Perspectives on Electronic Nicotine Delivery System Use Cessation Among Adults in Rural Areas: Implications for Future Studies.

INTRODUCTION: More young adults (age 18-24 years) in rural areas versus urban areas use electronic nicotine delivery systems (ENDS) - also known as e-cigarettes. Little is known about young adults' perceptions toward ENDS use and cessation. The objective of this study was to examine barriers and facilitators to ENDS use cessation among young adults living in rural areas, as well as their perceptions about ENDS use and cessation and to determine implications for future cessation studies. METHODS: We administered cross-sectional online surveys to young adults living in rural Midwestern counties. A total of 100 individuals responded to the surveys. Descriptive statistics were used to report their perceptions of ENDS use as well as barriers and facilitators to ENDS use cessation. The content analysis method was used to analyze the answers to an open-ended question regarding perceptions about the ENDS use cessation in the context of rural areas. RESULTS: Barriers to ENDS use cessation included perceived advantages to ENDS use, high nicotine dependence, and the perception that ENDS use was less harmful cigarettes. Facilitators to ENDS use cessation included cost of ENDS use, perceived harm, and high confidence in ability to quit. Participants' perceptions about ENDS use cessation in the context of rural areas were conceptualized under the themes of (1) exposure to and initiation of ENDS use, (2) continuation of ENDS use, and (3) prevention and cessation of ENDS use. CONCLUSIONS: Health care providers, tobacco control researchers, and public health advocates should be aware of barriers and facilitators to ENDS use cessation among young adults for future cessation intervention studies relevant specifically to rural areas.

Experiences and Perceptions of E-Cigarette Cessation for Young Adults in Rural Communities.

BACKGROUND: Electronic nicotine delivery systems (ENDS), also known as e-cigarettes, are the most commonly used tobacco products among young adults in the United States. Young adults in rural areas have a higher prevalence of ENDS use compared to their urban counterparts, yet there is limited evidence regarding the in-depth understanding of experiences and perspectives directly from young adults. OBJECTIVES: The aim of this study was to explore individual experiences and perspectives about use and cessation of ENDS from young adults in rural areas. METHODS: This was a qualitative study using interpretive description for analysis. Young adults (18-24 years) who used ENDS every day but not other tobacco products (cigarettes, smokeless, etc.) in the past month and had an address in a rural county of Wisconsin were eligible; there were nine participants interviewed using Zoom. Interview questions focused on initial use, maintenance of use, experiences of quitting, and social and rural environmental contexts regarding ENDS. RESULTS: Three themes emerged with eight categories: (a) addiction to ENDS and health, (b) cessation and resources, and (c) rural environment and culture in ENDS addiction. DISCUSSION: Findings have implications for ENDS cessation interventions targeting young adults in rural areas.

Public health nurses' perceptions and experiences of emergency preparedness, responsiveness, and burnout during the COVID-19 pandemic.

OBJECTIVE(S): To describe PHNs' perceptions and experiences of the COVID-19 pandemic, including training, response activities, and work-related challenges. DESIGN: This was a qualitative study using interpretive description for analysis. SAMPLE: PHN participants who worked in public health departments in Wisconsin were recruited using purposive sampling. A total of 15 PHNs participated in the study, including both general and supervisor-level PHNs. MEASUREMENTS: Data were collected via semi-structured interviews from March to May 2021. Interview questions focused on PHNs' perceptions, experiences, response activities, and burnout in relation to the current pandemic as well as perceptions and experiences of emergency preparedness and response in general. RESULTS: Five themes emerged in the study. These were: (1) experiences and observations of the COVID-19 pandemic, (2) organizational changes and their impacts, (3) public health emergency preparedness and response, (4) public health emergency response activities, and (5) role strain and burnout. CONCLUSIONS: Findings presented here have important implications for PHN training and support in emergency preparedness and response. A wide array of strategies focused on developing and supporting the PHN workforce in response to the public health crisis this area need to be implemented at the organizational, community, and policy levels.

