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Yu PK, Li X, Sofer T, Cunningham A, Owens J, Gold DR, Phipatanakul W, Redline S. A comparison of caregiver-reported snoring and objective snoring in children from urban neighborhoods. Am J Otolaryngol 2024; 45:104264. [PMID: 38696893 PMCID: PMC11194994 DOI: 10.1016/j.amjoto.2024.104264] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2023] [Accepted: 03/18/2024] [Indexed: 05/04/2024]
Abstract
OBJECTIVE Sleep Disordered Breathing (SDB) is both prevalent and under-recognized in pediatric minority populations. Recognition of SDB is often triggered by symptoms of caregiver-reported snoring. However, the validity and utility of caregiver reports likely vary across populations. Our objective is to assess the association between caregiver-reported snoring and objectively recorded snoring in a low-income urban community and explore factors associated with agreement between objective and subjective snoring. METHODS 169 6 to 12 year old participants underwent at-home sleep studies with a WatchPAT device as part of the Environmental Assessment of Sleep in Youth (EASY) cohort study. Differences in subjective snoring, objective snoring, and concordance between subjective and objective snoring based on socioeconomic and clinical characteristics were assessed. RESULTS The sample had a high proportion of non-white (78.9 %) and low income (39.6 %) children. Caregivers reported snoring for 20.7 % of the children and snoring was measured objectively for 21.9 %. Of those with objective snoring, only 29.7 % were identified as snorers by caregiver report (sensitivity: 0.30; specificity: 0.82). Primary Spanish language and co-sleeping were associated with increased caregiver reported snoring, and allergy was associated with increased objective snoring. Older child age and normal range BMI percentile were associated with higher concordance between caregiver and objective snoring. CONCLUSIONS Among a community-based, predominantly minority sample, caregiver-reported snoring resulted in under-estimation of prevalence of objectively assessed snoring. Reliance on caregiver report may poorly identify children with snoring or SDB in clinical practice.
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Affiliation(s)
- Phoebe K Yu
- Brigham and Women's Hospital, Division of Sleep and Circadian Disorders, Boston, MA, United States of America; Massachusetts Eye and Ear Infirmary, Department of Otolaryngology, Boston, MA, United States of America.
| | - Xiaoyu Li
- Brigham and Women's Hospital, Division of Sleep and Circadian Disorders, Boston, MA, United States of America; Harvard Medical School, Boston, MA, United States of America; Harvard T.H. Chan School of Public Health, Department of Epidemiology, Boston, MA, United States of America
| | - Tamar Sofer
- Brigham and Women's Hospital, Division of Sleep and Circadian Disorders, Boston, MA, United States of America
| | - Amparito Cunningham
- Boston Children's Hospital, Division of Immunology, Boston, MA, United States of America
| | - Judith Owens
- Harvard Medical School, Boston, MA, United States of America; Boston Children's Hospital, Division of Neurology, Boston, MA, United States of America
| | - Diane R Gold
- Brigham and Women's Hospital, Channing Division of Network Medicine, Department of Medicine, Boston, MA, United States of America; Harvard T.H. Chan School of Public Health, Department of Environmental Health, Boston, MA, United States of America
| | - Wanda Phipatanakul
- Harvard Medical School, Boston, MA, United States of America; Boston Children's Hospital, Division of Immunology, Boston, MA, United States of America
| | - Susan Redline
- Brigham and Women's Hospital, Division of Sleep and Circadian Disorders, Boston, MA, United States of America; Harvard Medical School, Boston, MA, United States of America; Harvard T.H. Chan School of Public Health, Department of Epidemiology, Boston, MA, United States of America
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Fortney CA, Garcia D, Gerhardt CA, Baughcum AE, Slaughter JL, Rodriguez EM. Pilot Testing Transcreated Spanish-Language Study Materials for Symptom Research With Infants and Parents in the Neonatal Intensive Care Unit. Adv Neonatal Care 2024; 24:243-252. [PMID: 38729653 PMCID: PMC11141341 DOI: 10.1097/anc.0000000000001166] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/12/2024]
Abstract
BACKGROUND Rising admission rates of Hispanic/Latinx families to the neonatal intensive care unit (NICU) have increased the number of non-English-speaking individuals who may wish to participate in research studies. However, a lack of appropriately translated research study materials may limit the opportunity for these families to be involved in research that could impact the care that infants and families receive in the NICU. PURPOSE The primary purpose was to pilot test study materials that were transcreated from English to Spanish with the assistance of a bilingual community advisory board with Spanish-speaking parents of NICU infants. METHODS A total of 19 Spanish-speaking parents (15 mothers and 4 fathers) who were representative of the population of interest completed paper-and-pencil surveys, along with a cognitive interview. Preliminary data related to decision-making and goals of care, infant symptoms, and their experiences in the NICU were also collected. RESULTS The internal reliability of the transcreated study instruments ranged from good to excellent (α= 0.82-0.99). Participants reported that study materials were not offensive and did not make them feel uncomfortable; however, they found some words/phrases to be confusing. Parents had the opportunity to provide suggested wording changes. IMPLICATIONS FOR PRACTICE AND RESEARCH Language barriers and a lack of cultural responsiveness can affect the care that infants and their families receive. More accurate and culturally appropriate transcreation of study materials can remove barriers to research participation and facilitate better communication with non-English-speaking families, which may lead to the development of better-informed evidence-based interventions and clinical practices in the NICU.
