Body Image Disturbance in Female Adolescents Using Online Learning Platforms: A Concept Analysis

Aim To analyze the concept of body image disturbance in female adolescents using online learning platforms as a phenomenon of interest to nurse practitioners and other health care practitioners. Background With the declaration of the COVID-19 pandemic, the use of online learning platforms as a primary mode of learning has increased exponentially among adolescents. While research is still lacking in this field, the literature on traditional social media suggests that these online learning platforms may negatively influence body image and emotional outcomes. Particularly vulnerable to these outcomes are female adolescents, whose construction of own body image is highly influenced by their self-perceived evaluation from their peers. While the concept of body image disturbance is well defined in adolescent eating disorders, it has not been characterized in the context of online learning platforms. Defining the concept of body image disturbance in this context is crucial for recognizing its occurrence and providing early intervention. Methods The Walker and Avant method of concept analysis was used to analyze the concept. Findings The defining attributes of body image disturbance among female adolescents using online learning platforms are: (1) Viewing a digitally distorted image of oneself and feeling displeasure with the perceived appearance; (2) Self-surveillance of one’s appearance; and (3) Upward comparison of one’s appearance with others and experiencing feelings of inadequacy. Conclusion As COVID-19 continues to disrupt the traditional school experience, nurse practitioners can use the presented scenarios, along with examples of questionnaires noted in this study, to recognize and delineate the occurrence of body image disturbance in female adolescents using online learning platforms. A standardized definition of the concept will enable nurse practitioners to recognize its occurrence and to provide interventions in a timely manner.

Out of the Closet: Nurse Practitioner Faculty Knowledge, Comfort and Willingness to Incorporate LGBTQ2SA Content into the Curriculum

Background To improve the health of LGBTQ2SA individuals, nurse practitioners need to increase their knowledge related to the health needs of sexual and gender minorities. However, nurse practitioners often feel unprepared as a result of a lack of content in their educational training. In order to better understand the current state of nurse practitioner education around sexual and gender minorities, it is critical to assess educational preparedness and faculty knowledge teaching the content. Purpose: The purpose of this study was to assess the knowledge and experience of nurse practitioner faculty in Ontario around LGBTQ2SA health and their comfort level teaching this material in the nurse practitioner program. Methods This quantitative descriptive study used purposeful sampling to recruit faculty from the Ontario Primary Health Care Nurse Practitioner Program. Data was collected using a modified survey administered on the Opinio platform. Results Twenty-three individuals completed the study. Most participants felt that LGBTQ2SA health content was important, but rarely or never taught. The most frequently identified strategies to promote faculty readiness to integration of LGBTQ2SA health topics into the curriculum included faculty development seminars, reviewing curriculum to identify gaps and partnering and utilizing LGBTQ2SA specific agencies as clinical sites. Conclusions Results indicate that barriers exist at the faculty level which may limit the extent to which LGBTQ2SA health topics are incorporated into the curriculum. Supporting faculty to develop their knowledge and comfort with this topic will allow them to better educate students to care for LGBTQ2SA clients.

Nurse-led self-management support after organ transplantation—protocol of a multicentre, stepped-wedge randomized controlled trial

Background Recipients of an organ transplantation face a number of challenges and often need to change their health behaviour. Good self-management skills are essential for optimal clinical outcomes. However, few interventions are available to support post-transplant self-management. To fill this gap, we developed a self-management support intervention offered by nurse practitioners. The primary aim of the study is to implement and test the effectiveness of the ZENN intervention in promoting self-management skills among heart, kidney liver and lung transplant recipients in comparison to standard care. The secondary aim is to assess the self-management support skills of nurse practitioners who will deliver the intervention. Methods This multi-centre stepped-wedge randomized controlled trial will take place from September 2020 until May 2023. All departments will commence with inclusion of patients in the control period. Each department will be randomly assigned to a start date (step in the wedge) to commence the experimental period. Patients in the control period will receive standard care and will be asked to complete questionnaires at baseline (T0), 6 months (T1) and 12 months (T2), to assess self-management, self-regulation, quality of life and adherence. During the experimental period, patients will receive standard care plus the ZENN intervention and receive the same set of questionnaires as participants in the control period. Nurse practitioners will complete a baseline and follow-up questionnaire to assess differences in self-management support skills. Video recordings of outpatient clinic consultations during the control and experimental periods will determine the differences in nurses’ needs-thwarting and needs-supporting skills between the control and experimental period. Discussion The ZENN intervention could be a useful approach to support patients’ self-management skills after organ transplantation and thus promote clinical outcomes as well as avoid adverse events. Trial registration Dutch Trial Register NL8469. Registered on March 19, 2020.

Exercise Recommendation for People With Bone Metastases: Expert Consensus for Health Care Providers and Exercise Professionals

PURPOSE: Exercise has been underutilized in people with advanced or incurable cancer despite the potential to improve physical function and reduce psychosocial morbidity, especially for people with bone metastases because of concerns over skeletal complications. The International Bone Metastases Exercise Working Group (IBMEWG) was formed to develop best practice recommendations for exercise programming for people with bone metastases on the basis of published research, clinical experience, and expert opinion. METHODS: The IBMEWG undertook sequential steps to inform the recommendations: (1) modified Delphi survey, (2) systematic review, (3) cross-sectional survey to physicians and nurse practitioners, (4) in-person meeting of IBMEWG to review evidence from steps 1-3 to develop draft recommendations, and (5) stakeholder engagement. RESULTS: Recommendations emerged from the contributing evidence and IBMEWG discussion for pre-exercise screening, exercise testing, exercise prescription, and monitoring of exercise response. Identification of individuals who are potentially at higher risk of exercise-related skeletal complication is a complex interplay of these factors: (1) lesion-related, (2) cancer and cancer treatment–related, and (3) the person-related. Exercise assessment and prescription requires consideration of the location and presentation of bone lesion(s) and should be delivered by qualified exercise professionals with oncology education and exercise prescription experience. Emphasis on postural alignment, controlled movement, and proper technique is essential. CONCLUSION: Ultimately, the perceived risk of skeletal complications should be weighed against potential health benefits on the basis of consultation between the person, health care team, and exercise professionals. These recommendations provide an initial framework to improve the integration of exercise programming into clinical care for people with bone metastases.

Quality of life of nurse practitioners during the COVID-19 pandemic

ABSTRACT Objective: to assess the quality of life of nurse practitioners during the COVID-19 pandemic and analyze related factors. Methods: cross-sectional and analytical study carried out with nurse practitioners. A questionnaire on sociodemographic characterization, work activities and changes perceived with the pandemic and WHOQOL-bref were used. To compare the groups of interest, analysis of covariance was used. Results: 572 professionals participated, who had a mean total quality of life score of 56.79 (SD=13.56). In the relationship of variables with WHOQOL-bref, having two or more jobs and being a nurse were associated with better quality of life, but being a woman and working more than 50 hours a week was associated with a worse perception of the construct. Conclusions: the factors analyzed indicate a lower perception of quality of life associated with the social domain, requiring interventions that reduce the damage to professionals’ health and contribute to quality of care provided.