The Effects of Exposure to Community Violence on Aspects of Adolescent Identity Development

PROBLEM:    A gap exists in our understanding of the impact of exposure to community violence on identity development. The purpose of this study was to explore how exposure to community violence affects adolescents' identity development. Data were collected to describe the perceptions, interpretations, and meanings adolescents ascribe to their experiences with community violence.
METHODS:    Male and female inner-city adolescents (13–18 years) were invited to share their personal stories about exposure to community violence. A constant comparative approach was employed to analyze data from personal narratives.
RESULTS:    All adolescents in this study reported exposure to violence and shared stories about living and coping with the prevalence of violence. Aspects of identity development that emerged in the data included self-perceptions, coping patterns, efficacy, and a moral self. Some stories revealed psychological distress that had potential for long-term developmental consequences. Personal strengths and positive attributes of the participants were also evident in the data.
CONCLUSIONS:    Exposure to community violence affected the identity development of these adolescents. When working with adolescents, it is important for nurses to assess for community violence exposure and promote coping strategies that reduce distress and foster healthy intimacy.     

Psychological adjustments made by postburn injury patients: an integrative literature review

Title.  Psychological adjustments made by postburn injury patients: an integrative literature review.
Aim.  This paper is a report of a review examining the variables that predispose individuals to significant psychological maladjustment following burn injury.
Background.  The psychological sequelae of burn injury are well documented; however, the variables that influence individuals' adjustment following burn injury lack consideration.
Data sources.  MEDLINE, Cumulative Index of Nursing and Allied Health, and Psychological Abstracts were searched using the keywords burn injury, psychological, psychosocial, rehabilitation, premorbid psychopathology, adjustment, reintegration, body image, post-traumatic stress disorder, depression, coping. Other sources were found from a manual search of nursing, medical and psychological literature and references of identified and related papers. The search strategy was limited to English-language research published between 1997 and 2008.
Review methods.  An integrative review of the studies was conducted over a 6-month time period during 2007–2008.
Results.  Burn patients are a heterogeneous group and typically have comorbidities. While preburn personality and coping strategies can influence long-term psychological adjustment, the relationship between postburn adjustment and burn size and severity, and gender are poorly understood. Much of the literature focuses on the prevalence of psychological maladjustment rather than on identifying variables that influence psychological adjustment.
Conclusion.  The diversity and complexity that characterize burn patients lead to unique adjustment difficulties. Recognizing these difficulties is the first step to offering appropriate intervention and treatment for this unique patient group.     

Type 1 diabetes: children and adolescents' knowledge and questions

Title.  Type 1 diabetes: children and adolescents' knowledge and questions.
Aim.  This paper is a report of a study conducted to describe what children and adolescents who have type 1 diabetes know and want to know about the disease.
Background.  Research indicates that young people's knowledge of diabetes may minimize their health complications, because with greater knowledge they may engage in more effective management practices and adherence.
Methods.  In this qualitative study, a purposive sample of 58 children and adolescents with type 1 diabetes were interviewed in 2005 about what they knew and wanted to know about their disease. Through a process of induction, major themes were identified from the data.
Findings.  The six major themes were: (a) Care , including both physical and emotional care, (b) Physiology , (c) Consequences , including both short- and long-term, as well as positive and negative consequences, (d) Cure , (e) Effects on the Family and (f) Experience at Diagnosis . Themes related to the unique challenges associated with type 1 diabetes were also identified.
Conclusion.  Nurses, diabetes educators and parents should provide developmentally appropriate information about diabetes care and management, scaffolding on existing knowledge. They should provide child-centred contexts in which children and adolescents can freely ask questions about their condition and problem-solve. Programmes that allow young people to develop coping skills and share experiences could also prove beneficial.     

