Matching Items (45)
Description
Background: Evidence about the purported hypoglycemic and hypolipidemic effects of nopales (prickly pear cactus pads) is limited. Objective: To evaluate the efficacy of nopales for improving cardiometabolic risk factors and oxidative stress, compared to control, in adults with hypercholesterolemia. Design: In a randomized crossover trial, participants were assigned to a 2-wk intervention with 2 cups/day of nopales or cucumbers (control), with a 2 to 3-wk washout period. The study included 16 adults (5 male; 46±14 y; BMI = 31.4±5.7 kg/m2) with moderate hypercholesterolemia (low density lipoprotein cholesterol [LDL-c] = 137±21 mg/dL), but otherwise healthy. Main outcomes measured included: dietary intake (energy, macronutrients and micronutrients), cardiometabolic risk markers (total cholesterol, LDL-c, high density lipoprotein cholesterol [HDL-c], triglycerides, cholesterol distribution in LDL and HDL subfractions, glucose, insulin, homeostasis model assessment, and C-reactive protein), and oxidative stress markers (vitamin C, total antioxidant capacity, oxidized LDL, and LDL susceptibility to oxidation). Effects of treatment, time, or interactions were assessed using repeated measures ANOVA. Results: There was no significant treatment-by-time effect for any dietary composition data, lipid profile, cardiometabolic outcomes, or oxidative stress markers. A significant time effect was observed for energy, which was decreased in both treatments (cucumber, -8.3%; nopales, -10.1%; pTime=0.026) mostly due to lower mono and polyunsaturated fatty acids intake (pTime=0.023 and pTime=0.003, respectively). Both treatments significantly increased triglyceride concentrations (cucumber, 14.8%; nopales, 15.2%; pTime=0.020). Despite the lack of significant treatment-by-time effects, great individual response variability was observed for all outcomes. After the cucumber and nopales phases, a decrease in LDL-c was observed in 44% and 63% of the participants respectively. On average LDL-c was decreased by 2.0 mg/dL (-1.4%) after the cucumber phase and 3.9 mg/dL (-2.9%) after the nopales phase (pTime=0.176). Pro-atherogenic changes in HDL subfractions were observed in both interventions over time, by decreasing the proportion of HDL-c in large HDL (cucumber, -5.1%; nopales, -5.9%; pTime=0.021) and increasing the proportion in small HDL (cucumber, 4.1%; nopales, 7.9%; pTime=0.002). Conclusions: These data do not support the purported benefits of nopales at doses of 2 cups/day for 2-wk on markers of lipoprotein profile, cardiometabolic risk, and oxidative stress in hypercholesterolemic adults.
ContributorsPereira Pignotti, Giselle Adriana (Author) / Vega-Lopez, Sonia (Thesis advisor) / Gaesser, Glenn (Committee member) / Keller, Colleen (Committee member) / Shaibi, Gabriel (Committee member) / Sweazea, Karen (Committee member) / Arizona State University (Publisher)
Created2013
Description
Cardiovascular disease (CVD) is the number one cause of death in the United States and type 2 diabetes (T2D) and obesity lead to cardiovascular disease. Obese adults are more susceptible to CVD compared to their non-obese counterparts. Exercise training leads to large reductions in the risk of CVD and T2D. Recent evidence suggests high-intensity interval training (HIT) may yield similar or superior benefits in a shorter amount of time compared to traditional continuous exercise training. The purpose of this study was to compare the effects of HIT to continuous (CONT) exercise training for the improvement of endothelial function, glucose control, and visceral adipose tissue. Seventeen obese men (N=9) and women (N=8) were randomized to eight weeks of either HIT (N=9, age=34 years, BMI=37.6 kg/m2) or CONT (N=8, age=34 years, BMI=34.6 kg/m2) exercise 3 days/week for 8 weeks. Endothelial function was assessed via flow-mediated dilation (FMD), glucose control was assessed via continuous glucose monitoring (CGM), and visceral adipose tissue and body composition was measured with an iDXA. Incremental exercise testing was performed at baseline, 4 weeks, and 8 weeks. There were no changes in weight, fat mass, or visceral adipose tissue measured by the iDXA, but there was a significant reduction in body fat that did not differ by group (46±6.3 to 45.4±6.6%, P=0.025). HIT led to a significantly greater improvement in FMD compared to CONT exercise (HIT: 5.1 to 9.0%; CONT: 5.0 to 2.6%, P=0.006). Average 24-hour glucose was not improved over the whole group and there were no group x time interactions for CGM data (HIT: 103.9 to 98.2 mg/dl; CONT: 99.9 to 100.2 mg/dl, P>0.05). When statistical analysis included only the subjects who started with an average glucose at baseline > 100 mg/dl, there was a significant improvement in glucose control overall, but no group x time interaction (107.8 to 94.2 mg/dl, P=0.027). Eight weeks of HIT led to superior improvements in endothelial function and similar improvements in glucose control in obese subjects at risk for T2D and CVD. HIT was shown to have comparable or superior health benefits in this obese sample with a 36% lower total exercise time commitment.
