes.

Development and validation of the mirror image comfort and avoidance scale (MICAS)

PURPOSE

The purpose of this study was to develop an instrument to measure the experience of viewing one's reflection in the mirror for use in rehabilitation, nursing, psychology, and in research studies designed to improve the mirror-viewing experience for those who have suffered psychological or bodily trauma. A secondary purpose was to explore demographic differences in each subscale of the instrument.

METHODS

The developed items went through content expert validation, exploratory and confirmatory factor analyses, and internal consistency reliability testing.

RESULTS

Using an exploratory factor analysis (n = 137) and a confirmatory factor analysis (n = 142), we validated a 17-item instrument for two distinct populations: veterans (n = 108) and individuals with upper and lower limb loss (n = 210). The mirror viewing comfort subscale (9 items; α = 0.90) and the mirror avoidance subscale (8 items, α = 0.94) were deemed reliable. Strong, significant correlations between pre-and post-comfort scores (r = 0.81, p < 0.001), as well as pre-and post-avoidance scores (r = 0.94, p < 0.001) provide evidence of test-retest reliability. Demographic differences were noted in the subscales.

CONCLUSIONS

This instrument contributes to a greater understanding of the experience of mirror-viewing in clinical practice. In interventional research studies to improve the mirror-viewing experience, this instrument can act as a manipulation check or outcome measure.Implications for rehabilitationIndividuals who suffer actual or perceived body disfigurement due to surgery or trauma may suffer mirror discomfort or mirror trauma when viewing their bodies in a mirror. This reaction is due to a pre-frontal cortex neurological disruption and autonomic nervous system fright/flight or faint. Psychological disorders (e.g., devastation, shame, self-revulsion, decreased body image) may ensue.Falls have occurred due to mirror trauma due to an autonomic nervous system disturbance (faint) and may result in ongoing mirror avoidance. When mirrors are needed for incision visualization, mirror avoidance has led to severe surgical site infections.Although there were many scales available in the literature to measure several aspects of the effects of actual or perceived body disfigurement, there were no scales that measured the mirror-viewing experience.Clinicians and researchers can use the Mirror Comfort and Avoidance Scale (MICAS) to assess mirror comfort and avoidance.

Factors Associated With African American Mothers' Perceptions of Human Papillomavirus Vaccination of Their Daughters: An Integrated Literature Review

PROBLEM IDENTIFICATION

African American (AA) women have a higher mortality rate for cervical and other cancers and are less likely to have received the human papillomavirus (HPV) vaccine than White women. Mothers play a significant family role and have a unique relationship with their daughters. Mothers' positive views on HPV vaccination may enhance the HPV vaccination rate among their daughters.

LITERATURE SEARCH

The review was conducted by searching literature in PubMed®, CINAHL®, ScienceDirect, Ovid MEDLINE®, and ProQuest databases. The search was limited to studies conducted in the United States and published since the inception of the HPV vaccine in 2006.

DATA EVALUATION

Of 10,566 publications retrieved, 28 articles were included in the final sample.

SYNTHESIS

Factors associated with HPV vaccination were approval and disapproval of HPV vaccination from physicians, family, and friends; HPV knowledge; attitude and belief about HPV vaccination; benefits of vaccination; and challenges of and barriers to HPV vaccination.

IMPLICATIONS FOR PRACTICE

Understanding factors related to HPV vaccination decisions among AA mothers will inform healthcare providers of the best approach to improving vaccination rates among this high-risk population.

The experience of nursing leadership in a crisis: A hermeneutic phenomenological study

AIM

This study aimed to understand nursing leaders' experience during the pandemic.

BACKGROUND

COVID-19 is a public health crisis that affects every nation in the world.

METHODS

Purposeful sampling was used to recruit 28 leaders in a large health care system. Data were collected via semi-structured audiotaped interviews. Results were analysed using hermeneutic phenomenology.

RESULTS

The structure in which leaders worked was described as: from the day-to-day grind to derailment and from manning the hospital to manning the frontlines. Five phenomenological themes were as follows: embodied leadership, navigating differently, trusting and earning trust, being the calm voice and envisioning the future.