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Affiliation(s)
- Christine A Fortney
- Martha S. Pitzer Center for Women, Children & Youth (Dr Fortney), The Ohio State University College of Nursing, Columbus, Ohio; Center for Biobehavioral Health (Dr Fortney, Ms Garcia, and Dr Gerhardt), Center for Perinatal Research (Dr Slaughter), Abigail Wexner Research Institute, Nationwide Children's Hospital, Columbus, Ohio; Department of Pediatrics (Dr Gerhardt, Dr Baughcum, and Dr Slaughter), The Ohio State University College of Medicine, Columbus, Ohio; Department of Psychology (Dr Gerhardt), The Ohio State University, Columbus, Ohio; Departments of Psychology and Neuropsychology (Dr Baughcum), Division of Neonatology (Dr Slaughter), Nationwide Children's Hospital, Columbus, Ohio; and Department of Educational Psychology (Dr Rodriguez), College of Education, University of Texas at Austin, Austin, Texas
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Hansen K, Jenkins E, Zhu A, Collins S, Williams K, Garcia A, Weng Y, Kaufman B, Sacks LD, Cohen H, Shin AY, Patel MD. A parental communication assessment initiative in the paediatric cardiovascular ICU. Cardiol Young 2024:1-9. [PMID: 38682563 DOI: 10.1017/s104795112402506x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 05/01/2024]
Abstract
OBJECTIVE Challenges to communication between families and care providers of paediatric patients in intensive care units (ICU) include variability of communication preferences, mismatched goals of care, and difficulties carrying forward family preferences from provider to provider. Our objectives were to develop and test an assessment tool that queries parents of children requiring cardiac intensive care about their communication preferences and to determine if this tool facilitates patient-centred care and improves families' ICU experience. DESIGN In this quality improvement initiative, a novel tool was developed, the Parental Communication Assessment (PCA), which asked parents with children hospitalised in the cardiac ICU about their communication preferences. Participants were prospectively randomised to the intervention group, which received the PCA, or to standard care. All participants completed a follow-up survey evaluating satisfaction with communication. MAIN RESULTS One hundred thirteen participants enrolled and 56 were randomised to the intervention group. Participants who received the PCA preferred detail-oriented communication over big picture. Most parents understood the daily discussions on rounds (64%) and felt comfortable expressing concerns (68%). Eighty-six percent reported the PCA was worthwhile. Parents were generally satisfied with communication. However, an important proportion felt unprepared for difficult decisions or setbacks, inadequately included or supported in decision-making, and that they lacked control over their child's care. There were no significant differences between the intervention and control groups in their communication satisfaction results. CONCLUSIONS Parents with children hospitalised in the paediatric ICU demonstrated diverse communication preferences. Most participants felt overall satisfied with communication, but individualising communication with patients' families according to their preferences may improve their experience.
