Contributions of Comorbid Diabetes to Sleep Characteristics, Daytime Symptoms, and Physical Function Among Patients With Stable Heart Failure
Background: Diabetes mellitus (DM) and heart failure (HF) are often comorbid. Sleep disturbances, poor physical functioning, and high levels of daytime symptoms are prevalent and contribute to poor quality of life in both populations. However, little is known about the independent and additive effects of comorbid DM on sleep, physical function, and daytime symptoms among patients with HF. Objective: The aim of this study was to investigate the extent to which comorbid DM confers independent and additive effects on sleep disturbance, physical functioning, and symptoms among patients with stable HF. Methods: This secondary a...
Source: Journal of Cardiovascular Nursing - August 14, 2015 Category: Nursing Tags: Articles Source Type: research

The Course of Sleep Problems in Patients With Heart Failure and Associations to Rehospitalizations
Conclusion: One-third of HF patients with sleep problems at discharge experienced persistent sleep problems at follow-up. Continued sleep problems were associated with all-cause and cardiovascular rehospitalizations. (Source: Journal of Cardiovascular Nursing)
Source: Journal of Cardiovascular Nursing - August 14, 2015 Category: Nursing Tags: Articles Source Type: research

Symptom-Hemodynamic Mismatch and Heart Failure Event Risk
Conclusions: A minority of adults with HF have concordant symptoms and hemodynamics. Either profile of symptom-hemodynamic mismatch in HF is associated with a greater risk of healthcare utilization for HF or death. (Source: Journal of Cardiovascular Nursing)
Source: Journal of Cardiovascular Nursing - August 14, 2015 Category: Nursing Tags: Articles Source Type: research

The Association Between Mild Cognitive Impairment and Self-care in Adults With Chronic Heart Failure: A Systematic Review and Narrative Synthesis
Conclusions: These findings have implications for clinical practice. It is known that HF patients have difficulty with self-care, and the influence of cognitive function needs to be considered when providing professional support. Further research to determine the feasibility and acceptability of cognitive assessment in routine clinical care is recommended. (Source: Journal of Cardiovascular Nursing)
Source: Journal of Cardiovascular Nursing - August 14, 2015 Category: Nursing Tags: Articles Source Type: research

Successful Mentoring Relationships: American Heart Association Council on Cardiovascular and Stroke Nursing
No abstract available (Source: Journal of Cardiovascular Nursing)
Source: Journal of Cardiovascular Nursing - August 14, 2015 Category: Nursing Tags: DEPARTMENTS: American Heart Association Council on Cardiovascular and Stroke Nursing Source Type: research

Proposed Dietary Guidelines 2015 and Implications for Cardiovascular Disease and Diabetes
No abstract available (Source: Journal of Cardiovascular Nursing)
Source: Journal of Cardiovascular Nursing - August 14, 2015 Category: Nursing Tags: DEPARTMENTS: Progress in Prevention Source Type: research

PCNA News
No abstract available (Source: Journal of Cardiovascular Nursing)
Source: Journal of Cardiovascular Nursing - August 14, 2015 Category: Nursing Tags: PCNA News Source Type: research

Outcomes of Biventricular Mechanical Support Patients Discharged to Home to Await Heart Transplantation
Conclusion: In this small single-center review, we found that complex medical patients with BiVADs can be discharged to home and can await a heart transplant from home under the close management of multidisciplinary acute care and outpatient teams. (Source: Journal of Cardiovascular Nursing)
Source: Journal of Cardiovascular Nursing - June 15, 2015 Category: Nursing Tags: Articles: Online Only Source Type: research

Communicating Risk With Relatives in a Familial Hypercholesterolemia Cascade Screening Program: A Summary of the Evidence
Conclusions: Most studies support direct contact of relatives via letter, mailed from the provider. Provider-initiated communication more often resulted in relatives being tested when compared with other methods of communication. Clinical Implications: On the basis of the literature, family members of current FH patients will be more likely to present to a provider for cascade screening if they receive written communication from the provider. (Source: Journal of Cardiovascular Nursing)
Source: Journal of Cardiovascular Nursing - June 15, 2015 Category: Nursing Tags: Articles: Online Only Source Type: research

