Current Sexual Trauma Among High-Risk Teen Mothers

PROBLEM:  The highest rate of reported intimate partner violence (IPV) is among women 15–45 years old ( Hart & Jamieson, 2001 ) with 20% of pregnant teens reporting abuse ( Campbell, 1999 ); however, little research on IPV and American Indian teen mothers has been done.
METHOD:  The purpose of this paper is to describe the degree of IPV and current sexual trauma among a group of Northern Plains adolescents being served by an American Indian teen mother program.
FINDINGS:  The relationship of trauma, substance abuse, and trauma symptoms are described. IPV was reported by 61% of the participants, with 37.5% reporting IPV during pregnancy and 22.5% reporting current sexual trauma.
CONCLUSIONS:  Development and testing of interventions for American Indian teen mothers, specifically related to trauma, are needed in addition to primary mental health services by agencies caring for this population.     

Promoting Positive Developmental Outcomes in Sexual Minority Youth Through Best Practices in Clinic–School Consultation

TOPIC:  Educational and healthcare service delivery systems play an important role within the lives of sexual minority youth.
PURPOSE:  To provide justification and recommendations for improving the coordination and collaboration of school-based mental health professionals and child and adolescent psychiatric nurses via presentation of a set of consultation best practices.
SOURCES:  Multidisciplinary literature specific to sexual minority youth, school climate, clinical experience, and consultation practices.
CONCLUSION:  Nurses are in a position to advocate for and provide education about sexual minority youth in schools and to provide direct support to this population. By creating collaborative relationships across clinics and schools, information and expertise can be shared and applied to affect change and lead to positive outcomes for all students.     

Health Risk Behavior of Youth in Foster Care

PROBLEM:    Many adolescent health problems are predominantly caused by risk behavior. Foster adolescents have disproportionately poor health; therefore, identification of risk behavior is critical.
METHOD:    Data from a larger study were analyzed to investigate the health risk behavior of 56 youth in foster care using the Child Health and Illness Profile–Adolescent Edition.
FINDINGS:    Data indicated that youth in foster care had some increased risk behavior when compared with a normative adolescent population. Younger adolescents and those in relative placement had less risky behavior. Risk behavior was increased for youth in foster care when they were in group homes, had experienced a parental death, or had a history of physical or emotional abuse or attempted suicide.
CONCLUSIONS:    These results point to areas of strength and vulnerability for youth in foster care and suggest areas for clinicians and caregivers of these adolescents to focus interventions towards harm reduction and enhancement of resiliency.     

Models of mental health care for older adults: a review of the literature

Aim.  This paper reviews literature that draws on models of mental health care for older adults.
Background.  It is predicted that as a consequence of the aging of the population the incidence of mental health disorders, common in older populations, will also rise. Many such disorders can be successfully managed if detected early. Assessment and management requires collaboration between health professionals who are skilled and educated in the management of older adults with mental illness and the use of models of care appropriate to this population.
Results.  The paucity of research in this area is demonstrated.
Conclusion.  The need for mental health nurses to challenge current models of mental health care for older adults is identified so that they take on an expanded and developed specialist role in care of older adults with mental illness.     

Poverty and Adolescent Mental Health

PROBLEM:  Poverty and accelerations of inequality, manifested by the increasing difference between the richest and poorest populations, have significant effects on the mental health of vulnerable groups. Adolescents are vulnerable to the effects of poverty. As a time of change and transition for youth and their families, adolescence creates both challenges and opportunities to intervene in the effects of poverty.
PURPOSE:  The purpose of this article is to discuss the significance of poverty and its impact on adolescent mental health and mental health services.
SOURCES:  An interdisciplinary literature search was conducted on the topic of poverty and adolescent mental health.
CONCLUSIONS:  Results indicated that nurses need to remain active participants in the provision of mental health services to adolescents in poverty and increase their advocacy for the creation of policy changes that address mental health needs of this population.     

Self-efficacy with application to adolescent smoking cessation: a concept analysis

Title.  Self-efficacy with application to adolescent smoking cessation: a concept analysis.
Aim.  This paper is a report of a concept analysis of adolescent smoking cessation self-efficacy.
Background.  Smoking cessation is a key preventive care/health promotion strategy offered by nurses worldwide. Most programming is tailored to adults although the reasons for smoking, along with coping strategies, resources and developmental stage, differ in adolescence. Understanding of the concept of self-efficacy as it relates to the adolescent population will assist nurses in addressing smoking cessation behaviours with this population.
Data sources.  The CINAHL and Proquest Nursing databases were searched for papers published between 1977 and 2007 using the keywords self-efficacy, adolescents and smoking cessation. The Walker and Avant method of concept analysis was applied.
Findings.  Adolescent smoking cessation self-efficacy is the confidence, perceived capacity and perceived ability that the teen possesses to quit smoking. Identified antecedents include developmental stage, past life support, emotional support, coping strategies, resources and emotional status. Consequences are smoking cessation: positive or negative. Empirical measures are identified.
Conclusion.  Levels of self-efficacy have been shown to be an important consideration in the approach of nurses to smoking cessation counselling with the adolescent client. The theoretical definition for this concept will provide the basis for nurses to design appropriate interventions for use in smoking cessation programmes targeted to adolescents. This definition identifies the key attributes of this concept that should be addressed when caring for this population.     

Improving the oral health of older people in long-term residential care: a review of the literature

Background.  Unrefutable evidence now links poor oral health with the development of preventable systemic illnesses and debilitating conditions that threaten quality of life and life itself. This is especially significant for an increasing older population who are dependent on others for care.
Aims and objectives.  The majority of studies analysing the oral health of older dependent people in long-term residential care have been undertaken by dental professionals. This critical literature review examines the issue from a nursing perspective because nursing care providers have a fundamental role in daily oral health provision for dependent residents.
Conclusions.  Multiple barriers were found to negatively impact on daily oral healthcare provision, including lack of care provider education, oral health values, availability of resources, implementation of supportive policies, documentation and oral health assessment tools.
Relevance to clinical practice.  The nursing profession, at all levels, must become pro-active in removing financial, political and workforce barriers that impact negatively on oral health outcomes. A multi-faceted approach is required to address these barriers, including development and implementation of oral health education programmes, assessment screening tools, care plans, documentation, supply of oral hygiene aids and the appointment of oral care 'champions'.     

Untangling the Health Disparities of Teen Pregnancy

PURPOSE.  The purpose of this secondary analysis is to determine whether a developmental maturity model differentially predicts pregnancy for African American, Puerto Rican, and Mexican inner-city teens.
DESIGN AND METHODS.  This is a secondary analysis of data from a case control study that tested a model of developmental maturity and teen pregnancy with 183 pregnant and never-pregnant pairs of inner-city teens matched on age, ethnicity, and freshman cohort.
RESULTS.  The models differentially predict pregnancy for the separate ethnic groups, with sexual behaviors being the most important factors regardless of ethnicity.
PRACTICE IMPLICATIONS.  The health disparities of teen pregnancies may not decrease unless patterns of dating/sexual behaviors are reversed.