RESUMEN
PURPOSE: Over 1 million Americans utilize skilled nursing facilities (SNFs) annually. Within SNFs, State Tested Nursing Assistants (STNAs) are primary caregivers; however, low retention rates are notable and threaten patient care. DESIGN: A phenomenological, qualitative study was conducted to explore intrinsic factors that influence STNAs' intent to stay in their positions. METHODS: Ten STNAs employed at for-profit SNFs participated in semistructured face-to-face interviews. Data were analyzed to identify broad concepts and recurrent themes. FINDINGS: Findings suggest that intrinsic factors supporting and threatening intent to stay included the fulfillment of basic psychological needs. Supporting themes included self-confidence, appreciation, positive relationships, and a willingness to go beyond required duties. Threatening themes included frustration, lack of support, and career advancement opportunities. CONCLUSIONS: Findings provide an understanding of factors that influence STNAs' intent to stay. CLINICAL RELEVANCE: The results may help guide the development of responsive strategies that improve quality and continuity of care in SNFs.
Asunto(s)
Intención , Asistentes de Enfermería/psicología , Adulto , Femenino , Humanos , Entrevistas como Asunto/métodos , Satisfacción en el Trabajo , Masculino , Persona de Mediana Edad , Asistentes de Enfermería/estadística & datos numéricos , Investigación Cualitativa , Instituciones de Cuidados Especializados de Enfermería/organización & administración , Instituciones de Cuidados Especializados de Enfermería/normas , Instituciones de Cuidados Especializados de Enfermería/estadística & datos numéricos , Encuestas y Cuestionarios , Lugar de Trabajo/psicología , Lugar de Trabajo/normasRESUMEN
The distal region of neural retina (ciliary marginal zone [CMZ]) contains stem cells that produce non-neural and neuronal progenitors. We provide a detailed gene expression analysis of the eyes of apc mutant zebrafish where the Wnt/beta-catenin pathway is constitutively active. Wnt/beta-catenin signaling leads to an expansion of the CMZ accompanied by a central shift of the retinal identity gene sox2 and the proneural gene atoh7. This suggests an important role for peripheral Wnt/beta-catenin signaling in regulating the expression and localization of neurogenic genes in the central retina. Retinal identity genes rx1 and vsx2, as well as meis1 and pax6a act upstream of Wnt/beta-catenin pathway activation. Peripheral cells that likely contain stem cells can be identified by the expression of follistatin, otx1, and axin2 and the lack of expression of myca and cyclinD1. Our results introduce the zebrafish apc mutation as a new model to study signaling pathways regulating the CMZ.