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Affiliation(s)
- Katherine Hansen
- Division of Cardiology, Department of Pediatrics, Stanford University School of Medicine, Stanford, CA, USA
- Division of Cardiology, Department of Pediatrics, University of Texas Southwestern Medical Center, Dallas, TX, USA
| | - Erin Jenkins
- Division of Cardiology, Lucile Packard Children's Hospital, Palo Alto, CA, USA
| | - Aihua Zhu
- Division of Cardiology, Department of Pediatrics, Stanford University School of Medicine, Stanford, CA, USA
| | - Shawna Collins
- Division of Cardiology, Lucile Packard Children's Hospital, Palo Alto, CA, USA
| | - Kimberly Williams
- Division of Cardiology, Lucile Packard Children's Hospital, Palo Alto, CA, USA
| | - Ariadna Garcia
- Quantitative Sciences Unit, Department of Medicine, Stanford University, Palo Alto, CA, USA
| | - Yingjie Weng
- Quantitative Sciences Unit, Department of Medicine, Stanford University, Palo Alto, CA, USA
| | - Beth Kaufman
- Division of Cardiology, Department of Pediatrics, Stanford University School of Medicine, Stanford, CA, USA
| | - Loren D Sacks
- Division of Cardiology, Department of Pediatrics, Stanford University School of Medicine, Stanford, CA, USA
| | - Harvey Cohen
- Palliative Care Program, Department of Pediatrics, Stanford University School of Medicine, Stanford, CA, USA
| | - Andrew Y Shin
- Division of Cardiology, Department of Pediatrics, Stanford University School of Medicine, Stanford, CA, USA
| | - Meghna D Patel
- Division of Cardiology, Department of Pediatrics, Stanford University School of Medicine, Stanford, CA, USA
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Ruiz Colón GD, Pizzitola RJ, Grant GA, Prolo LM. Disparities in Postoperative Communication Patterns Among Spanish-speaking Pediatric Patients with Hydrocephalus. J Pediatr 2023; 263:113678. [PMID: 37611737 DOI: 10.1016/j.jpeds.2023.113678] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/04/2023] [Revised: 07/19/2023] [Accepted: 08/14/2023] [Indexed: 08/25/2023]
Abstract
OBJECTIVE To determine if differences exist in postoperative communication patterns or healthcare use among English-speaking patients (ESPs) and Spanish-speaking patients (SSPs) with childhood hydrocephalus. STUDY DESIGN A single-institution, retrospective cohort study was conducted. Through simple random sampling, 50 ESPs and 50 SSPs (<18 years old) who underwent a ventriculoperitoneal shunt or endoscopic third ventriculostomy were identified. Demographics, communication with clinic (eg, number of calls or messages postoperatively), and healthcare use were collected. Multiple linear regressions assessed the significance of predictors on communication frequency and use. RESULTS SSPs were more likely to have a comorbidity and ventriculoperitoneal shunt than ESPs. SSPs had longer median postoperative length of stay (P < .01) and 30-day readmission rate (P < .01) than ESPs. Only 18% of SSPs communicated with clinic; 11 total calls or messages were from SSPs vs 57 from ESPs (P < .01). The most common reason for outreach among both cohorts was a new symptom. ESP outreach most frequently resulted in reassurance or medical course changes on an outpatient basis (30% ESPs vs 0% SSPs; P = .04), whereas SSP outreach most frequently resulted in guidance to present to the emergency department (3% ESPs vs 36% SSPs; P < .01). Language remained a significant predictor for number of calls or messages, even after adjusting for comorbidity, operation type, and insurance (P < .01). CONCLUSIONS Despite having more complex disease, only 18% of SSPs communicated with the neurosurgical team postoperatively and were more frequently sent to the emergency department for management. Future research will explore communication barriers and preferences to ensure postoperative care is timely and patient centered.
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Affiliation(s)
| | - Rebecca J Pizzitola
- Department of Neurosurgery, Stanford University School of Medicine, Palo Alto, CA
| | - Gerald A Grant
- Department of Neurosurgery, Stanford University School of Medicine, Palo Alto, CA; Department of Neurosurgery, Duke University School of Medicine, Durham, NC
| | - Laura M Prolo
- Department of Neurosurgery, Stanford University School of Medicine, Palo Alto, CA; Division of Pediatric Neurosurgery, Lucile Packard Children's Hospital, Palo Alto, CA.