CONCLUSION

Disaster policies and procedures are needed that will alleviate leadership angst, maximize nursing resources, heighten trust and enhance communications.

IMPLICATIONS FOR NURSING MANAGEMENT

In 2020, we witnessed a previously inconceivable media and public focus on the value of nursing care. Leaders can use this pivotal moment in time as a catalyst towards securing the support needed in planning for the next pandemic.

Demystifying the mirror taboo: A neurocognitive model of viewing self in the mirror

Research has consistently demonstrated that viewing one's body in a mirror after an amputation or other perceived or visible body disfigurements can be a traumatic experience. Mirror viewing or mirroring is a taboo subject, which may be the reason this trauma has not been previously detected or acknowledged. Traumatic mirror viewing may lead to mirror discomfort, mirror avoidance, and a host of psychosocial concerns, including post-traumatic stress. As mirroring is complex, four qualitative mirror viewing studies, embodiment concepts, polyvagal theory, and memory theories were used to develop a model. In this article, foundational knowledge that led to the development of the model is shared. A neurocognitive model of mirror viewing is offered together with implications for nursing research, practice, and education.

The Language of Scholarship: Synthesis of the Literature

The purpose of this article is to educate nurses and nursing students on the meaning and location of scholarly literature. Select resources are identified to assist with identifying high-quality evidence-based publications, which is a vital competency to enhance scholarship for evidence-based practice in professional nursing practice.

The Language of Scholarship: How to Write an Abstract That Tells a Compelling Story

This article is for nurses and nursing students who are writing abstracts for poster or oral presentations, journal articles, or grants. The use of storytelling principles for scholarly writing demonstrated how a potentially dreary abstract can be created to captivate a reader. [J Contin Educ Nurs. 2019;50(3):107-108.].

School and Community-based Nurse-led Asthma Interventions for School-aged Children and Their Parents: A Systematic Literature Review

PROBLEM

Asthma is one of the most prevalent chronic diseases in the world. Lack of asthma knowledge can lead to asthma exacerbations, more emergency room visits, school absences, and decreased quality of life. This systematic review examines the effectiveness of educational intervention programs on asthma management for school-aged children and their parents beyond inpatient clinic settings.

ELIGIBILITY CRITERIA

Educational asthma interventions for school-aged children and their parents with comparison with usual asthma care and the outcome related to asthma management. Studies included were peer-reviewed and published in English within the last five years.

SAMPLE

The eight study articles were identified in ProQuest, Medline, CINAHL, and PubMed databases.

RESULTS

The review demonstrated that educational asthma interventions for children and their parents significantly improved knowledge and skills related to asthma self-management.

CONCLUSIONS

School and community-based asthma educational intervention programs are key components for good management of asthma condition. Well-planned asthma education programs are valuable and should go beyond inpatient clinic settings for promoting and maintaining health for children with asthma and their parents.

IMPLICATIONS

School nurses are well-positioned to assume a more prominent role in asthma care to improve child health and academic outcomes. School nurses have an opportunity to establish a trusting relationship that is foundational for collaborating with parents and students for better asthma management.

Body Image Perceptions of Women Veterans With Military Sexual Trauma

The researchers were invited to a transitional home for homeless women veterans to help veterans with body image issues. Convenience sampling was used to recruit 12 veterans who perceived they had a physical difference due to military service. Data were obtained in focus groups where the veterans were invited to share stories. Ricoeur's hermeneutic phenomenology guided the study. The research team learned early in the data collection stage that 11 of the 12 participants suffered military sexual trauma (MST). Three structures emerged in the data: (a) to speak up or not to speak, (b) from military pride to shameful anguish, and (c) invisible scars versus visible scars. A phenomenological interpretation of these invisible scars uncovered that viewing self in a mirror was depicted as viewing a stranger. Being with others, including family, was described as wearing a fake face. The phrase I am broken defined intimate relationships which were non-existent or strained. Shame permeated all body image structures. As the veterans listened to each other, they began to see themes in their stories. There was a shared sense of identity and a movement toward greater self-understanding and resolving. In addition to the recommendations the participants had regarding prevention of MST and recovery care of those with MST, implications for research and practice are provided.

