A review of the literature about depression in late life among Hispanics in the United States

Depression is a common psychiatric disorder with devastating effects on the older Hispanic population. This review synthesizes the research on depression among older Hispanics in the United States to educate and provide direction for further research and practice. A literature search of PubMed, CINAHL, and PsycINFO databases was conducted. Article titles, abstracts, and texts of articles were scanned for those that met the inclusion criteria for this review. Inclusion criteria included the following: research studies published between 2000 and 2012; studies published in the English language; studies about depression that included older Hispanics (50 years old and older) who resided in the United States; and studies about depression, acculturation, and other associated stressors that may contribute to depression in this population. The results of this review indicate that acculturation, associated stressors, health-related factors, and psychosocial factors may have a negative impact on older Hispanics' mental health. More research is needed to further explore Hispanics' perceptions and experiences of depression as well as the cultural dimensions of Hispanic depression. The cultural formulation can be a useful framework for assessment, prevention, and treatment of older Hispanics with depression. Knowledge regarding depression and what causes it can lead to better assessment practices, early detection, and culturally sensitive interventions, care and services.     

Health outcomes and polypharmacy in elderly individuals: an integrated literature review

The purpose of this integrated literature review was to determine the extent of research available related to polypharmacy and its effect on the health outcomes of the elderly population. A search of the Cumulative Index of Nursing and Allied Health Literature and Medline was conducted for studies published between 1995 and 2003 that linked polypharmacy and outcomes in the elderly population. The 16 studies in this integrative literature review were conducted in the United States, Canada, Australia, and Europe. Polypharmacy was shown to be a statistically significant predictor of hospitalization, nursing home placement, death, hypoglycemia, fractures, impaired mobility, pneumonia, and malnutrition. The effect of polypharmacy on elderly individuals is significant as demonstrated by this literature review. Nurses are in a unique position to monitor and potentially eliminate adverse effects of a complex medication regimen. Nursing research on polypharmacy and its effects on nursing-sensitive outcomes will help define guidelines for prevention and intervention.     

The nursing shortage in the United States of America: an integrative review of the literature

AIM: The aims of this paper are to review the literature to determine what factors are contributing to the nursing shortage in the United States of America (USA) and discuss possible solutions to this current and future nursing shortage. BACKGROUND: The need for nurses is often depicted as cyclical in nature. Throughout history, the USA has experienced a series of nursing surpluses and shortages. However, the current shortage has been characterized as being unlike those experienced in the past. Trends of an ageing Registered Nurse (RN) workforce and limited supply to fill the impending vacancies are some of the unique aspects that bring a new dimension to an old problem. Today's nursing shortage will not be resolved by simply returning to the solutions of yesteryear, and strategies to reduce its impact will have to be more creative and focus on the long-term. METHODS: Integrative literature review of published literature on the current nursing shortage in the USA from 1999 to 2001. DISCUSSION: Four main areas were identified as the major contributors to the nursing shortage in the USA: the ageing RN workforce; declining enrollment; the changing work climate; and the poor image of nursing. Solutions to the shortage followed similar themes to the contributing factors and encompassed four main areas: exploring recruitment efforts; exploring retainment efforts; improving the image of nursing; and supporting legislation that helps to rectify the shortage. CONCLUSION: There is firm evidence that the USA amidst a nursing shortage. Much is known about the many contributing factors but now nurses need to become proactive to help secure the future of their workforce. By forming partnerships within the profession and with other influential parties, nurses can be in the forefront of resolving their workforce issues.     

Repeat pregnancy among adolescent mothers: a review of the literature

Repeat pregnancy among adolescent mothers is a major problem facing healthcare providers today. Adolescents who experience multiple pregnancies often are subjected to overwhelming physical, social, economic, and psychological outcomes. Research is needed to investigate the problem of repeat pregnancy and provide empirical support for intervention programs developed to reduce the incidence. This paper is a review of previous research. Major factors related to repeat pregnancy are examined. In addition, recommendations for future research are discussed.     

Nurse practitioners' communication styles and their impact on patient outcomes: an integrated literature review

Purpose: The purpose of this review was to examine the published research from 1999 to 2005 describing nurse practitioner (NP)–patient interactions and to determine the best practice to enhance patient outcomes.
Data sources: Databases searched included Academic Search Elite, Cumulative Index to Nursing and Allied Health Literature (CINAHL), Health Source Consumer Edition, Health Source Nursing/Academic Edition, Medline, and PsychInfo.
Conclusions: Two communication styles described in the literature and determined by authors were (a) biomedical and (b) biopsychosocial. The biopsychosocial style is identified as patient-centered communication. Seven studies were then analyzed for NPs' communication styles and the impact that they had on patient outcomes. The studies analyzed demonstrated that biopsychosocial (patient-centered) communication style positively influences patient outcomes as evidenced by (a) improved patient satisfaction, (b) increased adherence to treatment plans, and (c) improved patient health.
Implications for practice: The results of this review indicate that patient-centered communication incorporated into the NPs' practice is associated with improving patient outcomes such as (a) improved patient satisfaction, (b) increased adherence to treatment plans, and (c) improved patient health. Future research needs to be performed in order to fully study the relationship between NPs using patient-centered communication style and its impact on patient outcomes. Clinical recommendations are made based on findings of the integrated literature review.     

HIV/AIDS among midlife African American women: an integrated review of literature

HIV occurs among African American women at rates exceeding those among White women, and the prevalence of HIV/AIDS is rising disproportionately among African American adults over 40. The literature between 1987 and 2003 was reviewed for data on prevention and risk taking behavior regarding HIV transmission among midlife African American women. A search of relevant databases revealed four reports specifically targeting African American women aged 40-65. Five reports including this population also included men and other ethnic/racial groups. Content analysis revealed that factors related to risk for HIV included socioeconomic factors, knowledge, perceived vulnerability, sexual assertiveness, and risk taking behavior. Findings suggest that further research on the relationships between sociocultural variables and individual factors may explain prevention and risk taking behaviors in midlife African American women.     

