Background: First-generation college students (FGCS) often experience more stress compared to continuing-generation students (Holden et al., 2021). This stress can stem from familial and cultural obligations, financial challenges, and the experience of being part of a racial or ethnic minority group. Storytelling is a psychosocial process involving sharing personal experiences or fictional stories, usually reflecting the behavior patterns and orientation to events present in the culture of the teller. Limited research has explored storytelling interventions to address self-compassion and stress levels in first-generation college students Aims: This pilot study aimed to assess the feasibility and preliminary effects of a storytelling intervention for first-generation college students on perceived stress, resilience, and self-compassion, as determined by pre- and post-intervention. In addition, the incorporation of heart rate variability (HRV) measurements during storytelling quantified the physiological stress levels associated with the intervention and its potential correlation with stress reduction. Of additional interest was to obtain a qualitative characterization of the experiences, stresses, and supportive factors described in the stories told by participants. Methods: FGCS were recruited at Arizona State University. Participants (N=22, M age=21.18 years, SD=3.172) attended a storytelling session for one hour in person. Heart-rate variability assessment was used to measure participant emotions and psychological coherence during in-person storytelling. The outcome measures included the Brief Resilience Scale (BRS), Perceived Stress Scale-10 (PSS-10), Patient Health Questionnaire-4 (PHQ-4), Self-Compassion Scale Short Form (SCS-SF), and HRV coherence was assessed during the intervention. Quantitative analyses were conducted in SPSS Version 27. Using the content of the stories shared in the intervention, qualitative content analyses were conducted with 3 research project members. Results: A total of 36 participants agreed to be contacted and were emailed. Of these 36, 10 declined to participate and 4 were ineligible due to unwillingness to commit to 2 hours over 2 weeks to complete the study, (including an in-person visit to the lab) yielding 22 consented participants (61% recruitment of those screened). All consented individuals completed data collection, attended a storytelling intervention session, and completed the post-intervention data collection (100% retention). 5 major themes emerged from the data: (1) Barriers within Journey; (2) Immigrant and Immigrant Family Experiences; (3) Facilitators within Journey; (4) Reasoning for Attending University. The direction of change for HRV coherence with self-compassion and depression-anxiety was as expected. T-tests were generated for pre- and post- intervention self-reports: T1-T3 BRS SD= 0.79247, t= -0.673; T1-T3 PSS SD= 5.39540, t= -0.514; T1-T3 PHQ for anxiety SD= 1.91429, t= 0.111; T1-T3 PHQ for depression SD= 1.62302, t= 1.708; T1-T3 SCS SD= 0.46319, t= -1.956. Conclusions: Participants described telling and sharing their stories as therapeutic and regenerative. Statistical tests of emotional regulation with HRVB demonstrated minimal change in stress response, with an increase in self-compassion. A storytelling intervention demonstrates a promising coping tool as an avenue for retelling distressing events and increasing self-compassion and resilience.

