Donna Shambley-Ebron

Self-Care and Mothering in African American Women With HIV/AIDS

African American women are the most rapidly growing group of people in the United States diagnosed with HIV/AIDS. The purpose of this study was to explore experiences of self-care and mothering among African American women with HIV/AIDS. It is important to recognize how culture affects illness management, childrearing, and daily living to design culturally appropriate nursing interventions for African American women. Critical ethnography was used to study 10 African American mothers from the rural Southeast who were HIV positive and mothered children who were HIV positive. Domains derived from the research were disabling relationships, strong mothering, and redefining self-care. The cultural theme was creating a life of meaning. African American mothers with HIV/AIDS in the rural Southeast used culturally specific self-care and mothering strategies reflective of cultural traditions. This study acknowledges strengths of African American women and generates theory that will enhance nursing care to this population.

New Paradigms for Transcultural Nursing: Frameworks for Studying African American Women

African American women continue to experience disparities in health status when compared to their European American counterparts, yet, often their unique perspectives are not presented in the nursing literature. This article will discuss various theoretical frameworks arising from Black women’s thought and reality that can be used to enhance and expand transcultural nursing knowledge. Historical, sociocultural, and literary perspectives will be used to illuminate the realities of African American women’s lives. Selected frameworks arising from these realities will be discussed that recognize the impact of race, class, and gender on the lives of African American women and have the potential to guide nursing research and practice.

Forensic sexual assault examination and genital injury: is skin color a source of health disparity?

PURPOSE The study objectives were to (1) estimate the frequency, prevalence, type, and location of anogenital injury in black and white women after consensual sex and (2) investigate the role of skin color in the detection of injury during the forensic sexual assault examination. METHODS A cross-sectional descriptive design was used with 120 healthy volunteers who underwent a well-controlled forensic examination after consensual sexual intercourse. RESULTS Fifty-five percent of the sample had at least 1 anogenital injury after consensual intercourse; percentages significantly differed between white (68%) and black (43%) participants (P = .02). Race/ethnicity was a significant predictor of injury prevalence and frequency in the external genitalia but not in the internal genitalia or anus. However, skin color variables--lightness/darkness-, redness/greenness-, and yellowness/blueness-confounded the original relationship between race/ethnicity and injury occurrence and frequency in the external genitalia, and 1 skin color variable--redness/greenness--was significantly associated with injury occurrence and frequency in the internal genitalia. CONCLUSIONS Although differences exist in anogenital injury frequency and prevalence between black and white women, such differences can be more fully explained by variations in skin color rather than race/ethnicity. Clinical recommendations and criminal justice implications are discussed.

In Our Grandmother's Footsteps: Perceptions of Being Strong in African American Women With Hiv/aids

One of the most significant challenges facing the health of black women in the 21st century is the growing numbers of human immunodeficiency virus/acquired immunodeficiency disease (HIV/AIDS) infections. An ethnographic study of African American mothers living with HIV/AIDS revealed that they believed in a tradition and heritage of strength that fostered their survival during difficult life experiences such as living and mothering with HIV/AIDS. They enacted this strength in culturally significant ways. This article discusses the importance of recognizing and supporting cultural strengths of African American women to help manage illness, while remaining cognizant of the context of oppression, discrimination, and stigma that distort cultural traditions and instead penalize women when they are ill.

African American Families on Autism Diagnosis and Treatment: The Influence of Culture

Cultural factors such as health care access and autism spectrum disorder (ASD) symptom interpretations have been proposed as impacting delayed diagnosis and treatment for African American children with ASD. A qualitative study of urban African American families caring for their child with autism was conducted with 24 family members and 28 ASD professionals. Cultural caring meant families protected their child from harm including potential or actual distrustful encounters, and took action for their child and community to optimize their child’s health and address the knowledge deficits of ASD within their community. Families and professionals believed cultural influences delayed families’ receiving and seeking appropriate health care for the African American child with ASD affecting timely autism diagnosis and treatment.

