Dianxu Ren

Self-esteem and optimism in rural youth: Gender differences

Abstract Aim: To identify and describe gender-related differences in the self-esteem and optimism levels of rural adolescents. Background: Self-esteem and optimism have been broadly examined and are associated with health-practices, social interaction, attachment, resiliency, and personal identity. Information describing the relationship of self-esteem and optimism as it relates to gender is limited. Methods: Using a cross-sectional survey design, students (N = 193) from three high-schools in rural Pennsylvania, USA completed the Rosenberg Self-Esteem Scale and the Optimism Scale-Life Orientation Test-Revised as part of a National Institute of Health, National Institute of Nursing Research funded study. Results: Both instruments’ mean scores were in the range of average for this population, with females scoring lower than males in both self-esteem (p < 0.0001) and optimism (p < 0.0001). The results of this study have nursing implications for evidenced based interventions that target self-esteem and optimism. Attention to self-esteem and optimism in female youth is recommended.

Relationships Between Depressive Symptoms and Perceived Social Support, Self-Esteem, & Optimism in a Sample of Rural Adolescents

Stress, developmental changes and social adjustment problems can be significant in rural teens. Screening for psychosocial problems by teachers and other school personnel is infrequent but can be a useful health promotion strategy. We used a cross-sectional survey descriptive design to examine the inter-relationships between depressive symptoms and perceived social support, self-esteem, and optimism in a sample of rural school-based adolescents. Depressive symptoms were negatively correlated with peer social support, family social support, self-esteem, and optimism. Findings underscore the importance for teachers and other school staff to provide health education. Results can be used as the basis for education to improve optimism, self-esteem, social supports and, thus, depression symptoms of teens.

Self-reported exercise during breast cancer treatment: results of a national survey.

Background:Exercise during treatment for early-stage breast cancer is helpful to mitigate fatigue and promote health. Little is known about the experiences of and preferences for exercise during treatment from a national perspective. Objective:The purpose of this descriptive survey was to explore womens experiences with and preferences for exercise during breast cancer treatment. Methods:An online survey was conducted through a national survey company to their eligible subscribers. This researcher-created, 1-time survey included forced-choice and open-ended questions about exercise participation and preferences during treatment for breast cancer. Results:One hundred sixty women who completed treatment for early-stage breast cancer in the previous year completed the survey. Walking was the most frequent form of exercise reported and preferred by the participants. Most participants did not meet current national guidelines for daily physical activity. Conclusion:Walking and exercises specific to women with breast cancer were most frequently performed and preferred among a national sample of women during their treatment for breast cancer. This finding supports previous studies. Implications for Practice:Oncology nurses can encourage their patients to participate in exercise and physical activities that they enjoy and can self-pace, while meeting daily physical activity recommendations. The results from this survey can help oncology nurses appreciate the exercise experience in this population of women.

Testing the ‘Teaching Kids to Cope with Anger’ Youth Anger Intervention Program in a Rural School-based Sample

The purpose of this paper is to report the longitudinal effects of the ‘Teaching Kids to Cope with Anger’ (TKC-A) program on self-reported anger in rural youth. Through a randomized controlled trial, 179 youths of 14–18 years of age, from three rural high schools, were randomized into a control (n = 86) and an intervention group (n = 93) for eight TKC-A weekly sessions. These students completed the STAXI-2 anger instrument questionnaires at baseline, post-intervention, 6 months, and at 1 year. T-test statistics were used to analyze and compare the control and intervention groups. Through analysis of the Anger Index sub-scale of the STAXI-2 at 1 year post-intervention, a significant difference was reported between the control and intervention group. Participants reported that the TKC-A intervention was helpful in coping with emotional, behavioral, and social aspects of anger. Future research may utilize the TKC-A with youth who have anger management problems. Psychiatric-mental health nurses can screen youth for anger and be cognizant of coping skills of youth, assess for anger problems and provide health education to youth about approaches for coping with anger.

A Quality Improvement Project to Improve Education Provided by Nurses to ED Patients Prescribed Opioid Analgesics at Discharge

Background: The opioid crisis continues to take an unprecedented number of lives and is the top cause of injury death in the United States. The emergency department is a setting where patients with pain seek care and may be prescribed an opioid, yet many patients do not receive evidence‐based education about taking their opioid safely. Like many communities across the country, Allegheny County, Pennsylvania, has experienced an increased rate of opioid overdoses; from 2015–2016, the number of opioid–related overdose deaths in the county increased by 44%. Methods: This quality improvement project is the implementation of a nurse‐delivered, evidence‐based education initiative for patients prescribed an opioid in an emergency department. Nurses were briefly trained on opioid safety and patient education, then over 12 weeks, delivered the dual‐modal (verbal and written) education with a patient teach‐back to verify comprehension. Results: Nurses who completed the project training on opioid safety and patient education had a statistically significant improvement in their knowledge. Patient satisfaction surveys showed 100% of patients reported clear understanding of how to take their pain medication, and out of the patients receiving the opioid pain education for the first time, 88.2% learned something new about how to safely take, store, or dispose of their pain medication. Implications for Practice: Improving the delivery of opioid prescription education at emergency department discharge will enhance patient knowledge and promote safety, which may help mitigate the opioid crisis by reducing the rate of opioid use disorder and accidental overdoses. Contribution to Emergency Nursing PracticeThe patient education process at discharge can be enhanced using a dual‐modal, patient teach‐back approach.Health care organizations should encourage emergency nurses to pursue continuing education on opioid safety.Emergency nurses can work with other healthcare professionals to ensure all patients prescribed an opioid analgesic at Emergency Department (ED) discharge receive opioid‐specific, evidence‐based education.

Implementation of a School-Based Bullying Program

ABSTRACT A bully is defined as anyone who participates in any form of repetitive negative and hurtful behavior, with the intent of inflicting harm (Highmark & Center for Safe Schools, 2013). Purpose: The purpose of this project was to evaluate the feasibility of implementing a bullying awareness, prevention, and screening program for teachers and school nurses. Methods: The sample included 174 fifth-graders from a public-school district in rural, southwestern Pennsylvania. Teachers received an educational program and students were screened for bullying using the PIPSQ. Results: Although not a significant finding, there was an increase in teacher’s knowledge post-education (p = 0.515). Although findings were not significant, the results of the PIPSQ revealed greater victimization in this school (M = 6.93), with bullying behaviors greater among boys (p = 0.000). Conclusions: The educational program and the PIPSQ tool appear to be a promising method to identify victimization and bullying within an elementary school setting; further research can determine significance of screening and faculty education.

Medical Emergency Team Response Processes for Behavioral Health Inpatient Units: Implications for Nursing Education

Following a literature review of nurses’ attitudes and perceived barriers regarding the utilization of medical emergency teams (METs) and completing key informant interviews with psychiatric nurses, a questionnaire developed by the researcher was administered to inpatient psychiatric nurses to further examine their attitudes and perceived barriers about MET utilization. Using a 23-item questionnaire, the psychiatric nurses were asked to rate each item using a 5-point Likert scale. Results indicated that nurses did not have a clear understanding of the criteria for calling a MET and also tended to seek out other staff personnel and/or a physician consultation prior to initiating a MET call. Results of this descriptive, quality improvement project were then used to revise and refine nursing education and practice regarding MET utilization.