Nursing Research to Improve Health and Health Care

Studies conducted by RWJF Nurse Faculty Scholars are providing important insights into ways to improve the nation’s health care system and patients’ health.

    • January 10, 2013

The Robert Wood Johnson Foundation’s (RWJF) Nurse Faculty Scholars program provides promising junior nursing faculty with research grants and the time to conduct groundbreaking research into pressing health care issues. Now in its fifth year, the program strengthens the academic productivity and overall excellence of nursing schools by developing the next generation of leaders in academic nursing. It is providing $28 million to five cohorts of outstanding junior nursing faculty to promote their academic careers, support their research, and reduce the severe nurse faculty shortage that is facing the nation.

Each Nurse Faculty Scholar receives a three-year $350,000 grant, which they use to conduct studies into health care practices and health behaviors to identify ways to improve health and health care. Several scholars recently published articles in peer-reviewed journals that address a variety of key contemporary health care issues.

Understanding Barriers to HPV Vaccination among Rural African Americans

Since the HPV vaccine was approved by the Food and Drug Administration six years ago, health care professionals have been encouraging parents to have their children immunized to avoid both the virus and the cancers it can cause. Numerous studies have investigated resistance to vaccinating children, but most of that research has focused on urban populations. A new study led by RWJF Nurse Faculty Scholar Tami Thomas, PhD, CPNP, RNC, assistant professor at the Emory University Nell Hodgson Woodruff School of Nursing, found that in African American rural communities, religious affiliation and education levels influenced parents’ decisions about whether to vaccinate their children.

Published in the Journal of Nursing Scholarship, Thomas’ study found that African American parents who self-identified as Baptist and/or had lower education levels were less likely to vaccinate their children than African American parents who self-identified with a non-Baptist religion and/or had more education. Rural African American parents who self-identified as non-Baptists were 3.6 times more likely to vaccinate their children than other parents in the study, which was conducted in three counties in rural Georgia. Researchers reported that religious affiliation and education levels influenced parents’ beliefs about their children’s vulnerability to HPV. For instance, it was a barrier to vaccinating a child if parents believed that a person can overcome or avoid sickness through faith in God, or that remaining chaste was the norm for young, unmarried people.

Thomas and her research team wrote: “The need to address cancer prevention education in rural areas is clear, but the complexities involved in educating parents must be addressed in the context of the local rural culture with community engagement. Findings imply several points of intervention: culture, religious affiliation, and parent education.”  The team recommended: educating parents on the benefits of HPV vaccination; identifying ways to intervene that respect the culture of rural communities (including religious and spiritual influences on personal health practices); having a policy to maintain vaccination programs in rural counties; and increasing pediatric health services in rural areas. The final recommendations include the development of school-based clinics and the use of telemedicine.

Read the study.

Improving Cognitive Function and Quality of Life for Breast Cancer Survivors

Many breast cancer survivors report problems with memory or feelings of mental slowness, which can have a negative impact on their quality of life. Researchers have found that training to improve memory and speed of processing are effective in older adults, but research on cancer patients has been limited.

Nurse Faculty Scholar Diane Von Ah, PhD, RN, an assistant professor at the Indiana University School of Nursing, led a team of researchers that investigated whether cognitive training, specifically memory and processing speed, could improve these functions in cancer survivors as well as improve overall cognitive function, symptom distress (such as depression, anxiety, and fatigue), and quality of life.

The study, published in Breast Cancer Research and Treatment, included 88 breast cancer survivors who were separated into three groups: one using a memory training intervention; one using a processing speed intervention; and a control group. All the participants were middle aged, had had early stage breast cancer, had received surgery and chemotherapy, and were long term survivors.

The team found that cognitive performance improved for both intervention groups for the functions the trainings addressed, and improvements were sustained for two months after the training was complete. Study participants in the speed intervention group also showed improvement in memory. Importantly, participants in both intervention groups also showed significant improvement in their perceived cognitive function, symptom distress, and quality of life compared with the control group.

The researchers intend to conduct another study to test the interventions on a larger, more diverse sample of breast cancer survivors.

Read the study.

Other studies published recently by RWJF Nurse Faculty Scholars include:

A study led by Ying Xue, DNSc, RN, associate professor at the University of Rochester School of Nursing, which found that registered nurses who work on short-term contracts through external staffing agencies (supplemental nurses) have similar education levels and only slightly less experience than permanent RNS. They are also younger, more diverse, and more flexible about relocating. The findings suggest that supplemental nurses may be key to helping hospitals meet the challenges posed by the projected nursing shortage. The study was published in Health Affairs. Read Xue’s study.

A study led by Matthew McHugh, PhD , JD, MPH, , RN, FAAN, assistant professor at the University of Pennsylvania School of Nursing, which found that increased nurse-to-patient staffing ratios and a good work environment for nurses were associated with reduced 30-day readmission rates for Medicare patients with heart failure, myocardial infarction, and pneumonia. The study may prove helpful to hospitals and health care systems seeking ways to reduce readmissions for Medicare patients and avoid financial penalties for excess readmissions under new provisions of the Affordable Care Act. The study was published in Medical Care. Read McHugh’s study.

A study led by Jennifer Doering, PhD, RN, associate professor at the University of Wisconsin-Milwaukee College of Nursing, which identified the factors that contribute to sleep deprivation among low-income new mothers. The researchers noted that many of the most common factors—bed-sharing, sleeping with the television on, drinking caffeine, and smoking—can be controlled. The study provides important insights into addressing sleep deprivation for health care providers who work with low-income postpartum women. It was published in the Journal of Obstetric, Gynecologic and Neonatal Nursing. Read Doering's study.

“The RWJF Nurse Faculty Scholars program is producing not only academic leaders, but also helping to advance the science of health care,” said National Program Director Jacquelyn Campbell, PhD, RN, FAAN. “The research our scholars are conducting will help shape the future of health care and improve patient care and quality of life, whether they are working to reduce the spread of HPV, improve cognitive function in breast cancer survivors, address the nursing shortage, improve outcomes for Medicare patients, or help new mothers get adequate sleep.”