Depressive Symptoms Impact Health-Promoting Lifestyle Behaviors and Quality of Life in Healthy Women
Background: Depressive symptoms are an independent risk factor of cardiovascular disease (CVD). More than 15% of persons with CVD have depressive symptoms, which are twice as likely to occur in women. Depressive symptoms in women being screened for CVD have not been well studied. Objective: The relationships between depressive symptoms, health-promoting lifestyle behaviors, heart disease risk awareness, cardiac risk, and quality of life (QOL) in women were investigated. Whether the effect of depressive symptoms on QOL was mediated by cardiac risk and/or health-promoting lifestyle behaviors was also examined. Methods: The W...
Source: Journal of Cardiovascular Nursing - June 15, 2015 Category: Nursing Tags: Articles Source Type: research

Depression and Anxiety as Predictors of Recurrent Cardiac Events 12 Months After Percutaneous Coronary Interventions
Conclusions: Patients with CAD who have a high level of anxiety and depression are at increased risk for recurrent cardiac events after PCI. Screening should be focused on patients who experience anxious and depressive feelings in addition to traditional risk factors. Furthermore, psychoeducational support interventions to reduce anxiety and depression after PCI may improve health outcomes. (Source: Journal of Cardiovascular Nursing)
Source: Journal of Cardiovascular Nursing - June 15, 2015 Category: Nursing Tags: Articles Source Type: research

Physical and Psychological Symptom Biomechanics in Moderate to Advanced Heart Failure
Conclusion: Cardiac biomechanics were related to physical symptoms and anxiety, providing preliminary evidence of the biological underpinnings of symptomatology among adults with HF. (Source: Journal of Cardiovascular Nursing)
Source: Journal of Cardiovascular Nursing - June 15, 2015 Category: Nursing Tags: Articles Source Type: research

Delirium, Subsyndromal Delirium, and Cognitive Changes in Individuals Undergoing Elective Coronary Artery Bypass Graft Surgery
Conclusion: Delirium and SSD after CABG are common. Greater number and severity of risk factors for delirium may predict increasingly poor outcomes, with the dose-response relationship between risk factors and outcomes for SSD intermediate between that for no symptoms and full delirium. Intervention trials are indicated, particularly for patients with a greater number and severity of predisposing and precipitating risk factors. (Source: Journal of Cardiovascular Nursing)
Source: Journal of Cardiovascular Nursing - June 15, 2015 Category: Nursing Tags: Articles Source Type: research

Experiences and Actions During the Decision Making Process Among Men With a First Acute Myocardial Infarction
Conclusion: Healthcare professionals should be aware that men experience a range of insidious and vague symptoms during their first AMI and must give greater emphasis to their narratives, particularly when objective clinical signs are limited or absent. Consideration should be given to the ways laypeople interpret online information when designing healthcare resources for the Internet. (Source: Journal of Cardiovascular Nursing)
Source: Journal of Cardiovascular Nursing - June 15, 2015 Category: Nursing Tags: Articles Source Type: research

Robotic Mitral Valve Repair
Conclusions: All 4 studies showed positive outcomes including decreased need for postoperative mechanical ventilation, intensive care unit length of stay, and hospital length of stay. The studies also showed that postrepair mitral regurgitation was equivalent to that of traditional open repairs at multiple different periods after surgery. Clinical Implications: Patients should be given the option for minimally invasive robotic mitral valve repair if they have no other risk factors such as peripheral vascular disease that prevent femoral cannulation for cardiopulmonary bypass or the need for concomitant cardiac surgery such...
Source: Journal of Cardiovascular Nursing - June 15, 2015 Category: Nursing Tags: Articles Source Type: research

Cognitive Behavioral Therapy in Depressed Cardiac Surgery Patients: Role of Ejection Fraction
Aims: The aim of this study was to evaluate the relationship of ejection fraction (EF) and depressive symptoms in cardiac surgery patients assigned to nurse-guided cognitive behavioral therapy (CBT) or usual care (UC). Methods: Depressive symptoms were assessed using the Beck Depression Inventory (BDI). Seventy-seven patients (31% women; mean [SD] age, 63.6 [9.8] years) received 8 weeks of either CBT or UC. Using repeated-measures analysis of variance, changes in depressive symptoms over time were evaluated. Results: There was a significant interaction among time, treatment group, and EF status (p = 0.019). In the patients...
Source: Journal of Cardiovascular Nursing - June 15, 2015 Category: Nursing Tags: Articles Source Type: research

