Rachel F. Schiffman

Exposure of Low-Income Families and Their Children to Neighborhood Violence and Paternal Antisocial Behavior

Objective. We examined the relation between neighborhood violence and father antisocial behavior with a national sample of fathers from low-income families with 3-year-old children Design. Children were classified into 4 groups based on their exposure to father antisocial behavior and neighborhood violence. Results. Children who experience high levels of each performed more poorly on indicators of emotion regulation. Children in risk groups were exposed to higher levels of family conflict, father depression, and poorer internal and external physical environments than children who were in the low-risk group. Children with fathers who were not antisocial were 3 times more likely to be spanked when the father resided in a high-risk neighborhood. Conclusions. Fathers should be included in early prevention programs targeting families with very young children, and such programs simultaneously challenged to broaden into community networks.

Advancing Symptom Science Through Use of Common Data Elements.

BACKGROUND Use of common data elements (CDEs), conceptually defined as variables that are operationalized and measured in identical ways across studies, enables comparison of data across studies in ways that would otherwise be impossible. Although healthcare researchers are increasingly using CDEs, there has been little systematic use of CDEs for symptom science. CDEs are especially important in symptom science because people experience common symptoms across a broad range of health and developmental states, and symptom management interventions may have common outcomes across populations. PURPOSES The purposes of this article are to (a) recommend best practices for the use of CDEs for symptom science within and across centers; (b) evaluate the benefits and challenges associated with the use of CDEs for symptom science; (c) propose CDEs to be used in symptom science to serve as the basis for this emerging science; and (d) suggest implications and recommendations for future research and dissemination of CDEs for symptom science. DESIGN The National Institute of Nursing Research (NINR)-supported P20 and P30 Center directors applied published best practices, expert advice, and the literature to identify CDEs to be used across the centers to measure pain, sleep, fatigue, and affective and cognitive symptoms. FINDINGS We generated a minimum set of CDEs to measure symptoms. CONCLUSIONS The CDEs identified through this process will be used across the NINR Centers and will facilitate comparison of symptoms across studies. We expect that additional symptom CDEs will be added and the list will be refined in future work. CLINICAL RELEVANCE Symptoms are an important focus of nursing care. Use of CDEs will facilitate research that will lead to better ways to assist people to manage their symptoms.

Recommendations of Common Data Elements to Advance the Science of Self‐Management of Chronic Conditions

PURPOSE Common data elements (CDEs) are increasingly being used by researchers to promote data sharing across studies. The purposes of this article are to (a) describe the theoretical, conceptual, and definition issues in the development of a set of CDEs for research addressing self-management of chronic conditions; (b) propose an initial set of CDEs and their measures to advance the science of self-management; and (c) recommend implications for future research and dissemination. DESIGN AND METHODS Between July 2014 and December 2015 the directors of the National Institute of Nursing Research (NINR)-funded P20 and P30 centers of excellence and NINR staff met in a series of telephone calls and a face-to-face NINR-sponsored meeting to select a set of recommended CDEs to be used in self-management research. A list of potential CDEs was developed from examination of common constructs in current self-management frameworks, as well as identification of variables frequently used in studies conducted in the centers of excellence. FINDINGS The recommended CDEs include measures of three self-management processes: activation, self-regulation, and self-efficacy for managing chronic conditions, and one measure of a self-management outcome, global health. CONCLUSIONS The self-management of chronic conditions, which encompasses a considerable number of processes, behaviors, and outcomes across a broad range of chronic conditions, presents several challenges in the identification of a parsimonious set of CDEs. This initial list of recommended CDEs for use in self-management research is provisional in that it is expected that over time it will be refined. Comment and recommended revisions are sought from the research and practice communities. CLINICAL RELEVANCE The use of CDEs can facilitate generalizability of research findings across diverse population and interventions.

Drug and substance use in adolescents.

This article provides an overview of adolescent drug and substance use, and includes prevalence and trends, commonly occurring comorbid conditions, clinical manifestations of drug and substance use, and evidence-based prevention and treatment principles. Risk and protective factors in five domains are also discussed in this article to provide guidance for assessment and care planning. A detailed table of the most prevalent drugs used by adolescents, including the drug’s street names and the clinical manifestations of each drug’s use, is offered to assist nurses in understanding their adolescent patients’ language and to aid in teaching. Nurses are in varied and ideal positions to begin early screening (and to include families, peers, and other important influences in the adolescent’s life), to provide continuity of care, and to advocate in the policy arena for development and funding of comprehensive and efficacious programs to help prevent or treat substance use in adolescents.

EXAMINING LONG‐TERM EFFECTS OF AN INFANT MENTAL HEALTH HOME‐BASED EARLY HEAD START PROGRAM ON FAMILY STRENGTHS AND RESILIENCE

Infant Mental Health based interventions aim to promote the healthy development of infants and toddlers through promoting healthy family functioning to foster supportive relationships between the young child and his or her important caregivers. This study examined impacts of an Infant Mental Health home-based Early Head Start (IMH-HB EHS) program on family functioning. The sample includes 152 low-income families in the Midwestern United States, expectant or parenting a child younger than 1 year of age, who were randomly assigned to receive IMH-HB EHS services (n = 75) or to a comparison condition (n = 77). Mothers who received IMH-HB EHS services reported healthier psychological and family functioning, outcomes that are consistent with the IMH focus, when their children were between the ages of 3 and 7 years of age. Specifically, mothers in the IMH-HB EHS group reported healthier family functioning and relationships, better coping skills needed to advocate for their families, and less stress in the parenting role versus those in the comparison condition. The study also examined support seeking coping, some of which changed differently over time based on program group assignment. Overall, findings suggest that the gains families achieve from participating in IMH-HB EHS services are maintained after services cease.

