Danny G. Willis

A central unifying focus for the discipline: facilitating humanization, meaning, choice, quality of life, and healing in living and dying.

Nursing has a rich history of knowledge development, yet there remains ambiguity about what is a proper central unifying focus for the discipline. At this time in our history, it is imperative that we clearly define and articulate who we are and what we offer. Confusion about a central unifying focus is a significant problem for practice given the current healthcare environment and global problems affecting health and healing. The authors propose a central unifying focus for the discipline: facilitating humanization, meaning, choice, quality of life, and healing in living and dying. This focus will serve as a basis for our professional identity, strengthen our endeavors, and provide the ontological and epistemological basis for our continuing evolution as a practice profession.

HATE CRIMES AGAINST GAY MALES: AN OVERVIEW

As the United States has become more multicultural and diverse, there has been an increase in violence motivated by hate. Hate crimes against gay males are the most prevalent of the hate crimes based on sexual orientation. Hate crimes have their roots in normative, individual, and societal attitudes and ideologies that lead to intimidation, bullying, teasing, physical assault, rape, and murder. This paper provides an overview of the issues specific to hate crime assaults against gay males. Mental health nurses may find this knowledge useful in developing further nursing inquiry, education, and clinical practice related to hate crime and violence prevention.

Meanings in adult male victims' experiences of hate crime and its aftermath

The purposes of this study were to describe gay mens experiences of hate crime and understand the meanings they attribute to it. Data were analyzed from individual interviews with seven gay men who recounted nine separate hate crimes. Participants perceived their hate crimes as homophobic acts of verbal harassment and violent assault targeted at silencing their identities, which they actively resisted. They perceived the aftermath as an extended period of time in which they lived with a heightened awareness of self, others, and the environment. This heightened awareness was reported to disrupt intimacy and social connectedness while they attempted to make meaning of their experiences and heal.

Distinguishing Features and Similarities Between Descriptive Phenomenological and Qualitative Description Research

Scholars who research phenomena of concern to the discipline of nursing are challenged with making wise choices about different qualitative research approaches. Ultimately, they want to choose an approach that is best suited to answer their research questions. Such choices are predicated on having made distinctions between qualitative methodology, methods, and analytic frames. In this article, we distinguish two qualitative research approaches widely used for descriptive studies: descriptive phenomenological and qualitative description. Providing a clear basis that highlights the distinguishing features and similarities between descriptive phenomenological and qualitative description research will help students and researchers make more informed choices in deciding upon the most appropriate methodology in qualitative research. We orient the reader to distinguishing features and similarities associated with each approach and the kinds of research questions descriptive phenomenological and qualitative description research address.

Profession at the crossroads: A dialog concerning the preparation of nursing scholars and leaders

The purpose of a practice disciplines terminal degree is to develop wise scholars to guide the profession in anticipating and meeting the health-related needs of those served via philosophical, conceptual/theoretical, and empirical inquiry on behalf of professional practice. Each of these dimensions is important for the disciplines ability to meet its obligations to society. However, contemporary circumstances have created a context within which the maturation of the profession may be threatened by an imbalance among the three dimensions of PhD education. Specifically, we discuss the possibility of a tilt toward the empirical at the expense of the other two. Yet, the philosophical and conceptual/theoretical dimensions are those that have permitted core disciplinary knowledge to be developed. We aim to create a dialog about current challenges and the responsibilities of the disciplines scholars for stewardship of the discipline and offer some strategies to ensure balance among the three equally important dimensions.

Spousal involvement and CPAP adherence: a dyadic perspective.

Poor adherence to continuous positive airway pressure (CPAP) treatment is associated with substantial health care costs, morbidity and mortality, and has been a leading obstacle in the effective management of obstructive sleep apnea (OSA). Successful interventions to improve CPAP adherence may ultimately include a variety of components. For patients living with spouses (refers to all domestic partners), the spouse will likely be an integral component to any successful intervention. Developing understanding of the role of spouses in adherence to CPAP has been identified to be a critical research need. This review expands the investigation of CPAP adherence to a broader context, from an exclusive focus on individual patients to a dyadic perspective encompassing both patients and their spouses. A conceptual framework based on social support and social control theories is proposed to understand spousal involvement in CPAP adherence. Methodologies for future investigations are discussed, along with implications for developing interventions that engage both patients and their spouses to improve CPAP use.

Children who witness violence: what services do they need to heal?

Children are witnesses to violence far too often in their daily lives. To elicit information on the needs of children and adolescents living in the United States who have witnessed violence in their homes, neighborhoods, or communities, we held focus groups with mothers who have survived interpersonal violence and whose family included child witnesses to violence (CWV), professionals who work with families affected by violence, and with adolescents who have witnessed violence. Based on four separate focus group discussions held in Massachusetts, involving a total of 45 participants, recommendations for screening, programming, and the development of healing interventions are offered to mental health professionals.

Moving Beyond Dwelling in Suffering A Situation-Specific Theory of Men’s Healing from Childhood Maltreatment

The authors present an explanation of the development of a situation-specific theory of men’s healing from maltreatment during childhood. Development of the theory was guided by Rogers’ science of unitary human beings (SUHB). The four multidimensional concepts of the theory are interpreted within the context of the SUHB from themes discovered from the findings of a hermeneutic phenomenological study of men who had been exposed to childhood maltreatment, including neglect and abuse. The concepts are: moving beyond suffering, desiring release from suffering, dwelling in suffering, and experiencing wellbeing. Moving beyond suffering is the process of healing from childhood maltreatment. Desiring release from suffering is the facilitator of men’s life experiences that speeds up the rate of evolution from moving beyond suffering to experiencing healing. Dwelling in suffering is the barrier in men’s life experiences that slows down the rate of evolution from moving beyond suffering to experiencing wellbeing.

Educator Sexual Abuse: Two Case Reports

Sexual abuse by educators has become an increasingly noted type of sexual abuse, especially among adolescents, for two reasons. First, there is a potential for these cases to be silent and prolonged and second, when disclosed, the forensic implications usually include both criminal and/or civil sanctions. For forensic case evaluations, developmental traumatology, or the intersection of the traumatic event(s) at a particular age of the student, is often the evaluating framework. We report on two forensic cases of a female student and a male student to emphasize the dynamics of adolescent sexual victimization, its impact on adolescent development, and evidence-based practice for symptom identification and treatment.

Conceptualizing surrogate decision making at end of life in the intensive care unit using cognitive task analysis

BACKGROUND Surrogate decision makers (SDMs) face difficult decisions at end of life (EOL) for decisionally incapacitated intensive care unit (ICU) patients. PURPOSE To identify and describe the underlying psychological processes of surrogate decision making for adults at EOL in the ICU. METHODS Qualitative case study design using a cognitive task analysis interviewing approach. Participants were recruited from October 2012 to June 2013 from an academic tertiary medical centers ICU located in the rural Northeastern United States. Nineteen SDMs for patients who had died in the ICU completed in-depth semistructured cognitive task analysis interviews. DISCUSSION The conceptual framework formulated from data analysis reveals that three underlying, iterative, psychological dimensions (gist impressions, distressing emotions, and moral intuitions) impact an SDMs judgment about the acceptability of either the patients medical treatments or his or her condition. CONCLUSION The framework offers initial insights about the underlying psychological processes of surrogate decision making and may facilitate enhanced decision support for SDMs.