Decision-making about prenatal genetic testing among pregnant Korean-American women.

OBJECTIVE: to understand the prenatal genetic testing decision-making processes among pregnant Korean-American women. DESIGN: a qualitative, descriptive research design. PARTICIPANTS: referrals and snowball sampling techniques were used to recruit 10 Korean-American women who had been recommended for amniocentesis during pregnancy in the United States (U.S.). All participants were born in Korea and had immigrated to the U.S. The number of years living in the U.S. ranged from 4 to 11 (M=5.7). SETTING: various regional areas of the U.S. MEASUREMENTS AND FINDINGS: the researchers conducted face-to-face or phone interviews using semi-structured interview guides. The interviews were conducted in the Korean language and lasted approximately 50-100minutes. The interview guides focused on the decision-making process and experiences with prenatal genetic testing, as well as reflections on the decisions. Four core themes emerged related to the participants' decision-making processes, according to their descriptions. These themes are (1) facing the challenges of decision-making, (2) seeking support, (3) determining one's preferred role in the decision-making process, and (4) feeling uncomfortable with the degree of patient autonomy in U.S. health care. KEY CONCLUSION: researchers concluded that many distinctive factors influence the decision-making processes used by pregnant Korean-American women. The results have the potential to improve shared decision-making practices regarding prenatal genetic testing. IMPLICATIONS FOR PRACTICE: clinicians need to understand the sociocultural underpinnings of pregnant Korean-American immigrants regarding prenatal genetic screening and testing as an initial step to engage these patients in shared decision-making.

Experiences of Prenatal Genetic Screening and Diagnostic Testing Among Pregnant Korean Women of Advanced Maternal Age.

PURPOSE: This study explored the experiences of Korean women of advanced maternal age undergoing prenatal genetic screening and diagnostic testing. DESIGN: A descriptive, qualitative design was used to guide the study. METHOD: Ten participants were purposely recruited from a large metropolitan Korean hospital for clinical observations and individual, semistructured interviews. The content analysis method was used to analyze field notes and interview transcripts. FINDINGS: Three themes emerged: reacting to an unfavorable screening result, dealing with the anticipated consequences of diagnostic testing, and realistically embracing the unborn child. CONCLUSIONS: The findings of this study inform the development of tailored interventions aimed at reducing the heavy emotional burdens placed on pregnant women and the stigma of bearing children with genetic conditions. Clear reciprocal communication and shared decision making should be promoted in the day-to-day practice of delivering health care for pregnant Korean women.

The Relationship between Cultural Competency and the Importance of Nurses' Qualities Perceived by Undergraduate Nursing Students

PURPOSE: This study was conducted to investigate the relationship between cultural competency and the importance of nurses' qualities perceived by undergraduate nursing students. METHODS: Researchers developed two tools for this study after reviewing the related literature and conducting research team workshops: questionnaire of cultural competency and the importance of nurses' qualities. 200 nursing students were recruited in convenient sampling to respond to these questionnaires. Of nurses' 10 qualities, major affecting factors on the cultural competency were identified by stepwise multiple regression analysis. RESULTS: The nursing students perceived technical nursing skills and professional nursing knowledge as nurses' most important qualities. However, 'having a passion for patient care', 'demonstrating strong nursing profession's code of ethics??and 'teaching and research ability' were found as significant influencing factors on the variance of the cultural competency. These three factors explained 16% of the total variances of the cultural competency (F=13.98, p<.001). CONCLUSION: The educational strategies to improve cultural nursing competency need to incorporate students' expectations for the professional nurses' roles. Also, further studies need to develop reliable and valid measurement tools for cultural competency

Reflections on attitudes, experiences, and vulnerability of intimate partner violence among Southeast Asian college women living in United States.

