Health-related, help-seeking behaviors in female Mexican-American adolescents

PURPOSE

To explore and describe the health-related, help-seeking behaviors of young female Mexican-American adolescents.

DESIGN

Qualitative exploratory-descriptive design using focus groups.

SETTING

Community recreation centers.

PARTICIPANTS

18 female Mexican-Americans ages 10-16 years residing in a South Central state.

MAIN OUTCOME MEASURES

A demographic information form and semi-structured interview designed for the study.

RESULTS

Subjects described two themes of help-seeking behaviors: seeking help for physical health problems and preventive healthcare from formal sources (i.e., community health clinics, family physicians, and public schools), and seeking help for concerns about pubertal development and pregnancy from informal sources (i.e., their mothers, aunts, sisters, and friends).

CONCLUSION

While young, female Hispanic adolescents may seek help from formal sources for preventive healthcare services and physical health problems not related to sexuality, they tend to seek help from informal sources for psychosocial and sexuality issues. Community-based interventions should be developed that focus on the importance of this pattern of help-seeking behaviors for young female Hispanics.

Ethnic differences in adolescents' perceived health status: preliminary findings

The purpose of this exploratory study was to identify ethnic differences in the perceived health status among three ethnic groups of adolescents. Significant differences were found for perceived health as measured by the General Health Rating Index (GHRI) [R2, 94) = 8.11, p = .0006]. Tukey's post hoc analysis showed that European American and Latino American subjects scored higher on the GHRI than African Americans. These preliminary findings have implications for further research on perceived health status among ethnically diverse populations of adolescents.

Health risks of homeless adolescents. Implications for holistic nursing

Although the exact number of homeless adolescents is unknown, it is estimated that this population may exceed 2 million. Literally living on the streets, homeless youth are at risk for a variety of physical, psychosocial, and spiritual health problems. Many engage in "survival sex," exchanging sexual favors for necessities of food, clothing, and shelter. Such risky sexual behaviors make them vulnerable to sexually transmitted diseases, including human immunodeficiency virus (HIV) and acquired immunodeficiency syndrome (AIDS), and unintended pregnancies. Many have serious, diagnosable mental health problems, whereas others suffer various consequences of substance abuse. There is a need for comprehensive and holistic health care services, for which the majority of homeless youth have very limited access. Holistic nursing can provide creative interventions for thus vulnerable population.

Affirming Cultural Diversity: A Pathways Model for Nursing Faculty

This article presents a model for affirming the diversity of backgrounds, learning styles, and career aspirations for students in baccalaureate and graduate nursing education. The theoretical model, known as Pathways, is developed with a travel analogy and begins by acknowledging the diversity of educational preparation and socialization experienced by students from various cultural, economic, and ethnic backgrounds. Learning styles and needs of these students are addressed through assessment and interventions that are individualized and serve as maps and guides through the professional learning sequence and into future professional careers. The model is useful for planning and evaluating expanded services for a broad spectrum of students. The focus of this article is on the preparation of faculty as mentors for students with disadvantaged backgrounds.

Adolescents' perceived barriers to healthcare services

PURPOSE

To explore adolescents' perceptions of information needed to feel both mentally and physically healthy and their perceptions of barriers that exist to obtaining health-care services related to these needs.

METHODS

A convenience sample of 64 adolescents ages 11-18 years, living in a metropolitan southern community. Content analysis was used to analyze the written responses of the subjects to open-ended questions.

FINDINGS

Adolescents wanted information about what activities were defined as healthy and unhealthy, including facts about exercise, nutrition, and expressing feelings. Perceived barriers included money, time, personal characteristics, parents, and unavailability of appropriate resources.

CONCLUSIONS

Findings have implications for designing services to meet the mental health care and educational needs of adolescents. Involving adolescents in the planning of these services is an important step in promoting health and self-care competence.

Ethnic identity, role integration, quality of life, and depression in Korean-American women

Little is known about how living between two cultures affects the mental health of immigrant women. This study examined the relationships between ethnic identity, role integration, quality of life, and depression in 76 Korean-American women. Quality of life was positively associated with role integration (r = .68, p < .01). Role integration and quality of life were negatively and significantly associated with depression (r = -.59 and r = -.72, p < .01, respectively). An exploratory path analysis was performed to examine the relationships between demographics and conceptual variables. Only quality of life and length of residence in the United States were strongly associated with depression. Findings have implications for psychiatric nursing practice.

