The purpose of this phenomenological study was to understand military nurses' experiences of care for Iraqi patients. Analysis yielded three themes-expanding practice, ethical dilemmas, and the cultural divide. "Expanding practice" is the nurses' descriptions of their personal initiative to seek opportunities for learning additional knowledge and skills so that they would be competent to provide care for all ages of patients from newborns to the elderly with a wide variety of complex diagnoses. "Ethical dilemmas" represented the mental distress the nurses experienced when confronted with moral imperatives related to the safe care of the patient. Nurses were faced with feelings of animosity toward provision of care of host nation patients, lack of trust in interpreters, and distressed because of their inability to ensure continuity of care. The "cultural divide" showed the challenges that the nurses confronted when caring for a population with a different language, value system, customs, and traditions. The themes support existing research and extend information about care of host nation patients adding depth and breadth to specific content areas. These nurses developed situated knowledge needed for particular challenges and experienced personal and professional growth.
Little research has been done to explore the integrity of emotion-based decision-making performance in individuals with posttraumatic stress disorder (PTSD). In the current study, performance on two decision-making tasks with both positive and negative reinforcement, the standard Iowa Gambling Task (IGT) and the variant Iowa Gambling Task (vIGT), and measures of mood symptoms, were compared between U.S. active-duty soldiers diagnosed with PTSD (n = 23) and soldiers with no PTSD (n = 23). The results revealed that the PTSD group, when compared to controls, reported significantly higher anxiety and depression symptoms. The PTSD group showed similar behavioral performance as controls on the standard IGT but failed to choose advantageously on the vIGT, which has been shown to reflect hypersensitivity to punishment. Medicated participants, being treated with antidepressants, showed significantly better overall performance on the IGT but not on the vIGT compared to nonmedicated participants. The results suggest that soldiers being treated for PTSD have a unique decision-making pattern that may be attributed to difficulty in processing delayed reward when presented with immediate punishment.
Background: Cardiovascular disease (CVD) continues to be the No. 1 cause of death in the United States and globally, and individuals with a history of a cardiac event are at increased risk for a repeat event. Physical inactivity creates health problems for individuals with chronic heart disease. Evidence shows that physical activity (PA), as a central component of cardiac rehabilitation phase II (CRII), decreases hospital readmission and mortality. Yet, individual adherence to PA tends to decline several months following CRII completion. Objective: The purpose of this review was to evaluate current literature for interventions designed to assist individuals diagnosed with myocardial infarction (MI), coronary artery bypass graft (CABG), coronary artery disease (CAD), and percutaneous coronary intervention (PCI) to maintain or increase PA post-CRII. Methods: A systematic search of 5 electronic databases including hand-searched articles between 2000 and 2019. Key Medical Subject Headings (MeSH) search terms included cardiac rehabilitation, intervention, exercise or PA, outcomes, compliance, adherence, or maintenance. Only interventions implemented following CRII program completion were included for review. Results: Based on the inclusion criteria, the search yielded 19 randomized control trials retained for descriptive analysis. Interventions were categorized into 3 domains. The intervention designs varied widely in terms of duration of the intervention and the length of time to outcome measurement. Most interventions were short-term with only 2 studies offering a long-term intervention of greater than 1 year. Interventions using a theoretical approach most often included a cognitive-behavioral model. Conclusions: Interventions offered shortly after completion of CRII may help cardiac patients maintain PA and reduce the risk of experiencing additional cardiac events; however, more quality research is needed. Additional research to examine PA maintenance in older adults (70 years and older) would be valuable based on the increase in average lifespan. Studies with larger and more diverse samples, and less variation in methods and outcomes would greatly increase the ability to conduct a high-quality meta-analysis.
Implementation of learning to provide nurses language skills and cultural awareness of the diet, customs and beliefs of Iraqi people as well as the economic, political, and social factors that have an impact on their lives will promote quality nursing care and optimal health outcomes.
Background and PurposeCardiovascular disease (CVD) is a major cause of death in the United States. The military are viewed as fit, ready to fight and that jumping out of perfectly good airplane or going to war is a greater risk than CVD. The purpose of this study was to determine reliability and validity of the Cardiovascular Risk Perception Survey (CRPS).MethodsA cross-sectional descriptive design was performed, supported by the Health Belief Model. Internal consistency reliability (Cronbach's alpha) and validity (principal component analysis) were examined.ResultsFifty-five participants were included in this study. Construct validity of the CRPS was supported by principal component analysis; indicating one scale that measured cardiovascular risk perception. The Cronbach's alpha is reported .865.ConclusionInitial psychometric testing of the CRPS provides evidence for construct validity and internal consistency reliability.
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