ContributorsSawyer, Brandon J (Author) / Gaesser, Glenn A (Thesis advisor) / Shaibi, Gabriel (Committee member) / Lee, Chong (Committee member) / Swan, Pamela (Committee member) / Buman, Matthew (Committee member) / Arizona State University (Publisher)
Created2013
Description
Purpose: The purpose of this study was to examine the acute effects of two novel intermittent exercise prescriptions on glucose regulation and ambulatory blood pressure. Methods: Ten subjects (5 men and 5 women, ages 31.5 ± 5.42 yr, height 170.38 ± 9.69 cm and weight 88.59 ± 18.91 kg) participated in this four-treatment crossover trial. All subjects participated in four trials, each taking place over three days. On the evening of the first day, subjects were fitted with a continuous glucose monitor (CGM). On the second day, subjects were fitted with an ambulatory blood pressure monitor (ABP) and underwent one of the following four conditions in a randomized order: 1) 30-min: 30 minutes of continuous exercise at 60 - 70% VO2peak; 2) Mod 2-min: twenty-one 2-min bouts of walking at 3 mph performed once every 20 minutes; 3) HI 2-min: eight 2-min bouts of walking at maximal incline performed once every hour; 4) Control: a no exercise control condition. On the morning of the third day, the CGM and ABP devices were removed. All meals were standardized during the study visits. Linear mixed models were used to compare mean differences in glucose and blood pressure regulation between the four trials. Results: Glucose concentrations were significantly lower following the 30-min (91.1 ± 14.9 mg/dl), Mod 2-min (93.7 ± 19.8 mg/dl) and HI 2-min (96.1 ± 16.4 mg/dl) trials as compared to the Control (101.1 ± 20 mg/dl) (P < 0.001 for all three comparisons). The 30-min trial was superior to the Mod 2-min, which was superior to the HI 2-min trial in lowering blood glucose levels (P < 0.001 and P = 0.003 respectively). Only the 30-min trial was effective in lowering systolic ABP (124 ± 12 mmHg) as compared to the Control trial (127 ± 14 mmHg; P < 0.001) for up to 11 hours post exercise. Conclusion: Performing frequent short (i.e., 2 minutes) bouts of moderate or high intensity exercise may be a viable alternative to traditional continuous exercise in improving glucose regulation. However, 2-min bouts of exercise are not effective in reducing ambulatory blood pressure in healthy adults.
ContributorsBhammar, Dharini Mukeshkumar (Author) / Gaesser, Glenn A (Thesis advisor) / Shaibi, Gabriel (Committee member) / Buman, Matthew (Committee member) / Swan, Pamela (Committee member) / Lee, Chong (Committee member) / Arizona State University (Publisher)
Created2013
Description
Nationally, African Americans suffer disproportionately from diabetes; with 13.2% of African Americans diagnosed with diabetes compared to 7.6% of non-Hispanic whites (CDC, 2014). Nearly one-half of all people with diabetes are non-adherent to their oral medications; adherence to insulin therapy was 60%-80% (Brunton et al., 2011; Cramer, 2004; Rubin, 2005). This study explored the question, "What mechanisms are associated with adherence to diabetes medication, including insulin, for African Americans in the Southwest?" Twenty-three people participated in the study; 17 participated in interviews and six participated in gendered focus groups. A community-based participatory research (CBPR) approach engaged the African American community as partners in research.