Maternal and Paternal Parenting, Acculturation, and Young Adolescents'' Psychological Adjustment in Korean American Families

PROBLEM: Maintaining healthy psychological adjustment may be more complicated for Korean American young adolescents than for their European American counterparts. Korean American families live in two cultures and the issue of acculturation challenges their parenting, which is a critical factor for young adolescents' psychological adjustment. METHODS: Hierarchical multiple regressions were used to analyze 106 family data (young adolescents, mothers, and fathers) on parenting (acceptance-rejection and behavioral control), acculturation (integration, assimilation, separation, and marginalization), and young adolescents' psychological adjustment. FINDINGS: Only young adolescents' reports of maternal and paternal acceptance-rejection were related to their report of psychological adjustment. However, maternal acculturation moderated the relation between mothers' reports of maternal acceptance-rejection and behavioral control and young adolescents' report of their psychological adjustment. CONCLUSIONS: Parental acceptance-rejection is related to young adolescents' psychological adjustment when adolescents perceive themselves as accepted or rejected by parents. The relation between mothers' report of maternal acceptance-rejection and behavioral control and adolescents' psychological adjustment needs to be considered within the context of maternal acculturation.     

Adolescents in Acute Mental Distress on Inpatient Pediatric Settings: Reflections From a Pediatric Liaison Practitioner

TOPIC:  The impact of adolescents in acute mental distress admitted onto inpatient pediatric settings: on the staff group caring for them and the adolescents' consequent experience of the service provided.
PURPOSE:  To examine the impact that this client group can have on the staff, the environment, and wider professional system from an applied psychodynamic standpoint. The aim of this study is to identify practical strategies for providing effective child and adolescent mental health service consultation liaison for this complex and high-risk group.
SOURCES:  This study draws on psychoanalytic theories of adolescent development, trauma, organizational dynamics, and reflections on personal experiences in the field of pediatric liaison. The challenges of providing effective support in this context are illustrated with clinical examples from the author's own practice.
CONCLUSIONS:  The importance of attending to the very primitive anxieties and subsequent defense mechanisms aroused in staff caring for adolescents in the context described is highlighted. A case is made for the provision of mental health consultation and support that provides emotional containment for the young people and staff, and that incorporates understanding of the organizational issues that can contribute to the complexity of this work.     

Relationships of age and gender to hope and spiritual well-being among adolescents with cancer.

The purpose of this study was to examine hope and spiritual well-being, with its 2 dimensions of religious well-being and existential well-being, as they relate to age and gender among adolescents with cancer. A cross-sectional design was guided by the conceptual framework, Adolescent Psychosocial Adaptation to the Cancer Experience. A total of 78 adolescents with a diagnosis of cancer were enrolled from 2 pediatric oncology clinics. Middle adolescents (15-17 years of age) reported higher religious well-being than late adolescents (18-20 years of age). Middle-adolescent boys were more hopeful than were early adolescent boys (13- 14 years of age). Also, girls were more hopeful and reported higher spiritual well-being than age the boys. Developmental phase and/or gender may influence adolescents' levels of hope, spiritual well-being, religious well-being, and existential well-being as they cope during the cancer experience. The nurse should consider developmental phase and gender when planning interventions to foster hope and spiritual well-being in adolescents' adaptations to the cancer experience.     

妇科肿瘤照顾者照护体验质性研究的meta整合

目的：通过系统总结妇科肿瘤照顾者的照护体验,旨在全面了解其内心需求,为更好地开展工作提供依据。方法：计算机检索the Cochrane Library、Pub Med、EMbase、Scopus、CINAHL等数据库搜集关于妇科肿瘤患者的照顾者照护体验的质性研究,检索年限为建库至2019年4月。采用澳大利亚JBI循证卫生保健中心质性研究质量评价标准评价文献质量,采用汇集性整合的方法进行结果整合。结果：共纳入7篇研究,提炼出35个完好明确的研究结果,将相似的研究结果归纳形成11个新类别,得出3个整合结果。诊断时的心理状态：震惊、否认和求助;诊断后：照顾者的生活和心理状态的变化;应对：照护者满怀希望,重新开始新的生活。结论：医护人员应关注妇科肿瘤患者的照护者的心理需要,为妇科肿瘤患者提供更优质的家庭护理和更全面的社会支持,提高妇科肿瘤患者及其照顾者的生活质量。     

