Lynn Rew

Youth Resilience Framework for reducing health-risk behaviors in adolescents.

Adolescents engage in risky behaviors that compromise their health. Leading causes of morbidity and mortality are associated with a few preventable health-risk behaviors initiated in childhood and early adolescence. Interventions that enhance protective factors in childhood are needed to offset these vulnerabilities and thus promote the health of adolescents. The Youth Resilience Framework is presented that addresses individual and sociocultural risk factors and protective resources that can influence health outcomes throughout adolescence. This framework incorporates a developmental approach to address precursors and health-risk behaviors that may be amenable to early health-promoting interventions.

A systematic review of the literature: workplace violence in the emergency department

AIMS AND OBJECTIVES To synthesise the body of literature on workplace violence in the emergency department and to identify characteristics of intervention studies that are the basis for guiding best practice modelling in the clinical setting. The research question addressed was what are the characteristics and findings of studies since 2004 on workplace violence in the emergency department? BACKGROUND Emergency departments are prone to increased incidents of workplace violence. Workplace violence in the health care setting has become a hot topic of policy, political debate and research in recent years. Despite the research that has been carried out in this area, little consensus exists as to what are the best practices for mitigating violence in this setting. Design.  Systematic literature review. METHODS Search using four online databases, including MEDLINE, CINAHL, PsycINFO and the Dissertations and Theses Full Text Database. RESULTS Most research focused on the incidence rates of workplace violence in the emergency department and effects on staff. There was a significant lack of intervention studies to provide a framework for guiding evidence-based practice. Themes of under-reporting violence, barriers and attitudes towards reporting, description and characterisation of incidents of violence, predisposing factors and the concept of safety or lack of fear were all major content areas addressed in the literature. CONCLUSIONS Incidence of workplace violence in the emergency department has been well documented in numerous published studies. Emergency department workers are exposed to significant rates of physical and verbal abuse. Under-reporting of workplace violence in the emergency department is common and contributes to the difficulty in accurately tracking violence. RELEVANCE TO CLINICAL PRACTICE Future research must move beyond descriptive studies to include more advanced research methods. Few practice-guiding implications can be gained from this body of research because of the lack of intervention studies.

Measuring Cultural Awareness in Nursing Students

Recognizing the need for a valid and reliable way to measure outcomes of a program to promote multicultural awareness among nursing faculty and students, the authors developed a cultural awareness scale. In the first phase of the study, a scale consisting of 37 items was generated from a literature review on cultural awareness, sensitivity, and competence in nursing. A Cronbachs alpha reliability coefficient of .91 was obtained from a sample of 72 student nurses. In the second phase, the items were presented to a panel of experts in nursing and culture to determine content validity. A content validity index of .88 was calculated, and the total number of items on the scale was reduced to 36. The scale then was administered to 118 nursing students. Data from the two samples then were combined, and factor analysis was conducted to support construct validity. Cronbachs alpha for the combined samples was .82.

Ethnic identity, role integration, quality of life, and depression in Korean-American women

Little is known about how living between two cultures affects the mental health of immigrant women. This study examined the relationships between ethnic identity, role integration, quality of life, and depression in 76 Korean-American women. Quality of life was positively associated with role integration (r = .68, p < .01). Role integration and quality of life were negatively and significantly associated with depression (r = -.59 and r = -.72, p < .01, respectively). An exploratory path analysis was performed to examine the relationships between demographics and conceptual variables. Only quality of life and length of residence in the United States were strongly associated with depression. Findings have implications for psychiatric nursing practice.

Sexual abuse, alcohol and other drug use, and suicidal behaviors in homeless adolescents

