Medication Decision Making in Low-Income Families of Black Children With ADHD: A Mixed Methods Study

OBJECTIVES

The purpose of this study was to explore how and why some low-income Black caregivers seek medication treatment for their children with ADHD.

METHODS

Using a sequential exploratory mixed method design, Phase 1 comprised an indepth case study design of seven low-income Black caregivers of children receiving medication for ADHD. Based on findings from Phase 1, the second phase involved a secondary analysis of data on Black uninsured or publicly insured children age 6 to 17 with ADHD (n = 450).

RESULTS

Factors influencing medication decision-making included child safety and volatility, caregiver mental health, caregiver aggravation, family centered care (FCC), shared decision making (SDM), sole caregiver status, and school involvement. After adjusting for ADHD severity, previous receipt of special education services and experiences of FCC and SDM were independently associated with receipt of a medication for ADHD.

CONCLUSIONS

Clinicians and school personnel can intervene to decrease disparities in the treatment of ADHD.

Effects of a short-term linguistic class on communication competence of international nurses: implications for practice, policy, and research

International nurses face a host of challenges in their transition and adaptation to the U.S. health care environment. Language and communication barriers have been ranked consistently as a top concern by employers, regulatory agencies, and international nurses themselves. Researchers in this study examined the effects of a 10-week linguistic class on the reduction of phonologic errors affecting foreign accent in a sample of international nurses. The linguistic course appeared to be effective in improving the international nurses' linguistic competence by reducing their phonologic errors significantly. Moreover, the intervention narrowed the linguistic gap between international nurses from non-English and English-speaking countries. Findings from this study have important implications for practice, policy, and research regarding quality of care, as well as for the transition, job satisfaction, and retention of international nurses.