Theresa Standing

Leadership and nurse retention: the pivotal role of nurse managers.

As the link between executives and bedside nurses, nurse managers assume roles that bridge both organizational and professional goals. Nurse retention is one of the many responsibilities that characterize the nurse managers work. To better understand the pivotal role of nurse managers, the authors describe the views of 32 nurse managers regarding their roles and the characteristics they need to promote retention.

Grandmothers and Caregiving to Grandchildren: Continuity, Change, and Outcomes Over 24 Months

PURPOSE Transitions in caregiving, such as becoming a primary caregiver to grandchildren or having adult children and grandchildren move in or out, may affect the well-being of the grandmother. DESIGN AND METHODS This report describes caregiving patterns at 3 time points over 24 months in a sample of 485 Ohio grandmothers and examines the effects of stability and change in grandmother caregiving roles (raising a grandchild, living in a multigenerational home, or not caregiving to grandchildren). Drawing on the Resiliency Model of Family Stress, the study examined caregiving stress and reward, intrafamily strain, social support, resourcefulness, depressive symptoms, mental and physical health, and perceived family functioning. Caregiver group, time of measurement, switching between caregiver groups, and baseline age, race, education, work status, and marital status were considered as independent variables within the context of a one-way treatment structure in a mixed-model multivariate analysis. RESULTS There were significant caregiver group effects for all variables, except mental health and resourcefulness. Grandmothers raising grandchildren reported the most stress, intrafamily strain, and perceived problems in family functioning, the worst physical health and more depressive symptoms, and the least reward and subjective support. Across groups, there were significant time effects, with worsening physical health and increased stress over time. Switching to higher levels of caregiving was associated with worsening physical health and increases in stress, intrafamily strain, and perceived problems in family functioning. IMPLICATIONS Recommendations for research and for practice, especially during times of caregiving transition or for grandmothers raising grandchildren, are discussed.

Grandmothers' Diaries: A Glimpse at Daily Lives

Little information exists about the daily lives of women who are grandmothers, and the differences in daily stresses based on caregiving status to grandchildren. This content analysis examines the stresses of 64 grandmothers as grouped by caregiver status (grandmothers raising grandchildren, grandmothers living in multigeneration homes, non-caregivers to grandchildren) as recorded in three-week diaries. The nature of salient issues and stressful interactions differed by caregiver groups. Grandmothers raising grandchildren reported more stresses related to grandchildrens routines, activities, and school progress, more time pressure, and difficult interactions with grandchildren. The diary entries of grandmothers in multigenerational homes reflected their supplemental role in childcare, and sometimes stressful interactions with other family members. Grandmothers with no routine caregiving to grandchildren reported more involvement with those outside the immediate family. Many general concerns about the well-being of the family represent commonalities in grandmothers despite differences in current caregiving roles to grandchildren.

Delegation: what it means to acute care nurses.

As health care costs rise, nurses are increasingly delegating tasks to unlicensed assistive personnel (UAP). The purpose of this phenomenologic study was to describe delegation from the perspective of the acute care nurse. We analyzed interviews with staff nurses, and a description of the meaning of delegation was developed using Donabedians structure, process, outcome model to organize the findings. The process of delegation centered on communication and on nurse-UAP relationship and was shaped by the structural themes. The outcomes of delegation included nursing and patient outcomes. An enhanced content on communication and interpersonal relations is needed in nursing education.

Effects of maternal employment and prematurity on child outcomes in single parent families.

BackgroundEffects of maternal employment for preschool children vary based on specific characteristics of the mother’s employment, the family’s economic status, and the mother’s attitudes about employment. However, there is limited research on a growing group of children at developmental risk—those born prematurely and living in a single-parent family. ObjectiveTo examine the effects of maternal employment and prematurity on child cognition and behavior in single-parent families. MethodsSixty preterm and 61 full-term preschool children were recruited through NICU admission records and birth records. Data were collected with the Kaufmann Assessment Battery for Children, Peabody Picture Vocabulary Test, Child Behavior Checklist, Parenting Stress Index, and the Life History Calendar. ResultsGreater hours employed was related to higher achievement and mental processing scores only. Less discrepancy between actual and desired employment was related to higher achievement, mental processing, and language scores and lower behavior scores. Prematurity was not related to child cognitive and behavioral performance. Only the relationship between discrepancy and language remained after statistical control. ConclusionsThe concerns about negative effects of maternal employment on young children may be overstated, especially in low-income, single-mother families. These findings are especially important in the context of welfare reform.

