Scott Weber

Relationships Between Depressive Symptoms and Perceived Social Support, Self-Esteem, & Optimism in a Sample of Rural Adolescents

Stress, developmental changes and social adjustment problems can be significant in rural teens. Screening for psychosocial problems by teachers and other school personnel is infrequent but can be a useful health promotion strategy. We used a cross-sectional survey descriptive design to examine the inter-relationships between depressive symptoms and perceived social support, self-esteem, and optimism in a sample of rural school-based adolescents. Depressive symptoms were negatively correlated with peer social support, family social support, self-esteem, and optimism. Findings underscore the importance for teachers and other school staff to provide health education. Results can be used as the basis for education to improve optimism, self-esteem, social supports and, thus, depression symptoms of teens.

A stigma identification framework for family nurses working with parents who are lesbian, gay, bisexual, or transgendered and their families.

Parent relationships and family life provide important psychological and health benefits for growing children and adults. Social stigma experienced by parents who are lesbian, gay, bisexual, or transgendered, and by their children, creates significant stress on families. Families headed by parents who are sexual orientation or gender identity minorities may require special guidance for navigating an unusually complicated terrain related to parenting and family life. The focus of this article is social stigma, its causes, and health impacts on these families. Approaches that family nurses can take to evaluate stigma when working with this population of families are identified and discussed. This article reviews practice and research literature to examine the impacts of stigma on the social security, lived experience, and health status of these families. The article then applies the Link and Phelan (2001) stigmatization model to work with LGBT parents to help family nurses improve practice effectiveness.

Decision Support in Multi-Professional Communication

This paper explores the role of clinical decision support systems (CDSS) in facilitating communication between physicians, nurses, patients and family members. Thirty-three critical care unit nurses and physicians were interviewed regarding the APACHE III CDSS. This qualitative, descriptive study suggests that registered nurses and physicians are primarily motivated to use CDSS when this technology allows them to forecast the potential outcomes of decisions prior to actually making those decisions. These forecasts are used to advocate for care decisions with other disciplines, patients and their family members. Implications for professional practice and recommendations for future research are described.

Policy Aspects and Nursing Care of Families With Parents Who Are Sexual Minorities

Families in which parents are lesbian, gay, bisexual, or transgender are more diverse than they are similar. This article reviews current literature to identify fundamental issues facing families that include sexual minority parents and their children. The unique nursing needs of families with gay, lesbian, transgender, or bisexual parents are critically examined for direct relevance to family nursing practice. Nurses and other health care professionals can incorporate current knowledge of unique child developmental, parenting, and legal issues into their work with these families. Nursing assessment and policies that consider the unique needs of these families will be addressed.

THIS ARTICLE HAS BEEN RETRACTED Critical care nurse practitioners and clinical nurse specialists interface patterns with computer‐based decision support systems

Purpose: The purposes of this review are to examine the types of clinical decision support systems in use and to identify patterns of how critical care advanced practice nurses (APNs) have integrated these systems into their nursing care patient management practices. The decision‐making process itself is analyzed with a focus on how automated systems attempt to capture and reflect human decisional processes in critical care nursing, including how systems actually organize and process information to create outcome estimations based on patient clinical indicators and prognosis logarithms. Characteristics of APN clinicians and implications of these characteristics on decision system use, based on the body of decision system user research, are introduced. Data sources: A review of the Medline, Ovid, CINAHL, and PubMed literature databases was conducted using “clinical decision support systems,”“computerized clinical decision making,” and “APNs”; an examination of components of several major clinical decision systems was also undertaken. Conclusions: Use patterns among APNs and other clinicians appear to vary; there is a need for original research to examine how APNs actually use these systems in their practices in critical care settings. Because APNs are increasingly responsible for admission to, and transfer from, critical care settings, more understanding is needed on how they interact with this technology and how they see automated decision systems impacting their practices. Implications for practice: APNs who practice in critical care settings vary significantly in how they use the clinical decision systems that are in operation in their practice settings. These APNs must have an understanding of their use patterns with these systems and should critically assess whether their patient care decision making is affected by the technology.Purpose: The purposes of this review are to examine the types of clinical decision support systems in use and to identify patterns of how critical care advanced practice nurses (APNs) have integrated these systems into their nursing care patient management practices. The decision-making process itself is analyzed with a focus on how automated systems attempt to capture and reflect human decisional processes in critical care nursing, including how systems actually organize and process information to create outcome estimations based on patient clinical indicators and prognosis logarithms. Characteristics of APN clinicians and implications of these characteristics on decision system use, based on the body of decision system user research, are introduced. Data sources: A review of the Medline, Ovid, CINAHL, and PubMed literature databases was conducted using “clinical decision support systems,”“computerized clinical decision making,” and “APNs”; an examination of components of several major clinical decision systems was also undertaken. Conclusions: Use patterns among APNs and other clinicians appear to vary; there is a need for original research to examine how APNs actually use these systems in their practices in critical care settings. Because APNs are increasingly responsible for admission to, and transfer from, critical care settings, more understanding is needed on how they interact with this technology and how they see automated decision systems impacting their practices. Implications for practice: APNs who practice in critical care settings vary significantly in how they use the clinical decision systems that are in operation in their practice settings. These APNs must have an understanding of their use patterns with these systems and should critically assess whether their patient care decision making is affected by the technology.

