June Andrews Horowitz

An international study exploring levels of postpartum depressive symptomatology.

OBJECTIVE Differences in postpartum depressive symptomatology (PPDS) among an international sample of 892 women from nine countries representing five continents were explored. METHOD Edinburgh Postnatal Depression Scale (EPDS) and Beck Depression Inventory (BDI) were used to assess PPDS among a convenience sample that completed the two questionnaires twice, yielding a total of four sets of scores per subject. Women sampled were primiparae with no obstetrical complications, and had a healthy baby. Depression history and therapy were ruled out as exclusion criteria. RESULTS Mean scores for EPDS and BDI varied across sites at both time points (P value<.001). European and Australian women had the lowest levels of PPDS, USA women fell at the midpoint, and women from Asia and South America had the highest depressive symptom scores. The moderate concordance between the EPDS and BDI suggested that the measures have complementary uses for screening and assessment. CONCLUSION Utility of EPDS and BDI for yielding profiles of postpartum womens depressive symptomatology was demonstrated. Further research to validate depressive symptom measures with diverse international populations is indicated.

Identifying and treating postpartum depression

Postpartum depression affects 10% to 20% of women in the United States and negatively influences maternal, infant, and family health. Assessment of risk factors and depression symptoms is needed to identify women at risk for postpartum depression for early referral and treatment. Individual and group psychotherapy have demonstrated efficacy as treatments, and some complementary/alternative therapies show promise. Treatment considerations include severity of depression, whether a mother is breastfeeding, and mothers preference. Nurses who work with childbearing women can advise depressed mothers regarding treatment options, make appropriate recommendations, provide timely and accessible referrals, and encourage engagement in treatment.

Teasing and Bullying Experiences of Middle School Students

BACKGROUND: In the United States, 9% to 15% of children experience chronic teasing and bullying that may be harmful. OBJECTIVE: The purpose was to explore teasing and bullying experiences of middle school students as part of the Child-Adolescent Teasing Scale (CATS) project. STUDY DESIGN: Seven focus groups were conducted with 11-to 14-year-old middle school students from Massachusetts, New Mexico, and Mississippi. Moderators used a semistructured interview guide to elicit views. Recorded sessions were transcribed; content analysis of verbatim accounts was used to identify sources of teasing and bullying. RESULTS: Sources of teasing and bullying were physical appearance, personal behavior, family and environment, and school relations. “Being different in any way” was the underlying theme. CONCLUSIONS: Teasing and bullying were universal and distressing, and were affected by context, frequency, and individually attributed meanings. Clinicians and school staff may use findings to identify children who might be at risk for psychological and physical harm.

The Inextricable Nature of Mental and Physical Health: Implications for Integrative Care

There is growing evidence that physical health problems are caused and exacerbated by psychological factors. Research indicates that psychological distress leads to physical disease through impairment of the neuroendocrine system and its interface with the body’s immune response. However, the current health care delivery system splinters care into “psychiatric” and “physical” health silos. New approaches are needed to assure adequate professional knowledge of behavioral health at basic licensure, to increase the use of advanced practice psychiatric—mental health nurses in primary care settings, to identify and teach behavioral competencies for primary care providers, and to fund the design and evaluation of integrative models of care.

Methodological Challenges in Research with Vulnerable Families

Researchers studying vulnerable families can face formidable impediments. The purpose of this article is to provide an overview of methodological challenges commonly encountered in research with vulnerable family units or members and to suggest problem-solving strategies. The following issues are examined: (a) obstacles to identifying, accessing, recruiting, and retaining vulnerable families as research participants; (b) responsibilities of researchers concerning unanticipated health care crises, informed consent, and participant and researcher safety; and (c) issues in training clinicians as research team members. Examples are drawn from the literature as well as from family and family-related research studies conducted by the authors that involve both quantitative and qualitative designs, along with various family situations.

Measurement of Maternal-Infant Interaction

Evaluating the quality of the maternal-infant relationship is a challenge to researchers and clinicians interested in infant development and quality of early parenting. The purpose of this article is to describe and critique commonly used measures of maternal-infant interaction to assist researchers in making informed decisions about measuring this variable. The measures reviewed are valuable approaches to assessment of parent-child interaction for research; several are adaptable for clinical use as well. In selecting the most appropriate measure for a particular study, investigators are encouraged to consider the conceptual model on which the instrument is based, accessibility of training, extent of previous use, evidence of reliability and validity, and specific requirements for equipment, specialized laboratory setting, administration, and scoring. Using maternal-infant interaction measures that are appropriate for clinical practice could assist psychiatric-mental health nurses and other mental health clinicians to identify problematic aspects of interaction that may be amenable to treatment with interpersonal, cognitive, behavioral, and psychoeducational strategies.

Psychometric Evaluation of the Child-Adolescent Teasing Scale

BACKGROUND This article presents the psychometric evaluation of the Child-Adolescent Teasing Scale (CATS), an instrument to be used as a screening measure with middle school students. METHODS A 70-item scale was initially derived from qualitative data obtained from focus groups comprised of middle school students. A diverse sample of participants (N=764) then completed the CATS and the Piers-Harris Childrens Self-Concept Scale (PHCSCS); their mothers completed the Pediatric Symptom Checklist (PSC) and a demographic information form. A psychometric sample (N=666) without missing data was used for subsequent analyses. RESULTS Principal components analysis resulted in a 32-item, 4-factor solution: Personality & Behavior Teasing (14 items), Family & Environment Teasing (7 items), School-Related Teasing (9 items), and Teasing About My Body (2 items). The standardized Cronbachs alpha for the final version was .94 and ranged from .83 to .90 for the subscales. The CATSs content validity, initially ascertained a priori by experts, was re-reviewed upon the instruments refinement and supported. One-tailed t tests of mean differences between low- and high-scoring CATS groups on the PSC (t=-3.41, p<.03) and the PHCSCS (t=-11.39, p<.001) and supported the CATSs criterion-related validity. CONCLUSIONS The 4-factor, 32-item CATS is psychometrically defensible and has demonstrated potential as a screening measure to identify students who are at risk from distressing teasing.

Tasks and communication as an avenue to enhance parenting of children birth-5 years: an integrative review.

Every day, normative functions of parenting and their significance are under-investigated. An integrative review of tasks and communication involved in parenting young children informed by Horowitz (1995) and Blumer (1969) was conducted.Research articles consistent with inclusion criteria were published from 1995 to 2013 and focused on parenting tasks and communication. Themes consistent with Horowitz and Blumer were identified. Nurses are reminded about the significance of attending to the everyday, normative work of parenting young children, the potential meaning derived from this work, and the importance of assessing parental development as well as the importance of continuing research in this area.

Report of the 13th International Family Nursing Conference: The Art and Science of Family Nursing: Transforming Health for Families, Pamplona, Spain, 2017

The 13th International Family Nursing Conference (IFNC13) took place June 14 to 17, 2017 in Pamplona, Spain, the ancient city of the Basques and featured location in Ernest Hemingway’s masterpiece, The Sun Also Rises. In this beautiful setting, a gathering of 329 family nurses from 29 countries (see Table 1) shared the latest family nursing research, education, and practice centered on the theme of The Art and Science of Family Nursing: Transforming Health for Families. IFNC13 was organized by the International Family Nursing Association (IFNA) Conference Committee and was third official meeting of IFNA since its inception in 2009. For a history of the International Family Nursing Conferences, see Bell (2015) (http://janicembell.com/2015/09/ history-of-the-international-family-nursing-conferences/). IFNC13 began with a memorable Welcome Reception in the Museum of Art at the University of Navarra by celebrating the diverse heritage of the