Women's use of resources in leaving abusive relationships: a naturalistic inquiry

Studies have considered the experiences of women in terminating abusive relationships. However, the personal strengths and internal resources women use to assist them in terminating have not been studied. The purpose of this naturalistic inquiry was to explore what personal strengths and inner resources contributed to (1) the actual making of women's decision to terminate the abusive relationship, and (2) their ability to successfully follow through with this decision. Themes of turning point, realization, reframing, agency, and self-efficacy emerged from the study. The results suggest a process, although the steps were not sequential and were repeated numerous times before the women were finally successful in leaving. Based on results of this study, implications for intervention include the promoting of cognitive approaches such as reframing and self-talk to facilitate the process of leaving.     

Leaving an abusive partner: an empirical review of predictors, the process of leaving, and psychological well-being

Four facets of leaving an abusive relationship are reviewed: (a). factors related to initially leaving an abusive partner; (b). the process of leaving an abusive relationship; (c). the psychological well-being of survivors after leaving; and (d). the predictors of this well-being. The conceptual and methodological limitations of studies in each of these areas are presented. Consistently found predictors of leaving include both material and psychological factors. Because battered women typically undergo several shifts in their thinking about the abuse before leaving permanently, research on leaving as a process is highlighted. A stress-process framework is used to explain the seemingly paradoxical finding that some women just out of the abusive relationship may have greater psychological difficulties than those who are still in it. For those experiencing the most stress, psychological health can worsen over time. Researchers and practitioners need to pay more attention to the plight of women who have left abusive partners.     

Women living with disabilities and their experiences and issues related to the context and complexities of leaving abusive situations

The health of women with disabilities, like other women, is affected by experiences of violence and abuse. However, the experiences of women living with disabilities is less well known and an important issue for rehabilitation professionals. In this paper we focus on presenting women's knowledge and experiences of violence and abuse regarding where abuse takes place, the forms of abuse; and the complexities associated with ‘taking action'. Women participants for this study had to be: 18 years of age or older; a Canadian citizen; able to participate in English; self-defined with a disability; and, be living in an urban area of Canada. Data presented is based on an innovative community-academic research study in which focus groups discussions using electronic technology (i.e. blackboard and chat rooms) were conducted with women living with disabilities across the country on important health issues. Participants' recommendations are also presented. Discussion of the findings focus on policy and practice implications related to dedicated resources, access to information and training initiatives for rehabilitation professionals and women themselves.     

Double binding, abusive intimate partner relationships, and pregnancy.

The purpose of this study was to extend and integrate the process theories of abuse and becoming a mother in order to provide a contextually appropriate perspective for understanding women's behavioural responses to intimate partner abuse during pregnancy. Double binding is proposed as a construct for understanding intimate partner abuse during pregnancy. Double binding refers to the simultaneous and often conflicting psychological and social processes of binding-in to the unborn child and to the abusive intimate partner that women engage in as they perform the developmental tasks associated with becoming a mother while living with an abusive partner.This construct was developed through an inductive-deductive process using clinical experience, a literature review, and qualitative data from 2 studies of abuse during pregnancy. The authors conclude that double binding is a suitable lens through which to interpret pregnant women's behavioural responses to abuse.They offer suggestions regarding clinical practice and research to further develop appropriate interventions incorporating this construct.     

The lived experience of women in abusive relationships who sought spiritual guidance

Women in abusive relationships have recognized the silence of religious institutions and clergy in addressing intimate partner violence. The old message, that women are to blame when family dysfunction occurs, remains evident in society. The objective of this qualitative study was to describe the experience of abused women attempting to decrease their spiritual distress and obtain spiritual guidance from their religious leaders. The findings revealed that clergy were not helpful in alleviating the women's spiritual distress or intervening in the violence. Four themes that epitomized the negative outcomes of the help-seeking behavior were spiritual suffering, devaluation, loss, and powerlessness.     

Physiology of wound healing and risk factors that impede the healing process

In the critically ill patient, wound repair can be impeded by processes inherent to the illness, its treatment, and the critical care environment. This vulnerability to wound complications increases patient morbidity and mortality as well as length of stay, resource consumption, and hospital cost. The physiology of wound healing and factors that impede wound repair are discussed. Those factors commonly seen in critical illness include advanced age, diabetes mellitus, compromised immunocompetence, inadequate perfusion, and oxygenation, infection, malnutrition, obesity, and preoperative illness. Knowledge of management of the physiologic factors that affect wound healing enables the nurse to maximize tissue repair and prevent wound complications.     

Understanding the inflammatory process in wound healing

The basic elements of wound healing can be described using three sequential and overlapping phases: inflammation, proliferation and regeneration. These phases represent a highly organized, tightly regulated and complex sequence of events that are dependent on an exquisite balance between various cell types and mediators. Inflammation is a prerequisite to healing; however, chronic wounds in particular exhibit a prolonged inflammatory response, thus providing an ideal environment for bacterial infiltration and proliferation. Considering that approximately 70% of all wounds are chronic, with the majority of wound care being delivered in the community, this paper aims to support nurses in their understanding of inflammation in order to enhance clinical practice.     

Depression and family relationships: ideas for healing

Like a pebble that creates ripples when dropped into still water, depression is a health problem with an impact that reaches beyond the individual to touch family members. This health problem can limit the individual's ability to function and can create distress for loved ones. In this article, the authors present a clinical vignette about maternal depression to highlight the reciprocal nature of depression and family functioning. Family focused interventions based on the Calgary Family Intervention Model and the Illness Beliefs Model are presented and include psychoeducation, circular pattern diagrams, and therapeutic letters. The authors conclude the article with a discussion of implications for nursing practice.     