Improving Adherence in African American Women With Uncontrolled Hypertension
Conclusion: The culturally tailored program used the African American church as a basis for recruitment and implementation of the program that retained all participants over a 6-month period. African American women living in rural Texas who participated in a 6-week intervention program demonstrated a significant decrease in blood pressure over a 6-month period regardless of whether they were in the intervention or control group. In general, they had a relatively good knowledge of HTN and reported an average level of adherence. Future studies using a culturally tailored program with a larger sample size are warranted to dec...
Source: Journal of Cardiovascular Nursing - June 15, 2015 Category: Nursing Tags: Articles Source Type: research

Cardiovascular Risk Factors in Young Adults: A Literature Review
This extensive literature review focuses on cardiovascular risk factors in young adults, with an emphasis on hyperlipidemia and hypertension. Multiple studies have confirmed that hyperlipidemia and hypertension during young adulthood are associated with coronary heart disease (CHD) in later decades, and CHD is one type of cardiovascular disease. The primary risk factors identified in the literature that are predictive of CHD are age; gender; race/ethnicity; smoking status; high blood pressure; and elevated lipid levels, especially low-density lipoprotein cholesterol. The current guidelines are insufficient to address scree...
Source: Journal of Cardiovascular Nursing - June 15, 2015 Category: Nursing Tags: Articles Source Type: research

A Systematic Approach Incorporating Family History Improves Identification of Cardiovascular Disease Risk
We examined a systematic approach incorporating FH in CVD risk assessment, validating risk reclassification using carotid intima-media thickness (CIMT), a surrogate measure of atherosclerosis. Methods: Of 413 consecutive patients prospectively enrolled in the Integrative Cardiac Health Project Registry, a subgroup of 239 was low or intermediate risk by the Framingham Risk Score. A systematic approach for the assessment of FH was applied to this subgroup of the registry. A positive FH for premature CVD, defined as a first-degree relative having a CVD event before the age of 55 years in men and 65 years in women, conferred r...
Source: Journal of Cardiovascular Nursing - June 15, 2015 Category: Nursing Tags: Articles Source Type: research

Eight-Year Outcomes of a Program for Early Prevention of Cardiovascular Events: A Growth-Curve Analysis
Background: Early identification of cardiovascular diseases allows us to prevent the progression of these diseases. The Bale/Doneen Method, a prevention and treatment program for heart attacks and ischemic strokes, has been adopted nationally in primary care and specialty clinics. Objectives: The main purpose of this study was to evaluate the effect of the Bale/Doneen Method on lipoproteins and carotid intima-media thickness (IMT) for cardiovascular disease prevention and reduction. A secondary purpose was to illustrate the use of latent growth-curve analysis in studying trajectories of clinical outcomes and biomarkers in ...
Source: Journal of Cardiovascular Nursing - June 15, 2015 Category: Nursing Tags: Articles Source Type: research

Risk Stratification: An Important Stroke Risk Reduction Strategy in Elderly Patients With Nonvalvular Atrial Fibrillation
No abstract available (Source: Journal of Cardiovascular Nursing)
Source: Journal of Cardiovascular Nursing - June 15, 2015 Category: Nursing Tags: DEPARTMENTS: Progress in Prevention Source Type: research

PCNA News
No abstract available (Source: Journal of Cardiovascular Nursing)
Source: Journal of Cardiovascular Nursing - June 15, 2015 Category: Nursing Tags: PCNA News Source Type: research

Insufficient Living: Experiences of Recovery After Infective Endocarditis
Conclusions: Recovery after IE is perceived as “Insufficient Living.” Patients experience an altered life and shocking weakness, and on the road to recovery, support is needed. Research in follow-up care, supporting patients’ ability to cope with potential physical and psycho-emotional consequences of IE, is encouraged as a result of these findings. (Source: Journal of Cardiovascular Nursing)
Source: Journal of Cardiovascular Nursing - April 22, 2015 Category: Nursing Tags: Articles: Online Only Source Type: research

