Stress and Trauma Among Nurses in Development (STAND): A Descriptive Study.

BACKGROUND: Mental health conditions related to traumatic stress exposure are common in practicing nurses. Less is known about the impact of trauma on nursing students and how it affects their transition to practice. OBJECTIVES: The purpose of this study is to understand the experience of trauma exposure and resulting symptoms in undergraduate nursing students. DESIGN: This is an analysis of baseline data from a longitudinal study. Students in an undergraduate nursing program completed a survey with validated instruments to measure trauma exposure, risk and protective factors, and trauma symptoms. SETTINGS: The study took place in an undergraduate nursing program in the United States. PARTICIPANTS: A total of 248 nursing students participated in the study. RESULTS: The nursing students reported a higher number of adverse childhood experiences and post-traumatic stress disorder (PTSD) symptoms than the general population. Additionally, mental health symptoms and burnout symptoms increased over time. CONCLUSIONS: Nursing students are at high risk for PTSD and other mental health conditions due to cumulative trauma. Interventions are needed to address trauma in developing nurses.

Trauma-Informed Professional Development: A Concept Analysis.

GOAL: This study reports an analysis of the concept of trauma-informed professional development as it applies to staff nurses in health care organizations. BACKGROUND: There is an urgent need for interventions to protect staff nurses from the psychological impact of traumatic events. By integrating the principles of trauma-informed care into professional development practices, nursing professional development practitioners have a unique opportunity to support nurses and help to promote recovery from trauma-related mental health outcomes. Data were obtained from a content searching service. METHOD: Walker and Avant's approach to concept analysis was used (2019). RESULTS: An operational definition of the concept of trauma-informed professional development as applied to staff nurses in health care organizations was developed. Potential benefits include staff nurse well-being, empowerment, resilience, and enhanced competency. Potential consequences for health care organizations include increased staff morale and retention. CONCLUSION: By applying trauma-informed professional development activities, nursing professional development practitioners can minimize negative consequences when teaching topics that could unintentionally adversely affect some participants. [J Contin Educ Nurs. 2024;55(2):69-77.].

A Socioecological Model of Transition to Nursing Practice.

A newly licensed nurse's (NLN) transition to practice (TTP) is affected by interactions inside and outside the hospital. The aim of this Delphi study was to create a socioecological model of TTP. Included in the socioecological model are personal characteristics and interactions at the relationship, community, and societal levels that the NLNs feel affects their TTP. This socioecological model can be used to plan TTP programs that address the holistic needs of the NLNs.

The Healers Are Broken: A Call for Trauma-Informed Professional Development in Nursing.

The COVID-19 pandemic has highlighted the fact that nurses are at risk for poor mental health, but there is evidence that this risk existed long before the pandemic started. Nurses in professional development have a unique opportunity to support nurses through trauma-informed professional development. Evidence-based interventions, such as peer support, attention to cultural differences, and empowerment, can enhance protective factors and also promote recovery from trauma-related poor mental health outcomes.

The experience of nursing leadership in a crisis: A hermeneutic phenomenological study.

AIM: This study aimed to understand nursing leaders' experience during the pandemic. BACKGROUND: COVID-19 is a public health crisis that affects every nation in the world. METHODS: Purposeful sampling was used to recruit 28 leaders in a large health care system. Data were collected via semi-structured audiotaped interviews. Results were analysed using hermeneutic phenomenology. RESULTS: The structure in which leaders worked was described as: from the day-to-day grind to derailment and from manning the hospital to manning the frontlines. Five phenomenological themes were as follows: embodied leadership, navigating differently, trusting and earning trust, being the calm voice and envisioning the future. CONCLUSION: Disaster policies and procedures are needed that will alleviate leadership angst, maximize nursing resources, heighten trust and enhance communications. IMPLICATIONS FOR NURSING MANAGEMENT: In 2020, we witnessed a previously inconceivable media and public focus on the value of nursing care. Leaders can use this pivotal moment in time as a catalyst towards securing the support needed in planning for the next pandemic.

Helping Experienced Pediatric Nurses Bridge the Gap Between Intermediate and Intensive Care.

The desire for career advancement has been identified as a cause of nurse turnover. In order to prevent nurses wanting to advance in their career from leaving the organization, a program was developed to transition nurses from pediatric acute and intermediate care to the intensive care unit. The intervention included classroom training, social support, and a formal orientation. Turnover rates are lower for participants in the program, and transitions to the intensive care unit have been successful.

Developing the WATCh Nurse: A Qualitative Approach to Understanding a Pediatric Rapid Response Role.