A Synopsis of Ricoeur's Phenomenology of the Will: Implications for Nursing Practice, Research, and Education

The will is a word that nurses may use to describe their patients' actions or inactions. This concept has been extensively addressed by religions, psychologists, and philosophers. Ricoeur offered a phenomenology of the will in which three overarching key concepts were uncovered: decision, action, and consent. In this article, Ricoeur's elaborative and exhaustive description of these three concepts is summarized. Examples as to how a phenomenology of the will may guide nurses in their day-to-day clinical practice in caring are provided. In research, Ricoeur's phenomenology of the will may be used as a heuristic to guide phenomenological studies. An introduction to the will may act as a bridge between the art and science of nursing, providing nursing students with a greater understanding of the meaning of and need to provide holistic care.

Establishing a Clinical Research Council in Home Health and Hospice

This project focused on the development of a clinical research council in a home health and hospice organization. Strengths of establishing a council included enhanced use of evidence-based practice, an increase in cross-discipline collaboration, and recruitment and retention. Council members evaluated their learning needs to establish a research education program. An organizational evaluation reviewed library and institutional review board access, system research departments, internal policies, electronic database, and clinical tools. Planning for sustainability included developing an organizing framework, creating community collaborations, and establishing a research pathway.

The Language of Scholarship: How to Rapidly Locate and Avoid Common APA Errors

This article is relevant for nurses and nursing students who are writing scholarly documents for work, school, or publication and who have a basic understanding of American Psychological Association (APA) style. Common APA errors on the reference list and in citations within the text are reviewed. Methods to quickly find and reduce those errors are shared.

The Mirror Program: Preparing Women for the Postoperative Mastectomy Mirror-Viewing Experience

PROBLEM

Preparing women for the experiences they will endure during the breast cancer trajectory improves psychological outcomes and quality of life. Women have found that it may be difficult to view themselves in a mirror after having a mastectomy. Supporting women who have had a mastectomy in mirror-viewing and body image is a relatively new yet important intervention in oncology nursing.

METHODS

The feasibility of a preoperative mirror program given by oncology nurse navigators to women who were scheduled for a mastectomy was examined in this randomized control study.

FINDINGS

Pre- and postoperative data on anxiety, body image, depression, emotional well-being, and mirror use were collected from intervention participants (n = 10) and control subjects (n = 9).

CONCLUSION

This article illustrates the development of the mirror program and the results of the feasibility trial, and provides a discussion with implications for future research.

Positive parenting

AIM

While parenting has been researched and explored in both the professional and public realms, elements of the current key constructs involving the positive parenting of a child are still missing. The aim of this article is to define the concept of positive or "good" parenting to further extend research toward child health promotion knowledge across disciplines.

METHODS

The Walker and Avant's concept analysis method was applied to this analysis.

SOURCES

Published literature and Google search on the worldwide web.

CONCLUSION

This analysis provides a definition of positive parenting. The key constructs found within this definition build a foundation for further research to develop measurable outcomes for positive parenting skills. These variables can also assist with research aims geared toward interventions to promote positive parenting.

The "Princess Mirror": Exemplars of the Use of the Mirror in Nursing Practice

PROBLEM

Incorporating mirrors into nursing is a relatively new field of research and practice. The focus of two studies was to explore (a) the meaning of women's mirror experiences following a mastectomy and (b) the experience of viewing self in the mirror for women who were terminally ill. The goal of the research was to establish a conceptual foundation for the development of nursing mirror interventions.

METHODS

Open-ended questions and dialogical engagement in one-to-one audio-taped interviews were used in both studies. Ricoeur's hermeneutic phenomenology was used to analyze the findings.

FINDINGS

Four concepts were uncovered in the experience of viewing self in the mirror: decision, seeing, understanding, and consent.