Background: First-generation college students (FGCS) often experience more stress compared to continuing-generation students (Holden et al., 2021). This stress can stem from familial and cultural obligations, financial challenges, and the experience of being part of a racial or ethnic minority group. Storytelling is a psychosocial process involving sharing personal experiences or fictional stories, usually reflecting the behavior patterns and orientation to events present in the culture of the teller. Limited research has explored storytelling interventions to address self-compassion and stress levels in first-generation college students Aims: This pilot study aimed to assess the feasibility and preliminary effects of a storytelling intervention for first-generation college students on perceived stress, resilience, and self-compassion, as determined by pre- and post-intervention. In addition, the incorporation of heart rate variability (HRV) measurements during storytelling quantified the physiological stress levels associated with the intervention and its potential correlation with stress reduction. Of additional interest was to obtain a qualitative characterization of the experiences, stresses, and supportive factors described in the stories told by participants. Methods: FGCS were recruited at Arizona State University. Participants (N=22, M age=21.18 years, SD=3.172) attended a storytelling session for one hour in person. Heart-rate variability assessment was used to measure participant emotions and psychological coherence during in-person storytelling. The outcome measures included the Brief Resilience Scale (BRS), Perceived Stress Scale-10 (PSS-10), Patient Health Questionnaire-4 (PHQ-4), Self-Compassion Scale Short Form (SCS-SF), and HRV coherence was assessed during the intervention. Quantitative analyses were conducted in SPSS Version 27. Using the content of the stories shared in the intervention, qualitative content analyses were conducted with 3 research project members. Results: A total of 36 participants agreed to be contacted and were emailed. Of these 36, 10 declined to participate and 4 were ineligible due to unwillingness to commit to 2 hours over 2 weeks to complete the study, (including an in-person visit to the lab) yielding 22 consented participants (61% recruitment of those screened). All consented individuals completed data collection, attended a storytelling intervention session, and completed the post-intervention data collection (100% retention). 5 major themes emerged from the data: (1) Barriers within Journey; (2) Immigrant and Immigrant Family Experiences; (3) Facilitators within Journey; (4) Reasoning for Attending University. The direction of change for HRV coherence with self-compassion and depression-anxiety was as expected. T-tests were generated for pre- and post- intervention self-reports: T1-T3 BRS SD= 0.79247, t= -0.673; T1-T3 PSS SD= 5.39540, t= -0.514; T1-T3 PHQ for anxiety SD= 1.91429, t= 0.111; T1-T3 PHQ for depression SD= 1.62302, t= 1.708; T1-T3 SCS SD= 0.46319, t= -1.956. Conclusions: Participants described telling and sharing their stories as therapeutic and regenerative. Statistical tests of emotional regulation with HRVB demonstrated minimal change in stress response, with an increase in self-compassion. A storytelling intervention demonstrates a promising coping tool as an avenue for retelling distressing events and increasing self-compassion and resilience.

Hematopoietic cell transplantation (HCT) is a treatment for hematologic malignancies. The procedure poses multiple medical risks ranging from infection to graft-versus-host disease. Patients must designate a full-time informal caregiver, typically a family member. Caregivers assume multiple medical and logistical responsibilities. Distress and burden are common. Psychosocial interventions, including narrative-based interventions, may offer support for caregivers. This thesis makes use of data collected as part of a digital storytelling intervention for HCT caregivers. Participants were 6 caregivers of HCT survivors who participated in a 3-day digital storytelling workshop, culminating in the creation of a personal story about their experience as a caregiver in the form of a video with narration in their own voice. Linguistic Inquiry and Word Count (LIWC, 2015) was used to characterize content of the stories. Compared to norms (base rates of word usage provided by the LIWC developers), caregivers used more first-person plural pronouns. Such use of we-talk may indicate caregiver-patient dyadic strength given other research linking we-talk to communal coping. Counter to prediction, caregivers did not differ from norms with respect to use of negative affect words or cognitive process words. They did, however, use more biological process words (to be expected given their focus on health) and more words indicative of affiliation (understandable in light of their interpersonal connection to the patient and supportive care role). Further research is needed to examine potential change in linguistic content across the HCT trajectory (from pre-transplant through long-term survivorship), also to compare caregiver and patient stories.

Hematopoietic stem cell transplantation (HSCT) is a unique but intense procedure used to save the lives of patients with hematopoietic malignancies. However, patients and caregivers undergoing HSCT can experience prolonged psychological distress due to an intense and distinctive transplant process. Types of psychological distress include anxiety, depression, social isolation, and post-traumatic stress disorder. Although this a significant healthcare problem, limited research has been conducted within the HSCT patient and caregiver population to investigate ways to improve their mental health. The purpose of this study was to examine the effects of an educational video intervention about post-transplant recovery in decreasing emotional distress and promoting emotional well-being in HSCT patients and caregivers. This pilot study utilized a quantitative single-group pretest-posttest design to examine the effect of educational videos on participant's emotional well-being. Four educational videos were developed using information gathered from several reliable bone marrow transplant and cancer websites. A convenience sampling method was used to recruit HSCT patient and caregiver participants. Eleven Caucasian, English-speaking individuals (6 patients, 5 caregivers; 54.5% female; M age= 43.7 years) across the United States were enrolled in the 60-90 minute online intervention. Participant responses were measured using pretest and posttest questionnaires. Results from the study found that the educational videos were effective in decreasing levels of depression and anxiety. Implications for nursing practice include the need to educate HSCT patients and caregivers about transplant recovery to decrease emotional distress. This study demonstrates the impact post-transplant education has on decreasing depression and anxiety in HSCT patients and caregivers.