PURPOSE: The objective of this study was to identify the characteristics and tasks vital for individuals to successfully navigate a proactive rapid response role at a quaternary children's hospital. DESIGN AND METHODS: A qualitative thematic analysis of open-ended interviews was utilized to define the essential characteristics and functions of a WATCh (Watch, Assess, Triage for Children) nurse. The sample included both WATCh nurses and other healthcare providers that work with WATCh nurses. RESULTS: Effective WATCh nurses are excellent communicators with advanced skills who are experienced, confident, and visible. They work as an extension of the nurse and as a care facilitator for high-risk children, advocate, and educator. CONCLUSIONS: A more proactive approach is essential for successful pediatric rapid response teams in hospital settings to prevent patient decompensation and code blue events. This study has identified that a successful program requires defined tasks and essential role characteristics. PRACTICE IMPLICATIONS: Implications for integration into practice include a defined selection process and training program for the WATCh nurse role to provide standardization and consistency. Experience was identified as an essential characteristic for the role but an exact amount was not defined. Strong communication skills are also necessary and while training can help supplement the characteristic, a certain level of personality and confidence should be identified in potential candidates. Training will need to include not only practice skills, but also personal skills to be an effective role in the institution.

Developing a Theory of Economic Solvency for Women Who Have Experienced Intimate Partner Violence.

Poverty and intimate partner violence create a cycle that is difficult for women to escape. To create programs to help women escape the cycle, a full understanding of economic solvency is needed. A Model of Economic Solvency has been created, and this Grounded Theory study serves to validate the model and give more details so that it can be effectively used in research and interventions. The revised model defines economic solvency as a woman's human capital, social capital, sustainable employment, independence, and assets. These factors are affected by opportunities and threats in her relationships, community, and society.

"Getting my Independence Back": Economic solvency program ideas from residents of a women's shelter.

OBJECTIVE: Intimate partner violence (IPV) is a serious public health issue that affects many women all over the world. One of the most consistent risk factors for IPV is poverty. On the other hand, IPV is also a risk factor for continued poverty, which puts many women in a cycle of violence and poverty that is difficult to escape. Interventions are needed to help women improve their economic solvency and decrease their poverty-based risk for IPV. DESIGN: The current study is a qualitative study to examine how women who have experienced IPV would plan and execute an intervention to improve economic solvency. SAMPLE: The participants were 21 diverse women living in a women's shelter. RESULTS: The major themes that came from the women's suggestions were as follows: addressing mental health, accountability, financial management classes, job skills and education, and other resources. CONCLUSION: Implications of this study include the need for more comprehensive programs, a general desire amongst the women for mentoring and accountability, and the need to address knowledge deficits about resources. This information can help resource providers to help build interventions to improve economic solvency in women who have experienced IPV and improve their overall safety.

Men of Mexican Origin Who Abuse Women: A Qualitative Study.

BACKGROUND: Current literature indicates that intimate partner violence is a complex phenomenon that exists worldwide. PURPOSE: However, little is known about why some men of Mexican origin abuse women. This descriptive study was conducted to understand the experiences of men of Mexican origin who abuse their intimate partners. METHOD: A qualitative research design was used to conduct this study in a south Texas border community adjacent to the United States-Mexico border. RESULTS: This study builds on existing research and furthers the knowledge related to the factors contributing to intimate partner violence, including cultural factors. The results also reinforce the negative impacts of intimate partner violence on children and the family structure. DISCUSSION: Further research is needed to support the development of a culturally appropriate prevention and intervention program for men of Mexican origin who abuse women and their families.

Developing and Testing of an Economic Index Tool for Abused Women With Children.

Violence and poverty combine to severely compromise the safety, health, and functioning of women with major pass-through effects to their children. To reduce poverty and mitigate violence, measures are needed to assess economic status before and after intervention programs. The purpose of the study was to develop a new tool to assess women's various sources of income, to measure the degree to which the components of the tool are independent, and assess the usefulness of the tool to assess the connection of economic status and mental health functioning among abused women. RESULTS: Using content and face validity techniques and exploratory factor analysis, the 5-item Economic Index Tool was derived that assesses formal and informal employment wages, family and government cash assistance, and child support. Concurrent and predictive validity models for both the raw and weighted scores were significant, χ² (1) = 65.02, p <.001, Nalgelkerke R² =.285 and χ² (1) = 108.44, p <.001, Nalgelkerke R² =.443, respectively. Both the raw and weighted scores were associated with increased odds of being above poverty, Odds Ratios were 1.242 and 1.306, respectively, and all p values were < 0.001. The Economic Index Tool revealed a positive connection of higher economic status and better mental health. The Economic Index Tool offers a rapid assessment of abused women's economic status that can be used to guide multifaceted intervention programs and measure program effectiveness.

Child Brides, Forced Marriage, and Partner Violence in America: Tip of an Iceberg Revealed.