A different way of being: adolescents' experiences with cancer

Adolescents with cancer face many challenges that may impact negatively their psychological well-being. In evaluating the psychosocial functioning of adolescents with cancer, research suggests that an altered self-image may emerge in those who have difficulty adjusting. However, little is known about adolescents' perceptions of how cancer affects their sense of self. Part of a larger study, this article addresses findings specific to understanding the impact that cancer and its symptoms had on adolescents' sense of self. To help discover meaningful interpretations of their experiences, a longitudinal, qualitative study was conducted. Data collection methods included open-ended, individual and focus group interviews and participant observation. The constant comparative method of data analysis yielded theoretical categories that were supported by the adolescents' narratives. Findings revealed that adolescents experienced changes in their lived bodies because of the symptoms and this, in turn, impacted their sense of self and way of being in the world. Six ways of being in the world were identified: life as a klutz; life as a prisoner; life as an invalid; life as an alien; life as a zombie; and life as a kid. In helping adolescents deal with the changes, it was important to family and friends to respond to them like they were the same person, but also to treat them special at times. Although adolescents spoke to the significance that cancer had on their lives, they described themselves as "still being pretty much the same person."     

Stress and coping in Australian nurses: a systematic review

LIM J., BOGOSSIAN F. & AHERN K. (2010) Stress and coping in Australian nurses: a systematic review. International Nursing Review 57 , 22–31
Aim:  To identify factors that contribute to stress in Australian nurses, consider the coping strategies they use and examine the effects of stressors on nurses' health and well-being.
Background:  Stress is a major concern in the nursing profession with work overload, nurse shortages and high turnover rates as the common stressors. Although nursing stress has been studied extensively, there is a lack of clarity on the nursing situation in Australia.
Methods:  A systematic review of the current literature was conducted on stress and coping strategies within the Australian nursing population.
Results:  Stressors included work overload, role conflicts and experiences of aggression. Coping strategies included seeking support, problem solving and self-control. The majority of the studies reported detrimental effects on nurses' physical and mental well-being with little consideration given to the spillover effects of nursing work stress to their family and social relationships.
Conclusion:  Recommendations included factoring in personal and work stresses, promoting the use of effective coping strategies and maintaining supportive social relationships.     

Falling ill with Guillain-Barré syndrome: patients' experiences during the initial phase

Objective:  Research describing the personal experiences of Guillain-Barré syndrome (GBS) is limited, but is important for identifying the patients' need of support. The aim of this study was to describe experiences of falling ill with GBS, with the focus on the onset of disease, the diagnosis and the illness progress during hospital care.
Methods:  The study included 35 persons, 20–78 years old. They were interviewed 2 years after the onset of GBS. The interviews were analysed using qualitative content analysis.
Results:  The onset was described as either an incomprehensible, prolonged, increasing deterioration with puzzling sensations or as a frightening, rapid onset with a sudden loss of body control. The majority of the persons relied heavily on the reassurance of a positive prognosis, and expressed immense confidence in being able to recover. During the early phase at the hospital, a rapid and steady course of improvement inspired hope in many persons. In contrast, even in this early phase of hospital care some individuals expressed doubts of a slow recovery. Feelings of fear and insecurity were evident when losing body functions, thus causing helplessness. Sensations of pain, numbness and lost body image increased their vulnerability. Half of the ventilator-treated persons expressed vivid memories of scary hallucinations.
Conclusion:  The onset is characterized by an incomprehensible bodily deterioration or a frightening, rapid paralysis. In the initial phase, there is hope for recovery, which for many individuals is reinforced by a steady recovery. In contrast, early psychosocial support may be necessary for some persons with an alarmingly slow recovery.     