Explanation for Cessation of Breastfeeding in Mothers of Twins

This study used content analysis to examine reasons for cessation of breastfeeding of twins by 2 time points: 9.4 weeks and 28.3 weeks of age. From a convenience sample of 123 mothers, 110 initiated breastfeeding for their twins. Thirty women had stopped breastfeeding by time 1, with an additional 37 women stopping by time 2. Three major themes were identified regarding weaning: factors related to breastfeeding process, to mother’s role and health, and to infant behavior and health. Subcategories were identified for each theme, with additional subcategories emerging at time 2. Cited reasons are similar to those given by singleton mothers; however, mothers of twins identified unique issues related to infants’ behaviors, challenges presented by growth and development, and time commitments that interfered with breastfeeding continuation. Implications of the study suggest the need for continued lactation support as the twins grow and develop and new breastfeeding issues arise.

Grandmothers' Transitions in Caregiving to Grandchildren

Many grandmothers experience transitions in their caregiving roles to grandchildren as living arrangements change and parents assume more or less responsibility. The meanings of these transitions have received little attention, yet life transitions can be stressful. This qualitative study focuses on learning how grandmothers perceive these changes in household composition and the meanings these changes have. Analysis of semistructured telephone interviews with 26 transitioning grandmothers identified themes, including mixed feelings, changes in personal freedom, flexibility with unpredictable changes, spirituality as strength, commitment to grandchildren, and role transformation. The majority of status changes were from multigenerational or primary caregiving homes to non-coresident status. The meaning of the changes differed by status groups. The frequency of caregiving changes and the unique meanings of such changes extend our understanding of grandmothers as caregivers. Increased awareness and understanding of these meanings are important for nurses as they provide health care for this increasing population.

Resourcefulness Training for Grandmothers Raising Grandchildren Establishing Fidelity

Over one million American grandmothers raise grandchildren, and many experience stress that adversely affects their mental health. Teaching resourcefulness skills can minimize this stress. However, before testing effectiveness of resourcefulness training (RT), its fidelity must be established. This pilot intervention trial examined the fidelity of two methods of RT: expressive writing (journaling) and verbal disclosure (voice recording) using a quasi-experimental design with random assignment of 80 grandmothers to RT—expressive writing, RT—verbal disclosure, or expressive writing or verbal disclosure alone. Quantitative data (Resourcefulness Scale) and qualitative data (journals, recordings) were collected. Grandmothers with RT showed greater resourcefulness over time than those without RT, with similar effects for RT—expressive writing and RT—verbal disclosure. Evidence for the use of RT skills was found in journals and recordings. The findings provide support for RT intervention fidelity and support moving forward to test RT effectiveness in reducing grandmothers’ stress and promoting their mental health.

The Relationship between HIV-Related Knowledge and Safe Sexual Behavior in African American Women Dwelling in the Rural Southeast

There is an epidemiological shift toward increased rates of HIV infection in African American women, despite widely available information regarding HIV prevention. The purpose of this study was to determine the relationship between HIV-related knowledge and high-risk sexual behavior while controlling for related variables. A multivariate regression model was selected to differentiate the effects of these variables. The participants were 75 African American women, aged 18 to 38. The results indicated a positive relationship between HIV-related knowledge and high-risk sexual behaviors using the Pearsons r correlation coefficient (0.411, p < .001). Age of first sexual experience, number of lifetime sexual partners, income, educational level, and level of HIV-related knowledge were then regressed onto level of high risk sexual behavior using a hierarchical techniques. Only total years of education achieved statistical significance (p < .001 on the first step and p < .05 on the second step).

Disseminating our Breakthroughs: Enacting a Strategic Framework

Abstract A comprehensive framework to diffuse research findings is presented and its implementation by the Frances Payne Bolton School of Nursing is illustrated.