AIM: The purposes are to (a) examine the emerging concepts of connection within nursing practice and education; (b) evaluate current measures of connections within nursing practice and education; and c) identify strategies for enhancing connections between nursing educators and students and for nurses and patients.

BACKGROUND: Nursing and other disciplines rely on connections, although the term has evolved significantly in recent years due to changes of perceptions and expectations within other disciplines and within society. The lack of an empirical tool and defined attributes has constrained research and knowledge development. The initial exploration provided the first step in understanding the context and meaning of the word connect within the nursing profession. Three specific components were identified in this initial exploration within the nursing perspective: (a) respect, (b) trust, and (c) mutuality. Although the foundation of nursing care is based on the relationship and connections between the nurse and the patient, it is further identified in the first article that the need to further investigate the emerging ideas of connection within nursing practice and education.

METHODS: A detailed literature review was used to explore the phenomena of connection. The review of literature was performed through searches of CINAHL, EBSCO, and PubMed utilizing resources from the disciplines of transportation, business, technology, and nursing. Criteria for inclusion were (a) peer--reviewed articles; (b) articles published in English; and c) articles published between 2000 and 2014. Search terms included: connect, connection, connected, connectedness, and nursing. The search yielded a total of 114 articles; 33 were selected for inclusion. Definitions and related attributes were organized and classified based on relevance and frequency within the literature.

RESULTS: The attributes that were consistently found in the literature within the nurse to patient connection were: (a) interactions between the person and the object of connection; (b) an inherent need to be part of a social system; (c) use of communication in verbal, written, non­verbal, physical or virtual format; (d) the occurrence of meaningfulness, trust, mutuality and respect; (e) polychronicity; and (f) technology based emphasis. Instruments that measure connections and connectedness provide valuable insight into the concept. However, they do not adequately address the concept of connection as it relates to nursing practice and education with current technological.

CONCLUSIONS: While connection is a common term and fundamental to the role of the nurse/patient relationship, the defining attributes of connect have dynamically changed, and therefore require new understanding. It is critical to restructure the nurse to patient connection and to redefine the term within nursing practice and education with the inclusion of the multifaceted technological advances that define our current generations. Strategies that would enhance the nursing educator and student connection include: a) creation of additional nursing educational based Apps and Apps that focus on self-instruction tutorials and remediation techniques for non-successful students; b) integration of technological learning modalities into nursing curricula in both undergraduate and graduate programs; c) reduction of use of textbooks and inclusion of technology based learning; d) development of learning communities inside and outside of the classroom; e) creation of virtual resource support with simultaneous communication and valuable nursing information; f) and increased use of virtual environment and virtual communication.

Nursing ; Technology

The purpose of this study was to explore the knowledge, perception, and beliefs of newly arrived Filipino immigrants regarding Type 2 Diabetes Mellitus (T2DM), healthy lifestyle, and perceived barriers to healthy lifestyle. This is a qualitative study. A sample (n=40) of newly-arrived (less than six years in United States) first generation Filipino immigrants, not diagnosed with T2DM, living in southeastern part of United States were the focus of the study. Face to face interviews were conducted using an interview guide. No further interviews were conducted after data were saturated. The data sources were field notes and audio-recorded interviews, which were transcribed verbatim by the researcher. This study complied with the protocol for human subjects’ protection as obtained from the institutional review board. Prior to analyses of the transcripts, each transcript was read at least twice and compared to the recordings to ensure accuracy and completeness. To ensure trustworthiness, selected transcripts were reviewed and coded by two experience qualitative researchers to ensure inter-coder reliability. A significant number of the participants had little knowledge and few beliefs about T2DM. The perceptions of T2DM were varied, but several beliefs were widely held: (a) T2DM is a “sugar disease” that is based on sweet food intake, (b) participants were aiming to achieved healthy lifestyles through diet, exercise and prayers and (c) T2DM can result from several factors, including barriers to healthy lifestyle that includes stress, possible discrimination, and not enough information to navigate health resources. Although immigration brings opportunities, there are also numerous risks. Some of the diabetes beliefs that this study delineates provide anchors for future culturally appropriate intervention programs for recent Filipino immigrants. One of the major findings in this study was the low diabetes literacy among the participants. Immigrants with low diabetes literacy may have lower awareness of the disease condition, which may have a negative impact on their disease prevention behaviors. Migratory background is also an important factor influencing beliefs about disease prevention. These results provide information for the design of health programs for the prevention of T2DM in the Philippines and United States.
Acculturation ; Healthy Lifestyle ; Diabetes Mellitus, Type 2

PURPOSE: Web-based interventions offer low cost and practical strategies to promote self-care for adult individuals with various health conditions and status issues around the globe. The purpose of this review was to summarize the current recent literature in  examining  the  effectiveness  of  web-based  interventions  to  promote  healthy lifestyles related to anthropometric measurements in adult individuals with various health conditions and status.
DESIGN: A systematic review of literature was conducted.   Search of the literature was employed to web-based intervention studies in refereed journals written in the English  language.  The  databases  searched  were  PubMed,  Ovid  MEDLINE, CINAHL,  and  Google  Scholar,  with  a  search  period  of  2004-2014.In addition to these databases, a manual search was also used. 
METHODS: All studies were examined by three reviewers for eligibility using the Jadad scoring  system.Thirteen randomized controlled trial (RCT) studies (n=13)  met criteria in this review and revealed significant associations between the utilization of web-based health promotion interventions on anthropometric measurements in adult populations with health related conditions.
FINDINGS: Seven  studies  reported  overall  positive  changes  in  the  participants' anthropometric measurements at the completion of each study. Four out of seven studies reported that adult participants' in the intervention groups had greater weight loss  as  compared  to  the  control  groups.  In  addition,  one  study  out  of  the  seven studies reported a larger reduction in BMI of the participants in the intervention group.Two studies out of 13 studies reported positive changes in BMI, waist circumference,body fat, and waist-hip-ratio in the control groups. 
CONCLUSIONS:The outcomes from this review may prove useful information of effectiveness of web-based interventions relative to physiological outcomes such as anthropometric measurements. These programs can inform transformative practice and improvement of global health.  

Human ; Male ; Female ; Aged ; Middle Aged ; Waist-hip Ratio ; Waist Circumference ; Global Health ; Health Promotion ; Adipose Tissue ; Healthy Lifestyle