The mediating role of nurses' attitude towards reporting child abuse and neglect.

PURPOSE: Attitudes towards reporting child abuse and neglect play a significant role in determining the tendency to report abuse and neglect. In addition, Cognitive Response Theory (Shen, 2020) suggests that individuals actively process messages by producing pro and/or counter arguments referred to as "Gain - loss thoughts". However, literature positioning the variable, attitudes towards reporting, as a mediator, as well as its importance, are limited. The purpose of the study was to investigate the mediating effect of pediatric nurses' attitudes between "gain-loss thoughts" and the tendency to report child abuse and neglect. DESIGN AND METHODS: A cross-sectional study examined 124 pediatric nurses working in central Israel's hospital departments concerning nurses' tendency to report (tendency to report = TTR), attitudes towards reporting, and "gain-loss thoughts" (positive and negative consequences for the child). RESULTS: Most of the nurses had professional experience of 11 years or more (n = 75; 62.5%). According to the findings, nurses' attitudes towards reporting mediate the effect of gain-loss on the TTR child abuse and neglect. CONCLUSIONS: Findings from this study contributed to our understanding of the importance of pediatric nurses' attitudes in determining the TTR abuse and neglect. Only nurses' positive attitudes towards reporting child abuse had a mediating effect on TTR. PRACTICE IMPLICATIONS: Understanding the importance of attitudes and gain-loss thoughts can serve as a strategy for training programs and in the assimilation of reporting obligations by health professionals in general and nurses in particular.

Taking responsibility for sexual health curricula content: A national study of Israeli nursing faculty.

BACKGROUND: Little is known about sexual health education for nursing practice that nursing students receive in their undergraduate curricula. OBJECTIVES: This study examined nursing curricula for sexual health content and the context in which it was taught. Faculty's professional background, attitudes, perceived barriers, and facilitators were examined. METHODS: A mixed-methods national cross-sectional study was conducted. All Israel's nursing school directors were approached (n = 27) with a 51.8 % response rate. RESULTS: All participants (100 %) reported positive attitudes (M = 4.5, SD = 0.51) toward integrating sexual health content into nursing practice curricula; however, the general perception of most nursing schools (79.6 %) was that nursing students received insufficient preparation to deal with patient sexual concerns. Sexual health assessment was integrated into academic curricula only in two nursing schools (n = 2), with no school including clinical competencies for sexual health in their clinical practice (0 %). According to the results of the qualitative analysis, education, including faculty education and student curriculum, and comfort were identified as facilitators for the inclusion of sexual health content into nursing curricula. In contrast, discomfort, education, and cultural issues were described as barriers. CONCLUSION: Comprehensive sexual health education is mandatory content for nursing practice. The lack of sexual health content in the nursing curricula may limit the student's ability to assess the patient's sexual health in professional practice. Therefore, regulatory organizations in nursing education need to include this competency as a mandatory component of nursing education content.

Interprofessional palliative and end-of-life education: short-term and long-term outcomes - mixed-methods analysis.

ObjectiveInterprofessional care is integral to end-of-life (EOL) and palliative care (PC) and may be suited for EOL and PC education.We evaluate the impact of an interprofessional EOL care curriculum on participants, during the course, on completion and 4 years laterusing quantitative (questionnaires) and qualitative (open-ended questions and interviews) methods.The course included 14 fifth and sixth-year medical students, 9 social work students and 7 nursing students enrolled in master's degree programmes. Seventeen participants completed questionnaires 4 years later and eight participated in interviews.On postcourse questionnaires, participants attributed high value to interprofessional education (IPE) (4.77/5±0.50 on a Likert scale). Four years later, participants reported that IPE impacted their professional (3.65/5±1.11) and personal lives (3.94/5±1.09) and found PC IPE important (4.88/5±0.33).Conventional content analysis showed that the course enabled discussion of death and dying and provided an opportunity for a personal-emotional journey. It offered an approach to EOL care and an opportunity to experience interprofessional teamwork at the EOL resulting in behavioural change.Interprofessional EOL education resulted in meaningful and lasting self-reported personal and professional behavioural outcomes.

Spiritual Interventions Used by Jewish Women to Facilitate the Family Continuum: A Qualitative Study.

