Linda L. Dunn

Prenatal Predictors of Intimate Partner Abuse

OBJECTIVE To determine the prevalence of physical abuse and to identify predictors of abuse in a sample of pregnant women in Alabama. DESIGN A prospective, correlational design was used. SETTING Participants were drawn from four unrelated public and private prenatal clinics in Tuscaloosa, Alabama. PARTICIPANTS The sample consisted of pregnant women between 20 and 34 years of age who had no high-risk health conditions and who initiated prenatal care during the 1st trimester. Four hundred thirty-nine ethnically diverse women completed interviews during the 1st and 3rd trimesters and had available birth outcomes. MAIN OUTCOME MEASURE Physical abuse during pregnancy was measured by a modified version of the Abuse Assessment Screen. Bivariate and multiple logistic regressions yielded significant associations between individual predictors and physical abuse during pregnancy. RESULTS The findings showed that 10.9% of the sample experienced physical abuse during the current pregnancy and 62% reported the intimate partner or former intimate partner to be the perpetrator. The best predictive model included stressful life events, depression, lack of faith in God or a higher power, and lack of contraceptive use.

A prospective study of psychosocial job strain and birth outcomes.

We conducted a prospective study in Alabama to examine the relation between job strain during pregnancy and birth outcomes. We hypothesized that maternal jobs high in demands and low in control would lead to lower birth weight in offspring. The sample consisted of 480 black and white women, 20 to 34 years of age receiving early prenatal care. Adjusting for standard covariates, women with high strain jobs had babies with birth weights 190 gm lower than those born to mothers in low strain jobs or unemployed (95% CI = 48gm, 333gm). Black women experienced a greater effect from job strain than white women.

Spiritual well-being, anxiety, and depression in antepartal women on bedrest.

This descriptive correlational study examined relationships among anxiety, depression, and spiritual well-being (SWB) in three groups of women (non-pregnant, normal pregnancy, high-risk pregnancy on bedrest). Women in each group completed a demographic survey, a Spiritual Well-Being Scale, and depression and anxiety subscales from the Abbreviated Scale for the Assessment of Psychosocial Status in Pregnancy. All groups (N = 180) demonstrated significant, inverse relationships among SWB, anxiety, and depression. Findings emphasize the importance of obstetrical nurses screening pregnant women to evaluate emotional health, especially in high risk pregnancies. Collaboration with mental health nurses may be useful in developing interventions to improve a womans SWB, reduce anxiety and depression, and improve pregnancy outcomes.

The Provision of Spiritual Care by Registered Nurses on a Maternal—Infant Unit

Purpose: This study explores the spirituality, spiritual well-being (SWB), and spiritual care provision of registered nurses on a maternal—infant unit. Methods: Data collection instruments included a demographic and spiritual care form, Spiritual Perspective Scale (SPS), and Spiritual Well-Being Scale (SWBS) to address the studys research questions. Findings: Significant positive correlations were found between SPS and SWBS as well as religious well-being (RWB) and existential well-being (EWB; subscales of SWBS). Religious attendance was significantly correlated with SPS, SWBS, and RWB but not EWB. Frequency of spiritual assessment themes was first encounter and when needed, whereas reaching up and reaching out described their provision of spiritual care. Conclusion: The sample was highly spiritual, spiritually well, and provided varied spiritual care. Implications: More spiritual care research is needed. Content on providing spiritual care must be enhanced within nursing curriculums as well as with nurses in practice.

“Trouble Won’t Last Always” Religious Coping and Meaning in the Stress Process

Meaning-based coping, particularly religious coping, might lead to positive emotions in stressful situations. Religious coping is common among older adults. We explored the experience of religious coping, organizational religious affiliation, and one’s relationship with God among older adults with advanced chronic illness and their caregivers. Research questions included: How is religious coping experienced in this context? How is a relationship with God experienced in coping? How is meaning experienced in this context? Brief qualitative interviews uncovered descriptions of experiences using the qualitative descriptive method. Three themes were identified: God is a provider, one’s religion and relationship with God when coping are essential, and the God–person relationship is intimate. Care recipients coped through their personal relationship with God, whereas caregivers coped through religious beliefs and support. Meaning was defined as purpose, responsibility, and duty.

Reintegration of Military Nurse Veterans

ABSTRACT This research focuses on how measures of mindfulness, spirituality, and storytelling affect the reintegration of 159 military nurses after service in a combat zone. Chief nurses of all branches of service forwarded a survey link to nurses who had served in Iraq or Afghanistan during Operation Iraqi Freedom or Operation Enduring Freedom. Data were analyzed using descriptive statistics and regression analyses. Findings suggest that spirituality, mindfulness, and storytelling strategies may mitigate the effects of war on deployed nurses. Nurses used a variety of strategies that made their time during deployment less stressful and their reintegration after deployment less traumatic.

Spiritual Needs: Focus on Forgiveness

Every time I turn on a newscast or pick up my morning paper, I learn of more heartache caused by hurting people who so selfishly hurt others. In her book, Hurt People Hurt People, Wilson (1993) describes the root of hurting others: unforgiveness. In recent editorials, I have tried to convey that we all have spiritual needs, one of which is forgiveness. Every human being needs to give and receive forgiveness from self, others, and the Sacred (Carson & Koenig, 2008). In an effort to better understand the process of forgiveness, I have found it helpful to consider what forgiveness is and isn’t. Forgiveness is NOT pardoning, excusing, condoning, forgetting, or even reconciling. Forgiveness is letting go rather than seeking revenge. Forgiving is freeing up your energy in order to move on with life. Healing enables us to discover renewed meaning and purpose through our experiences. I think a great example is to think about walking outside barefooted on a warm summer’s day when suddenly you step on a thorn…ouch!! What happens if you keep walking? The more you walk, the more if hurts. If the thorn is not removed, your foot will become infected – could even become so badly infected that amputation would become necessary. What should have been done initially? By all means, stop and remove the thorn. The pierced site may bleed or remain sore for a brief time, but it will heal without the adverse effects that result from failure to remove the thorn. Therefore, when pierced by “thorns” (hurt from others), stop and begin the healing process. Without “removing the thorn” (forgiveness), anger, resentment, bitterness, and depression (infection) will result. These results will rob us of our peace and joy; our body, mind and spirit will suffer. As nurses, we must be holistically well in order to minister to those placed in our care. How can we be instruments of healing if we have not addressed the hurt in our own lives through the process of forgiveness?