Exploring the feasibility of email-mediated interaction in survivors of abuse.

There is a growing use of email-based provision of information, development of health-related skills and interventions; however, use of email to assist women and children experiencing abuse after receiving Protection from Abuse (PFA) court order has not been explored. The specific aim of this research was to test the feasibility of an email device called MIVO for use in interacting with women and children after receiving PFA. This qualitative design used a three-step recruitment, screening and email interaction with mothers and their adolescent child after obtaining informed consent and training in the use of an email device. Sample included six pairs of mother and child (n = 12) who have received a PFA within the past 6 months. Demographic data were gathered using the sociodemographic questionnaire. Qualitative data were gathered using email messages from mother and child pairs. Results showed that email interaction is a feasible and acceptable way of providing support and information to survivors of abuse after their PFA. The following themes in their order and rank of appearance were found in the email interaction between the nurse and survivors: (1) safety issues; (2) job-related issues; (3) school-related issues; (4) parenting-related issues; and (5) health-related issues. Themes identified for the children were school work and friends. Privacy, confidentiality and respect for individual rights are paramount in email interactions. Email interaction is useful in education, screening, safety instructions and follow-up care. Technological devices such as MIVO may have usefulness as an email interaction device among women, their child and a nurse to reduce their risk for further interpersonal violence/abuse and to increase disclosure of abuse. Healthcare providers need to identify technological developments, and through evidence-based research examine their feasibility and adaptability for translation into practice specifically, in caring for survivors of abuse.

An assessment of nicotine dependence among pregnant adolescents.

Studies have reported that between 28 and 62% of pregnant teenagers smoke (Cornelius, Taylor, Geva, & Day, 1995; Trollestrup, Frost, & Starzyk, 1992). Because smoking is prevalent among pregnant teenagers, the purpose of this research is to assess nicotine dependence in this high-risk group. This study analyzed baseline data from a sample of pregnant teen smokers who had volunteered to participate in a smoking cessation study (N = 94). Nicotine dependence was measured by adapting the Fagerstrom Tolerance Questionnaire (FTQ; Prokhorov, Pallonen, Fava, Ding, & Niaura, 1996), and by a 6-item withdrawal symptom scale. The overall FTQ score found among pregnant adolescents was 3.10 (SD = 2.3) compared to the mean overall FTQ score among vocational-technical students of 4.27 (SD = 2.2) (Prokhorov et al., 1996). Duration of smoking in years was significantly correlated with the overall FTQ score (r = 0.43, p < .01). Quantity of smoking, as measured by average number of cigarettes smoked, significantly correlated with overall FTQ scores (r = 0.67, p < .01). Lighter smokers were more likely to have previously attempted to quit, however, among the quit attempters, those who smoked 10+ cigarettes per day reported greater severity of withdrawal symptoms than those who smoked less per day. Prenatal education and smoking cessation programs for pregnant teenagers, and pregnant women in general, need to consider that nicotine dependence is an important issue. Early pregnancy may be an opportune time to intervene among pregnant smokers; incentives may be necessary to attract those women who are the heaviest smokers, and possibly the most dependent on nicotine.

PIP: This study assessed nicotine dependence among pregnant adolescent smokers in order to enhance the efficacy of smoking-cessation programs. This study analyzed baseline data from a sample of 94 pregnant teen smokers who had volunteered to participate in a smoking cessation study. Nicotine dependence was measured by adapting Fagerstrom Tolerance Questionnaire (FTQ), and by a 6-item withdrawal symptom scale. The overall FTQ score found among pregnant adolescents was 3.10 (SD = 2.3) compared to the mean overall FTQ score among vocational-technical students of 4.27 (SD = 2.2). Duration of smoking in years was significantly correlated with the overall FTQ score. Quantity of smoking, as measured by average number of cigarettes smoked, significantly correlated with overall FTQ scores. Lighter smokers were more likely to have previously attempted to quit. However, among the attempters to quit, those who smoked 10+ cigarettes per day reported greater severity of withdrawal symptoms than those who smoked fewer per day. Prenatal education and smoking cessation programs for pregnant teenagers, and pregnant women in general, need to consider that nicotine dependence is an important issue. Early pregnancy may be an opportune time to intervene among pregnant smokers; incentives may be necessary to attract those women who are heaviest smokers, and possibly the most dependent on nicotine.

Self-image and self-esteem in African-American preteen girls: implications for mental health.

Current research suggests that pubertal development is occurring earlier in African-American preteen girls in response to familial contextual factors, which may make them vulnerable to low self-image and self-esteem dissatisfaction. This lowering in self-image and self-esteem may contribute to the early initiation of sexual behaviors, putting these girls at risk for pregnancy and sexually transmitted diseases. These potential risks place these girls in need of prepubertal health promotion, yet preadolescents are not frequently a focus of nursing care delivery except when summer camp and back-to-school physicals are performed. This article presents an in-depth overview of selected literature on self-esteem, discusses findings on self-image and self-esteem from a pilot study on pubertal influences on accelerated sexual behavior, and proposes health promotion strategies for pre- and peripubertal girls to promote positive mental health outcomes. More focused attention is needed on health promotion targeting the developmental transition health needs of prepubertal girls. Targeted health promotion activities may foster healthier pre- and peripubertal girls' perceptions of the meaning of their pubertal physical changes and stronger self-image and self-esteem. The goal of these health promotion activities should be to foster continuity of positive self-image and self-esteem among preteen girls, which is essential to prevent initiation of premature-for-age risk of problem behavior, such as early coitus.