Although breast and prostate cancer are those most frequently diagnosed in Canada, information about the ways in which gender, class, race, culture, and other social determinants impact the experience of African Canadians living with cancer is lacking. This study began to address this gap by exploring cultured and gendered dimensions of African Nova Scotians’ experiences of these two cancers. Using a participatory action research approach, data were collected in two phases of focus group discussions in five African Nova Scotian communities from a total of 57 people, including those with breast or prostate cancer and their families and associates. Findings provide insight into how gender and meanings of masculinity and femininity in the African Nova Scotian community unavoidably interact with other social structures such as race and class to affect women and men’s perceptions and experiences of these two cancers. These insights point to the need for culturally appropriate and meaningful health interventions. As a prerequisite, health care professionals need to have an understanding of the overlapping and contextualized nature of gender, class, and race and be willing and able to work in partnership with African Nova Scotian communities to identify and develop strategies that reflect the realities of peoples’ lives.

Background: Falls of hospitalized older adults are of concern for patients, family members, third-party payers, and caregivers. Falls are the most common safety incident among hospitalized patients with fall rates from 2.9–13 per 1,000 patient days. Little effectiveness research has been conducted on nursing interventions and other variables associated with falls of older adults during hospitalization. Purpose: The purpose of this exploratory outcomes effectiveness study was to examine variables associated with falls during hospitalization of older adults. Method: An effectiveness research model composed of patient characteristics, clinical conditions, nursing unit characteristics, medical, pharmacy, and nursing interventions was tested using generalized estimating equations (GEE) analysis. The sample consisted of 10,187 hospitalizations of 7,851 patients, aged 60 or older, admitted for acute care services over a 4-year period. Those included in the sample either had received the Nursing Interventions Classification (NIC) intervention of Fall Prevention (defined as “instituting special precautions with patient at risk for injury from falling” [Dochterman & Bulechek, 2004, p. 363]) or were at risk for falling as defined by a fall risk assessment scale. Data were obtained retrospectively from 9 clinical and administrative data repositories from 1 tertiary care hospital. Discussion: Variables that were positively associated with falls, after controlling for other variables in the model, included several medical and nursing treatments; several types of medications including antidepressants, benzodiazepines, antipsychotic, and psychotropic agents; and several types of nursing treatments including restraints and neurologic monitoring (at low use rates of <2 times a day). Variables inversely associated with falls included registered nurse (RN) skill mix, pressure ulcer care, pain management, and tube care. Conclusions: The study demonstrates the importance of conducting interdisciplinary effectiveness research that includes nursing care. Most of the variables associated with falls were interventions (medical, pharmacy, and nursing). Dose of nursing treatments and RN skill mix were also associated with falls.

Learned resourcefulness may be an important and necessary resource for people with diabetes to adequately manage their disease. This study used a cross-sectional, descriptive correlation design to examine the relationships of demographic characteristics, stressors, learned resourcefulness, and depressive symptoms among adult Taiwanese with diabetes mellitus. A convenience sample of 131 individuals recruited from outpatient primary care centers from two major hospitals in Taiwan participated in this study. Data were collected with a demographic questionnaire, blood tests, Rosenbaum’s self-control schedule, and the Center for Epidemiological Studies depression scale. Data analysis consisted of descriptive statistics and regression analysis. Findings suggest that individuals with diabetes who had greater learned resourcefulness and better glycemic control also had fewer depressive symptoms. In addition, learned resourcefulness partially mediated the relationship between glycemic control and depressive symptoms.

Resistiveness to care (RTC) by persons with dementia significantly adds to subjective and objective burden for caregivers and may be triggered by environmental factors, including communication. This case study evaluated behavioral responses of a nursing home resident with dementia to nursing staff use of elderspeak communication (infantilizing speech). Four videotaped staff-resident interactions that were previously recorded were coded for staff elderspeak communication and resident RTC. Total elderspeak scores (M = 29.5, SD = 25.74) and RTC scores (M = 8.75, SD = 13.79) were correlated r = 0.93, p = .03. This preliminary single-subject observational study suggests a relationship between staff elderspeak communication and RTC in a nursing home resident with dementia that warrants further investigation. Limitations include the use of a convenient case study sample with inability to control time of day, medications, different care activities, staff characteristics, and other factors. Knowledge about communication in dementia care may inform nursing care practices to overcome behavioral symptoms such as RTC and improve quality of life for individuals with dementia and working conditions for nursing staff.

As methods for concept analysis have evolved, scholars have confounded the initial exploration of a concept with techniques for developing the conceptual unit, extending nursing theory, and establishing nursing knowledge. We argue that nursing is at a critical juncture in the methodological development of concept-driven research. In order to maximize the potential contribution of this type of research, approaches to concept analysis must be held separate and distinct from approaches to concept advancement. We advocate the use of principle-based concept analysis to determine appropriate techniques for advancing a concept. Concept advancement refers to strategic concept-driven inquiries that incrementally build the specification of conceptual meaning to a more precisely defined unit of meaning that has greater utility for research application. Examples of a project that employed strategic techniques for concept advancement are used to illustrate the flow of serial small projects.