Major themes emerging from the data included illness perception, support, and the process of medication adherence. Acceptance of the diabetes diagnosis was imperative for medication adherence. Stigmatization of diabetes was salient in the recruitment process and as it related to mechanisms for adherence. Furthermore, many informants were not aware of a family history of diabetes before their own diagnosis. Four gendered emerging typologies were identified, which further illuminated major themes. Moreover, an eight-step process of medication adherence model is discussed. The researcher was able to identify culturally compatible strategies that may be extended to those struggling with medication adherence. The implications section suggests a set of strategies that healthcare providers can present to people with diabetes in order to increase medication adherence.
Major themes emerging from the data included illness perception, support, and the process of medication adherence. Acceptance of the diabetes diagnosis was imperative for medication adherence. Stigmatization of diabetes was salient in the recruitment process and as it related to mechanisms for adherence. Furthermore, many informants were not aware of a family history of diabetes before their own diagnosis. Four gendered emerging typologies were identified, which further illuminated major themes. Moreover, an eight-step process of medication adherence model is discussed. The researcher was able to identify culturally compatible strategies that may be extended to those struggling with medication adherence. The implications section suggests a set of strategies that healthcare providers can present to people with diabetes in order to increase medication adherence.
ContributorsWardian, Jana (Author) / Marsiglia, Flavio F (Thesis advisor) / Sun, Fei (Committee member) / Shaibi, Gabriel (Committee member) / Arizona State University (Publisher)
Created2015
Description
Obesity in Hispanic youth has reached alarmingly high levels, increasing the risk of type 2 diabetes, hyperlipidemia, hypertension, and cardiovascular disease. In Mexican American children ages 6-11 years, 41.7% are overweight and obese, 24.7% are obese and 19.6% have a Body Mass Index (BMI) greater than the 97th percentile. While personal, behavioral, and environmental factors contribute to these high rates, emerging literature suggests acculturation, self-efficacy and social support are key influences. The one-group, pre- and post-test, quasi-experimental design used a community-based participatory research (CBPR) method to test the feasibility, acceptability, and preliminary efficacy of the 8-week intervention. Social Cognitive Theory (SCT) was used to guide the design. Measurements included an analysis of recruitment, retention, participant satisfaction, observation of intervention sessions, paired t-tests, effect sizes, and bivariate correlations between study variables (acculturation, nutrition and physical activity [PA] knowledge, attitude and behaviors, perceived confidence and social support) and outcome variables (BMI z-score, waist circumference and BP percentile) Findings showed the SSLN program was feasible and acceptable. Participants (n = 16) reported that the curriculum was fun and they learned about nutrition and PA. The retention rate was 94%. The preliminary effects on adolescent nutrition and PA behaviors showed mixed results with small-to-medium effect sizes for nutrition knowledge and attitude, PA and sedentary behavior. Correlation analysis among acculturation and study variables was not significant. Positive associations were found between perceived confidence in eating and nutrition attitude (r = .61, p < .05) and nutrition behavior (r = .62, p < .05), perceived confidence in exercise and nutrition behavior (r = .66, p < .05), social support from family for exercise and PA behavior (r = .67, p < .01) and social support from friends for exercise and PA behavior (r = .56, p < .05). These findings suggest a culturally specific healthy eating and activity program for adolescents was feasible and acceptable and warrants further investigation, since it may fill a gap in existing obesity programs designed for Hispanic youth. The positive correlations suggest further testing of the theoretical model.