Introduction: Spiritual interventions (SI) are used by patients and their families as a means to promote health. The family continuum (FC), which includes finding a partner/spouse, getting married, becoming pregnant, and having a safe pregnancy/birth, is an important concept for the Jewish culture as well as other cultures that have a traditional family-centered approach. There is a dearth of professional literature pertaining to SI to promote the FC. Although patients may use SI, this information is not routinely collected in a health history. The purpose of the study was to describe the experience of Jewish women's use of SI to promote the FC. Methods: This ethnographic study included interviews of Jewish women pertaining to FC, a text review, and field study. Coding of the text, site visits, and interviews were performed and reviewed to identify categories and themes and were refined until saturation was achieved. Results: Fifty-three observant and non-observant Jewish women participated in the study. Women expressed that SI were the means for them playing an active role in fulfilling the FC, and included intermediaries to God, self-improvement, and folk/spiritual remedies. The examples of SI included: visits to holy sites and spiritual leaders for blessings and advice, prayers, psalms, doing good deeds, eating special foods, wearing amulets, and performing certain SI with predesignated repetitions. Women attributed these SI to attaining an FC. Women who achieved each FC milestone without difficulty tended to use less SI, whereas women's SI usage increased the longer a milestone was not achieved. Conclusions: Jewish women are using many SI to promote the FC. Health care should be delivered in a culturally competent manner, which includes the incorporation of safe cultural practices. Obtaining a cultural assessment as part of the medical history could assist the health care professional in integrating safe SI into patient care.

Body image and scar assessment: A longitudinal cohort analysis of cardiothoracic, neurosurgery and urology patients.

BACKGROUND: Scar severity and scar viewing are known to affect body image. The literature is lacking on the relationship between body image and surgical scar assessment. The aims of this study were to compare patients from 3 different surgical departments in terms of body image and scar assessment at discharge, in comparison with nurses' scar assessment, and 3 months post-surgery. In addition, the research examined age and gender in relation to the main variables. METHODS: A longitudinal, comparative, correlational study was conducted using an instrument which included a health history, a nurses scar assessment tool and a patient scar assessment tool at hospital discharge, as well as a body image tool used both at discharge and at 3 months' post-surgery. The 10-item body image scale was comprised of affective items, behavioural items and cognitive items. The STROCSS 2019 checklist is used. RESULTS: 75 patients were studied who were mostly male (68.0%) with a mean age of 59 and married (77.3%). The sample distribution of departments included 30.7% cardiothoracic, 29.3% neurosurgery and 40% urology. Cardiothoracic patients displayed a significant negative body image pre-surgery compared to post-surgery. Neurosurgical patients' scar assessments were significantly higher than nurses' assessments with no differences found in the other departments. CONCLUSIONS: The healthcare team needs to consider engaging patients in post-surgery discussions concerning scarring and body image. The results of this study revealed that expectations in both clinician and patient participants need to be assessed and evaluated for congruency in order to offer a greater patient-focused peri-operative experience.

Urinary incontinence type, symptoms, and quality of life: A comparison between grand multipara and non-grand multipara women aged ≥50 years.

AIM: Parity and age are risk factors for urinary incontinence (UI). The aim of this study was to compare grand multipara women (GMP) to non-grand multipara (NGMP) women concerning UI types (stress urinary incontinence [SUI], urge urinary incontinence [UUI]), symptoms, and quality of life. METHODS: This correlation-comparative study used three tools: a demographic/health questionnaire, Questionnaire for Urinary Incontinence Diagnosis (QUID), and Incontinence Quality of Life (I-QOL). RESULTS: The sample included 132 women, from 50-88 years of age: 65 NGMP women (mean age: 67.23 years) and 67 GMP women (mean age: 65.04 years). The GMP group had a higher score, compared to the NGMP group, for UI type (by QUID) and a lower QOL (by I-QOL) , with none of the scores found to be statistically significant. By dividing the sample into age groups, 50-59 and ≥60 years, the interaction between the parity and the age groups was found to be significant for both the SUI and UUI. CONCLUSION: The innovation of this study is the in-depth insight into the association between parity and age regarding UI type.

Do parental decision-making patterns predict compliance with use of child booster seats?

Booster seat use for 4-9 year olds remains the lowest of all age groups in many countries. The objective of this study is to examine whether parents' decision-making patterns, as measured by the Melbourne Decision Making Questionnaire, relate to car booster seat use. Israeli parents of 4-7 years old children (n = 398) answered a questionnaire about car safety and decision-making habits. Ninety per cent of parents reported having a booster seat; 70.5% reported consistent booster seat use in general and on short drives during the last month (booster seat use compliance index). Greater compliance index was positively related to a vigilant decision-making pattern, passenger compliance with rear seat belts and families with fewer children. Lower booster seat use compliance index was associated with buck-passing decision-making pattern. Health professionals and policy-makers should take into account parents' habitual decision-making patterns when designing interventions for car booster seat compliance.

Sexual function and quality of life of women with stress urinary incontinence: a randomized controlled trial comparing the Paula method (circular muscle exercises) to pelvic floor muscle training (PFMT) exercises.