A Simple Education Tool for Ventricular Assist Device Patients and Their Caregivers
Conclusions: Driveline care is not comprehensively discussed in the literature and lacks detail in the particulars of wound care, patient education, and the adaptation of driveline care to the patient’s home environment. An educational booklet was designed to convey what is currently known about preventing driveline infections to those who are responsible for providing the required daily care. Evaluation of patient education material by those using the material is essential. As with all written material, the information will require updating as new evidence becomes available. Clinical Implications: Managing driveline...
Source: Journal of Cardiovascular Nursing - April 22, 2015 Category: Nursing Tags: Articles: Online Only Source Type: research

10-Year Risk for Cardiovascular Disease Among Male Workers in Small-Sized Industries
Conclusion: To reduce CVD risk, education regarding lifestyle modification should be emphasized for small-sized industrial workers who are overweight, physically inactive, and heavy alcohol drinkers and who work as bus or taxi drivers. Careful attention is also needed for younger workers who are a latent risk group for the development of CVD. (Source: Journal of Cardiovascular Nursing)
Source: Journal of Cardiovascular Nursing - April 22, 2015 Category: Nursing Tags: Articles Source Type: research

Gender- and Age-Specific Prevalence of Metabolic Syndrome Among Korean Adults: Analysis of the Fifth Korean National Health and Nutrition Examination Survey
Background: Despite the growing prevalence of metabolic syndrome (MetS) in Korea, information is lacking on gender- and age-specific patterns in prevalence of MetS among Korean adults. Aims: The aims of this study were to examine (1) gender-specific prevalence of MetS by its component abnormalities, (2) the prevalence of MetS and its component abnormalities by gender and 10-year age groups, and (3) gender-specific lifestyle risk factors for MetS presentation among Korean adults. Methods: A secondary data analysis was performed using the most recent national survey. A sample group of 5760 adults (mean age, 44.6 ± 0.4...
Source: Journal of Cardiovascular Nursing - April 22, 2015 Category: Nursing Tags: Articles Source Type: research

Cardiac Acute Care Nurse Practitioner and 30-Day Readmission
Conclusions: The addition of a cardiac acute care NP to medical teams caring for myocardial infarction and heart failure patients had a positive impact on 30-day emergency department return and hospital readmission rates. (Source: Journal of Cardiovascular Nursing)
Source: Journal of Cardiovascular Nursing - April 22, 2015 Category: Nursing Tags: Articles Source Type: research

Transcatheter Aortic Valve Replacement Options for Severe Aortic Stenosis in High-Risk Patients
This article examines transcatheter aortic valve replacement as an evolving technology and medical procedure with the high-risk and inoperable patients in mind. Since then, the geriatric patient population is ever increasing and the numbers of severe aortic stenosis cases are expected to increase accordingly. It is vital for healthcare professionals to be well informed to give competent care. Summary: International research over the last decade has shown promising results in improved quality of life with regard to pain, functional status, and overall health. This research has expanded to the United States within the last f...
Source: Journal of Cardiovascular Nursing - April 22, 2015 Category: Nursing Tags: Articles Source Type: research

Psychometric Evaluation of the Stroke Impact Scale 3.0
Conclusion: The new factorial structure of the SIS 3.0 with 4 factors showed better psychometric properties than the original 8-factor structure did. This evidence supports further use of the SIS 3.0 in clinical practice and research. (Source: Journal of Cardiovascular Nursing)
Source: Journal of Cardiovascular Nursing - April 22, 2015 Category: Nursing Tags: Articles Source Type: research

Construct Validity of the Chinese Version of the Self-care of Heart Failure Index Determined Using Structural Equation Modeling
Conclusion: The Chinese version of the SCHFI is a theory-based instrument for assessing self-care of Chinese patients with heart failure. (Source: Journal of Cardiovascular Nursing)
Source: Journal of Cardiovascular Nursing - April 22, 2015 Category: Nursing Tags: Articles Source Type: research

Determining Target Heart Rate for Exercising in a Cardiac Rehabilitation Program: A Retrospective Study: Erratum
No abstract available (Source: Journal of Cardiovascular Nursing)
Source: Journal of Cardiovascular Nursing - April 22, 2015 Category: Nursing Tags: DEPARTMENTS: Erratum Source Type: research

Development and Testing of the Feasibility and Acceptability of a Tailored Dietary Intervention in Patients With Heart Failure
Conclusion: The TADI is ready for testing in larger sample studies to manage sodium intake. (Source: Journal of Cardiovascular Nursing)
Source: Journal of Cardiovascular Nursing - April 22, 2015 Category: Nursing Tags: Articles Source Type: research