Women's experiences with vaginal pessary use

Title.  Women's experiences with vaginal pessary use.
Aim.  This paper is a report of a study of the lived experiences of women using vaginal pessaries for the treatment of urinary incontinence (UI) and/or pelvic organ prolapse.
Background.  The use of a vaginal pessary offers a non-surgical treatment option to provide physical support to the bladder and internal organs. As the literature asserts, a woman's choice to use a pessary is very individual and involves not only physical, but also psychological and emotional considerations.
Method.  Narrative inquiry was used to conduct face-to-face semi-structured interviews in 2007 with 11 postmenopausal women who accessed services from a Urogynecology Clinic in Eastern Canada.
Findings.  The women's stories revealed that living with a pessary is a life-changing experience and an ongoing learning process. The women's comfort level and confidence in caring for the device figured prominently in their experiences. Psychosocial support provided by the clinic nurses also played a primary role in the women's experiences.
Conclusion.  Women and healthcare professionals need to be aware of the personal isolation and embarrassment, and social and cultural implications that urinary incontinence may cause as well as the subjective experiences of using a pessary. With appropriate support, vaginal pessaries can provide women with the freedom to lead active, engaged and social lives.     

Receptivity of African American Adolescents to an HIV-Prevention Curriculum Enhanced by Text Messaging

PURPOSE.  This study assessed African American adolescents' receptivity to an HIV-prevention curriculum enhanced by text messaging.
DESIGN AND METHODS.  Two focus groups were conducted with 14 African American adolescents regarding how an HIV-prevention curriculum could be enhanced for text messaging delivery.
RESULTS.  The adolescents were receptive to the idea of text messaging HIV-prevention information but wanted to receive a maximum of three messages per day during the hours of 4:00–6:00 p.m.
PRACTICE IMPLICATIONS.  By taking the findings of this study, nurses, other healthcare providers, and community-based organizations can adapt evidence-based interventions for text messaging delivery to individuals at high risk for HIV infection.     

母亲经历围产儿死亡事件体验的系统评价

目的 系统评价母亲经历围产儿死亡事件的体验。方法 计算机检索中国知网、万方、VIP、PubMed、Web of Science、Medline、Wiley、EMbase数据库从建库至2020年3月有关母亲经历死产和围产儿死亡事件体验的质性研究,对文献进行质量评价后,采用Noblit和Hare's的Meta民族志方法对研究文献进行分析归纳。结果 纳入研究文献16篇。提炼出一个核心概念"母亲在痛苦的绝望中寻求新希望",基于以下4个主题,无声痛苦：母亲承受巨大的身心压力,负性情感突出;寻找出路：母亲通过应对策略抵御内心的痛苦;重建世界：母亲生活的改变与成长;未来曙光：母亲渴望得到尊重与照顾,对未来充满希冀。结论 医务人员应充分认识到围产儿的死亡不仅仅是医学问题,更是社会问题。应关注母亲心理变化,重视对母亲的情感支持,促进母亲生活重建。     

Almost Normal: Experiences of Adolescents With Implantable Cardioverter Defibrillators

PURPOSE.  The purpose of this study was to describe the experiences of adolescents with implantable cardioverter defibrillators (ICDs).
DESIGN AND METHODS.  This qualitative study explored the lived experiences of 14 adolescents with ICDs using face-to-face, semistructured interviews.
RESULTS.  Six themes were identified: life interrupted; still the same, except; sometimes it's tough; it cuts both ways; unique joule; and living life regular.
PRACTICE IMPLICATIONS.  These findings suggest that nurses could make a significant impact on the lives of adolescents with ICDs by focusing their efforts away from viewing the adolescent through an illness lens and more toward a normalization lens.     

Fostering coping by adolescents with newly diagnosed cancer

OBJECTIVES: To review a research program about adolescents' coping with life-threatening illness and nurses' role in fostering the adolescents' coping efforts. DATA SOURCES: Research studies, review articles, and book chapters. CONCLUSIONS: Adolescents who have cancer are at risk of negative health outcomes. Promoting positive coping during the developmental period of adolescence helps adolescents to assume greater responsibility for their health actions. IMPLICATIONS FOR NURSING PRACTICE: Certain behaviors initiated by health care providers on hopefulness in adolescents assists the ill adolescents in articulating their hopes and realising or redefining those hopes.