Complementary and alternative medicine (CAM), also known as integrative medicine, is an important intervention used for holistic care of patients. It is patient-centered care, addressing multiple aspects of one's health ranging from physical and psychosocial to spiritual influences. CAM has been successful in patients' symptom and stress management, and has grown substantially in recent decades, especially in oncology nursing. Despite widespread use and their support for CAM therapies, nurses' lack of CAM knowledge and vocabulary are barriers to communication with patients. Also, little is known about the student nurses' awareness of CAM and the college instructors' opinions on the intervention, which are crucial in developing the college nursing education on integrative medicine. The purpose of this study was to describe the college nursing students' knowledge and their instructors' perspectives on integrative medicine and oncology care, and compared the data of the two populations. Convenience and snowball sampling were used to recruit participants from the community in College of Nursing and Health Innovation (CONHI) at Arizona State University (ASU). Five students (M age = 20.6 years; 80% female) and five nursing instructors (M age = 56.8 years; 100% female) were invited to 60-90 minute in-depth interviews on perceptions and knowledge of CAM. Four major themes emerged from the interviews: (1) Insufficient awareness and knowledge of CAM; (2) education and information needs on CAM; (3) positive attitudes toward CAM; and (4) importance of nurses' roles in CAM. Implications for nursing included need for more structured and efficient CAM in nursing programs; early exposure and education of college nursing students on CAM; and academic relationships between nursing instructors and students.

Hematopoietic stem cell transplantation (HCT), a common treatment for various hematopoietic cancers, involves lengthy hospital stays as well as intensive chemotherapy prior to the transplant. Many patients exhibit clinically significant symptoms of depression, anxiety, or post-traumatic stress disorder (PTSD) after transplant, due to the demanding nature of the treatment process and the associated risks. However, little research has been done concerning how nurses' actions impact the emotional well-being of these patients; most studies lack evidence related to the nursing staff's precise role in this distressing situation. The purpose of this study was to explore, using a qualitative approach, participants' personal experiences with their nurses throughout all phases of treatment, focusing on interventions and actions nurses took to ease the participants' reported anxiety, depression, or PTSD symptoms. A convenience sampling method was used to recruit participants. Nine English-speaking individuals (M age = 55 years; 78% female; 67% allogeneic) from around the US were invited to participate in semi-structured in-depth interviews. Seven major themes emerged from the interviews: (1) support from nurse, (2) physical symptoms, (3) emotional/cognitive distress, (4) open/honest communication, (5) coping, (6) continuity of nurses, and (7) anticipatory guidance. Results indicated the need for heavy psychosocial support, informational support, and active listening from nurses. Implications for nursing practice included an increased need for education on the best timing for implementation of nurse-led interventions, as well as further investigation into strategies for nurses to provide optimal psychosocial care for HCT patients.

Colorectal cancer (CRC) is the third most prevalent form of cancer in both genders and second highest cause of cancer-related death in the United States. Despite the availability of preventative CRC screening, Latinos as a group are of particular concern for CRC as they tend to have a lower screening rate, contributing to the possibility of late-stage diagnosis or even death. However, little is known about the perceptions of CRC screening and factors which contribute to beliefs about CRC in Latinos. Most studies are quantitative and rarely include a qualitative approach focusing on cultural aspects and communication with physicians. The purpose of this study was to explore participants' perceived facilitators and barriers to CRC screening, as well as perspectives on physician recommendation and fatalism, using a qualitative approach. A convenience and snowball sampling were used to collect the data. Eight English-speaking Latino individuals (M age=56 years; 75% female) in the Phoenix, Arizona area were invited to 60-90 minute in-depth interviews on perceptions of the colorectal cancer screening process. Ten major themes emerged from the interviews: (1) lacking awareness and knowledge of CRC screening, (2) attitude toward CRC and screening, (3) availability of preventive care, (4) physician trust, (5) fear, (6) desire for increased information, (7) personal learning, (8) lifestyle factors, (9) cultural impact, and (10) willingness to change lifestyle. Results indicated varying levels of perceived knowledge of colorectal cancer, little perceived risk of diagnosis, desire for more information, and a high level of physician trust. Implications for nursing included increased need for CRC screening educational resources, as well as further investigation of the influence of fatalistic belief in CRC screening compliance for the Latino population.