The Importance of Self-Perceptions to Psychosocial Adjustment in Adolescents With Heart Disease

INTRODUCTION This study examined the importance of self-perceptions as determinants of psychosocial adjustment reported by adolescents with heart disease and compared adolescents with heart disease to healthy norms. METHODS Ninety-two adolescents with heart disease from a single Midwestern institution provided reports of self-perceptions (health, self-worth, competence, and importance), internalizing behavior problems (IPs; e.g., anxiety and depression) and externalizing behavior problems (EPs; e.g., attention problems and aggression), and health-related quality of life (HRQOL). Hierarchical linear regression was used to assess the impact of self-perceptions, as well as clinical factors (e.g., illness severity, time since last hospitalization, and medications) and demographic characteristics on outcomes. RESULTS Self-perceptions explained the most variance in behavioral and HRQOL outcomes (R(2)adj = 0.34 for IP, 0.24 for EP, and 0.33 for HRQOL, p < .001). Male gender and lower household income were associated with more behavior problems. Clinical variables were only related to HRQOL. Compared with healthy norms, IPs were significantly more common in male adolescents and HRQOL was lower (p < .001). DISCUSSION Adolescents with heart disease are at risk for internalizing behavior problems and reduced HRQOL; however, positive self-perceptions appear to be protective. Self-perceptions are critical and should be addressed by clinicians.

Nurse Researchers in Children's Hospitals

Little is known about the role of nurse researchers (NRs) and the structure of nursing research programs in childrens hospitals in the United States. This descriptive study obtained survey data from 33 NRs. Data suggest that the NR role is emerging and has both commonalities and unique components when compared with the previous studies of NRs in adult hospitals. Most participants have been in their position for less than 4 years. Conducting research, having staff development related to research, and facilitating evidence-based practice or research were common responsibilities. The structure of nursing research programs impacts both the NRs and the program outcomes.

Factors associated with parent depressive symptoms and family quality of life in parents of adolescents and young adults with and without Spina Bifida

PURPOSE The purpose of this study was to explore factors related to parental depressive symptoms (PDS) and family quality of life (FQOL) in parents of adolescents and young adults (AYA) with and without a specific chronic health condition (CHC), spina bifida. METHODS Two hundred and nine parents of AYA (112 with SB; and 97 without) and their AYA (46% males and 54% females) took part in a multi-site cross-sectional descriptive correlational study. In telephone interviews parents reported on measures of family satisfaction, resources, cohesion, stress, demographic and clinical data. RESULTS In the multivariate analyses, 38% of the variance of PDS was explained by family income, family resources and parent stress. Having a child with SB was not predictive of PDS. However, having a child with SB, along with family satisfaction, parent stress and PDS explained 49% of the variance of FQOL. PDS partially mediate the relationship of family resources and FQOL. CONCLUSION PDS, family stress, and resources should be evaluated routinely, especially for those with low income. Parents of AYA with SB who have elevated PDS are at increased risk of having lower reported FQOL.

English-Language Proficiency, Academic Networks, and Academic Performance of Mexican American Baccalaureate Nursing Students

AIM We examine how academic networks mediate between English‐language proficiency and academic performance. BACKGROUND The relationship between English‐language proficiency and academic performance remains inconclusive; it is possible that academic networks play a role in this relationship. Filling this knowledge gap is central to building best practices in teaching, and to evaluating the impact of networks on success. METHOD Data were analyzed from 164 Mexican American nursing students. We used English Language Acculturation Scale (ELAS) items as predictors, interaction with academic networks as the mediating variable, and course grade as the outcome; regression analyses were performed. RESULTS Interaction with academic networks correlated with grades; ELAS was not significant. Instead, academic networks mediated between entrance GPA and grades, an unexpected finding. CONCLUSION Academic networks are critical in academic performance. However, only those students who have a history of high performance are likely to have or to activate academic networks.

Is Assisted Self-Management a Viable Concept for Individuals With Cognitive Impairment?

Self-management science is one of four key themes within the National Institutes for Nursing Research (access https:// www.ninr.nih.gov/aboutninr/ninr-mission-and-strategicplan/themes-self-management#.UyNMhM7N4f_). Th e science of self-management examines ways to help individuals with chronic conditions, their families, and caregivers manage their illness and enhance their health behavior. Th e science of self-management has advanced our understanding of the behaviors that individuals can use to infl uence their health; the processes of acquiring the requisite knowledge and skills to enact behaviors; and the contextual factors that can infl uence self-management behaviors. Self-management theories focus on cognitively intact individuals who can problem solve, make decisions, collaborate with their health care provider, and access resources that will optimally meet their needs (Grady & Gough, 2014). But what about individuals with cognitive defi cits and their family caregivers? In this issue of Research in Gerontological Nursing (RGN), a team from the Netherlands reports on how and by whom family caregivers want to be supported in their self-management when caring for a relative with dementia (Huis in het Veld et al., 2018). We are pleased to publish this article, which is a beginning step in understanding important elements of self-management support for caregivers of individuals with dementia. Th is editorial will explore the self-management that even those with substantial cognitive impairment (CI) may be able to accomplish and make suggestions for broadening the scope of current theoretical models to include the selfmanagement of individuals with CI.