To provide culturally sensitive intimate partner violence (IPV) prevention programs for ethnic groups, a basic foundational understanding of Southeast Asian (SEA) women living in the United States is vital. The purpose of this study was to describe SEA college women's perceptions of IPV and how the women recognize their vulnerability to such violent situations. Qualitative methods using focus group discussions were employed to elicit participants' perceptions. Participants included 18 SEA college women, ages 18-34 (Mean=22; SD=7.22). Transcriptions were analyzed using a content analysis approach. Five themes emerged: recognition of IPV; perception of individual vulnerability to IPV; experience and responses to IPV; help seeking and support system; and strategies used for prevention of IPV. Findings yielded an understanding of intertwined issues of cultural norms associated with IPV, social and economic disparities, and challenges for IPV prevention in SEA communities. Culturally sensitive prevention programs will be more effective by reforming cultural values, while at the same time promoting non-violent relationships and increasing access to services.

Undergraduate nursing students' attitudes toward mental health nursing.

OBJECTIVES: The purpose of this study was to describe undergraduate nursing students' attitudes toward mental health nursing and how these attitudes influenced their professional career choices in mental health nursing. DESIGN: A descriptive, online survey was utilized to examine students' perceptions of mental health nursing. A total of 229 junior and senior nursing students were recruited from eight nursing colleges in Midwestern United States to participate in this survey. RESULTS: Students of different ages, genders, ethnicities, and nursing programs did not report significantly different perceptions of: (a) knowledge of mental illness; (b) negative stereotypes; (c) interest in mental health nursing as a future career; and (d), and beliefs that psychiatric nurses provide a valuable contribution to consumers and the community. Negative stereotypes were significantly different between students who had mental health nursing preparation either in class (p=0.0147) or in clinical practice (p=0.0018) and students who had not. There were significant differences in anxiety about mental illness between students who had classes on mental health nursing (p=.0005), clinical experience (p=0.0035), and work experience in the mental health field (p=0.0012). Significant differences in an interest in a future career in mental health nursing emerged between students with and without prior mental health experience and between students with and without an interest in an externship program with p-values of 0.0012 and <0.0001, respectively. CONCLUSIONS: The more exposure that students have to mental health nursing through clinical experiences, theory classes, and previous work in the field, the more prepared they feel about caring for persons with mental health issues.

Thai female adolescents' perceptions of dating violence.

We explored how Thai female adolescents describe the meaning and context of dating violence. Twenty-four students, aged 15-17, were purposively recruited from a secondary school in Bangkok for individually audio-taped interviews. The interviews lasted 45- 70 minutes. ATLAS ti 5.2 was selected for content analysis. Five themes emerged, including characteristics of adolescent romantic relationships, influences on adolescent romantic relationships, perceptions of dating violence, cycle of dating-violence experiences, and influences on adolescents' perceptions of dating violence. The findings indicate a foundation for developing culturally sensitive programs for dating-violence prevention among Thai adolescents.

Comparisons between Thai adolescent voices and Thai adolescent health literature.

Thai adolescents are hesitant to openly talk to adults; however, they are avid users of the Internet. In 2002, faculty of the Boromarajonani College of Nursing, Nopparat Vajira, Thailand, established a webboard to reach out to high school students for questions and answers on adolescent health. Adolescents pose health questions, which are answered by nursing faculty and students. A total of 106 questions were selected for content analysis. Thai adolescent studies for the years 1992 to 2004 were identified from searches of CINAHL, ERIC, MEDLINE, and PsycINFO databases. The selection criteria required that chosen articles have a Thai adolescent health focus, be written in English, and be retrievable. Of the 68 citations identified, 23 studies met inclusion criteria. Content of the Thai adolescent webboard was compared with a content analysis of the retrieved Thai adolescent research. Physiological development, sexuality, and risky behaviors were common literature themes, whereas Thai adolescents expressed concerns about love and dating relationships. Parenting and parent-child relationships were discussed on the webboard but not in the literature. Analysis of the mental health revealed differences between the literature that covered psychosocial change, and the webboard questions concerned with body image, the need for emotional support, and satisfaction and conflicts of friendship. It is recommended that investigators consider incorporating adolescents as research team participants, particularly as they examine mental health promotion, adolescent and family relationships, and concerns of Thai adolescents.