ContributorsStevens, Carol (Author) / Gance-Cleveland, Bonnie (Thesis advisor) / Komnenich, Pauline (Committee member) / Shaibi, Gabriel (Committee member) / Arcoleo, Kimberly (Committee member) / Arizona State University (Publisher)
Created2011
Description
ABSTRACT PHYSCIAL ACTIVITY AND EXECUTIVE FUNCTIONING IN COLLEGE STUDENTS INTRODUCTION: Regular physical activity may increase neurological development, which has been shown to increase cognitive functioning in older adults and those with dementia. Studies have also shown physical activity and exercise may positively affect executive functioning in children. Little is known about the influence of physical activity on executive functioning in college students between the ages of 18-21 years, a population that is traditionally thought of as healthy. Therefore, the purpose of this study is to explore the association between physical activity and executive functioning in college-aged students. We hypothesize that regular physical activity is positively associated with executive functioning scores and that this association is independent of adiposity. METHODS: Twenty males and 29 females (19.5 ± 0.1 yrs. old) participated in this study. Physical activity was assessed using the International Physical Activity Questionnaire (IPAQ). Executive function was assessed by Stroop Color and Word Association Test (Stroop) and Trail Making Test A & B. A verbal ability test (analogies, synonyms, antonyms) was given in order to control for intelligence. Body composition was determined by a Tanita TBF-300 Body Composition Analyzer. RESULTS: Partial correlations between physical activity/inactivity measures and measures of executive functioning were generally small (r-values ≤ 0.2) and not significant. However, there was a significant inverse correlation between log moderate physical activity minutes per week and Stroop interference scores (r=0.50, p=0.01). Also, a trend towards significance was noted for the correlation between sitting minutes per week and Stroop interference scores (r=0.4 p=0.08) CONCLUSION: These results suggest that in college students, moderate physical activity is inversely associated with executive functioning while sitting time may be positively associated with executive functioning. These findings are in contrast to previous studies in children and older adults, and may indicate a unique relationship between physical activity/inactivity and executive functioning in college students. Future studies to further examine this population in greater depth are warranted.
ContributorsBurks, Hillary (Author) / Shaibi, Gabriel (Thesis advisor) / Swan, Pamela (Committee member) / Limbers, Christine (Committee member) / Arizona State University (Publisher)
Created2012
Description
The health enhancing effects of physical activity are well documented in the literature. However, women continue to report lower participation in exercise and physical activity (PA) compared to men. As women age an overall trend in decreased activity is observed. The primary place of activity reported in women is the home and one of the most commonly reported reasons for lack of physical activity is the lack of time. Few instruments have been developed that focus on the activity patterns of women. The Cross Cultural Physical Activity Study that this study was based on targeted women of color to assess the types of activity and constraints to activity experienced by African American and Native American women over 40 years old. This secondary data analysis focused on the psychometric properties of two scales used in the above study, The Physical Recreation Questionnaire (PRQ) and The Typical Week Physical Activity Survey (TWPAS). An exploratory factor analysis (EFA) was conducted on the 18 items from the Physical Recreation Questionnaire (PRQ) which focused on constraints to PA. The results of the EFA were a poor fit of a two factor model. The three factor model had a favorable fit in the EFA. Confirmatory factor analysis (CFA) was then conducted on the 18 items in the PRQ. Results of the CFA supported the presence of three latent variables: enjoyment of PA, constraints to PA, and negotiation of constraints to PA. The Typical Week Physical Activity Survey (TWPAS) is a 35 item measure of moderate PA that includes the activities most often reported by women. The purpose of the TWPAS was to capture habitual PA that might not be recorded in other PA questionnaires. The TWPAS was correlated with criterion measures of PA records, treadmill, accelerometer, and BMI. Although correlations were small, they were in the expected direction with the criterion measures. The evaluation of the instruments supported the presence of the construct of constraints to PA in the PRQ and the measurement of moderate intensity PA in the TWPAS.
