Reducing Sexual Risk with Practice of Periodic Secondary Abstinence

Objective: Test a novel intervention to help sexually experienced girls increase abstinence behaviors and attitudes. Design: A quasi-experimental repeated measures design using qualitative and quantitative data. Setting: Two alternative public schools. Participants: Thirty-three females whose mean age was 16 and who were 79% African American participated. Most (79%) had experienced a pregnancy. Intervention: A 6 session, weekly, interactive intervention was delivered. Data were collected at baseline, last session, and at 5 and 7 month follow-ups. Main Outcome Measures: Measured outcomes related to abstinence included participants’ reasons, behaviors, stages of change, and attitudes. Results: The most common reason for abstinence was not wanting to have sex. At each postintervention data collection point, most participants (greater than or equal to 74%) reported that they had purposefully avoided sex. Duration of consecutive days of abstinence increased although only significantly at 5 month follow-up. Abstinence behaviors increased with the largest change from first to last session. Stage of change advanced from preparation to action by 7 month follow-up. Attitudes toward abstinence became more favorable. Conclusion: Effective sexual risk reduction interventions are critically needed to promote safety. Nurses may assist young women to decrease their sexual risks by teaching them to practice periodic abstinence

Parenting a Second Time Around: An Ethnography of African American Grandmothers Parenting Grandchildren Due to Parental Cocaine Abuse

This study describes a group of six African American grandmothers parenting their grandchildren secondary to cocaine abuse on the part of the parents. It explores the manner in which such parenting affected the grandmothers’ health. Data for this ethnography design were collected through participant observation, field notes, taped interviews, and supplementary data sources. The identification of cultural themes evolved from domain and taxonomic analyses. The themes—parenting a second time around, sacrifice, and God’s presence in daily life—expressed aspects of the grandmothers’ culture. The effects on health varied from none to exacerbation of chronic illnesses. The study results, and its picture of life from the grandmothers’ perspectives, suggest areas of nursing assessment and intervention that otherwise might be left unexplored

Recommendations for Sexuality Education for Early Adolescents

Objective: To determine community support and identify appropriate learning methodologies, parameters of delivery, and intervention content. Design: Qualitative descriptive study in which participants were interviewed in a semistructured format. Data were analyzed thematically. Setting: An urban pediatric primary care clinic from which youths and parents were recruited. Participants: Ten youths, 10 parents, and 10 community members. Community members included professional and laypersons who had experience in working with early adolescents or in working with children of any age on sexuality issues. Overall, most participants were female (67%) and African American (67%). Results: Descriptions of early adolescents ’ knowledge of sexuality, participants ’ support for sexuality education for early adolescents, recommendations for education content, and preferred methods for education delivery. Conclusion: The participants supported comprehensive sexuality education for early adolescents. They believed that it would help youths to be abstinent, would provide some protection from sexual abuse, and would prepare them to practice safer sex in the future

Conducting Life History Research With Adolescents

This article is a commentary on the life history approach, which specifically described aspects of and offered suggestions for conducting life history research with adolescents. The life history approach is well suited to a wide variety of types of health-related inquiry. In this article, the author used an exemplar study to show how well the life history approach was suited for questions regarding adolescent issues. This approach was also a good match for the developmental skills and needs of adolescents. The author uses the strengths and weaknesses of the approach and a detailed example of how she used the life history data to identify themes drawn from the exemplar study. She makes specific suggestions, including the development and implementation of an interview guide, planning and scheduling interviews, and the use of a life history grid. She includes examples of each suggestion and a sample life history grid

Understanding Sexual Abstinence in African American Teens

Purpose: To explore the perspectives of teenage girls on how life contexts influenced sexuality and sexual abstinence. Study Design and Methods: A qualitative descriptive study with a convenience sample of 14 sexually abstinent African American adolescent females who were interviewed to obtain their life histories. Narrative analysis was used to identify unique and common experiences and to develop themes. Results: For these participants, being abstinent was a way to demonstrate their emerging identities as adult women. They described themselves as faithful, unique persons who defied negative stereotypes, avoided risky situations, wanted to be strong women like their mothers and grandmothers, and were selective about their friends. The primary challenge to abstinence was their degree of vulnerability to sexual harassment, romantic partner pressure, and female peer pressure. Clinical Implications: Abstinence is a complex state of being that is influenced by a variety of contexts, develops over time, and is consciously chosen. Maintaining abstinence requires effort and a variety of skills. While these young women were cognitively familiar with reasons why they should refrain from sex, nurses may still assist youth with being abstinent by providing ongoing teaching and specific dialogue on how to refrain from sex