Previous research has shown that homeless youth have high rates of suicidal ideation, sexual abuse, and abuse of alcohol and other drugs. However, little is known about how these rates differ by gender and ethnicity. Our objective was to describe patterns of sexual abuse, alcohol and other drug use, and indicators of suicidal behaviors in homeless adolescents and to determine gender and ethnic differences in these factors. We used secondary data analysis of data from surveys completed by 96 homeless youth whose average age was 17.9 years. Over 60% of the sample reported a history of sexual abuse; the majority were under the age of 12 years when they first tried alcohol, marijuana, and cocaine; 56.3% had injected drugs, and 46.9% had tried inhalants. During the past 12 months, 35.1% had seriously considered suicide and 12.3% had actually attempted suicide at least once. Significantly more Hispanics than Whites had considered suicide (chi 2 = 4.31, p = .038). A disproportionate number of Hispanics (95% of the sample) reported a history of sexual abuse. Participants with a history of sexual abuse were significantly more likely than those who did not have a history of sexual abuse to have used alcohol and/or marijuana (chi 2 = 9.93, p < .01) and to have considered suicide in the past 12 months (F = 14.93, p < .001). We found that sexual abuse history is greater in this sample than in the general population and is particularly prevalent among Hispanic/Latino subjects. As in other studies, sexual abuse was more common among females than among males. High prevalence of sexual abuse, alcohol and other drug use, and suicidal behaviors in this sample of homeless youth underscores the need to develop and test community-based interventions to improve their health status.Previous research has shown that homeless youth have high rates of suicidal ideation, sexual abuse, and abuse of alcohol and other drugs. However, little is known about how these rates differ by gender and ethnicity. Our objective was to describe patterns of sexual abuse, alcohol and other drug use, and indicators of suicidal behaviors in homeless adolescents and to determine gender and ethnic differences in these factors. We used secondary data analysis of data from surveys completed by 96 homeless youth whose average age was 17.9 years. Over 60% of the sample reported a history of sexual abuse; the majority were under the age of 12 years when they first tried alcohol, marijuana, and cocaine; 56.3% had injected drugs, and 46.9% had tried inhalants. During the past 12 months, 35.1% had seriously considered suicide and 12.3% had actually attempted suicide at least h once. Significantly more Hispanics than Whites had considered suicide ( h 2 = 4.31, p = .038). A disproportionate number of Hispanics (95% of the sample) reported a history of sexual abuse. Participants with a history of sexual abuse were significantly more likely than those who did not have a history of sexual abuse to have used alcohol and/or marijuana ( h 2 = 9.93, p < .01) and to have considered suicide in the past 12 months ( F = 14.93, p < .001). We found that sexual abuse history is greater in this sample than in the general population and is particularly prevalent among Hispanic/Latino subjects. As in other studies, sexual abuse was more common among females than among males. High prevalence of sexual abuse, alcohol and other drug use, and suicidal behaviors in this sample of homeless youth underscores the need to develop and test community-based interventions to improve their health status.

Personal strengths of homeless adolescents living in a high-risk environment

Health-risk behaviors and associated adverse health outcomes in homeless adolescents are well documented. Strengths of these youth that contribute to their health and well-being are seldom acknowledged. The purpose of this secondary analysis of qualitative data was to identify strengths that protect homeless youth. Two types of strengths emerged: resources and self-improvement. Resources served as the foundation for survival whereas self-improvement served as a process that enabled youth to consider a more healthy future. By recognizing the many strengths of homeless youth, nurses may develop community-based programs to help this population reenter society.

Intuition: A neglected hallmark of nursing knowledge.

Intuition as a hallmark of nursing knowledge was traced through an analysis of literature published in the American Journal of Nursing between 1900 and 1985. Three questions were addressed: Does the concept appear in the literature; if so, what are its attributes; and how did they evolve through time? Titles of articles (n = 14,971) were examined and from this population only 51 were found to contain intuition or related terms. From analysis of the paucity of literature containing the concept it is concluded that intuition as an essential component of complex decision making is neglected in the professional literature.

Acknowledging intuition in clinical decision making.

The purpose of this study was to develop and validate a scale to measure nurses’ acknowledgment of using intuition in clinical decision making. Development and validation of the scale was carried out in three phases. In Phase 1, scale items were generated from the published literature in nursing and management and a Content Validity Index (CVI) of .96 was computed on responses from a panel of five experts. In Phase 2, the scale was pilot-tested on a random sample of 106 psychiatric mental health nurses. In Phase 3, the revised scale was presented to a convenience sample of 112 nurses attending continuing education programs. Seven items were found to explain 40.6% of the variance in scores and were retained as the final unidimensional scale. Construct validity was supported by a difference in means of two groups that also differed on another measure of intuition.

Intuition: concept analysis of a group phenomenon.

Intuition as a group phenomenon is clarified through the process of concept analysis using the analytical process outlined by Walker and Avant. Intuition as a respectable characteristic of creative and powerful groups is based on uses of the concept; identification of attributes, antecedents, and consequences; construction of various cases; and identification of empirical referents. Suggestions for applications in nursing education, nursing administration, and professional organizations follow.

State of the science: intuition in nursing, a generation of studying the phenomenon.

A systematic review of nursing literature was conducted to determine the state of the science with respect to the use of intuition in nursing practice and nursing education. The Cumulative Index for Nursing and Allied Health database was used to identify the priority population. From this database, 45 research articles that were written in English, published in nursing journals, and that contained the word intuition in the title and/or abstract and in which intuition was a major term were analyzed. Findings show that, to date, most studies are descriptive, exploratory in design. Nurses affirm that intuition is salient to expertise in clinical practice and should be carefully taught to students and novice nurses.