Forensic nursing educational development: an integrated review of the literature

The forensic area of practice has been a popular career choice and area of study for many of the health science disciplines. Forensic nursing is a nursing specialty with subspecialties that focus on nursing practice who care for victims and offenders, living and deceased at the clinical legal interface. This integrated review of the literature overviewed the historical development of each of the forensic nursing subspecialties and identified gaps in specialty nursing educational development. Although multiple studies for the last 30 years identified the need for forensic nursing education, recommendations did not soon translate into educational curriculum development. The literature showed that role development was not concurrent with educational development in all forensic nursing subspecialties.     

The effect of school-based health clinics on teenage pregnancy and parenting outcomes: an integrated literature review.

Teenage pregnancy outcomes have become an increasing concern in the United States. Education and support of pregnant teens are critical factors that may determine good or poor pregnancy outcomes. Poor outcomes may include low birth weight, developmental delays, and poor academic performance. Although the number of teenagers experiencing pregnancy and parenting has declined in the U.S., school-based health clinics can be used to provide support and guidance designed to avoid the negative outcomes associated with teenage pregnancy and parenting. By having school-based health clinics, nurse practitioners and school nurses can provide much needed services to pregnant and parenting teens. These services should include educational support, counseling, and community resources. This inquiry provides a metasynthesis of the literature and will review, examine, and summarize the literature relating to the effect of school-based clinics on teenage pregnancy and parenting outcomes.     

Existential suffering in the palliative care setting: an integrated literature review

ContextExistential and spiritual concerns in relation to palliative end-of-life care have received increasing attention over the past decade.ObjectivesTo review the literature specifically related to existential suffering in palliative care in terms of the significance of existential suffering in end-of-life care, definitions, conceptual frameworks, and interventions.MethodsA systematic approach was undertaken with the aim of identifying emerging themes in the literature. Databases using CINAHL (1980–2009), MEDLINE (1970–2009), and PsychINFO (1980–2009) and the search engine of Google Scholar were searched under the key words existential suffering, existential distress, existential pain, palliative and end of life care.ResultsThe search yielded a total of 156 articles; 32% were peer-reviewed empirical research articles, 28% were peer-reviewed theoretical articles, and 14% were reviews or opinion-based articles. After manually searching bibliographies and related reference lists, 64 articles were considered relevant and are discussed in this review. Overall analysis identifies knowledge of the following: 1) emerging themes related to existential suffering, 2) critical review of those identified themes, 3) current gaps in the research literature, and 4) recommendations for future research. Findings from this comprehensive review reveal that existential suffering and deep personal anguish at the end of life are some of the most debilitating conditions that occur in patients who are dying, and yet the way such suffering is treated in the last days is not well understood.ConclusionGiven the broad range of definitions attributed to existential suffering, palliative care clinicians may need to be mindful of their own choices and consider treatment options from a critical perspective.     

A literature review of advanced clinical nursing practice in the United States of America

Advanced nursing practice in the United States of America has evolved over the past decades in two related but distinct directions:- the nurse practitioner (NP) and the clinical nurse specialist (CNS). This two-role evolution was in response to social demands for increased access to affordable, quality primary health care, and at the same time to the specialised nursing care requirements of increasingly complex patients. Thus, nurse practitioners became synonymous with primary and clinical nurse specialists with specialised, acute care. There is evidence that there is an advanced practice role for both the CNS and the NP and that much of the knowledge, skills and competencies are shared depending on the clinical situation. There have been successes and failures in the development of the two roles. The clinical nurse specialists have a more respectable image among the powerful nursing education elite, but nurse practitioners are widely recognised by consumers and other health care professionals and are valued by cost-conscious managers as a viable, cheaper alternative to physicians. The literature suggests it may well be time to take the best attributes of the two roles and merge them under the term 'advanced nurse practitioner'.     

The United States Trypanosoma cruzi Infection Study: evidence for vector-borne transmission of the parasite that causes Chagas disease among United States blood donors

BACKGROUND: Screening US blood donors for Trypanosoma cruzi infection is identifying autochthonous, chronic infections. Two donors in Mississippi were identified through screening and investigated as probable domestically acquired vector‐borne infections, and the US T. cruzi Infection Study was conducted to evaluate the burden of and describe putative risk factors for vector‐borne infection in the United States. STUDY DESIGN AND METHODS: Blood donors who tested enzyme‐linked immunosorbent assay repeat reactive and positive by radioimmunoprecipitation assay, and whose mode of infection could not be identified, were evaluated with a questionnaire to identify possible sources of infection and by additional serologic and hemoculture testing for T. cruzi infection. RESULTS: Of 54 eligible donors, 37 (69%) enrolled in the study. Fifteen (41%) enrollees had four or more positive serologic tests and were considered positive for T. cruzi infection; one was hemoculture positive. Of the 15, three (20%) donors had visited a rural area of an endemic country, although none had stayed for 2 or more weeks. All had lived in a state with documented T. cruzi vector(s) or infected mammalian reservoir(s), 13 (87%) reported outdoor leisure or work activities, and 11 (73%) reported seeing wild reservoir animals on their property. CONCLUSION: This report adds 16 cases, including one from the Mississippi investigation, of chronic T. cruzi infection presumably acquired via vector‐borne transmission in the United States to the previously reported seven cases. The estimated prevalence of autochthonous infections based on this study is 1 in 354,000 donors. Determining US foci of vector‐borne transmission is needed to better assess risk for infection.