Risks and Protective Factors for Stress Self-Management in Parents of Children With Autism Spectrum Disorder: An Integrated Review of the Literature.

PROBLEM: Stress in parents of children with autism spectrum disorder (ASD) has been reported to be very high. However, little is known about what risk and protective factors influence parental stress self-management in this population. Accordingly, this manuscript is a synthesis of the risk and protective factors that impact self-management of stress in these parents. The concepts in the individual and family self-management theory context domain were used as a framework to guide data collection and analysis. ELIGIBILITY CRITERIA: Searches were conducted using CINAHL, MedLine and PsychInfo. Studies were included if they addressed context factors in parents of children with ASD and were written in English. SAMPLE: Ninety-eight studies met review criteria. RESULTS: This review highlighted risk factors to parental stress self-management within the context of condition-specific factors, physical and social environment, and individual and family. The most concerning of these findings is that parents struggle accessing a diagnosis and services for their child and are frustrated with health care providers' knowledge of ASD and lack of communication. CONCLUSIONS: The risks parents experience as they care for their child with ASD far outweigh the protective factors for self-management of parental stress. IMPLICATIONS: Nurses who are aware of these issues can make important changes to their practice and have a significant impact on parental stress self-management and the care of children with ASD.

Autism Spectrum Disorder and the Child's Weight-Related Behaviors: A Parents' Perspective.

To explore parent perspectives of how the attributes of their child's autism spectrum disorder(ASD) impact nutrition, physical activity, screen time behaviors and risk for obesity. Secondarily, we examined the parent's perception of the healthcare providers (HCP) influence on these weight-related behaviors. DESIGN AND METHOD: We conducted and audio-recorded telephone interviews with parents of children with ASD (n=8) using a structured question guide. Data were transcribed and thematic analysis was conducted. Issues surrounding weight-related behaviors and parental strategies used were reported. RESULTS: Two overarching themes with eight subthemes emerged: (1) Challenges related to features of ASD (subthemes included fixation on food, sensory issues/rigidity, developmental factors, impaired social skills, and medication effects) and (2) Challenges related to the care of children with ASD (subthemes included lack of individualized care planning, picking your battles and the impact of ASD on family). CONCLUSION: Strategies extracted from the parent narratives promoted both healthy and unhealthy weight-related behaviors. The key finding in this study is that some parents did not follow HCP guidance when they perceived that the HCP did not understand their particular situation. PRACTICE IMPLICATIONS: Implementation of healthy weight-related behaviors can be optimized when providers consider the child's challenging ASD behaviors, affirm the difficulties encountered by the family and provide guidance that builds on the individual child/family strengths.

Stress and Parents of Children with Autism: A Review of Literature.

The purpose of this review is twofold. The first is to synthesize factors that impact parents' experiences of caring for a child with autism spectrum disorder (ASD); the second is to identify factors that impact parental stress and parental decision-making to use autism services or not. Parents of children with ASD score higher on levels of stress than other groups of parents. The daily challenges of caring for the child are endless and effect all aspects of the child's care as well as the parent's mental health and ability to manage the needs of the child and family. Understanding more about the challenges parents face will provide direction for research, intervention development, and practice. Accordingly, a search was conducted using CINAHL and Medline. Inclusion criteria included articles available in full text, published in English, and focused on children with ASD distinct from other diagnoses, as well as parental experiences of caring for a child with ASD. Articles (N = 132) that met the inclusion criteria were summarized. Challenging aspects of the child's diagnosis and care are discussed, as well as the factors that impact parental stress and decision-making to use autism services. Recommendations for research and practice include interventional development related to early diagnosis, disparity, access to care, parental decision-making to use autism services, and parental stress management.

Concept analysis: method to enhance interdisciplinary conceptual understanding.

This article is a presentation of a method of concept analysis designed to assist in understanding the unique manner in which various disciplines use the same word or group of words to describe differing conceptual ideas. Nurse researchers often borrow research instruments developed in other disciplines. However, research instruments are developed in accordance with the philosophical underpinnings of a specific discipline with the intent to contribute to the knowledge base of that discipline. Therefore, it is uncertain whether research instruments borrowed from other disciplines actually measure the conceptual phenomenon from a nursing perspective.

Contentment in "Songs of the Gorilla Nation: My Journey through Autism": A Humanbecoming Hermeneutic Study.

This article is an example of the use of narrative in the form of a memoir to explore the humanly lived experience of contentment. The humanbecoming school of thought provided a philosophical foundation and theoretical framework for this hermeneutic interpretation of Dawn Prince-Hughes' published memoir, "Songs of the Gorilla Nation: My Journey through Autism." The findings-contentment is enduring serenity unfolding with inspiring unburdening as cherished convictions arise amid disharmony answer the research question: what is contentment as humanly lived? This study enhances knowledge about contentment as quality of life.

Knowing in nursing: a concept analysis.

AIM: This paper is a report of an analysis of the evolution of the concept of knowing in nursing. BACKGROUND: Following the seminal contribution of Carper in 1978, knowing has been discussed with increasing frequency in the nursing literature with reference to the development of nursing knowledge. Various patterns of knowing, as well as research focused on reflection on experience, have been the foundation for activities and research designed to improve practice as well as patient care in clinical, community, education, cultural and administrative settings. METHODS: Rodgers' evolutionary method of concept analysis provided the framework for this analysis. The data source was a search of literature published from 1978 to 2007. Three aims guided the analysis: to understand how the concept of knowing is used in nursing, how it is used in other health-related disciplines and how the concept has evolved into the current interpretation. DISCUSSION: Analysis revealed that knowing in nursing refers to a uniquely personal type of knowledge constructed of objective knowledge interfaced with the individual's subjective perspective on personal experience. Knowing is a dynamic process and a result of personal reflection and transformation as the individual lives and interacts in the world. Its antecedents are experience, awareness and reflection. The consequences are understanding, finding meaning and transformation. CONCLUSION: This analysis illuminates an area in which nursing has carved out its own niche in healthcare research. The concept of knowing in nursing practice and research reflects a focus on the individual experience of health and illness.

Strategies to promote success on the NCLEX-RN: an evidence-based approach using the ACE Star Model of Knowledge Transformation.

This article describes an evidence-based project undertaken to develop and implement educational strategies to improve NCLEX-RN scores in a baccalaureate nursing program. The ACE Star Model of Knowledge Transformation, a tool used to assist in understanding the process of knowledge discovery and transformation in evidence-based practice, guided this project. A review of the literature revealed a downward trend in successful completion of the NCLEX-RN along with anecdotal reports of educational strategies intended to improve success on the exam. The literature review failed to uncover evaluations of the effectiveness of reported strategies. Resultant recommendations included an integrated strategy consisting of assessment testing, independent study, and simulated NCLEX examinations. Evaluation of the strategies revealed improved success on the NCLEX-RN. Pass rates from rose from 87.76 percent in fall 2001 to 94.81 percent in fall 2004.