Rose M. Mays

Human papillomavirus, genital warts, Pap smears, and cervical cancer: Knowledge and beliefs of adolescent and adult women

The high prevalence of genital warts, human papillomavirus (HPV), and the viruss cancer-causing potential warrant that women be well informed about these conditions and measures to prevent them. The purpose of this descriptive study was to examine womens knowledge and beliefs about genital warts, HPV, cervical cancer, and Pap tests. We interviewed 40 women recruited from health clinics in Chicago (20 adults) and Indianapolis (20 adolescents) about these issues. Audiotapes of the interviews were transcribed and analyzed. Among both the adults and adolescents there was a good deal of misunderstanding about symptoms associated with genital warts, about the purpose of Pap smears, and about the association of genital HPV with abnormal Pap smears and cervical cancer. The gaps in womens understanding about this potentially deadly infection suggest the need for more comprehensive education about preventing genital HPV, the infections possible sequelae, and the significance of Pap screening for cancer detection and prevention.The high prevalence of genital warts, human papillomavirus (HPV), and the viruss cancer-causing potential warrant that women be well informed about these conditions and measures to prevent them. The purpose of this descriptive study was to examine womens knowledge and beliefs about genital warts, HPV, cervical cancer, and Pap tests. We interviewed 40 women recruited from health clinics in Chicago (20 adults) and Indianapolis (20 adolescents) about these issues. Audiotapes of the interviews were transcribed and analyzed. Among both the adults and adolescents there was a good deal of misunderstanding about symptoms associated with genital warts, about the purpose of Pap smears, and about the association of genital HPV with abnormal Pap smears and cervical cancer. The gaps in womens understanding about this potentially deadly infection suggest the need for more comprehensive education about preventing genital HPV, the infections possible sequelae, and the significance of Pap screening for cancer detection and prevention.

Recommending STI vaccination to parents of adolescents: The attitudes of nurse practitioners

Background: Future successful sexually transmitted infection (STI) vaccine programs will depend on health professionals’ readiness to vaccinate adolescents. Goal: The goal was to examine nurse practitioners’ willingness to recommend STI vaccines to parents of adolescent patients. Study Design: Participants rated 13 hypothetical vaccine scenarios, each of which was defined along 4 dimensions: infection; patient age, patient gender, and American Academy of Pediatrics (AAP) endorsement. Conjoint analysis was used to determine the relative contribution of each dimension to the ratings. Results: Generally, participants were amenable to recommending STI vaccines. Conjoint analysis indicated that AAP recommendation, infection, and patient age most strongly influenced ratings. There was particular interest in an HIV vaccine, but there was reluctance to vaccinate younger adolescents or to vaccinate without AAP en- dorsement. Conclusions: Nurse practitioners are willing to recommend STI vaccines to parents of adolescents. Professional organization endorsement plays an important role in this decision. Younger-aged adolescents were not viewed as candidates for these vaccines.

Peer review of teaching in Web-based courses in nursing.

With the explosion of college-level Web-based courses, concern has arisen about the quality of online courses. Peer review of online courses is one method of ensuring that these courses meet the highest standards. Although numerous colleges and universities use peer review for classroom presentations, clinical experiences, and course materials, peer review of an online course may require a different type of expertise. This article describes the process for conducting a peer review of teaching in Web-based courses and explains how documentation of peer review of an online course can be used for faculty development, promotion and tenure decisions, curriculum decisions, and program review.

Assessing Cultural Competence of Policy Organizations

Assessment of the capabilities of human service providers to care for individuals from diverse cultures has been widely discussed in the literature. However, a less examined area is the appraisal of the cultural competence of the administrative or policy bodies whose actions shape the character of these human services. This article demonstrates an approach for evaluating a policy organization’s cultural competence using a governmental agency as a case study. Findings from this assessment prompted this agency to generate plans to further enhance its cultural competence.

The Centers for Disease Control and Prevention Revised Recommendations for HIV Testing: Reactions of Women Attending Community Health Clinics

The purpose of this study was to examine reactions to the Centers for Disease Control and Prevention revised recommendations for HIV testing by women attending community health clinics. A total of 30 women attending three community clinics completed semistructured individual interviews containing three questions about the recommendations. Thematic content analysis of responses was conducted. Results were that all agreed with the recommendation for universal testing. Most viewed opt-out screening as an acceptable approach to HIV testing. Many emphasized the importance of provision of explicit verbal informed consent. The majority strongly opposed the elimination of the requirement for pretest prevention counseling and spontaneously talked about the ongoing importance of posttest counseling. The conclusion was that there was strong support for universal testing of all persons 13 to 64 years old but scant support for the elimination of pretest prevention counseling. In general, respondents believed that verbal informed consent for testing as well as provision of HIV-related information before and after testing were crucial.

Refinement of a Conceptual Model for Adolescent Readiness to Engage in End-of-Life Discussions.

Background: Adolescents living with incurable cancer require ongoing support to process grief, emotions, and information as disease progresses including treatment options (phase 1 clinical trials and/or hospice/palliative care). Little is known about how adolescents become ready for such discussions. Objective: The purpose of this study was to explore the process of adolescent readiness for end-of-life preparedness discussions, generating a theoretical understanding for guiding clinical conversations when curative options are limited. Methods: We explored 2 in-depth cases across time using case-study methodology. An à priori conceptual model based on current end-of-life research guided data collection and analysis. Multiple sources including in-depth adolescent interviews generated data collection on model constructs. Analysis followed a logical sequence establishing a chain of evidence linking raw data to study conclusions. Synthesis and data triangulation across cases and time led to theoretical generalizations. Initially, we proposed a linear process of readiness with 3 domains: a cognitive domain (awareness), an emotional domain (acceptance), and a behavioral domain (willingness), which preceded preparedness. Results: Findings led to conceptual model refinement showing readiness is a dynamic internal process that interacts with preparedness. Current awareness context facilitates the type of preparedness discussions (cognitive or emotional). Furthermore, social constraint inhibits discussions. Conclusions: Data support theoretical understanding of the dynamism of readiness. Future research that validates adolescent conceptualization will ensure age-appropriate readiness representation. Implications for Practice: Understanding the dynamic process of readiness for engaging in end-of-life preparedness provides clinician insight for guiding discussions that facilitate shared decision making and promote quality of life for adolescents and their families.