Janice Agazio

An Untapped Resource: Using Youtube in Nursing Education

Minimal information is available in the literature addressing video sharing in nursing education. Using multiple examples, the authors discuss the use of YouTube, a popular video-sharing and social networking site. YouTube is used to illustrate theoretical content, involve students, and inspire innovative teaching methods. Faculty can use this technology to stimulate student discussions, share information, and create a learning community. YouTube stimulates active learning and brings new relevance and applications to nursing curriculum.

Stress, Coping, and Well-Being in Military Spouses During Deployment Separation

This study examined the relationships between stress, coping, general well-being, and sociodemographic characteristics using Lazarus and Folkman’s theory of stress and coping. A descriptive correlational design was used. The sample consisted of 105 female spouses of currently deployed active duty military members. Instruments included the Perceived Stress Scale, the Jalowiec Coping Scale, and the RAND-36. Perceived stress was the best predictor of both mental and physical well-being, accounting for 51.7% and 25.4% of the variance, respectively. Evasive and optimistic coping contributed an additional 1.9 % and 4.3%, respectively, to the variance in mental well-being. Differences in coping use were found among rank groups, those who grew up in a military family, and those with a previous deployment separation. Nurses are in an ideal position to identify military spouses at risk and provide education on effective coping behaviors shown to positively affect well-being during deployment separation.

Army nursing practice challenges in humanitarian and wartime missions.

The research question guiding this study was: What are the nursing practice challenges for Army nurses in military operations other than war (MOOTW), or humanitarian missions and wartime? Using a descriptive qualitative design, 75 Army Nurse Corps officers with deployment experience participated in a focused interview either in person or by telephone. Deployment locations included Bosnia, Honduras, Iraq, Afghanistan and other worldwide locations. Nurses recounted challenges and adjustments made to deliver high quality patient care to soldiers and civilian casualties especially for multi-level traumatic injuries. Specialized skill sets and personal adaptation were necessary for practice under austere conditions in these environments. By understanding the practice of nursing in MOOTW and wartime, nurses can best prepare and train to effectively function and care for patients in these challenging settings.

Determinants of Health-Promoting Behaviors in Military Spouses During Deployment Separation

The purpose of this research was to describe predictors of participation in health-promoting behaviors among military spouses. A total of 105 female spouses of currently deployed active duty military members were surveyed to determine their perceived stress and participation in the health-promoting behaviors of exercise, diet, checkups, substance use/avoidance, social behaviors, stress management/rest, and safety/environmental behaviors. Demographic and deployment information was also collected. Regression analyses showed perceived stress was predictive of several health behaviors including exercise, social behaviors, stress management/rest, and safety/environmental behaviors. Increased perceived stress was associated with decreased participation in these behaviors. Deployment factors predicted only dietary behaviors and stress management/rest. As the minimum anticipated length of the deployment increased, healthy dietary behavior decreased. Likewise, as the number of deployments experienced increased, stress management and rest decreased. Stress brought on by military deployment may have detrimental effects upon participation in a health-promoting lifestyle.

Finding a Balance: Health Promotion Challenges of Military Women

In this study, we explored what may determine, or predict, United States military womens health promotion behaviors. Using a descriptive correlational design grounded in Penders Health Promotion model, 491 military women completed instruments measuring their demographic variables, perception of health, definition of health, self-efficacy, and interpersonal influences to determine the significant factors affecting participation in health promotion activities. The outcome indicated that self-efficacy and interpersonal influences were the most influential in determining health promotion. This research illuminates some of the challenges working women face in meeting health promotion activities and how best to support their ability to participate in healthy behaviors.

Mothers going to war: The role of nurse practitioners in the care of military mothers and families during deployment

Purpose: Many military women are being called to separate from their children to go to war. Most previous research has focused upon paternal, rather than, maternal, separation. The purpose of this article is to describe the experience of military mothers and their children during wartime deployments with clinical implications for nurse practitioners (NPs) in military or community settings. Data sources: Using grounded theory methods, 37 active duty and reserve component military women participated in a one‐time interview. Included were women who deployed for at least 4 months to Iraq or Afghanistan and had at least one child under the age of 12 during the separation. Conclusions: Military families present unique challenges for NPs. Mother deployments offer opportunities for intervention and anticipatory guidance across the trajectory of the separation. Military womens emotional and physical health must be supported before, during, and following deployment. Implications for practice: NPs are ideally positioned to support military families. During deployment, the NPs focus may shift to care of the children and their caregiver. Before and at reintegration, NPs are in a key position to intervene early for posttraumatic stress and support family readjustment.

