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Background: Nurses have an essential role in implementing evidence-based practices (EBP) that contribute to high-quality outcomes. It remains unknown how healthcare facilities can increase nurse engagement in EBP.

These findings emphasize the difficulties of establishing and maintaining a therapeutic partnership between patients and clinicians. The results underscore the need for system-wide interventions that promote the success of a therapeutic patient-clinician relationship in order to achieve long-term success in chronic disease management.

BackgroundOur data have indicated that minority breast cancer survivors are receptive to participating in lifestyle interventions delivered via email or the Web, yet few Web-based studies exist in this population.ObjectiveThe aim of this study was to examine the feasibility and preliminary results of an email-delivered diet and activity intervention program, “A Lifestyle Intervention Via Email (ALIVE),” delivered to a sample of racial and ethnic minority breast cancer survivors.MethodsSurvivors (mean age: 52 years, 83% [59/71] African American) were recruited and randomized to receive either the ALIVE program’s 3-month physical activity track or its 3-month dietary track. The fully automated system provided tools for self-monitoring and goal setting, tailored content, and automated phone calls. Descriptive statistics and mixed-effects models were computed to examine the outcomes of the study.ResultsUpon completion, 44 of 71 survivors completed the study. Our “intention-to-treat” analysis revealed that participants in the physical activity track made greater improvements in moderate to vigorous activity than those in the dietary track (+97 vs. +49 min/week, P<.001). Similarly, reductions in total sedentary time among those in the physical activity track (−304 vs. −59 min/week, P<.001) was nearly 5 times greater than that for participants in the dietary track. Our completers case analysis indicated that participants in the dietary track made improvements in the intake of fiber (+4.4 g/day), fruits and vegetables (+1.0 cup equivalents/day), and reductions in saturated fat (−2.3 g/day) and trans fat (−0.3 g/day) (all P<.05). However, these improvements in dietary intake were not significantly different from the changes observed by participants in the physical activity track (all P>.05). Process evaluation data indicated that most survivors would recommend ALIVE to other cancer survivors (97%), were satisfied with ALIVE (82%), and felt that ALIVE was effective (73%). However, survivors expressed concerns about the functionality of the interactive emails.ConclusionsALIVE appears to be feasible for racial and ethnic minority cancer survivors and showed promising results for larger implementation. Although survivors favored the educational content, a mobile phone app and interactive emails that work on multiple email domains may help to boost adherence rates and to improve satisfaction with the Web-based platform.Trial RegistrationClinicalTrials.gov NCT02722850; https://clinicaltrials.gov/ct2/show/NCT02722850 (Archived by WebCite at http://www.webcitation.org/6tHN9VsPh)

Background: Empirical evidence supports the contention that implementing caring nurse behaviors results in improved patient experience; however, previous studies find differences between patient and nurse perceptions of caring. Significance: Good patient experience is positively related to desired clinical and financial outcomes. Nurse caring is a critical component in the patient experience. Objective: The purposes of this project were to evaluate the congruency between nurse and patient perceptions of nurse caring in a long-term acute care hospital and to determine how much patient perception of nurse caring changes over time. Method: The study employed mixed methods using a triangulation strategy in which quantitative data from patients and qualitative data from nurses were collected simultaneously and compared for interpretation. Results: Time affected patient perception of caring significantly. Patients and nurses disagreed about the extent to which nurses ask patients what they know about their illnesses, help them deal with bad feelings, and make them feel comfortable. Conclusion: Patients and nurses do not always agree about the quality of caring behaviors, but exposure to nurses over time positively affects patient perception of nurse caring.