ContributorsBishop, Jewel (Author) / Ainsworth, Barbara (Thesis advisor) / Komnenich, Pauline (Committee member) / Arizona State University (Publisher)
Created2012
Description
Background: Latinos have disproportionately high rates of obesity and type 2 diabetes. Family-based interventions may reduce chronic disease risk among Latinos across generations.
Purpose: To assess the efficacy of Athletes for Life (AFL), a 12-week community-and-family-based behavioral intervention, for improving diet, physical activity (PA), anthropometrics, fitness, and biochemical outcomes among mostly Latino parents.
Methods: Parents with at least one child 6-11 years of age were randomized to active AFL participation (n=14) or a wait-list control (n=14) group. AFL consisted of twice weekly 90 minute sessions (45 minutes of nutrition-focused lessons and 45 minutes of PA participation) designed to promote fruit and vegetable consumption, reduction of sugar intake, and increasing habitual PA. Data were collected prior to and immediately after the 12 week intervention.
Results: Participants (37.9±7.2y) were mostly Latino (93%), Spanish speaking (68%), and women (93%). Relative to participants in the control group, AFL participants had a significant reduction in body fat (-1.1±1.2% vs. 0.2±1.2%; p=0.014), resting (-7.6±10.2 bpm vs. +2.1±6.8 bpm; p<0.01), exercise (-8.4±8.7 bpm vs. +0.4±7.3 bpm; p<0.01), and recovery heart rate (-11.9±12.8 bpm vs. -0.3±11.4 bpm; p=0.01), and one mile run time (-1.5±1.0 min vs. -0.1±0.9 min; p<0.01), and a significant increase in estimated VO2 peak (+1.9±1.9 ml/kg/min vs. 0.0±1.8 ml/kg/min; p=0.01). AFL participants also reported an increase in the number of days/week accumulating 30 minutes of MVPA (+0.8±3.2 vs. -1.5±2.3; p=0.004) and daily servings of fruits (+1.3±1.4 vs. +0.3±1.4; p<0.05) and vegetables (+1.8±1.7 vs. +0.1±1.2; p<0.05), relative to control participants. There were no significant differences between groups in changes in diet assessed by 3-day food record, accelerometer-measured PA, weight, blood pressure, visceral fat, biomarkers for cardiovascular disease or nutritional biomarkers.
Conclusions: Despite the lack of effects on diet and PA behaviors, AFL shows promising preliminary efficacy for reducing body fat and improving fitness among adult participants. Future research aimed at improving fitness among Latino parents with family-based intervention is warranted.
Purpose: To assess the efficacy of Athletes for Life (AFL), a 12-week community-and-family-based behavioral intervention, for improving diet, physical activity (PA), anthropometrics, fitness, and biochemical outcomes among mostly Latino parents.
Methods: Parents with at least one child 6-11 years of age were randomized to active AFL participation (n=14) or a wait-list control (n=14) group. AFL consisted of twice weekly 90 minute sessions (45 minutes of nutrition-focused lessons and 45 minutes of PA participation) designed to promote fruit and vegetable consumption, reduction of sugar intake, and increasing habitual PA. Data were collected prior to and immediately after the 12 week intervention.
Results: Participants (37.9±7.2y) were mostly Latino (93%), Spanish speaking (68%), and women (93%). Relative to participants in the control group, AFL participants had a significant reduction in body fat (-1.1±1.2% vs. 0.2±1.2%; p=0.014), resting (-7.6±10.2 bpm vs. +2.1±6.8 bpm; p<0.01), exercise (-8.4±8.7 bpm vs. +0.4±7.3 bpm; p<0.01), and recovery heart rate (-11.9±12.8 bpm vs. -0.3±11.4 bpm; p=0.01), and one mile run time (-1.5±1.0 min vs. -0.1±0.9 min; p<0.01), and a significant increase in estimated VO2 peak (+1.9±1.9 ml/kg/min vs. 0.0±1.8 ml/kg/min; p=0.01). AFL participants also reported an increase in the number of days/week accumulating 30 minutes of MVPA (+0.8±3.2 vs. -1.5±2.3; p=0.004) and daily servings of fruits (+1.3±1.4 vs. +0.3±1.4; p<0.05) and vegetables (+1.8±1.7 vs. +0.1±1.2; p<0.05), relative to control participants. There were no significant differences between groups in changes in diet assessed by 3-day food record, accelerometer-measured PA, weight, blood pressure, visceral fat, biomarkers for cardiovascular disease or nutritional biomarkers.
