Suicide by firearm: One family's lived experience

In this paper, my nephews and I will share our individual perspectives of their father's completed suicide 30 years ago. Our intention is that the importance of recovery, hope, and support will be illuminated by telling our unique stories to describe the lived experience of a tragedy by gun violence and its longstanding effects.

American Academy of Nursing expert panel consensus statement on inequities in the juvenile justice system rooted in systemic and structural racism

The overrepresentation of youth of color has long been acknowledged and accepted in juvenile justice and legal systems. Many risk factors contribute to the detention and incarceration of youth; however, there is little evidence to explain how structural inequities and systemic racism add to that vulnerability. Historically, laws were passed to benefit the White society and resulted in outcomes that caused grave aftereffects for people of color and in some cases, ethnic minorities. Within the context of juvenile justice and the lens of critical race theory, the authors of this paper seek to illuminate selected historical educational, environmental, legal, and health care policies, practices, and decisions that led to their detrimental consequences. Recommendations for mitigating both intended (through law, funding, policies) and the unintended barriers as experienced by youth of color are presented.

Implementation of Sexual Assault Services in a Clinic Setting

Sexual assault services cost Americans more than $420,000,000 annually for medical and mental health services. Personal costs include lost wages, lost quality of life, and victim assistance. Public costs include police work, legal adjudication, and sanctioning (penalties). In 2014, an estimated 284,350 adult women were sexually assaulted in the United States. Sexual assault is significantly underreported by those who are assaulted. Upon determination that sexual assault services in a clinic setting were nonexistent, services for sexual assault were developed and implemented in a clinic setting in a Midwestern state. The purpose of clinic services was to provide support, assessment, and forensic examinations for adult women and to evaluate the number of women receiving services. A quality improvement approach was used to determine how and when sexually assault victims received sexual assault services. Persons who have been sexually assaulted vary in gender and age; however, for the purpose of the pilot project, implementation initially included services to women over 18 years of age. Although the number of female patients receiving care was low in the inaugural clinic during the implementation and evaluation period, the services provision remains a viable option for women who experienced sexual assault in a community that previously had no access to clinic services.

The clinical practice project: planning to publish

PURPOSE

An increasing number of journals focused on clinical practice publish high-quality projects. However, research reports typically follow a distinct design, which is not always appropriate for reporting clinical practice projects. The purpose of this article is to provide a succinct guide for planning and reporting clinical projects, specifically, the Doctor of Nursing Practice applied clinical project.

DATA SOURCES

Literature concerning clinical practice project planning and preparation for publication was reviewed for this article.

CONCLUSIONS

This article provides a section-by-section summary of elements frequently included when preparing a manuscript for publication. The elements addressed in this article are suggestions and their inclusion and sequencing may vary depending on specific journal requirements.

IMPLICATIONS FOR PRACTICE

If information from clinical research projects is to contribute to nursing knowledge in the form of lessons learned and information about translation of research into clinical practice, the design and conduct of the project must be rigorous and information about implementation and findings must be accurate and clearly communicated.

A qualitative study using a systemic perspective exploring the remediation of abusive interactions in intimate heterosexual couples

Very little attention has been paid to both partners beliefs about why violence in their previously abusive relationship has stopped or significantly reduced despite well-documented details in the research literature outlining the characteristics of both victims and perpetrators. This study aimed to provide some understanding of how each partner believed that the violence has ended. However their answers often were not definitive; instead, they uncovered the complexities in their relationship and their struggle to overcome the uncertainty they have to achieve and maintain successful remediation. The article is based on a qualitative Interpretative Phenomenological Analysis (IPA) study that explored the nature of the relationship between six heterosexual couples before and after a therapeutic intervention for the men perpetrators, which followed the Duluth Model. The study included how they both understood the violence and how they maintained nonviolence in their relationship. The men were notably still in the process of reprocessing their understanding of why they were violent and they needed to further understand their reactions to maintain their nonviolence. The IPA themes provided some understanding of how the participants thought they had a better understanding of the factors that had maintained their relationship since the termination of the intervention. The themes, generated from the interviews provided by the perpetrators and their victims, are explored and some explanations for the successful continuation of their relationship following treatment are suggested. Implications for widening the treatment options for men perpetrators are suggested in addition to providing treatment options for couples who wish to remain within their relationships and need help to identify unhelpful and dangerous patterns of interaction.

Psychometric testing of the children's resourcefulness scale

PROBLEM

Resourcefulness is known to reduce depression in adults, but its effects on children are less well known, possibly for lack of a psychometrically sound measure.

METHODS

This study examined the reliability and validity of the 32-item Children's Self-Control Scale (C-SCS), which measures resourcefulness, in 122 school-aged children.

FINDINGS

Standard scale refinement methods produced a 10-item scale with alpha= .72 and correlations with the C-SCS (r = .86), positive thoughts (r = .38), and depressive symptoms (r =-.32). Factor analysis revealed two factors: problem-solving and delay of gratification.

