Rita Black Monsen

National survey of genetics content in basic nursing preparatory programs in the United States.

The purpose of the study described in this article was to reassess the type and amount of genetics content in basic nursing preparatory programs in the United States. Recommendations are made for increasing genetics content in baccalaureate nursing programs. These recommendations are a result of the synthesis of the current survey data with previous data and recommendations.

Mothers' experiences of living worried when parenting children with spina bifida

This study describes the lived experience of mothers of children with spina bifida. Thirteen mothers of children between the ages of 12 and 18 years participated in at-home, audiotaped interviews. Each participant was asked to describe, through narrative, what it is like to be the mother of a child with spina bifida. The researcher used Heideggerian hermeneutical methodology to transcribe and analyze interview texts. Examination of the data revealed the constitutive pattern living worried and its two relational themes: treating them like other children and staying in the struggle. Nurses can use narratives to create supportive relationships with mothers of children with disabilities and to pursue research that extends the understanding of these women and their struggles.

Having a future: Sexual decision making in early adolescence

There is meager information about how adolescents decide to become sexually active and use protection against pregnancy and disease. The purpose of this project was to explore the thinking of adolescents, ages 12 to 14, about becoming sexually active and using protection during sexual encounters. In a health class, 45 adolescents responded to questions about influences on having sex and using protection. Short-answer, written responses were analyzed using Heideggerian hermeneutic interpretation. The reflections of youth faced with sexual decision-making focused on self-protection against pregnancy and disease. Postponing sexuality or using protection meant having a future, one that could hold the promise of love, marriage, and desired children.

Genetics, Nursing, and Public Policy: Setting an International Agenda

In the last decade of the 20th century, government sponsored and private-sector research endeavors in genetics have unveiled remarkable new knowledge that has the potential to improve human health on a global scale. The purpose of this article is threefold. The authors (a) draw attention to accomplishments achieved thus far in setting policies for genetic nursing, (b) recommend a holistic agenda for advancing genetic nursing education policies nationally and internationally, and (c) recommend essential components of policy development that depict nursing’s interest in genetic concerns globally. The authors encourage nurses worldwide to participate in health, social, ethical, and public policy deliberations related to genetics.

Comparison of Attitudes toward Death and Dying among Nursing Majors and other College Students

Recent studies of attitudes toward fear of death and dying among under-graduates have been sparse. Hoelters Multidimensional Fear of Death Scale (MFODS) [1] was developed among undergraduates to discern fear of death or death anxiety. The purposes of this study were to 1) examine the factor structure and reliability estimates of Hoelters MFODS in a contemporary sample of college students and 2) compare the attitudes of nursing majors with those of other college students at a small liberal arts university in rural, southwestern Arkansas. It was hypothesized that the 1) attitudes of nursing majors would differ from those preparing for other careers and 2) attitudes of nursing majors and other undergraduates would differ at each level of student status (freshman through senior years). This was a descriptive study surveying attitudes among students who were recruited through cooperating faculty in courses serving all undergraduate majors. Informed consents were signed after review of the introductory information by the students. The sample consisted of 405 students, ages eighteen to sixty-four years (mean age 26 years); 27 percent were males and 73 percent females. Nursing students comprised 24 percent of the sample and were marginally different demographically from other students. The MFODS (a 42-item, pencil-and-paper instrument including a demographic questionnaire) was administered in one classroom session. Factor structure was derived using principal components analysis with varimax rotation and revealed eight subscales accounting for 21 percent of the variance. The total scale alpha reliability was .88, with eight subscale alpha reliabilities ranging from .75 to .85. The results of comparisons of nursing students with others revealed differences on three subscales and the total MFODS. Nursing students were less fearful of the dead, less fearful of being conscious while dead, and less fearful of being destroyed after death. Analyses of students by levels of student status revealed that freshman nursing students were most fearful of the dead and junior nursing students were most fearful of discovering a dead body. Other undergraduate freshmen were most fearful of events after death such as treatment of the body after death, being practiced on by medical students, being embalmed, being conscious in a morgue, and the thought of never being found after death. There were no significant findings among comparisons of nursing and other undergraduate majors by level of student status (freshman through senior). It was concluded the MFODS was a reliable instrument. Nursing students displayed significant attitudinal differences as compared to other students examined. Students who study nursing may bring greater acceptance of death and the dying process to health care arenas. Longitudinal comparison studies and qualitative analyses of attitudes were recommended to further elucidate professional socialization processes.

Nursing and Genetics: a feminist critique moves us towards transdisciplinary teams:

Genetic information and technologies are increasingly important in health care, not only in technologically advanced countries, but world-wide. Several global factors promise to increase future demand for morally conscious genetic health services and research. Although they are the largest professional group delivering health care world-wide, nurses have not taken the lead in meeting this challenge. Insights from feminist analysis help to illuminate some of the social institutions and cultural obstacles that have impeded the integration of genetics technology into the discipline of nursing. An alternative model is suggested - the transdisciplinary model - which was developed initially by a nurse and introduced in the 1970s into the delivery of health care and social services for children with developmental disabilities. This holistic model enables all health care professionals to have an equal voice in determining how genetic health care will be globalized.