Factors influencing a health promoting lifestyle in spouses of active duty military.

The purpose of this study was to understand the factors influencing the health promoting behaviors (HPBs) of military spouses. Penders Health Promotion Model provided the theoretical framework guiding this study. One hundred twelve female spouses were surveyed regarding their perceived health status, perceived stress, self-efficacy, social support, and participation in HPBs. Perceived health status, self-efficacy, social support, and HPBs were positively related, whereas perceived stress was negatively related. Hierarchical multiple regression analysis showed perceived stress and social support to be predictive of an overall health promoting lifestyle (HPLPII), with the full model explaining 49.7% of the variance.

Cultural Awareness Nursing Care of Iraqi Patients

Purpose: The aim of this study was to describe the cultural factors that have an impact on military nursing care for Iraqi patients. The results were part of a larger study in which the purpose was to understand nurses’ experiences of delivery of care for Iraqi patients. Method: Three focus groups, consisting of military registered nurses and licensed practical nurses, were used to generate rich descriptions of experiences in a military combat support hospital in Iraq. Data were analyzed using thematic analysis methods. Findings: Culturally, the differences between the Iraqi patients and the nurses included variations in communication, diet, and beliefs and values in reference to gender and patient dependency. Conclusion: The findings indicated that the nurses need language skills and cultural customs and beliefs training to provide care to culturally diverse patients. In addition, support services, such as dieticians, need to be involved in the plan of care to address applicable cultural issues. Implications: Implementation of learning to provide nurses language skills and cultural awareness of the diet, customs and beliefs of Iraqi people as well as the economic, political, and social factors that have an impact on their lives will promote quality nursing care and optimal health outcomes.

Chapter 6 impact of deployment on military families.

To date, approximately 300,000 families including 700,000 children have been affected by the increased and repeated number of deployments in support of the Global War on Terror in Iraq and Afghanistan since 2001. The purpose of this review is to discuss the impact of these deployments on family members of active duty and reserve/guard personnel. A search of literature across the years of military conflicts reveals waves of studies emerging after World War II, the Vietnam conflict, Desert Storm/Shield, and now the most recent wars. Study designs most frequently include qualitative exploratory, survey methods, and program evaluations. The field is limited by small scale projects, service- and facility-specific samples, and knowledge extracted from related topics. More research is needed to achieve a more comprehensive understanding across the trajectory of the deployment experience for both service personnel and family members as well as long-term outcomes.

Making the hard decisions: Ethical care decisions in wartime nursing practice

BACKGROUND Codes of ethics set forth standards of ethical conduct for nurses. However, nurses involved in wartime operations, or disasters, may often have their moral compass challenged by the patient care decisions necessary under adverse conditions. Reverse triage, resource allocation, and promotion of patient autonomy present multiple challenges to meeting commonly applied ethical principles. PURPOSE The purpose of this study was to use the International Council of Nursing code of ethics as a framework to organize the ethical issues emerging from wartime nursing. METHODS This article represents a secondary analysis of two studies using thematic analysis to identify ethical issues encountered by military nurses during the recent conflicts in Iraq and Afghanistan. Data were collected from nurses deployed from 2002 to 2015 and from 111 military nurses during focused interviews. DISCUSSION Across both studies, issues such as resource allocation, patient triage, cultural differences, and equitable treatment for all emerged as challenges within the wartime environment. Nurses were at a loss at times as to how best to manage the situations and recommended that more education is needed in ethical decision making before, during, and after deployment as a debriefing strategy. Similar issues have been documented in military and disaster literature indicating that such challenges are not limited to the recent conflicts but cross time and location. CONCLUSION By better understanding how nurses define, assess, and manage the ethical situations they encounter in wartime nursing practice, military nurses can better prepare for future conflicts, provide mentorship and targeted education to hopefully reducing any feelings of moral distress, and promote ethical decision making that will best promote outcomes in accordance with nursings ethical codes.