Pediatric nurses' differentiations between acceptable and unacceptable parent discipline behaviors: a Q-study

Engagement and Retention of Families in Universal Australian Nurse-Home-Visiting Services: A Mixed-Methods Study

Family support is offered to Australian parents of young children using a mix of targeted and universal child and family health services including nurse-home-visiting programmes. These rely on the voluntary engagement of families. In this study, the capacity to engage and retain families, including those at risk of becoming involved with child protection services, was examined. The broad objective was to identify nursing practices used at the interface of health and child protection services and to articulate those practices. Child and Family Health Nurses (CFHN) (n = 129) participated in a pragmatic, multilevel mixed-methods study. A questionnaire was used to identify nursing practices in the first phase of this study followed by focus groups in the second phase to describe these practices in more detail. Three practice themes were identified and described: enrolment, retention and conclusion of the nurse-family relationship. Universal child and family health services feature flexible, advanced, and multidimensional family support services including child protection practices. This paper focuses on practices employed by nurses to engage and retain families where child protection concerns are identified.

A scoping review of Q-methodology in healthcare research

BACKGROUND

Q-methodology is an approach to studying complex issues of human 'subjectivity'. Although this approach was developed in the early twentieth century, the value of Q-methodology in healthcare was not recognised until relatively recently. The aim of this review was to scope the empirical healthcare literature to examine the extent to which Q-methodology has been utilised in healthcare over time, including how it has been used and for what purposes.

METHODS

A search of three electronic databases (Scopus, EBSCO-CINAHL Complete, Medline) was conducted. No date restriction was applied. A title and abstract review, followed by a full-text review, was conducted by a team of five reviewers. Included articles were English-language, peer-reviewed journal articles that used Q-methodology (both Q-sorting and inverted factor analysis) in healthcare settings. The following data items were extracted into a purpose-designed Excel spreadsheet: study details (e.g., setting, country, year), reasons for using Q-methodology, healthcare topic area, participants (type and number), materials (e.g., ranking anchors and Q-set), methods (e.g., development of the Q-set, analysis), study results, and study implications. Data synthesis was descriptive in nature and involved frequency counting, open coding and the organisation by data items.

RESULTS

Of the 2,302 articles identified by the search, 289 studies were included in this review. We found evidence of increased use of Q-methodology in healthcare, particularly over the last 5 years. However, this research remains diffuse, spread across a large number of journals and topic areas. In a number of studies, we identified limitations in the reporting of methods, such as insufficient information on how authors derived their Q-set, what types of analyses they performed, and the amount of variance explained.

CONCLUSIONS

Although Q-methodology is increasingly being adopted in healthcare research, it still appears to be relatively novel. This review highlight commonalities in how the method has been used, areas of application, and the potential value of the approach. To facilitate reporting of Q-methodological studies, we present a checklist of details that should be included for publication.

A Q-methodology study of the type of support mentors need when assessing underperforming nursing students

AIMS

To identify and describe patterns of the shared viewpoints of nurse mentors about the support obtained from link lecturer in assessing underperforming students.

DESIGN

Non-experimental, exploratory research design.

METHODS

Q-methodology was applied to explore the viewpoints of 26 mentors about support. The data were collected from May-September 2018. During the development of the Q-set, we combined a naturalistic and theoretical approach, resulting in 27 statements. The participants ranked statements into a Q-sort grid. PQ-Method 2.35 software was used to perform a principal component analysis to identify different patterns of the mentors' viewpoints.

RESULTS

Five factors of shared viewpoints, which accounted for 62% of the total variance, were derived from the factor analysis: (a) Confident in professional assessment and expects respect from link lecturer; (b) confident about the limit but need guidance in documentation. (c) Confident in the assessment but need support to manage concerns; (d) require knowledge and skills but not emotional support; and (e) dialogue and collaboration rather than information.

CONCLUSIONS

Based on our findings, all mentors need different types of support from the link lecturer, depending on their experience as a mentor and nurse and educational credits in mentorship. The central principle identified in this study was that mentors need to feel secure in their role. The accessibility, approachability, and willingness of the link lecturer to participate in dialogue and collaboration are important, but emotional support is not.

IMPACT

Our findings provide insights into the type of support mentors need when assessing underperforming students. The findings highlight the necessity of a link lecturer who is accessible and is meeting the mentors' need for knowledge and skills about assessment and mentoring. The nurse education programme must prioritize resources to ensure that the link lecturer can follow-up with the student and the mentor.

Immigrant Vietnamese women's adaptation to culture and society in rural areas of Korea

BACKGROUND

International marriages between Vietnamese women and Korean men have increased rapidly in Korea. Successful adaptation of these women is challenging, and concerns on the issue have been raised. Most existing studies have surveyed Vietnamese immigrant women in urban Korea; less is known about women residing in rural areas of Korea. Uncovering the experiences and perspectives of these women can inform the design of community support resources. The purpose of this study was to identify a typology to effectively describe the subjective perspectives of Vietnamese women residing in rural Korea on adaptation to Korean culture and society.

METHODS AND RESULTS

A Q-methodological study was conducted with five steps: construction of the concourse, Q sample, selection of participants, Q-sorting, and data analysis. Twenty-six Vietnamese women married to Korean men who attended local public health centers were surveyed and asked to rank-order 39 Q-statements using a 9-point scale. Principal component factor analysis using a pc-QUANL program was performed to identify adaptation sub-types. Four types of adaptation were identified and labeled: positive adaptation (35.54%), passive adaptation with reservations (8.33%), adaptation with frustration (6.20%), and adaptation and involvement (5.33%). These four types explained 55.40% of the total variance in the women's experience of adaptation to Korean culture and society.

