Elizabeth Sloand

SELF-MEDICATION WITH COMMON HOUSEHOLD MEDICINES BY YOUNG ADOLESCENTS

Our study examines the self-medication practices of children ages 10-14. We developed a questionnaire that addressed several aspects of such behavior. A convenience sample of subjects (n = 86) completed the questionnaires in school settings in a northeastern metropolitan area. The data showed that a vast majority of the adolescents (89%) have access to the medicine in their households: 36% of them medicated themselves the last time they had any medicine. Most of their medication choices were appropriate, except in the area of gastrointestinal problems. There is a need for further investigation of this issue and incorporating the findings into the practice of pediatric nurses.Our study examines the self-medication practices of children ages 10-14. We developed a questionnaire that addressed several aspects of such behavior. A convenience sample of subjects (n = 86) completed the questionnaires in school settings in a northeastern metropolitan area. The data showed that a vast majority of the adolescents (89%) have access to the medicine in their households: 36% of them medicated themselves the last time they had any medicine. Most of their medication choices were appropriate, except in the area of gastrointestinal problems. There is a need for further investigation of this issue and incorporating the findings into the practice of pediatric nurses.

Ambulatory medical care in rural Haiti.

Introduction. In 2005, a team of U.S. physicians, nurse practitioners, nurses, pharmacists, emergency medical technicians and lay support personnel provided health services in an isolated town in rural Haiti. Methods. During one week, the team saw 788 patients. They recorded age, sex, vital signs, diagnoses, and treatments in an electronic database. A descriptive analysis is presented. Results. Intestinal parasitosis was the third most common diagnosis overall, and the most common diagnosis for children. For adults aged 50 years or older, 52% of women and 37% of men had elevated blood pressures, significantly more than adults aged 15–49 years. Discussion. This paper focuses on intestinal parasitosis and hypertension. Periodic anti-helminthic treatment and community sanitation are discussed as ways to reduce the burden of parasites and secondary malnutrition. Challenges to implementing a sustainable antihypertensive program are discussed, including patient education, medication availability and prioritization, and adequate follow-up in a very austere rural setting.

Challenges and benefits of international clinical placements in public health nursing.

International clinical placements offer interested nursing students unique opportunities for development of nursing expertise and cultural competence skills. The authors review the professional literature regarding nursing student experiences in international sites, describe the development of international clinical sites in a required baccalaureate public health nursing course, and summarize challenges and benefits of the program.

Cross-cultural validation of the parent-patient activation measure in low income Spanish- and English-speaking parents

OBJECTIVE (1) To measure healthcare activation among low-income parents by language (English/Spanish); and (2) to assess the psychometrics of the Parent-Patient Activation Measure (P-PAM) in the study population. METHODS We surveyed parents/guardians of publicly-insured children who were established patients at a pediatrics clinic for ≥6months. Surveys included the Parent-Patient Activation Measure (P-PAM), a 13-item measure adapted from the well-validated Patient Activation Measure (PAM). RESULTS Of 316 surveys, 68% were completed in Spanish. Mean activation score in the English-language survey group was 79.1 (SD 16.2); mean score in the Spanish-language group was 70.7 (SD 17.9) (p<0.001). Scale reliability was high (English α=0.90; Spanish α=0.93). The P-PAM had acceptable test-retest reliability, but no previously reported PAM factor structure fit the study data adequately for either language. CONCLUSIONS Healthcare activation among low-income parents was greater for parents surveyed in English compared with those surveyed in Spanish. The P-PAM has acceptable reliability and validity in English and Spanish, but a different factor structure than the PAM. PRACTICE IMPLICATIONS Activation as measured by the P-PAM may not have the same associations with or impact on health/healthcare outcomes in pediatrics compared with adults owing to possible measure differences between the P-PAM and PAM.

Fathers’ Beliefs About Parenting and Fathers’ Clubs to Promote Child Health in Rural Haiti

Health care providers are challenged to use culturally appropriate, low-technology approaches to improve child health in resource-poor countries. Village fathers’ clubs is one approach used in rural Haiti since 1994. Fathers meet regularly for health education and community-building activities. Our aim was to investigate parenting practices and beliefs among Haitian fathers of young children and to explore their views on fathers’ clubs. We conducted semistructured interviews with 18 fathers. Themes identified were fathers’ involvement in routine care of their children, the close partnerships of fathers and mothers in child care, fathers’ responsibilities to their communities, and fathers’ clubs as an important supportive institution for the Haitian fathers and their families. Rural Haitian fathers reported taking a very active role in the lives of their families and children. Increased involvement of fathers should be explored as a strategy to improve child health and survival in other parts of Haiti and throughout the world.