Midkine gene expression in the healing process of gastric ulcer

Midkine is a newly cloned growth-promoting factor for fibroblastic cells. This study was performed to investigate the possible role of midkine in the stomach. Rats with acute or chronic gastric mucosal lesions were used. Histologically, acute mucosal lesions are not accompanied by the formation of granulation tissue; conversely, chronic mucosal lesions are accompanied by the formation of granulation tissue. The expression of the midkine gene was found in the normal intact gastrointestinal tract, especially the submucosal and muscle layers. Midkine mRNA increased during the healing stage of chronic gastric ulcer accompanied by a fibroblastic reaction. Furthermore, the fibroblast cell line MRC-5 expressed midkine mRNA strongly. Therefore, midkine may have some role in the healing of gastric deep ulcers that is accompanied by fibroblast proliferation.     

Understanding the multifaceted mechanisms of diabetic wound healing and therapeutic application of stem cells conditioned medium in the healing process

Mesenchymal stem cells (MSCs) transplantation seems to be a promising new therapy for diabetic wound healing (DWH), and currently, arrays of MSCs from various sources ranging from umbilical, adipose to dental sources are available as a treatment modality for this disease. However, it now appears that only a fraction of transplanted cells actually assimilate and survive in host tissues suggesting that the major mechanism by which stem cells participate in tissue repair are most likely related to their secretome level. These include a wide range of growth factors, cytokines, and chemokines, which can be found from the conditioned medium (CM) used to culture the cells. Basic studies and preclinical work confirm that the therapeutic effect of CMs are comparable with the application of stem cells. This review describes in detail the wound healing process in diabetes and the cellular and biological factors that influence the process. Subsequently, through a comprehensive literature search of studies related to wound healing in diabetics, we aim to provide an overview of scientific merits of using MSCs‐CM in the treatment of diabetic wound as well as the significant caveats, which restricts its potential use in clinical set‐ups. To our best knowledge, this is one of the first review papers that collect the importance of stem cells as an alternative treatment to the DWH. We anticipate that the success of this treatment will have a significant clinical impact on diabetic wounds.     

Endoscopic characteristics of the healing process of ulcerative colitis

This study compared the histologic characteristics of ulcerative colitis with findings on conventional colonoscopy and on magnification and dye application for 70 sites that underwent biopsy. The primary objective was to study the correspondence between histologic findings and endoscopic findings with respect to glandular restructuring and the resolution of inflammation from the active to the remission phase of ulcerative colitis. Widened grooves, as assessed by the endoscopic staining technique and magnified observation, most closely correlated with histologic evidence of resolution of inflammation, and vascular markings and color tone of the mucosa on general colonoscopy most closely correlated with histologic evidence of glandular restructuring, such as glandular maturity. Magnifying endoscopy after dye application, in addition to conventional endoscopy, is therefore considered essential in the evaluation of ulcerative colitis during the resolving phase.     

Effect of polarized light in the healing process of pressure ulcers

A trial was conducted to examine the effect of polarized light on pressure ulcers of 1st, 2nd and 3rd grades. Patients with two pressure ulcers, one of which received the polarized light therapy (experimental ulcer) and the other acting as control, were included in the study. The experimental ulcers received treatments for 2 weeks consisting a 5 min therapy session each day, excluding weekends, for 10 days. Experimental and control ulcers were assessed as they appeared on admission and reassessed at the end of each week. Fifty-five patients aged 37-85 years (67.1 +/- 11.9 years) were studied. Pressure ulcers of 1st, 2nd and 3rd grades receiving extra treatment with polarized light had increased values of epithelial tissue between the first and second assessments of 0-30.9% and between the second and third assessments of 30.9-21.7%. Values of the control pressure ulcers were, respectively, from 0 to 5.5% and from 5.5% to 3.1%. The mean pink/white colour values of the experimental ulcers, between the first and second measurements increased significantly compared with the control ulcers (P = 0.021) and also increased significantly between the second and third measurements (P = 0.003). The mean values of 'no and minimal exudate' of the experimental ulcers increased significantly between first and second measurements compared with the control ulcers (P = 0.001), and similarly, significantly between the second and third measurements (P = 0.002). Mean surface areas of the experimental ulcers decreased significantly between the first and second measurements from 2.84 to 2.54 cm2 (P < or = 0.001) and between the first and third measurements from 2.84 to 2.26 cm2 (P < or = 0.001). Mean surface areas of the control ulcers decreased between the first and second measurements from 2.10 to 2.08 cm2 (P < or = 0.42) and between the first and third measurements from 2.10 to 2.04 cm2 (P < or = 0.007). Pressure ulcers subjected to extra treatment with polarized light in the early stages (first to third measurements) showed improvement in the healing process than the control ulcers.     

Evolution of wound dressings and their effects on the healing process

Over the last decade, there has been a rebirth of interest in wound healing research, partly due to advances in biotechnology leading to the feasibility of producing large quantities of pure, human growth factors thought to be important in the healing process and also due to the recognition that certain new dressing materials have a favorable impact in wound healing. This paper describes some of the newer dressing materials and discusses the basis for the biological effects of these products. As progress continues, it is likely that future approaches will combine the use of dressings with drugs or active agents selected to prevent or treat infection, start or stimulate the healing process, or control the production of scar tissue.