Preparation of undergraduate nursing faculty to incorporate genetics content into curricula

Faculty education has been identified as one key to the incorporation of genetics into nursing education and practice (Donaldson 1997; Mathews 1985). A multifaceted program was developed in 1996 to educate nursing faculty about genetics. The program was funded by the Ethical, Legal, and Social Implications Research Program (ELSI) of the National Human Genome Research Institute at the National Institutes of Health. The specific aims of the program were to (1) increase nursing faculty knowledge about human genetics and its clinical application and (2) improve and/or expand the human genetics content taught in RN preparatory nursing education programs. This multifaceted program is one effort to enable students graduating from RN preparatory programs to begin meeting the basic genetics needs of health care consumers. Genetics-related services that all nurses should be able to provide have been delineated in the recently publishedStatement on the Scope and Standards of Genetics Clinical Nursing Practice(International Society of Nurses in Genetics 1998). These services include management of genetic information and iden tification and referral of and support and care for per sons affected by or at risk for manifesting or transmit ting genetic conditions. To enable nurses to provide these basic services, the document further states that all practicing nurses should have a course in human genetics as well as genetics content and clinical experiences integrated throughout their RN preparatory programs. Results from multiple surveys over the past two decades, however, consistently revealed that nurses received limited genetics education in their basic nursing programs (Hetteberg and others 1998; Mertens and others 1984; Monsen 1984; Scanlon and Fibison 1995; Williams 1985). As a part of the Genetics Program for Nursing Faculty, a national survey was done to reassess the type and amount of genetics content in nursing curricula (Hetteberg and others 1998) as well as nurs ing faculty preparation to teach genetics content. Results indicated that the majority of nursing faculty responsible for teaching genetics content received lim ited formal educational preparation to do so (Prows and Hetteberg, unpublished results). Nursing faculty’s limited education in genetics is a significant barrier to increasing genetics content in nursing curriculum.

Prevention is Best for Fetal Alcohol Syndrome

WE CAN WORRY justifiably when we see women of reproductive age drink alcohol because even a small amount taken at any time during pregnancy can lead to irreversible damage in the developing baby. We hope that every pregnancy can be wanted and planned for, but that is not a realistic goal for many young people in our communities today. Some of the most troubling situations surround so-called “party schools” where young people in colleges and universities engage in binge drinking, at times consuming significant amounts of alcohol on weekends or on vacation breaks away from classes. Many young men and women drink and experiment with unprotected sex and risk pregnancy as well as exposure to sexually transmitted diseases. Fetal alcohol syndrome (FAS) and the associated range of disorders (alcohol-related neurodevelopmental disorder and alcohol-related birth defects), collectively referred to as fetal alcohol spectrum disorders (FASD), appear in an estimated 40,000 infants each year, costing our nation up to

State of the Art and Science of Knowledge Development in Genetic Nursing

6 billion in health, educational, and social services annually (May & Gossage, 2001). Wattendorf and Muenke (2005) describe the three cardinal features of FAS as shortened palpebral fissures (abnormally small space between the inner and outer canthus of each eye), smooth philtrum (absence of grooves on the upper lip), and thin vermilion border (abnormally

A New Horizon for Newborn Screening

Since the early 1980s, the medical science of human genetics has found acceptance in standards of assess ment and intervention in modern health care systems around the world. Genetic tests were once performed for rare genetic diseases; however, there has been a shift from the traditional genetics services to a new realization that genetics plays some component in nearly all human illness except possibly trauma, according to Francis Collins, MD, PhD, Director of the National Human Genome Research Institute (personal communication, 17 July 1996). Despite this shift toward a genetics paradigm in health care (Anderson, Monsen, Prows, Jenkins, & Tinley, in press), the discipline of nursing remains slow to incorporate genetics content into nursing education at all levels (Donaldson 1997). Furthermore, the need to create new nursing knowledge for this rapidly emerging nursing specialty has not been fully realized by nurse theoreticians, nurse researchers, nursing faculty, or practicing nurses. Consequently, it seems appropriate and timely to address the following questions on a national level. What is the state of the art and science of genetic nurs ing as we approach the new millennium? How can a small cadre of genetic nursing experts facilitate national recognition and value for the impact of genet ics on nursing practice and nursing’s potential to genetic health care services? Who among the nursing leadership have the power to create change in the entire discipline? Who will accept the challenge of dis seminating genetic nursing knowledge as a national agenda? Nurse editors and leaders in continuing education have national credibility and authority; and within their roles, they influence professional practices, advance education, and promote research priorities. They already operate within national education and research infrastructures, and they have the ability to influence policy formation and the evolution of nurs ing knowledge. Professional journals are repositories for new knowledge in any discipline. Editors and peer review ers are responsible, in part, for shaping knowledge in the discipline. The Nursing Organization Liaison Forum (NOLF) gathers nursing specialty organizations that affiliate with the American Nurses Association (ANA). NOLF comprises a large number of the nation’s nurses, nearly all of whom are in clinical practice, education, and/or research roles. ANA and NOLF comprise nearly half of the nation’s 2.6 million nurses (Dickenson-Hazard 1998) and provide most of the continuing education programming to this population. Nursing leaders in continuing education are key decision makers for selecting and presenting new informa tion about health care technologies and setting practice standards for using these in clinical practice. Both groups of nursing leaders lift the discipline’s knowl edge base to new levels by publishing and/or present ing new nursing research, theoretical discussions, and critical reviews that guide clinical practice, new mod els for delivering and evaluating services, and public health policy—all of which are founded on new dis coveries about human health and illness, made by nurse and nonnurse scientists (ANA 1995). The nearly 2.6 million practicing nurses in the United States depend on these two groups of nursing