Lycopene Dietary Intervention: A Pilot Study in Patients With Heart Failure
Conclusions: These findings suggest that the antioxidants in a 30-day intervention of V8 juice affect CRP levels in a sample of female patients with HF. (Source: Journal of Cardiovascular Nursing)
Source: Journal of Cardiovascular Nursing - April 22, 2015 Category: Nursing Tags: Articles Source Type: research

Emotions and Health: Findings From a Randomized Clinical Trial on Psychoeducational Nursing to Patients With Implantable Cardioverter Defibrillator
Conclusions: Primary emotions are affected after implantable cardioverter defibrillator implantation. Improvements over time were found. However, it was not possible to detect any effect of a short-term psychoeducational nursing intervention. Evaluating the primary emotions might be a good way for nurses to monitor patients’ psychological outcomes because the instrument is sensitive to changes over a short period. Further development of early psychoeducational nursing interventions for patients with implantable cardioverter defibrillators is needed. (Source: Journal of Cardiovascular Nursing)
Source: Journal of Cardiovascular Nursing - April 22, 2015 Category: Nursing Tags: Articles Source Type: research

A Comparison of 2 Devices for Radial Artery Hemostasis After Transradial Coronary Intervention
This study included 600 patients who had undergone transradial coronary intervention who were randomized into 2 groups after the procedure: 300 were treated with a radial compression device (TR Band, Terumo Medical, Tokyo, Japan) (CD group) and the other 300 patients were treated using a chitosan-based pad (Anscare, Daxon, Taoyuan, Taiwan) (CS group). Compression time, major and minor access site bleeding complications, and incidence of radial artery occlusion were recorded. Results: There were no statistical differences in the baseline clinical characteristics of the patients between the 2 groups. Compression time in the ...
Source: Journal of Cardiovascular Nursing - April 22, 2015 Category: Nursing Tags: Articles Source Type: research

20 Things You Didn’t Know About Nutrition and Cardiovascular Disease
No abstract available (Source: Journal of Cardiovascular Nursing)
Source: Journal of Cardiovascular Nursing - April 22, 2015 Category: Nursing Tags: DEPARTMENTS: 20 Things You Didn't Know Source Type: research

“Mediterranean” Dietary Pattern for the Primary Prevention of Cardiovascular Disease: Summaries of Nursing Care-Related Systematic Reviews From the Cochrane Library
No abstract available (Source: Journal of Cardiovascular Nursing)
Source: Journal of Cardiovascular Nursing - April 22, 2015 Category: Nursing Tags: DEPARTMENTS: Cochrane Nursing Care Corner Source Type: research

A Report from The American Heart Association Council on Cardiovascular and Stroke Nursing
No abstract available (Source: Journal of Cardiovascular Nursing)
Source: Journal of Cardiovascular Nursing - April 22, 2015 Category: Nursing Tags: DEPARTMENTS: American Heart Association Council on Cardiovascular and Stroke Nursing Source Type: research

Effectiveness of Popular Weight Loss Diets on Cardiovascular Risk Reduction
No abstract available (Source: Journal of Cardiovascular Nursing)
Source: Journal of Cardiovascular Nursing - April 22, 2015 Category: Nursing Tags: DEPARTMENTS: Progress in Prevention Source Type: research

PCNA News
No abstract available (Source: Journal of Cardiovascular Nursing)
Source: Journal of Cardiovascular Nursing - April 22, 2015 Category: Nursing Tags: PCNA News Source Type: research

The Association Between Central Fat Distribution and Recurrent Cardiovascular Disease Events in Female Survivors of Nonfatal Myocardial Infarction
Conclusions: These results suggest that central fat distribution is positively associated with a recurrence of cardiovascular events after incident MI in women. The absence of decreased risk with secondary prevention interventions suggests that more investigation into the association of central abdominal fat and secondary prevention management is warranted. (Source: Journal of Cardiovascular Nursing)
Source: Journal of Cardiovascular Nursing - February 14, 2015 Category: Nursing Tags: Articles: Online Only Source Type: research

Impact of a Nurse-Led Heart Failure Program on All-Cause Mortality
Conclusions: Our nurse-led HFP was independently associated with improved survival among patients with decompensated heart failure. Further research is required to confirm this finding. (Source: Journal of Cardiovascular Nursing)
Source: Journal of Cardiovascular Nursing - February 14, 2015 Category: Nursing Tags: Articles: Online Only Source Type: research