THIS ARTICLE HAS BEEN RETRACTED Nursing Care of Families With Parents Who Are Lesbian, Gay, Bisexual, or Transgender

TOPIC:  Families in which parents are lesbian, gay, bisexual, or transgender are more diverse than they are similar. The numbers of parents and children in these families appear to be increasing with implications for nurses and other clinicians. PURPOSE:  This paper reviews the current literature to determine the fundamental issues facing alternate families that include sexual minority parents and their children. It also explores the unique nursing needs of families with gay, lesbian, transgender, or bisexual parents in the field, which are critically examined for direct relevance to psychiatric nursing practice. SOURCES USED:  Current theoretical and research literature in nursing, child development, family law, and healthcare professional journals. CONCLUSIONS:  Despite a relative lack of pathology noted in the literature related to families with sexual minority parents, nurses, and other healthcare professionals can incorporate current knowledge of unique child developmental, parenting, and legal issues into their work with these families. Assessments and interventions that address the unique needs of these families may help parents and children to deal with social stress from being perceived as “different” by other children, or as “problematic and threatening” by other parents.

THIS ARTICLE HAS BEEN RETRACTED Results of Psychometric Testing of the RADS‐2 With School‐Based Adolescents Seeking Assistance for Sexual Orientation and Gender Identity Concerns. Part 2: Research Brief

PROBLEM First-stage measures of depressive symptoms need to demonstrate high levels of accuracy in capturing all the facets of depressive illness in order to be maximally useful for nurses performing psychosocial assessments and for nurse researchers. METHODS Reliability, validity, and factor analysis testing were conducted on the Reynolds Adolescent Depression Scale (RADS-2). Factor analysis testing examined each item of the instrument to identify the clinical characteristic it measures as well as the broad profiles of symptoms the instrument reveals. FINDINGS Four factors were identified and all appear to demonstrate adequate internal consistency reliability. CONCLUSIONS Psychometric results demonstrate a firm foundation for nursing clinical and research uses for the RADS-2.

THIS ARTICLE HAS BEEN RETRACTED Depressive Illness in Teens and Preteens and Effectiveness of the RADS‐2 as a First‐Stage Assessment. Part 1: Descriptive Paper

PROBLEM Measurement of the characteristics and severity of depression in adolescence is an emerging science. During patient assessment, or if using first-stage screening measures in practice, nurses must be confident that these instruments demonstrate high levels of accuracy in capturing the specific features of depressive symptoms expressed in diverse individuals. METHODS A review of the scientific literature of depressive illness and its assessment in teens and preteens is presented. The Reynolds Adolescent Depression Scale-Revised (RADS-2) measure is introduced and evaluated from a nursing practice standpoint. FINDINGS The RADS-2 is easy to use and demonstrates good reliability, validity, and construct features, providing evidence for nurses that the measure can be used with confidence in assessment of depressive symptoms in adolescents. CONCLUSIONS The RADS-2 is an effective first-stage assessment of depressive mood in teens and preteens.

DISSOCIATIVE SYMPTOM DISORDERS IN ADVANCED NURSING PRACTICE: BACKGROUND, TREATMENT, AND INSTRUMENTATION TO ASSESS SYMPTOMS

Less well-known among the psychiatric disorders, dissociation is one of the most common underlying symptoms of individuals seeking mental health care (Maldonado, 2001). Closely associated with post-traumatic stress disorder, dissociation characteristics may include inconsistent consciousness, autobiographical forgetfulness, difficulties in self-regulation, regressions, alternate identities, disorganization in the development of a cohesive sense of self, depersonalization, and derealization (Trickett, Noll, Reiffman & Putnam, 2001). The major constructs and dimensions of the dissociative symptom disorders in adults are introduced. Several of the most prominent psychometric instruments that nurses and other mental health clinicians may use as adjuncts to diagnosis and treatment are described.

Psychometric Design and Testing of the Parenting Paradigms Scale

This article describes the design and field testing of the 28-item Parenting Paradigms Scale, a measure of adults’ intentions, expectations, social attitudes, values, and behavioral assumptions related to parenting and parenthood. Items were developed by consensus by three parent focus groups that included 16 total participants; of these 16 parents, 10 were heterosexual parents and six were gay or lesbian parents. The parent groups developed prospective items describing parenting attitudes and expectations that reflected the four constructs of Izek Ajzens (1982) Theory of Planned Behavior, a theoretical framework widely used to predict behavior. The resulting Parenting Paradigms Scale was reviewed for content validity, pilot tested, and administered to 340 lesbian and gay adults, ages 18 to 72 years, who were parents to at least 1 child under the age of 18 at the time of assessment. Principal axis factor analysis with Oblimin rotation supported four dimensions. The Parenting Paradigms Scale measure demonstrated reliability and validity as a measure of lesbian and gay adults’ social norms, assumptions, values, and expectations regarding parenting or planned parenting. Though initially field tested with sexual minority parents, it is anticipated that the measure can be used to assess parenting intention with any parent population.