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Russell EA, Hsu D, Camp EA, Soto-Ruiz K, Leaming-Van Zandt K. Spanish-Speaking Caregivers' Perception of Emergency Physicians' Interpersonal and Communication Skills in a Pediatric Emergency Department. Pediatr Emerg Care 2023; 39:253-258. [PMID: 36999987 DOI: 10.1097/pec.0000000000002681] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
OBJECTIVES Medical communication is more than just the delivery of information; language differences between physicians and patients/caregivers create a challenge to providing effective care in the pediatric emergency department (ED). Overcoming this barrier is vital to providing high-quality care. We evaluated Spanish- versus English-speaking caregivers' perception of their pediatric ED physicians' interpersonal and communication skills. We also compared perceptions of Spanish- versus English-speaking caregivers who self-identified as Hispanic. METHODS This study is a retrospective analysis of data from surveys administered in an urban, free-standing children's hospital ED. Surveys were administered in English and Spanish to pediatric patient caregivers. In person, video, and telephonic interpretations were available during patient encounters. RESULTS There were 2542 (82.4%) surveys completed in English and 543 (17.6%) in Spanish. There were significant differences in demographic data of English versus Spanish survey respondents, including level of education, insurance status, and rates of nonpublic insurance. Spanish survey respondents rated their physicians' interpersonal skills lower than English survey respondents. There were 1455 (47%) surveys completed by the respondents who self-identified as Hispanic. Within this group, 928 (63.8%) respondents completed the survey in English and 527 (36.2%) in Spanish. Among this Hispanic population, the Spanish survey respondents rated their physicians' interpersonal and communication skills lower than English survey respondents. After adjusting for education level and insurance type, these differences persisted. CONCLUSIONS Language barriers have a meaningful impact on physician ability to communicate effectively in the pediatric ED. Improving physicians' ability to overcome this barrier is essential toward enriching patient outcomes and experience in the ED.
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Affiliation(s)
- Eric A Russell
- From the Division of Emergency Medicine, Department of Pediatrics, Baylor College of Medicine and Texas Children's Hospital, Houston, TX
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Batool SH, Safdar M, Eman S. Relationship between parents' health literacy and child health: systematic review. LIBRARY HI TECH 2022. [DOI: 10.1108/lht-11-2021-0398] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
PurposeParents' health literacy is an important element to ensure the sound health of children. One of the major purposes of this study was to systematically collect and review the literature that identified the relationship between two variables: parents' health literacy and their child's health.Design/methodology/approachTo meet the purpose, the authors searched four well-reputed research databases such as Web of Science, Scopus, Google Scholar and LISTA (Library, Information Science and Technology Abstracts) comprehensively to collect the relevant research on the topic. Except for books, various types of content from different years were used for this review. The investigators used Preferred Items for Systematic Reviews and Meta-analysis guidelines to select eligible studies for this review. The authors also assessed the quality of the reviewed research in the light of well-reputed quality guidelines shared by Boynton and Greenhalgh (2004).FindingsThe majority of the reviewed studies found a statistically significant relationship between parents' health literacy and the health of their children. Findings also identified that the majority of the reviewed literature scored from 9 to 12 on the quality assessment criteria. Results also highlighted that the majority of the reviewed research on parents' health literacy and child health has been conducted in the USA and utilized quantitative methods to conduct research on the topic under this study.Research limitations/implicationsThis systematic review has multiple theoretical and practical implications for parents, policymakers and researchers.Originality/valueThis is the first systematically collected and reviewed paper on the relationship between parents' health literacy and child health.
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Diaz EN, Pineda JA, Le Q, Wright JA, Greaney ML, Lindsay AC. How do Central American Parents in the United States View the Importance of and Obtain Information About Behaviors Associated with the Risk of Early Childhood Obesity? HISPANIC HEALTH CARE INTERNATIONAL 2022; 21:78-88. [PMID: 35435048 DOI: 10.1177/15404153221093735] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Background: Data suggest that Latinx preschool-age children are at increased risk of obesity. The fastest-growing Latinx population in the United States originates from El Salvador, Guatemala, and Honduras, also known as the Northern Triangle countries. Purpose: To describe how Central American parents from the Northern Triangle countries perceive the importance of energy balance-related behaviors (EBRBs), their preferred sources to obtain information about EBRBs, and to assess whether these differ by parent's gender and country of the nativity. Methods: Cross-sectional survey. Results: Seventy-four parents with at least one child between 2 and 5 years of age participated in the study. More than half were immigrants from El Salvador, Guatemala, and Honduras and were classified as having low acculturation. Mothers perceived consuming >5 fruits and vegetables daily, limiting sugar-sweetened beverages consumption, and having <2 hours daily screen time as extremely important, whereas fathers perceived these behaviors as being less important. Although a higher proportion of foreign-born than US-born parents perceived most of the assessed EBRBs (4 out of 6) as extremely important, these differences were not significant. Parents reported multiple sources to obtain EBRB-related information. Direct person-to-person interactions were the most commonly preferred sources, with pediatricians being the top source (97.3%), followed by other parents (86.5%), and WIC professionals (74.3%). Pediatricians were the preferred source to obtain information about EBRBs, irrespective of parent's gender and country of the nativity. A higher proportion of US-born than foreign-born parents reported a preference to obtain EBRB-related information from other parents. Conclusions: Findings suggest the significance of understanding how Central American parents perceive the importance of EBRBs and the sources they would prefer to obtain information for their children's EBRBs. Study findings have implications for health education and obesity prevention interventions designed to reach and deliver key evidence-based child health information to Central American parents from the Northern Triangle countries in the United States.