Self-efficacy, coping, and well-being among nursing students sexually abused in childhood

Preparing nursing students to work with sexually abused children has received little attention by pediatric nurse educators. These students often are themselves survivors of such abuse. The population of undergraduate nursing students attending a major university was invited to participate in a mailed survey to test hypotheses concerning differences in self-efficacy, coping, and well-being between subjects who were sexually abused in childhood and those who were not. A total of 87 students (79 women and 8 men) responded by returning the completed survey. Forty-seven percent of the women (n = 37) and 38% of the men (n = 3) in the sample reported having had one or more unwanted sexual experiences in childhood. Significant correlations were found between self-efficacy and confrontive coping (r = .58), emotive coping (r = .49), and palliative coping (r = -.46); between well-being and emotive coping (r = -.24); and between well-being and palliative coping (r = -.25). One-way analysis of variance (ANOVA) techniques were used to analyze differences in self-efficacy, coping (confrontive, emotive, and palliative), and well-being between the two groups (abused = 40 and not abused = 47). A significant difference in emotive coping was found. These findings suggest that nurse educators and administrators need to be sensitive to pediatric nurses' childhood sexual experiences. Such nurses must be knowledgeable and emotionally equipped to support the child and family through the process of recovery. It is important for them to be aware of how their own coping strategies and well-being affect the care they provide vulnerable children.

SEXUALLY ABUSED ADOLESCENT: Conceptualization of Sexual Trauma and Nursing Interventions

1. Many adolescent victims of sexual abuse display symptoms that reflect alterations in individual coping and thought processes, social isolation and impaired verbal communication, and alterations in spiritual well-being. 2. Nursing interventions based on a multidimensional model of sexual trauma focus on helping the adolescent learn to plan and carry out activities within a safe environment to improve a sense of self, improve interpersonal relationships, and decrease spiritual isolation and hopelessness. 3. Nursing interventions are designed to assist the adolescent to integrate past experiences, including memories and feelings, with current decisions to engage in self-protective and health-promoting behaviors.

A comparative study among college students of sexual abuse in childhood

A disproportionate random sample (200 women, 400 men) of students attending a major university was invited to participate in a mailed survey to study differences in self-efficacy, coping, and well-being between men and women who were sexually abused in childhood and those who were not. A total of 271 students (111 women, 160 men) responded by returning the completed survey. Fifty percent of the women and 22% of the men in the sample reported one or more unwanted sexual experiences in childhood. Multivariate analysis of variance (MANOVA) techniques to analyze differences in self-efficacy, coping (confrontive, emotive, palliative), and well-being between women and men who reported childhood sexual abuse and those who did not showed significant interaction effects by sex for abuse (F = 2.609, P = .025, df 5,263) and significant effects by sex (F = 3.356, P = .006), but no significant differences for abuse alone. Univariate F tests were significant (F = 5.386, P = .021) for palliative coping with abused men reporting the highest scores, abused and nonabused women having the highest scores on emotive coping (F = 9.049, P = .003), and nonabused men and women having highest scores on well-being (F = 7.276, P = .007). A second MANOVA was performed on data from 245 students (nonabused and those who reported contact sexual abuse). Significant interaction effects by sex for abuse (F = 2.259, P = 0.49, df 5,237) and main effects for abuse (F = 3.225, P = .008) were found. Although abused men scored lowest on well-being, both abused men and abused women scored higher on emotive coping and lower on well-being than nonabused subjects. These are new findings with implications for developing and testing nursing interventions for this vulnerable group of young adults.

Intuition in psychiatric-mental health nursing

A descriptive study was done to explore how psychiatric-mental health nurses define and act on intuition in clinical practice with children and adolescents, and to identify supports for and barriers to taking such action. Interviews of 16 nurses were tape-recorded, transcribed, and analyzed for manifest and latent content. Findings support previous studies about intuition in nursing practice and have implications for psychiatric-mental health nurses working with high-risk populations of children and adolescents.