Forced marriage is a violation of human rights and thwarts personal safety and well-being. Child brides are at higher risk of intimate partner violence (IPV) and often are unable to effectively negotiate safe sex, leaving them vulnerable to sexually transmitted infections, including human immunodeficiency virus, and early pregnancy. The prevalence of forced marriage and child marriage in the United States is unknown. The intersection of forced marriage and child marriage and IPV is equally unknown. When 277 mothers who reported IPV to shelter or justice services were asked about a forced marriage attempt, frequency and severity of IPV, mental health status, and behavioral functioning of their child, 47 (17%) reported a forced marriage attempt with 45% of the women younger than 18 years of age at the time of the attempt. Among the 47 women, 11 (23%) reported death threats, 20 (43%) reported marriage to the person, and 28 (60%) reported a pregnancy. Women younger than 18 years reported more threats of isolation and economic deprivation associated with the attempt as well as pressure from parents to marry. Regardless of age, women experiencing a forced marriage attempt reported more intimate partner sexual abuse, somatization, and behavior problems for their children. Forced marriage attempts occurred to one in six women (17%) reporting IPV and are associated with worse functioning for mother and child. The frequent occurrence and associated effect of forced marriage attempts to maternal child functioning indicates routine assessment for a forced marriage attempt as part of comprehensive care for women reporting IPV.

Perceived Fertility Control and Pregnancy Outcomes Among Abused Women.

OBJECTIVE: To describe the degree of perceived fertility control and associated likelihood of unintended pregnancy and poor pregnancy outcomes among women who report intimate partner violence. DESIGN: Cross-sectional cohort study design. SETTING: Five domestic violence shelters and one district attorney's office in a large urban metropolis in the United States. PARTICIPANTS: A total of 282 women who reported intimate partner violence and reached out for the first time to a shelter or district attorney's office for assistance. METHODS: This 7-year prospective longitudinal study began in 2011. Participants in the overarching study are being interviewed every 4 months. During the 32-month interview period, participants responded to a one-time, investigator-developed, fertility control questionnaire in addition to the ongoing repeated measures. RESULTS: Almost one third (29%) of the participants reported at least one unintended pregnancy attributed to their abusers' refusal to use birth control, and 14.3% of the participants reported at least one unintended pregnancy as a result of their abusers' refusal to allow them to use birth control. Participants were 28 times more likely to have abuse-induced miscarriages if their pregnancies resulted because their abusers did not use birth control (OR = 28.70, p < .05). Finally, participants were 8 times more likely to report premature births if they were abused because of their use of birth control (OR = 8.340, p < .05). CONCLUSION: Women in abusive relationships reported compromised fertility control associated with abuse and increased risk for unintended pregnancy as well as the adverse pregnancy outcomes of premature birth and miscarriage.

Predicting Abused Women With Children Who Return to a Shelter: Development and Use of a Rapid Assessment Triage Tool.

To develop a tool to predict risk for return to a shelter, 150 women with children, exiting a domestic violence shelter, were evaluated every 4 months for 24 months to determine risk factors for returning to a shelter. The study identified four risk factors, including danger for murder, woman's age (i.e., older women), tangible support (i.e., access to money, transportation), and child witness to verbal abuse of the mother. An easy to use, quick triage tool with a weighted score was derived, which can identify with 90% accuracy abused women with children most likely to return to shelters.

Modeling the intergenerational impact of partner abuse on maternal and child function at 24 months post outreach: Implications for practice and policy.

OBJECTIVE: Many women are exposed to partner violence during their lifetime which affects mental health and child development. This study revalidates an intergenerational model connecting partner violence to poor functioning for mothers and children using structural equation techniques. METHOD: A longitudinal design collected data on 300 mother-child pairs. Comparisons between the model, tested at study entry and again at 24 months, are reported. Maternal measures included childhood experiences of abuse, partner abuse, chronic pain, and mental health. The Child Behavior Checklist measured child function. RESULTS: Comparison of both models revealed that maternal chronic pain, maternal mental health, and child witnessing of mother's abuse remain strong predictors of child dysfunction. Maternal social support and self-efficacy are significant predictors of more positive maternal mental health with a conduit effect on child behavior. CONCLUSION: Intimate partner violence directly impacts the victim and also has a secondary impact on the children of abuse victims.

Partner Abuse of Mothers Compromises Children's Behavioral Functioning Through Maternal Mental Health Dysfunction: Analysis of 300 Mother-Child Pairs.

Partner violence is associated with numerous negative consequences for victims, especially poor mental health. Children who are exposed to partner violence are more likely to have behavior problems. Nevertheless, research on the relationship between severity of abuse, maternal mental health functioning following partner violence, and child behavior problems is limited. We explored the direct and indirect effects on the child's behavioral functioning of severity of maternal abuse and maternal mental health functioning following abuse. A sample of 300 mothers was recruited when they sought assistance for abuse for the first time at shelters for abused women or at the district attorney's office. Severity of abuse, mothers' mental health functioning, and child behavioral functioning were measured by maternal self-report at entry into the study and 4 months later. In SEM analysis, at both entry and 4 months, severity of abuse had a direct effect on maternal mental health functioning, which in turn had a direct effect on child behavioral functioning. The path from severity of abuse to child behavioral functioning also was significant but became non- significant once maternal mental health functioning was added to the equation, indicating that the path from severity of abuse to child behavioral functioning was indirect and occurred as a result of the mother's mental health functioning, which remained directly linked to child behavioral problems. Intergenerational interventions are needed to address both maternal mental health and child behavioral functioning when a mother reports partner violence and is experiencing mental health problems.