CONCLUSIONS

This study provides data that may be helpful in understanding the challenges immigrant women in rural areas of Korea face, and in planning family-sensitive adaptation support programs for these women and their families.

Parenting Needs Among Mothers of Young Children During Military Deployment

PURPOSE

To examine perceptions of what mothers of young children (birth to 5 years old) need to be a "good parent" while their military spouse is deployed.

DESIGN

Q methodology was used to uncover different views on military spouses' parenting needs.

METHODS

In Phase 1, 18 statements related to military spouses' parenting needs were elicited based on review of existing literature and seven supplementary qualitative interviews. In Phase 2, 143 military-connected mothers completed an anonymous online Q-sort to rank the importance of the 17 statements from least to most important for being a good parent during deployment. Written comments explaining rankings were also collected.

FINDINGS

Across respondents, the most important needs during deployment were making sure their children were happy and healthy, keeping themselves and their children connected with the deployed parent, and being financially stable. Three unique views were uncovered, which differed by mothers' reliance on their family versus the military community for support, and the importance of self-care.

CONCLUSIONS

Results highlighted the extent to which mothers of young children enter "survival mode" during their spouse's deployment, and differences were found in what was most important for being a good parent during this stressful period.

CLINICAL RELEVANCE

Findings underscore the complexity of creating programs to support military parents whose different backgrounds, experiences, and expectations are likely to affect service uptake and benefit.

Promoting Continuous Quality Improvement in the Alabama Child Health Improvement Alliance Through Q-Sort Methodology and Learning Collaboratives

OBJECTIVE

Q-sort methodology is an underutilized tool for differentiating among multiple priority measures. The authors describe steps to identify, delimit, and sort potential health measures and use selected priority measures to establish an overall agenda for continuous quality improvement (CQI) activities within learning collaboratives.

METHODS

Through an iterative process, the authors vetted a list of potential child and adolescent health measures. Multiple stakeholders, including payers, direct care providers, and organizational representatives sorted and prioritized measures, using Q-methodology.

RESULTS

Q-methodology provided the Alabama Child Health Improvement Alliance (ACHIA) an objective and rigorous approach to system improvement. Selected priority measures were used to design learning collaboratives. An open dialogue among stakeholders about state health priorities spurred greater organizational buy-in for ACHIA and increased its credibility as a statewide provider of learning collaboratives.

CONCLUSIONS

The integrated processes of Q-sort methodology, learning collaboratives, and CQI offer a practical yet innovative way to identify and prioritize state measures for child and adolescent health and establish a learning agenda for targeted quality improvement activities.

Integrative review: nurses' roles and experiences in keeping children safe

AIM

To identify nurses' role and experiences of keeping children safe.

BACKGROUND

Approaches to preventing, identifying and responding to child abuse and neglect have moved towards a multidisciplinary approach where all professionals are expected to contribute to the goal of keeping children safe. Frequently in contact with children and families, nurses well positioned to contribute to keeping children safe from abuse and neglect. Much has been published around nurses' experiences of their role in keeping children safe, but this literature has not yet been synthesized to determine the challenges and potential scope of this role.

DESIGN

Integrative review following an Integrative Review framework.

DATA SOURCES

Studies were identified through a search of the electronic databases CINAHL, Medline, Web of Science, Scopus and Informit to identify literature published between 2005-2015.

REVIEW METHODS

All the studies were critically appraised for methodological quality using the Critical Skills Appraisal Programme. Data from each study were extracted and categorized according to the review aims and the study's major findings.

RESULTS

Inclusion criteria were met in 60 studies. Three main findings were identified including nurses' insufficient knowledge, need for validation and improved communication and balancing surveillance and support for vulnerable families.

CONCLUSIONS

Nurses have many roles and experiences in keeping children safe but often felt they did not have the knowledge, skills and support to take action in this area. Further research is needed to understand why nurses feel inadequate and disempowered to advocate and intervene on the behalf of children at risk of abuse or neglect.

Examining Perceptions and Attitudes

The purpose of this article is to compare and discuss the use of Likert-type scales and Q-methodology to examine perceptions and attitudes in nursing research. This article provides a brief review of each approach, and how they have been used to advance our knowledge in health-related perceptions and attitudes. Although Likert-type scales are economical, efficient, and easy to analyze, the results can be difficult to interpret or translate into meaningful practice. In contrast, Q-methodology yields holistic and in-depth information on what the prevailing perceptions and attitudes are, but its conduct is logistically challenging and the results' generalizability can be limited. The appropriate uses of either or both approaches to answer different research questions will be discussed. Nurse scientists are called upon to continue our exploration, utilization, and expansion of unique methodologies that directly speak to a meaningful examination of these important constructs in nursing research.

Variation in Acceptable Child Discipline Practices by Child Age: Perceptions of Community Norms by Medical and Legal Professionals

Mandated child abuse reporters may judge specific disciplinary practices as unacceptable for young children, whereas child law professionals arbitrating allegations may be less inclusive. Do the views of these groups diverge, by child age, regarding discipline? Judgments of community norms across a wide range of children's ages were obtained from 380 medical and legal professionals. Because the Parent-Child Conflict Tactics Scale (PC-CTS) can be used to assess the epidemiology of child disciplinary behaviors and as a proxy to examine the incidence or prevalence of child abuse, the disciplinary practices described on the PC-CTS were presented as triggers for questions. Significant child age effects were found for disciplinary practices classified as "harsh." The consistencies between legal and medical professionals were striking. Both groups reflected changes in United States norms, as non-physical approaches were the most approved. We conclude that instruments estimating the prevalence of child maltreatment by parent-report should consider modifying how specific disciplinary practices are classified. Copyright © 2016 John Wiley & Sons, Ltd.