Barriers and Facilitators to Engaging Communities in Gender- Based Violence Prevention following a Natural Disaster

Humanitarian workers in disaster settings report a dramatic increase in gender-based violence (GBV). This was true after the 2010 Haiti earthquake when women and girls lost the relative security of their homes and families. Researchers from the United States Virgin Islands and the United States mainland responded by collaborating with Haitian colleagues to develop GBV-focused strategies. To start, the research team performed a situational analysis to insure that the project was culturally, ethically, and logistically appropriate. The aim of this paper is to describe how the situational analysis framework helped the researchers effectively approach this community. Using post-earthquake Haiti as an exemplar, we identify key steps, barriers, and facilitators to undertaking a situational analysis. Barriers included logistics, infrastructure, language and community factors. Facilitators included established experts, organizations and agencies. Researchers in such circumstances need to be respectful of community members as experts and patient with local environmental and cultural conditions.

“The women, they maltreat them… therefore, we cannot assure that the future society will be good”: Male perspectives on gender-based violence: A focus group study with young men in haiti

ABSTRACT The purpose of this study was to explore the perceptions of violence against women (VAW) held by Haitian men to gain a better understanding of why VAW occurs. Women in Haiti have experienced significant violence, both before and following the 2010 earthquake. Fifteen men aged 26 to 47 participated in a focus group. The data revealed three themes: mens beliefs about VAW and its context, factors influencing VAW, and recommended interventions. When approaching VAW, men must be part of the collective effort. Their insights are valuable when planning and implementing interventions to decrease VAW in Haiti and worldwide.

A community-oriented primary care nursing model in an international setting that emphasizes partnerships.

Purpose To present an interdisciplinary, community‐oriented primary care nursing model that effectively draws upon the strengths of advanced practice nurses (APNs), both nurse practitioners and community health nurses. Data sources Articles in professional nursing journals, international data sources, and the clinical experiences of the authors, both domestic and international. Conclusions The model, developed domestically, was utilized successfully by APNs internationally in a medical mission endeavor in rural Haiti. Many partners, domestic and Haitian, worked as an interdisciplinary team to deliver quality health care to an impoverished population. Graduate nursing students participated in the program, which offered opportunities and challenges for both novice and expert nurses. Implications for practice Nurse practitioners, community health nurses, and nursing faculty members can use this model to enhance their professional practice. They can learn that clients can be optimally cared for whether the community served is domestic or international. Nursing faculty can teach graduate nursing students about the value of partnerships and collaboration.

Recruitment and retention strategies for an urban adolescent study: Lessons learned from a multi-center study of community-based asthma self-management intervention for adolescents

Intervention studies with urban adolescents and families affected by asthma are critical to improving the disproportionate morbidity in this population. Community-based recruitment and retention strategies in a multi-site longitudinal project evaluating an asthma self-management intervention for adolescents are presented. Successful recruitment strategies depended on the geographic and cultural characteristics of each study site. Partnering with providers and groups known to the target population and in-person contact with target population were found effective. Flexibility accommodating modified and new approaches, securing multiple contacts and repeating mailings as well as capitalizing on the benefits of subject payment was critical to achieving long-term subject engagement of 85% in the study. Ongoing monitoring and adjustment of recruitment and retention strategies is recommended.

Experiences of violence and abuse among internally displaced adolescent girls following a natural disaster

AIM To describe the physical, psychological and sexual violence among internally displaced adolescent girls following the 2010 Haiti earthquake and related risk factors, health concerns and cultural norms. BACKGROUND Thousands of adolescents were displaced following the earthquake, leaving them vulnerable to abuse and violence. Displaced survivors are disproportionately vulnerable to violence after natural and man-made disasters. DESIGN A descriptive-correlational design was used to: (1) describe the extent of violence, health risks and concerns in the displaced adolescent girls; and (2) identify correlations in the strength and magnitude of relationships between selected variables including demographics, risk factors and cultural tolerance of violence. METHODS Data were collected from participants using computer-assisted self-interviews between 2011-2013 including demographics, pre- and post-earthquake violence, perpetrators, risk factors and health consequences. Analysis included frequency, logistic regression and multiple regression. RESULTS/FINDINGS A majority reported physical, psychological, or sexual abuse both pre- (59%) and post- (64.1%) earthquake. Pre-earthquake, abused adolescents reported the perpetrator as a boyfriend (50%) or family member (30%). Post-earthquake, 20.5% of physical abuse perpetrators were family members. Pre- and post-earthquake physical and sexual abuse did not change. The risk of being sexually abused post-earthquake increased after controlling for age and education. CONCLUSION Displaced adolescent girls reported similar rates of physical and sexual abuse pre- and post-earthquake. These findings show the importance of preventive policies for adolescent girls in disaster situations in countries with low resources. Social and cultural change is critically needed since abuse was at an unacceptably high rate prior to the earthquake.