Barriers to disclosure among sexually abused male children. Implications for nursing practice

This article identifies, through a critical review of current research, several factors that may account for the reluctance of male children to disclose details of sexual abuse. The factors then are related to implications for practice and research that are relevant for child and adolescent mental health nurses.

Childhood sexual abuse: toward a self-care framework for nursing intervention and research

The study of childhood sexual abuse is not limited to a single professional domain. Nurses, physicians, sociologists, psychologists, criminologists, and other professionals have studied various factors associated with this increasing problem. Multiple approaches to the study of this phenomenon have led to confusion and misunderstanding about the initial and long-term effects of sexual abuse. This article provides a self-care framework based on previous research from several domains and offers suggestions for nursing interventions and further research.

Correlates of health-promoting lifestyle and sexual satisfaction in a group of men

The purpose of this exploratory, correlational survey was to determine predictors of a health-promoting lifestyle and sexual satisfaction among a group of healthy men. A second purpose was to determine the relationship between these outcome variables within this population. A total of 136 survey packets was mailed to members of two social groups, and 41 completed surveys were returned (33%). Step-wise multiple regression analysis and Pearson product-moment correlations were used to analyze the data. Significant predictors of health-promoting lifestyle were body image, education, and self-esteem (p less than .0001); level of education was the only significant predictor of sexual satisfaction (p = .0223); and the relationship between health-promoting behaviors and sexual satisfaction was significant (r = -.3783, p = .008). Findings have implications for theory development and nursing practice in the area of sexual health.

Intuition in critical care nursing practice

Research that addresses intuition as experienced by nurses in critical care settings is rare; however, evidence to support the usefulness of intuition in making complex clinical decisions is mounting. The research reported here suggests that intuition is not a second-rate substitute for intelligent and rational decision-making; rather, it is a legitimate adjunct to empirical observation and linear analysis.

Long-term effects of childhood sexual exploitation

In this article two conceptual frameworks for understanding the effects of childhood sexual exploitation are presented: the traumagenic dynamics model and the model of information processing. Various research studies of the long-term effects of this problem are reviewed and summarized. Results of these studies show that survivors of childhood sexual exploitation experience a variety of long-term effects, including low self-esteem, posttraumatic stress disorder, depression, suicidal attempts, and drug and alcohol abuse. Implications for nursing practice and research are suggested.

Childhood sexual exploitation: long-term effects among a group of nursing students

The purpose of this preliminary study was to examine differences in levels of self-esteem and depression between students who reported incidents of sexual exploitation in childhood and those who did not. A nonprobability sample of 55 nursing students enrolled in a university-based program completed the Childhood Sexual Experiences Survey, Rosenberg's Self-Esteem Scale, and Beck Depression Inventory. Results showed significant differences between groups in self-esteem (F = 4.387, p = 0.041) and in depression (F = 8.015, p = 0.007). Subjects who reported incidents of childhood sexual exploitation had lower levels of self-esteem and higher levels of depression than the comparison group. Results support previous research and have implications for long-term effects of sexual exploitation in this special population of young adults.

Construct validity in instrument development: a vital link between nursing practice, research, and theory

Construct validity provides a vital linkage between nursing practice, research, and theory. Seventeen articles published in Advances in Nursing Science that met the criterion of reporting instrument development or modification were examined for evidence of these linkages. All were based on theoretical constructs; nursing problems were identified in 15, and 14 provided evidence of construct validity. Factor analysis was the primary method of construct validity reported. Implications for nursing practice were limited, suggestions for research focused on further instrument development, and only half reported implications for theory development. The findings indicate the need to strengthen links between practice, research, and theory.

Intuition: a neglected hallmark of nursing knowledge

Intuition as a hallmark of nursing knowledge was traced through an analysis of literature published in the American Journal of Nursing between 1900 and 1985. Three questions were addressed: Does the concept appear in the literature; if so, what are its attributes; and how did they evolve through time? Titles of articles (n = 14,971) were examined and from this population only 51 were found to contain intuition or related terms. From analysis of the paucity of literature containing the concept it is concluded that intuition as an essential component of complex decision making is neglected in the professional literature.