Background and Purpose: Older people living with HIV (OPLWH) face complex challenges as they age. Although advances in antiretroviral therapy have transformed human immunodeficiency virus (HIV) infection into a chronic condition and increased longevity, aging with HIV is often accompanied by multimorbidity, polypharmacy, stigma, social isolation, and mental health concerns. These intersecting factors complicate clinical management and are not always fully addressed in traditional HIV care models. Methods: This study aimed to explore the clinical care experiences of OPLWH over age 50. A qualitative descriptive inquiry was undertaken to gain an in-depth understanding of participants’ experiences. Semistructured individual interviews were conducted with 16 OPLWH. All interviews were audio-recorded and transcribed verbatim. Data were analyzed using thematic analysis, following an iterative process of coding, categorization, and theme development to identify patterns across participants’ narratives. Results: Five key themes emerged: (a) looking beyond the virus and T-cells; (b) detecting emerging health needs related to aging with HIV; (c) identifying and addressing psychological and social needs; (d) addressing barriers to accessible and coordinated care; and (e) supporting patient empowerment, advocacy, and education. Participants required more comprehensive support in advocacy, social connection, care accessibility, and care coordination. Conclusions: Findings reveal critical gaps in nursing practice and emphasize the need for patient-centered, holistic care for OPLWH. Nursing practice should incorporate comprehensive assessments that address physical, psychological, and social domains; enhance interdisciplinary collaboration; and prioritize proactive screening for age-related comorbidities, mental health concerns, and social determinants of health. Future research should develop and evaluate interventions designed to reduce loneliness and social isolation and enhance social connectedness among OPLWH.
Background and Purpose: Natural disasters such as earthquakes create major challenges for families managing chronic illnesses, particularly children with diabetes. Earthquake-related stress intensifies the demands of disease management and increases family burden. Guided by the Family Management Style Framework, this study examined how parents' coping with earthquake stress influences their ability to manage their child's condition. Method: A descriptive, cross-sectional study was conducted with 140 parents of children with diabetes receiving care at a training and research hospital. Data were collected between March and June 2023 using an Information Form, Coping with Earthquake Stress Scale, and Family Management Measure. Descriptive statistics, Pearson correlation analysis, and multiple linear regression were used to analyze the data. Results: The findings revealed significant relationships between coping strategies and family management outcomes. Disease management was positively associated with family functioning (p < .05), while life challenges and lower parental agreement were negatively correlated with family management scores (p < .05). Regression analysis showed that earthquake stress coping strategies significantly predicted family management outcomes, explaining 26.2% of the variance (R² = .262, F = 2.402, p = .021). Implications for Practice: The parents' coping with earthquake-related stress is a significant predictor of family management outcomes, explaining 26.2% of the variance. Interventions that strengthen adaptive coping strategies, enhance family functioning, and support parental agreement may improve chronic disease management in children with diabetes following disasters. Health care professionals should prioritize psychosocial support and family-centered education to mitigate life challenges and support effective disease management in postearthquake settings.
Background: Moyamoya disease is a chronic cerebrovascular condition requiring ongoing self-management to prevent complications. Riegel's theory of self-care in chronic illness posits that factors such as disease knowledge, self-efficacy, social support, and access to care influence self-care maintenance, monitoring, and management, which in turn affect health outcomes and quality of life (QoL). Aim: To test a structural equation model of factors influencing self-care and outcomes in adults with moyamoya disease based on Riegel's self-care theory. Methods: A cross-sectional survey of 211 adults with moyamoya disease collected data on disease knowledge, self-efficacy, social support, access to care, self-care maintenance, monitoring, management, health status, and QoL (Korean version of the 12-Item Short Form Health Survey). Structural equation modeling was performed using IBM SPSS Statistics 30.0 and AMOS 30.0 to test the hypothesized model. Results: The proposed model demonstrated good fit. Disease knowledge, self-efficacy, social support, and access to care were significantly associated with self-care maintenance, monitoring, and management. These self-care processes, in turn, were positively related to better health status and higher QoL. The model explained a substantial proportion of variance in health status and QoL. Conclusion: The findings support the applicability of Riegel's self-care theory in moyamoya disease. Interventions to enhance patients' disease knowledge, self-efficacy, social support, and access to care may improve self-care and ultimately lead to better health outcomes and QoL in this population.
Background and Purpose: Barriers to patient recruitment, retention, and diversity are persistent challenges in clinical trials (CTs). With little evidence to advise best practices, clinical trials nurses (CTNs) remain an overlooked, patient-oriented resource. Applying a theoretical lens when investigating a complex problem ensures scientifically grounded inquiry and robust interpretation. The aims of this work were to evaluate the utility of D'Amour's structuration model of collaboration (SMC) for clarifying CTN roles and contributions; analyze how barriers to CTN collaboration affect research patient burden, safety, and participation; and examine how collaborative structures within the industry influence CTN involvement in CT design and conduct. Methods: SMC was selected as the theoretical mechanism because it functions reliably across organizational boundaries. A focused, theory-guided literature review was performed to map relevant evidence. Results: Findings indicated that CTNs represent a small, complex, and understudied specialty. Due to this niche status, CTNs have had limited representation within networks that facilitate disciplinary oversight and proactive patient advocacy. SMC articulates this relegation to downstream study operations. Although shared goals exist, a lack of CTN expertise in early study development perpetuates inefficiencies. This latent degree of collaboration is rooted in weak internalization and hindered by absent formalization and governance structures. Implications: CTNs are frequently cited as experts who enhance CT safety and overall success; however, this has not been thoroughly quantified. Therefore, in addition to CTN inclusion during CT design and protocol development, their consultative scope and impact must also be systematically measured and disseminated. Cultivating this knowledge could elevate CTN subspecialties into advanced practice status.
Background: Caring is central to nursing practice and education. While simulation is an effective modality to support the teaching of both technical and nontechnical skills, its impact on nurses' and nursing students' empathy and caring behaviors is less clear. Methods: A scoping review, guided by Arksey and O'Malley, Levac et al., and Joanna Briggs Institute frameworks and reported per Preferred Reporting Items for Systematic reviews and Meta-Analyses extension for Scoping Reviews, searched CINAHL, PsycInfo, MEDLINE, and Health Source: Nursing/Academic Edition. The inclusion criteria were original research or randomized controlled trial, use of simulated patients, nursing participants, and outcomes related to empathy or caring behaviors. Results: Of the 129 studies, 8 met the criteria (2019-2023). All reported improvements in self-perceived empathy and caring across various study designs. Conclusions: Simulation may enhance empathy and caring, though further research is needed to confirm causality.