The Association of Religiosity, Sexual Education, and Parental Factors with Risky Sexual Behaviors Among Adolescents and Young Adults

This study examined the association of religiosity, sexual education and family structure with risky sexual behaviors among adolescents and young adults. The nationally representative sample, from the 2002 National Survey of Family Growth, included 3,168 women and men ages 15–21 years. Those who viewed religion as very important, had frequent church attendance, and held religious sexual attitudes were 27–54% less likely to have had sex and had significantly fewer sex partners than peers. Participants whose formal and parental sexual education included abstinence and those from two-parent families were 15% less likely to have had sex and had fewer partners

Debrief in Emergency Departments to Improve Compassion Fatigue and Promote Resiliency

The purpose of this case study was to describe compassion fatigue using one nurse\u27s experience as an example and to present the process of Personal Reflective Debrief as an intervention to prevent compassion fatigue in emergency department (ED) nurses. Debriefing after adverse outcomes using a structured model has been used in health care as a nonthreatening and relatively low-cost way to discuss unanticipated outcomes, identify opportunities for improvement, and heal as a group. There are many methods of debrief tailored to specific timing around events, specific populations of health care workers, and amount of time for debriefing. Debrief with personal and group reflection will help develop insights that nurses may need to understand their own emotions and experiences, as well as to develop knowledge that can be used in subsequent situations. Regular engagement in a proactive scheduled Personal Reflective Debrief has been identified as a method of promoting resiliency in an environment where the realities of emergency nursing make compassion fatigue an imminent concern. Nurses working in the ED normally experience some level of stress because of high acuity patients and high patient volume; yet, repeated exposure puts them at risk for developing compassion fatigue. The Personal Reflective Debrief is one way emergency nurses can alleviate some of this caring-related stress and thereby become more resilient. Increasing nurses\u27 resilience to workplace stress can counter compassion fatigue. The key is to provide planned, proactive resources to positively improve resiliency

Relationship Between Scholastic and Health Behaviors and Reading Level in Adolescent Females

This was a study of 102 adolescent females, 12-20 years of age, presenting to a central city clinic for medical care. Participants completed an oral questionnaire that included demographics, and questions regarding scholastic history, sexual behavior, and substance use. Each subject completed the Accuracy Level Test (ALT), a reading test. The subject\u27s reading test grade level was subtracted from her appropriate grade in school to give a reading delay level (RDL). The mean reading grade level for all subjects was 6.7 ±2.6 and the average reading delay was 4.5 ±2.5 grades. Poor school attenders had greater reading delays (5.8 ±3.4 grades behind vs. 4.3 ±2.2 for good attenders

The Role of Spirituality and Religiosity in Persons Living With Sickle Cell Disease

Purpose: Sickle cell disease (SCD) is a serious debilitating chronic illness, affecting approximately 90,000 Americans and millions globally. Spirituality and religiosity (S/R) may ease the burden faced by persons living with SCD. The purpose of this study was to examine the role of S/R in adolescents and adults living with SCD in the research literature. Method: The electronic databases Cumulative Index to Nursing and Allied Health Literature, Health Source Nursing/Academic, ProQuest Health Module, PsycINFO, Medline, PubMed, and the American Theological Library Association were searched from January 1995 to December 2014. Findings: Of the 89 studies retrieved, 11 articles between 2001 and 2013 met the inclusion criteria and were reviewed. Four themes emerged. The themes included (a) S/R as sources of coping, (b) S/R enhance pain management, (c) S/R influence health care utilization, and (d) S/R improve quality of life. Discussion: Use of S/R may be significant in coping with SCD, managing pain, affecting hospitalizations, and affecting quality of life. This review can direct researchers exploring S/R in adolescents and adults living with SCD

Parents’ Perspectives on Shared Decision Making for Children With Solid Organ Transplants

Introduction The Institute of Medicine prioritizes active family and clinician participation in treatment decisions, known as shared decision making (SDM). In this article we report the decision-making experiences for parents of children who had a solid organ transplant. Method We performed a prospective longitudinal mixed methods study at five major U.S. children\u27s medical centers. Qualitative interview data were obtained at 3 weeks, 3 months, and 6 months after hospital discharge following the child\u27s transplant. Results Forty-eight parents participated in the study. Three themes were identified: (a) Parents expect to participate in SDM; (b) parents seek information to support their participation in SDM; and (c) attributes of providers\u27 professional practice facilitates SDM. SDM was facilitated when providers were knowledgeable, transparent, approachable, accessible, dependable, and supportive. Conclusions Parents expect to participate in SDM with their transplant team. Health care providers can intentionally use the six key attributes to engage parents in SDM. The results provide a framework to consider enhancing SDM in other chronic illness populations