CONCLUSION

Exemplar composite case studies across the care continuum are provided as examples of the way in which mirrors may be utilized in nursing practice.

The language of scholarship for novice writers

This article is an introduction to the language that is required to convey nursing knowledge through essays, dissertations, and articles in peer-reviewed journals. The tentative style of scholarly language is explored. Key elements of the uniform structure of headings, citations, and references are considered. Guidelines for reviewing one's own paper using computer-processing strategies are shared.

The ethical community consultation model as preparation for nursing research: a case study

This article describes a case study in which community consultation was used to assist in the preparation of a research project on viewing self in the mirror after mastectomy. Breast cancer survivors, nurses, and other health care professionals were consulted using a variety of interactive modalities. Over a period of three months, pre-research planning information was obtained from participants. A descriptive qualitative design was used to analyze the data. The ethical goals of community consultation provided the framework for dialogue and the synthesis of information. During this project, the potential benefits of the proposed research study were explored. Possible risks to future participants were discussed, and recommendations for participant protection suggested. Community members provided insight into the legitimacy of the study. Community consultation is a tool that researchers may consider when designing studies.

Therapeutic mirror interventions: an integrated review of the literature

The mirror is an object that shows one a reflected image of body areas. There appears to be limited nursing literature about the role of a nurse in the use of a mirror. There is, however, literature of the therapeutic use of mirrors in medicine, neurology, psychiatry, psychology, physical medicine and rehabilitation, and rheumatology. The objective of this article is to review the basic elements and the underlying theoretical framework of mirror interventions. In 2007 to 2008, a keyword, abstract, and title search was conducted for therapeutic mirror studies between the years 1998 and 2008. A multidisciplinary, integrated review approach was used when it became apparent that there were limited nursing studies. Qualitative and quantitative strategies for reviewing evidence were used, and a narrative synthesis approach was used to guide the comprehensive synthesis. Underlying theoretical models were identified, and five elements of mirror interventions were synthesized from the literature.

Opening Pandora’s Box: A Comprehensive Approach to Home Violence Prevention

The aim of this article is to describe a comprehensive approach to screening and intervening in home violence. Home care clinicians face a variety of potential abusive situations during the course of home visits. In the home, the victim may be the patient or the caregiver. The offender may be a related, paid, or professional caregiver or the patient. Abuse may be occurring between other persons in the home. A comprehensive home violence program embraces the horizon of abuse possibilities. The practical implications of merging domestic violence and elder abuse paradigms are discussed. Screening of both the patient and the caregiver is encouraged, and interventions are suggested for a number of situations.

Assessing the mirrors in long-term care homes: a preliminary survey

A preliminary survey of the mirrors available to residents was conducted in 10 long-term care homes. The framework underlying the study was Lawton's theory that the planned environment functions to maintain, support, and stimulate. The findings were discouraging. Some facilities had no mirrors available for bedbound residents or wheelchair users. In most facilities, a resident could not view his or her lower body in a mirror. The majority of mirrors were obstructed from view. This pilot study suggests a need for future mirror research. Implications for nursing are discussed, and placement of mirrors is described.

International reflections on knowledge and use of the mirror in nursing practice

TOPIC

There are no guidelines on the use of the mirror with patients in nursing practice. Nurses have used their experiences, personal preferences, and best-guess practice models when to offer a mirror.

PURPOSE

This international study provides insight into the current knowledge and uses of the mirror in nursing practice and, as such, provides a small foothold toward understanding the mirror as a multidimensional nursing tool.

SOURCE OF INFORMATION

Ten healthcare providers from eight countries (South Africa, Egypt, Japan, the Netherlands, Panama, Russia, Singapore, and the United Kingdom) took part in semistructured questionnaire conversations via email. Thematic analysis was performed on the data.

CONCLUSIONS

The results suggest the use of the mirror has a place in shaping nursing practice and is currently being used in nursing practice. Mirrors appear to be lacking in hospital environments. There is no known research to guide the nurse in the appropriate type of mirror to have in a hospital or any other healthcare environment.