Conclusions: Despite the lack of effects on diet and PA behaviors, AFL shows promising preliminary efficacy for reducing body fat and improving fitness among adult participants. Future research aimed at improving fitness among Latino parents with family-based intervention is warranted.
ContributorsChavez, Adrian (Author) / Vega-Lopez, Sonia (Thesis advisor) / Crespo, Noe (Committee member) / Hekler, Eric (Committee member) / Shaibi, Gabriel (Committee member) / Bruening, Meg (Committee member) / Arizona State University (Publisher)
Created2015
Description
Cardiovascular disease (CVD) is the leading cause of mortality in the U.S. While physical activity can reduce CVD risk, most adults do not engage in adequate physical activity to maintain or improve health. Older adults are less likely to participate in physical activity and experience a greater burden of CVD compared to younger adults. Despite knowledge of motivators and barriers to physical activity, the challenge to reduce cardiovascular risk in the older adult population remains unmet. Older adults face unique and complex barriers to physical activity, including limited social contextual resources and behavioral change processes. Interventions to enhance wellness motivation have demonstrated potential in promoting health behavior change among older adults.
The purpose of this study was to examine the feasibility of the Yoga for HEART (Health Empowerment and Realizing Transformation) Intervention to increase motivation for physical activity and improve cardiovascular health in older adults. A pilot randomized controlled trial design was used. The Intervention group received Yoga for HEART, a 12-week program to foster motivation for health behavior change. The Control group received a 12-week group yoga program that did not contain theory-based components. The intervention was based on Wellness Motivation Theory, conceptualizing health behavior change as dynamic process of intention formation and goal-directed behavior leading to the development of new and positive health patterns. Critical inputs (i.e., empowering education, motivational support, social network support) were designed to promote social contextual resources and behavioral change processes to increase motivation for physical activity and improve cardiovascular health.
Specific Aims were to: (a) examine intervention acceptability, demand, and fidelity, and (b) evaluate intervention efficacy in promoting physical activity and improving cardiovascular health through increased social contextual resources and behavioral change processes. Participants in the Intervention group realized a significant reduction in body mass index (BMI) from baseline to 12 weeks when compared to participants in the Control group. Intervention group participants demonstrated improvement in theoretical mechanisms (i.e., self-knowledge, motivation appraisal, self-regulation, environmental resources) and intended outcomes (i.e., body composition) when compared to Control group participants. Findings from this study support the feasibility of the Yoga for HEART Intervention in older adults.
The purpose of this study was to examine the feasibility of the Yoga for HEART (Health Empowerment and Realizing Transformation) Intervention to increase motivation for physical activity and improve cardiovascular health in older adults. A pilot randomized controlled trial design was used. The Intervention group received Yoga for HEART, a 12-week program to foster motivation for health behavior change. The Control group received a 12-week group yoga program that did not contain theory-based components. The intervention was based on Wellness Motivation Theory, conceptualizing health behavior change as dynamic process of intention formation and goal-directed behavior leading to the development of new and positive health patterns. Critical inputs (i.e., empowering education, motivational support, social network support) were designed to promote social contextual resources and behavioral change processes to increase motivation for physical activity and improve cardiovascular health.
Specific Aims were to: (a) examine intervention acceptability, demand, and fidelity, and (b) evaluate intervention efficacy in promoting physical activity and improving cardiovascular health through increased social contextual resources and behavioral change processes. Participants in the Intervention group realized a significant reduction in body mass index (BMI) from baseline to 12 weeks when compared to participants in the Control group. Intervention group participants demonstrated improvement in theoretical mechanisms (i.e., self-knowledge, motivation appraisal, self-regulation, environmental resources) and intended outcomes (i.e., body composition) when compared to Control group participants. Findings from this study support the feasibility of the Yoga for HEART Intervention in older adults.
