Pam Shockey Stephenson

Ambiguity and violence in adolescent dating relationships.

PROBLEM Little is known about dyadic processes that lead to adolescent dating violence. The purpose of this study was to examine the phenomenon of relationship ambiguity in adolescent dating relationships to better understand how ambiguity contributes to violence and aggression between dating partners. METHODS Data were drawn from 88 narratives of young adults who had participated in a study on adolescent dating violence. Interpretive phenomenology was used to produce an in-depth description of the phenomenon of relationship ambiguity. FINDINGS Relationship ambiguity results in differing expectations between partners regarding closeness and intimacy, fidelity, and obligation. These differences lead to conflicts that set the stage for violence and aggression in adolescent dating relationships. CONCLUSIONS A series of recommendations for clinicians working with adolescents are presented.

Peer Involvement in Adolescent Dating Violence.

This study investigated the ways in which peers are involved in adolescent dating violence. Eighty-eight young adults aged 18–21 were interviewed and asked to reflect on aggressive dating relationships they experienced as teens. The researchers used grounded theory to analyze the data. Findings showed that male and female peers were involved in adolescent dating violence in unique ways. Male peers were involved in dating violence by participating in the aggression, agitating the aggression, being the competition, trivializing the aggression, and keeping tabs on the recipient. Female peers were involved in dating violence by deserting the recipient, cheating with the boyfriend, being the audience, needling the male dating partner, and helping the recipient. Male and female peers were involved similarly in adolescent dating violence by confronting the partner. School nurses working with adolescents are uniquely positioned to approach adolescents about dating violence. Interventions aimed at promoting discussions with adolescents are discussed.

Spirituality and Uncertainty at the End of Life

PURPOSE/OBJECTIVES To examine the theoretical congruency between uncertainty and spirituality at the end of life (EOL). DATA SOURCES Relevant empirical and theoretical articles using the key words spirituality, uncertainty, terminal illness, and similar derivatives were drawn from the databases of CINAHL®, MEDLINE®, PsycINFO, and SocINDEX. DATA SYNTHESIS Spirituality and uncertainty were compared for theoretical congruency based on five general categories: prevalence, temporality, interpretation, quality, and directionality. The categories were drawn from the uncertainty literature and looked at the ability of spirituality and uncertainty to contribute to or detract from health. CONCLUSIONS This article presents an innovative way of viewing how spirituality is experienced at the EOL. The likelihood that uncertainty and spirituality can coexist as a simultaneous and even blended construct that influences the EOL is supported and warrants additional exploration. IMPLICATIONS FOR NURSING Health professionals must recognize the prevalence of spiritual uncertainty in the lives of their patients and understand the need to frequently assess for spiritual uncertainty. Specific recommendations are provided to guide professionals in addressing spiritual uncertainty with patients.

Adolescent Dating Violence and Peplau’s Dimensions of the Self

BACKGROUND: Adolescent dating violence (ADV) is a significant public health problem. Despite an association between ADV and lowered self-esteem, little research has examined identity issues in persons who have experienced ADV. OBJECTIVES: To use Peplau’s model of the dimensions of the self to describe identity concerns in those who experienced ADV. DESIGN: Verbatim comments that met Peplau’s definitions of self-statements were extracted from the narratives of 50 young adults who had taken part in an ongoing qualitative study on ADV. The statements were coded into Peplau’s dimensions using content analysis. RESULTS: 175 verbatim sentences were extracted from the narratives. The statements addressed 16 different personal characteristics, including strength, sociability, and aggressiveness. CONCLUSIONS: Individuals who have experienced ADV have a number of concerns related to self-concept. Recommendations are made regarding how these concerns may be addressed with investigative counseling, as described by Peplau.

Support for using five attributes to describe spirituality among families with a parent in hospice.

OBJECTIVE The importance of spirituality in the dying process is well documented. However, what spirituality means in these situations is hard to discern because few people (patients, families, researchers, or caregivers) will view spirituality in the same way. The present research supports the use of a spiritual framework consisting of five common attributes (meaning, beliefs, connections, self-transcendence, and value) as a mechanism for viewing spirituality for people nearing the end of life. Using qualitative interviews from two related studies, our study aims to describe the prevalence of spirituality and its nature according to these five spiritual attributes. METHODS Data from two previous studies were analyzed. The first employed the methods of grounded theory to understand the strategies adolescents used to manage the impending death of a parent. Some 61 participants from 26 families were interviewed, including ill parents/patients, well parents/caregivers, and adolescents. The second study consisted of 15 interviews with the surviving parent and adolescents from 6 of these families after the death of the parent. RESULTS The original research from which these data were drawn did not seek to describe spirituality. However, spiritual themes were prevalent in the stories of many participants and included each of the five spiritual attributes. SIGNIFICANCE OF RESULTS Our findings demonstrate the prevalence of spirituality in the everyday lives of these families and supports the use of the spiritual framework according to the five common attributes to describe spirituality.

The Spiritual Nature of Uncertainty Among Hospice Patients

People with protracted and life-limiting illness engage in end-of-life transitions as they prepare for death. The end of life is a time of mystery that elicits uncertainties in the form of questions, worries, and doubts. If not managed properly, uncertainties can contribute to emotional distress and feelings of lost control. Currently, uncertainty occurring at the end of life is underresearched. Phenomenology was used to explore the experience of uncertainty for 6 hospice patients using semistructured interviews. A 4-member, interpretive team analyzed the data. The participants were asked to describe the uncertainties that they had while they were dying. Interestingly, most of the stories about uncertainty were spiritual in nature. An overall theme of “uncertainty as a bridge” emerged from the data as the way uncertainties affected their dying. Two subthemes of “uncertainties about dying” and “uncertainties about important relationships” also emerge as the areas of greatest concern for participants. These findings support uncertainty as an important phenomenon for people preparing for death and one that providers of end-of-life care should understand.