Family History of Stroke Among African Americans and Its Association With Risk Factors, Knowledge, Perceptions, and Exercise
Conclusions: Family history of stroke was common in this sample; however, it did not translate into better understanding of stroke or better exercise behaviors and intentions. More can be done to identify African Americans with a FHS, especially those with multiple risk factors, to educate them about the significance of FHS while promoting lifestyle change and self-management. (Source: Journal of Cardiovascular Nursing)
Source: Journal of Cardiovascular Nursing - February 14, 2015 Category: Nursing Tags: Articles: Online Only Source Type: research

Intention to Abstain From Smoking Among Cardiac Rehabilitation Patients: The Role of Attitude, Self-efficacy, and Craving
Conclusions: The intention to (permanently) abstain from smoking, measured 2 to 4 weeks after hospitalization for a cardiac event, predominantly depends on attitude, self-efficacy, and craving. Interventions aimed at smoking cessation among cardiac rehabilitation patients should focus on these factors. (Source: Journal of Cardiovascular Nursing)
Source: Journal of Cardiovascular Nursing - February 14, 2015 Category: Nursing Tags: Articles Source Type: research

Determining Target Heart Rate for Exercising in a Cardiac Rehabilitation Program: A Retrospective Study
Conclusion: In the observed population, a THR of 30% to 50% above RHR underestimated the THR range of 70% to 85% HRmax GXT but provided adequate exercise intensity for patients at the beginning of a CR program based on percentage HRmax GXT, RPE and MET levels. (Source: Journal of Cardiovascular Nursing)
Source: Journal of Cardiovascular Nursing - February 14, 2015 Category: Nursing Tags: Articles Source Type: research

Commentary on “Predictors of Heart Failure Self-care in Patients Who Screened Positive for Mild Cognitive Impairment”
No abstract available (Source: Journal of Cardiovascular Nursing)
Source: Journal of Cardiovascular Nursing - February 14, 2015 Category: Nursing Tags: Articles Source Type: research

Predictors of Heart Failure Self-care in Patients Who Screened Positive for Mild Cognitive Impairment
Background: Heart failure (HF) is associated with cognitive impairment, which could negatively affect a patient’s abilities to carry out self-care, potentially resulting in higher hospital readmission rates. Factors associated with self-care in patients experiencing mild cognitive impairment (MCI) are not known. Objective: This descriptive correlation study aimed to assess levels of HF self-care and knowledge and to determine the predictors of self-care in HF patients who screen positive for MCI. Methods: The Montreal Cognitive Assessment was used to screen for MCI. In 125 patients with MCI hospitalized with HF, self...
Source: Journal of Cardiovascular Nursing - February 14, 2015 Category: Nursing Tags: Articles Source Type: research

The Association Between Regular Symptom Monitoring and Self-care Management in Patients With Heart Failure
Conclusion: Adequacy of self-care management was predicted by adherence to symptom monitoring behaviors. This finding suggests that regular symptom monitoring facilitates performance of adequate self-care management, which may contribute to a decrease in preventable hospitalizations in HF. (Source: Journal of Cardiovascular Nursing)
Source: Journal of Cardiovascular Nursing - February 14, 2015 Category: Nursing Tags: Articles Source Type: research

Psychometric Properties of the Symptom Status Questionnaire–Heart Failure
Conclusions: The findings of this study support the reliability and validity of the SSQ-HF. Clinicians and researchers can use this instrument to assess physical symptoms in patients with HF. (Source: Journal of Cardiovascular Nursing)
Source: Journal of Cardiovascular Nursing - February 14, 2015 Category: Nursing Tags: Articles Source Type: research

A Systematic Review of Patient Heart Failure Self-care Strategies
Conclusions: Healthcare providers must appreciate that patients view self-care as an “adaptation” that they undertake to maintain their independence and quality of life. In addition, HCPs must recognize that because self-care is a process of learning over time from experience, an individualized approach that emphasizes how to self-care must be adopted for patients to develop the necessary HF self-care skills. (Source: Journal of Cardiovascular Nursing)
Source: Journal of Cardiovascular Nursing - February 14, 2015 Category: Nursing Tags: Articles Source Type: research