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Affiliation(s)
- Elizabeth N. Diaz
- Department of Exercise and Health Sciences, College of Nursing and Health Sciences, University of Massachusetts, Boston, MA, USA
| | - Joanna A. Pineda
- Department of Exercise and Health Sciences, College of Nursing and Health Sciences, University of Massachusetts, Boston, MA, USA
| | - Qun Le
- Department of Public Health, University of Massachusetts Lowell, MA, USA
| | - Julie A. Wright
- Department of Exercise and Health Sciences, College of Nursing and Health Sciences, University of Massachusetts, Boston, MA, USA
| | - Mary L. Greaney
- Department of Health Studies, University of Rhode Island, Kingston, RI, USA
| | - Ana Cristina Lindsay
- Department of Exercise and Health Sciences, College of Nursing and Health Sciences, University of Massachusetts, Boston, MA, USA
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Velez T, Gati S, Batista CA, Nino de Rivera J, Banker SL. Facilitating Engagement on Family-Centered Rounds for Families With Limited Comfort With English. Hosp Pediatr 2022; 12:439-447. [PMID: 35411375 DOI: 10.1542/hpeds.2021-006403] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Abstract
OBJECTIVE Conducting family-centered rounds (FCR) for families with limited comfort with English (LCE) presents communication challenges. The objective of this study was to characterize the preferences of Spanish-speaking parents with LCE around interpretation and communication with the medical team during FCR to promote family engagement during rounds. METHODS This qualitative study was conducted at a tertiary care children's hospital in New York, New York. Eighteen Spanish-speaking parents of patients admitted to the hospital medicine service participated. Bilingual investigators conducted semistructured interviews over a secure virtual platform. Interview transcriptions were coded and analyzed by using a grounded theory approach and constant comparative method. Parents were recruited until thematic saturation was achieved. RESULTS Most participants were mothers (72%) from the Dominican Republic (61%). Responses from participants yielded a conceptual model depicting parents' perspectives on family engagement and bidirectional communication during FCR. Three major themes emerged: (1) importance of interpreter use, (2) understanding of medical information, and (3) participation in FCR. Within each theme, factors that facilitate or impede engagement in FCR were identified. Interpreters facilitated information sharing and parent understanding of medical care, increasing parent appreciation of FCR. Lack of language-concordant care and parents' perceived responsibility for the language barrier limited engagement. CONCLUSIONS Families with LCE value involvement during FCR, but face difficulties due to language barriers. Providers can support these families by empowering families' participation and by consistently using an interpreter. Understanding the preferences of families with LCE for participation in FCR will help providers deliver more equitable family-centered care.
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Affiliation(s)
- Teresitta Velez
- Columbia University Vagelos College of Physicians and Surgeons, New York, New York.,Department of Pediatrics, Children's National Medical Center, Washington, District of Columbia
| | - Stephanie Gati
- Department of Pediatrics, Columbia University Irving Medical Center, New York, New York.,Division of General Pediatrics, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania
| | - Chelsea A Batista
- Columbia University Vagelos College of Physicians and Surgeons, New York, New York.,Department of Pediatrics, Mount Sinai Kravis Children's Hospital, New York, New York
| | | | - Sumeet L Banker
- Columbia University Vagelos College of Physicians and Surgeons, New York, New York.,Department of Pediatrics, Columbia University Irving Medical Center, New York, New York
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Christian BJ. Translational Research - Parents and Pediatric Nurses Promoting Children's Health in Primary Care and During Hospitalization. J Pediatr Nurs 2020; 52:91-94. [PMID: 32279990 DOI: 10.1016/j.pedn.2020.04.007] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
Affiliation(s)
- Becky J Christian
- School of Nursing, The University of Louisville, Louisville, KY, USA.
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