ContributorsBarrows, Jennifer Leigh (Author) / Fleury, Julie (Thesis advisor) / Komnenich, Pauline (Committee member) / Belyea, Michael (Committee member) / Arizona State University (Publisher)
Created2018
Description
Nurses are ideally positioned to lead the transformation of healthcare delivery in the United States, however they must be prepared to do so. The Institute of Medicine has called for nurses to become change agents and assume leadership positions across all levels in order to become full partners with physicians and other health care providers. While clinical leadership is a responsibility for all nurses, expectations for new nurse clinical leadership have not been well studied.
This study sought to determine the nursing leadership competencies clinical managers expect of new nurses in an acute care setting and to identify gaps between end-of-program nursing leadership competencies, as outlined in The Essentials of Baccalaureate Education for Professional Nursing Practice, with leadership competencies identified by clinical managers in an acute-care setting.
A single, bounded case study approach was used to collect data from nurse managers and assistant nurse managers at one acute care hospital. Data from intensive interviews, focus groups, and archival records were analyzed. Seven major themes related to clinical leadership emerged, including intentional learning, communication, professional practice, advocacy, teamwork, influencing practice, and systems thinking. Traits, mentoring, and generational differences emerged as secondary themes.
Data from this study revealed a developmental sequence for clinical leadership. Certain expectations identified as antecedent to clinical leadership emerged initially, whereas other aspects of clinical leadership, developed later in the career trajectory. It was clear that accomplishing nursing care tasks was a fundamental expectation for professional nursing practice. Communication, teamwork and advocacy are crucial leadership competencies which help the new nurse to effectively manage time and provide safe, high-quality nursing care. As the new nurse continues to develop, systems thinking and influencing nursing practice emerge as significant expectations. Nurse managers have clear expectations for how new nurses should be prepared for clinical leadership. The degree to which clinical practice partners employing new nurses and academic nursing programs educating future nurses collaborate to establish expected outcomes is variable; however, academic-practice collaborations are crucial in developing educational standards for entry to practice in complex healthcare delivery systems.
This study sought to determine the nursing leadership competencies clinical managers expect of new nurses in an acute care setting and to identify gaps between end-of-program nursing leadership competencies, as outlined in The Essentials of Baccalaureate Education for Professional Nursing Practice, with leadership competencies identified by clinical managers in an acute-care setting.
A single, bounded case study approach was used to collect data from nurse managers and assistant nurse managers at one acute care hospital. Data from intensive interviews, focus groups, and archival records were analyzed. Seven major themes related to clinical leadership emerged, including intentional learning, communication, professional practice, advocacy, teamwork, influencing practice, and systems thinking. Traits, mentoring, and generational differences emerged as secondary themes.
Data from this study revealed a developmental sequence for clinical leadership. Certain expectations identified as antecedent to clinical leadership emerged initially, whereas other aspects of clinical leadership, developed later in the career trajectory. It was clear that accomplishing nursing care tasks was a fundamental expectation for professional nursing practice. Communication, teamwork and advocacy are crucial leadership competencies which help the new nurse to effectively manage time and provide safe, high-quality nursing care. As the new nurse continues to develop, systems thinking and influencing nursing practice emerge as significant expectations. Nurse managers have clear expectations for how new nurses should be prepared for clinical leadership. The degree to which clinical practice partners employing new nurses and academic nursing programs educating future nurses collaborate to establish expected outcomes is variable; however, academic-practice collaborations are crucial in developing educational standards for entry to practice in complex healthcare delivery systems.
ContributorsMiehl, Nickolaus (Author) / Komnenich, Pauline (Thesis advisor) / Hagler, Debra (Thesis advisor) / Lamb, Gerri (Committee member) / Arizona State University (Publisher)
Created2018