CONCLUSIONS

The 10-item scale may be useful for identifying children who are not resourceful and are at risk for depression.

A Case Study of Telephone Interpersonal Counseling for Women With Breast Cancer and Their Partners

PURPOSE/OBJECTIVES

To present a case study of one woman with breast cancer and her partner to provide a firsthand account of an innovative telephone interpersonal counseling intervention.

DATA SOURCES

Journal articles, book chapters, research data, and transcriptions of telephone counseling sessions.

DATA SYNTHESIS

Substantial evidence exists that face-to-face psychosocial interventions improve psychological adjustment and health-related quality of life for patients with cancer. Yet psychosocial interventions are not offered routinely, and many patients with cancer do not use face-to-face counseling mechanisms. The telephone may be an innovative and effective method of delivering interventions, and telephone-delivered interpersonal counseling may be an especially effective intervention for women with breast cancer and their partners.

CONCLUSIONS

Despite the fact that the telephone counseling occurred over a brief period of time, the woman and her partner in this case study reported substantial positive changes in their own distress (e.g., symptoms such as depression and anxiety) and the nature of their relationships with each other and their children. This is precisely the effect that would be predicted by interpersonal theories of psychological distress. These results were not atypical for other women and their partners who participated in the study.

IMPLICATIONS FOR NURSING

Family members play a significant role in supporting women through the breast cancer experience; thus, nurses should assess the emotional distress of both partners during the course of treatment and, if needed, provide critical education and referral to psychosocial interventions. This woman and her partner clearly benefited from the intervention, resulting in improved symptom management and quality of life. Although this intervention requires additional training in the advanced practice nursing role, some techniques of the intervention can be used by all nurses, regardless of specialty training.

Profiles of women with breast cancer: who responds to a telephone interpersonal counseling intervention

The purpose of this paper is to discuss the profiles of women with breast cancer for whom a telephone interpersonal counseling intervention (TIP-C) was beneficial for symptom management and quality of life. This analysis was based on 24 participants who completed the telephone counseling intervention and all three measurements over the course of 10-week pilot study. The typical woman with breast cancer was white, in her mid-fifties and married at the time of the study. The majority was Stage II and was receiving chemotherapy as their primary adjuvant treatment. Preliminary findings suggest that women who were in long-term marriages and reported no previous history of depression or cancer benefited most from the intervention. These women reported less depression, negative affect, symptom distress and fatigue, and improved quality of life. Several theories are proposed for these findings and implications for practice are discussed.

Telephone interpersonal counseling with women with breast cancer: symptom management and quality of life

PURPOSE/OBJECTIVES

To examine the effectiveness of a telephone interpersonal counseling (TIP-C) intervention compared to a usual care attentional control for symptom management (depression and fatigue) and quality of life (positive and negative affect, stress) for women with breast cancer.

DESIGN

Experimental with repeated measures.

SETTING

Academic cancer center and urban, private oncology offices.

SAMPLE

48 women with breast cancer who were in their mid-50s, married, and employed at the time of the study.

METHODS

Women were assigned to either the six-week TIP-C or attentional usual care groups. Women were matched on stage and treatment. Data were collected at baseline, after the six interventions, and one month postintervention. Measures included the Center for Epidemiologic Studies Depression Scale, Positive and Negative Affect Schedule, Multidimensional Fatigue Inventory, and Index of Clinical Stress.

MAIN RESEARCH VARIABLES

Depression, positive and negative affect, fatigue, and stress.

FINDINGS

Women in the intervention group experienced decreases in depression, fatigue, and stress over time and increases in positive affect.

CONCLUSIONS

The preliminary results partially supported the effectiveness of TIP-C for symptom management and quality of life. The authors hypothesized that decreased depression, reduced negative affect, decreased stress, decreased fatigue, and increased positive affect over time would be the resulting psychosocial effects, given the theoretical underpinnings of the intervention.

IMPLICATIONS FOR NURSING

Nurses need to assess the quantity and quality of the social support network early in treatment; women with less social support need to be referred to counseling and support services. Because these women have limited participation in face-to-face interventions, they should be encouraged to participate in telephone or online support programs or in other programs or organizations (e.g., churches, social clubs) that would provide support.

Health outcomes for people with serious mental illness: a case study

PURPOSE

To describe outcomes of clients with serious mental illnesses who used regional public mental health services; and what the public mental health system did well or needed to change to better satisfy clients' needs.

METHODS

A modal case study analysis method was used with 15 clients. Participants were interviewed three times.

FINDINGS

Participants reported dissatisfaction with their social functioning and general health, and unmet needs for case management services, social/recreational activities, and vocational rehabilitation.

CONCLUSIONS

The case study method is an effective way for nurses to evaluate public mental health systems and to determine areas for system intervention.