Introduction: This study used social network theory to explore the role of social support and social networks in health information–seeking behavior among Korean American (KA) adults.

Methods: A descriptive qualitative study using a web-based online survey was conducted from January 2013 to April 2013 in the U.S. The survey included open-ended questions about health information–seeking experiences in personal social networks and their importance in KA adults. Themes emerging from a constant comparative analysis of the narrative comments by 129 of the 202 respondents were analyzed.

Results: The sample consisted of 129 KA adults, 64.7% female, with a mean age of 33.2 (SD = 7.7). Friends, church members, and family members were the important network connections for KAs to obtain health information. KAs looked for a broad range of health information from social network members, from recommendations and reviews of hospitals/doctors to specific diseases or health conditions. These social networks were regarded as important for KAs because there were no language barriers, social network members had experiences similar to those of other KAs, they felt a sense of belonging with those in their networks, the network connections promoted increased understanding of different health care systems of the U.S. system, and communication with these network connections helped enhance feelings of being physically and mentally healthy.

Conclusions: This study demonstrates the important role that social support and personal social networks perform in the dissemination of health information for a large ethnic population, KAs, who confront distinct cultural challenges when seeking health information in the U.S. Data from this study also illustrate the cultural factors that influence health information acquisition and access to social support for ethnic minorities. This study provides practical insights for professionals in health information services, namely, that social networks can be employed as a channel for disseminating health information to immigrants.

This study tested the preliminary effectiveness of a health belief and text messaging intervention for parents of five- to eight-year-old children to determine whether health beliefs and influenza vaccine receipt differ when compared to a text messaging control group. Children are almost four times more likely to be infected with influenza than adults (Belshe Piedra, & Block, 2009), shed the greatest quantities of influenza virus, and have been recognized as vectors for spread of disease (Neuzil, Mellen, Wright, Mitchel, Jr., & Griffin, 2002b). The influenza immunization rate for school-age children is less than 56% (Centers for Disease Control and Prevention [CDC], 2014). Reasons for the low vaccination rate include parents’ misperceptions of influenza disease and vaccinations (Bhat-Schelbert et al., 2012; Taylor et al., 2002). There are few theory-based interventions for increasing influenza vaccination rates of school-age children; however, promising results have been found when using the constructs of the health belief model (HBM) (Chen et al., 2011; Coe, Gatewood, Moczygemba, Goode, & Beckner, 2012). Mobile technology using Short Message Service (SMS) text messaging may increase vaccination rates to a greater extent than traditional vaccine reminders (Daley et al., 2002; Grajalva, 2006). Prior to starting this study, only one randomized controlled trial testing text messaging to increase children’s influenza vaccination rates was found (Stockwell et al., 2012). In this study, text messaging was effective in promoting behavioral changes leading to a 4% increase in influenza vaccination (27.1% vs. 22.8%, RR = 1.19, p < .001). This study was a randomized controlled trial using a two-group pre- and posttest experimental design. This study found that a theory-based intervention (SayNo2Flu) guided by the HBM and combined with the use of mobile technology (SMS text messaging) did change parents’ influenza vaccination perceptions. It had an overall increase of 38.1% in Influenza vaccination rates in the intervention group (OR: 4.46, 95% CL, 1.705-11.706, p < .001). These results offer some insight into the use of theory-based preventative interventions for parents of young school-age children.