The growth and development of gerontological nurse leaders in policy

Cognitive-behavioral treatment for insomnia and mindfulness-based stress reduction in nurses with insomnia: a non-inferiority internet delivered randomized controlled trial

Background

Insomnia is a highly prevalent sleep disorder frequently comorbid with mental health conditions in nurses. Despite the effectiveness of evidence-based cognitive behavioral therapy for insomnia (CBT-I), there is a critical need for alternative approaches. This study investigated whether internet-delivered mindfulness-based stress reduction (IMBSR) for insomnia could be an alternative to internet-delivered CBT-I (ICBT-I).

Objective

The hypothesis was that the IMBSR would be noninferior to the ICBT-I in reducing the severity of insomnia among nurses with insomnia. Additionally, it was expected that ICBT-I would produce a greater reduction in the severity of insomnia and depression than IMBSR.

Method

Among 240 screened nurses, 134 with insomnia were randomly allocated (IMBSR, n = 67; ICBT-I, n = 67). The assessment protocol comprised clinical interviews and self-reported outcome measures, including the Insomnia Severity Index (ISI), Patient Health Questionnaire-9 (PHQ-9), the 15-item Five Facet Mindfulness Questionnaire (FFMQ), and the Client Satisfaction Questionnaire (CSQ-I).

Results

The retention rate was 55% with 77.6% (n = 104) of participants completing the study. At post-intervention, the noninferiority analysis of the ISI score showed that the upper limit of the 95% confidence interval was 4.88 (P = 0.46), surpassing the pre-specified noninferiority margin of 4 points. Analysis of covariance revealed that the ICBT-I group had significantly lower ISI (Cohen's d = 1.37) and PHQ-9 (Cohen's d = 0.71) scores than did the IMBSR group. In contrast, the IMBSR group showed a statistically significant increase in the FFMQ-15 score (Cohen's d = 0.67). Within-group differences showed that both the IMBSR and ICBT-I were effective at reducing insomnia severity and depression severity and improving mindfulness.

Conclusion

Overall, nurses demonstrated high levels of satisfaction and adherence to both interventions. The IMBSR significantly reduced insomnia severity and depression, but the findings of this study do not provide strong evidence that the IMBSR is at least as effective as the ICBT-I in reducing insomnia symptoms among nurses with insomnia. The ICBT-I was found to be significantly superior to the IMBSR in reducing insomnia severity, making it a recommended treatment option for nurses with insomnia.

National Institute on Aging Butler-Williams Scholars Program: The first 30 years

The development of a skilled research workforce in aging is fundamental to understanding conditions associated with growing older and extending healthy, active years of life. The National Institutes of Health (NIH) supports the training of health scientists, and its National Institute on Aging (NIA) prioritizes the professional development of investigators with an interest in aging. Since 1987, NIA's Summer Institute on Aging Research, renamed the Butler-Williams (B-W) Scholars Program in 2013, has offered an intensive one-week experience on issues, opportunities, and challenges of research on aging, with emphasis on disparities and health equity. The first 30 years of the Program are described in this report, including its history, selected curriculum highlights, Scholar outcomes, and qualitative data from faculty, and the program's impact on the training, growth, and development of scientists in aging research. Questions raised over a decade ago by the Committee on the Future Health Care Workforce for Older Americans Board on Health Care Services are revisited, and recommendations for the future are provided. This important Program remains an exemplar for the training and development of health scientists for careers that advance biomedical research and emphasize an equitable understanding of factors related to extending healthy years of life.

The Role of National Paid Family and Medical Leave Policies in Promoting Health Equity for Older Adults and Their Caregivers

More than 48 million unpaid family/friend caregivers in the United States provide care to older adults. This unpaid workforce provides essential support for family members or friends who have a serious, long-term illness or disability. However, family caregivers are often under supported, which contributes to negative health, economic, and psychological consequences. Despite the significant contributions of family caregivers, there are limited policy supports aimed at alleviating the hardships of care on this growing community. National paid family and medical leave policy in particular holds substantial potential to alleviate the compounding burdens faced by family caregivers and address systemic inequities that contribute to disproportionately poorer caregiving outcomes among historically marginalized older adults and their caregivers. The purpose of the current article is to provide an overview of the economic burdens and caregiving-related health disparities experienced by Black/African American and Hispanic/Latinx family caregivers and discuss the impact of paid leave policies on the overall health and well-being of older adults. We propose a "Call to Action" for gerontological nurses to work in partnership with transdisciplinary colleagues, stakeholders, and advocates to ensure all family care-givers have access to paid leave. [Journal of Gerontological Nursing, 48(3), 5-10.].

How and why nurses became involved in politics or political action, and the outcomes or impacts of this involvement

BACKGROUND

Nurses' political engagement is needed for societal advancements.

PURPOSE

The purpose of this study was to explain why and how nurses became politically active, and what they achieved.

METHODS

Qualitative, constant-comparative data analysis was used for this study. After 10 elected or politically-active Canadian nurses were interviewed, data saturation was confirmed.

FINDINGS

All were motivated by early life events to realize the importance of social justice and good government. Their nursing education and work equipped them to be capable of engaging in political spheres. All had developed knowledge of relevance for political purposes; in addition to confidence, communication skills, and other abilities to be effective politically. All highlighted the importance of being encouraged and assisted to engage politically. Positive micro-, meso-, and macro-level benefits of this involvement were identified.

CONCLUSIONS

More nurses should be inspired and helped to become active politically. It is critically important for nurses to inform and advance public policy, through direct political activities.