A Source of Healthcare Disparity: Race, Skin Color, and Injuries After Rape Among Adolescents and Young Adults

&NA; Differences in anogenital injury resulting from rape may occur because of racial or skin color differences in adult women. It is critical to determine if these differences also are associated with differences in injury prevalence and frequency in adolescents and young adults. In a retrospective review of medical records, we examined whether Black adolescent/young adult females had different anogenital injuries as compared to White females following rape. Next, we examined whether skin color differences explained a significant amount of the racial difference in injuries. We reviewed charts of 234 female victims of rape ages 14 to 29. Overall injury prevalence was 62.8%. Race was significantly associated with frequency of injuries in several anatomical locations, with White victims having a higher frequency of injuries than Black victims. Skin color was significantly associated with injury frequency in many anatomical locations, with victims with light skin sustaining more injuries than victims with dark skin. Even when skin color was included in the relationship, race remained a statistically significant factor, suggesting that the relationship between race and injuries may be more complicated than merely a skin color difference that has been mislabeled a racial difference.

My Sister, Myself A Culture- and Gender-Based Approach to HIV/AIDS Prevention

African American women are bearing an excess burden of HIV/AIDS, becoming infected at a rate 25 times that of White American women. This places African American girls at the highest risk for becoming infected with HIV/AIDS. Culturally appropriate prevention strategies are indicated to suppress this trend. Two qualitative research methods were used to evaluate a culture- and gender-based HIV prevention intervention: My Sister, Myself. Community action participatory research was used to engage the community in the development of the intervention for early-adolescent girls. Eight girls participated in the 8-week intervention. Data were collected about culture and gender identification, sexual health knowledge, and future intentions throughout the intervention. Focus groups and observation participation data revealed three major themes: “high aspirations,” “needing to know the truth,” and “internal, external, and eternal resources.” Findings indicate promise for intervention strategies that utilize culture- and gender-based strategies for HIV/AIDS prevention with young girls.

Parenting African American Children With Autism The Influence of Respect and Faith in Mother, Father, Single-, and Two-Parent Care

Purpose: Parents are the most significant contributor to care of children with autism spectrum disorder (ASD), and as such research on African American parenting in ASD is conspicuously absent. Findings relevant to parenting are discussed from a study with urban African American families caring for children with ASD. Design: An ethnonursing study was conducted with 24 African American family members of children with ASD and 28 professionals. Data were analyzed and reported as themes. Findings: Two universal themes of were found of respect and faith in God and family that influenced parental care. Two diverse themes of mother’s watchful care and father’s protective care, along with differences in feelings of isolation and dependence on supports were found among single- and two-parent families. Discussion and Practice Implications: When health care professionals increase their knowledge and understanding of cultural practices in the parental care of children with ASD, they provide health care that is culturally congruent.

Using Community-Based Participatory Research to Investigate Meaningful Prenatal Care Among African American Women:

Purpose: In the United States, African American babies die more than twice as often as White babies. The cause for this difference remains elusive, yet is likely complex with one factor being inadequate cultural care of pregnant African American women. The purpose of this study was to explore African American women’s perspectives of meaningful prenatal care. Design: Community-based participatory research was employed for this study using photovoice. The sample included 11 African American mothers in an urban community in Midwestern United States. Findings: Five themes were abstracted from the data: (1) Access to Care; (2) Soul Nourishment; (3) Companionship; (4) Help Me, Teach Me; and (5) The Future. Discussion/Conclusion: Meaningful prenatal care is influenced by culture. African American women need physical, social, and soulful support to enhance meaningfulness of care during pregnancy. Practice Implications: The findings support that meaningfulness of prenatal care for African American women may be enhanced by accessible and uniquely designed, culturally congruent models of prenatal care.

Stimulating research interest and ambitions in undergraduate nursing students: The research-doctorate pipeline initiative

BACKGROUND Innovative strategies may support the Institute of Medicines recommendation to increase the number of doctorally prepared nurses by 50% by 2020. Moreover, strategies implemented may increase the number and diversity of Doctor of Philosophy (PhD)-prepared nurses in particular. METHOD The purpose of this article is to describe the approaches used by one college of nursing to enact a research-doctorate pipeline initiative to inspire a diverse pool of undergraduate students to consider pursuing a PhD degree. Principles that served as the foundation for this pipeline initiative are identified. RESULTS Sixteen undergraduate students, with varying degrees of research interest, participated in this initiative. Students contributed an average of 35 hours as full members of research teams, and 94% completed the experience. Students with initial low interest in research reported enhanced interest after participation. Overall student experiences were positive and influenced future career plans. CONCLUSION Lessons learned and future steps for the pipeline initiative are presented.