AIM: To compare the effectiveness of the Paula method (circular muscle exercises) vs. pelvic floor muscle training (PFMT) exercises on sexual function (SF) and quality of life (QoL) of women with stress urinary incontinence (SUI). METHODS: A randomized controlled trial (RCT) was conducted in outpatient urban community clinics serving diverse socioeconomic populations between September 2004 and July 2005. The intervention included two exercise regimens: Paula method--12 weeks of private 45 minutes sessions; PFMT--12 weeks of group (up to 10 participants) sessions of 30 minutes in length once a week, for 4 weeks plus two additional sessions, 3 weeks apart. MAIN OUTCOME MEASURES: The Pelvic Organ Prolapse/Urinary Incontinence Sexual Questionnaire; the Incontinence Quality of Life Questionnaire; 1-hour clinic pad test; gynecological examination; demographic/health history. RESULTS: Sixty-six women in the Paula group and 60 women in the PFMT group. The mean SF scores post interventions were 38.72 (5.35) in the Paula group and 38.07 (5.80) in the PFMT group. SF score improvement was found to be significant in both groups (Paula, P = 0.01; PFMT, P = 0.05), as was in the QoL scores (Paula, P < 0.001; PFMT, P ≤ 0.001), with no significant difference between groups. There was a significant correlation between the mean SF score and the mean QoL score after the intervention (Paula: r = 0.4, P = 0.002; PFMT: r = 0.4, P = 0.009). A mild to moderate significant correlation was also found between the SF score and pad test results in both groups post intervention (r = -0.3, P = 0.02; r = -0.3, P = 0.04, respectively). CONCLUSION: This RCT study demonstrated the effectiveness of two exercise methods on SF and QoL in women suffering from SUI. The Paula method of exercise was presented for the first time in the literature as a conservative noninvasive treatment for SUI and SF.

Israeli and Chinese partners of women with breast cancer: a cross-cultural view of marital issues.

OBJECTIVE: Cultural nuances may influence the interface between the cancer experience and marital issues, specifically for the partner. Most of the literature has focused on the woman's narrative or couple's adjustment to cancer in general. The purpose of this study was to describe and compare the marital relationship, sexuality, and marital adjustment of Israeli and Chinese husbands of women with breast cancer and the discussion of the health-care team concerning these issues. METHODS: A convenience sample of 50 Chinese and 50 Israeli men, ages of 28-79 years, completed components of the Psychological Adjustment to Illness Scale, the Locke Wallace Adjustment Scale, and a background questionnaire. RESULTS: The majority of husbands were in their first marriage. The average time since diagnosis was 16.7 months. No significant difference was found between the two groups on issues of marital relationship. Significant differences were found between Israeli and Chinese husbands on sexual interest, pleasure, and performance (p<0.05). Israeli husbands reported a significantly higher level of marital adjustment as opposed to the Chinese husbands (p = 0.006). Marital adjustment for both groups was significantly related only to perceived quality of the relationship (p<0.03). CONCLUSIONS: Significant cultural differences were found in sexuality variables with no differences discerned on marital relationship variables. Couple-based interventions for marital issues are a critical component of support for both partners. Culturally sensitive assessment and care of the spouse as well as the woman with breast cancer should be part of a holistic, comprehensive family care plan.

Sexual function and quality of life for women with mild-to-moderate stress urinary incontinence.

INTRODUCTION: Sexual function is affected by stress urinary incontinence with or without pelvic organ prolapse. The aim of the study was to describe the sexual function of women with mild-to-moderate stress urinary incontinence, with or without pelvic organ prolapse (up to stage 2) and examine correlations with symptoms and quality of life. This investigation was part of a large, randomized, clinical trial of women with stress urinary incontinence who participated in an exercise intervention. METHODS: Women included in the study suffered from stress urinary incontinence as measured by a pad test and were interested in an exercise intervention. All participants underwent assessment for prolapse staging. Instruments included: the Pelvic Organ Prolapse/Urinary Incontinence Sexual Questionnaire (PISQ-12), Incontinence Quality of Life Questionnaire (I-QOL), and a health and urinary leakage questionnaire. RESULTS: One hundred and eighty-seven ambulatory women, aged 20 to 65 years, had a mean sexual function score of 36.9 (standard deviation [SD] 5.9). No significant correlation was found between the sexual function scores and quantity of urinary leakage. A significant correlation existed between the sexual function and I-QOL scores (P < .001). An additional finding was that women with urgency symptoms were older (P= .04) and had significantly lower sexual function scores (mean 35.7; SD 6.4) than those who did not report urgency (mean 38.7; SD 4.6; P < .001). DISCUSSION: Women with mild-to-moderate stress urinary incontinence, without or with lower stages of pelvic organ prolapse, demonstrated good sexual function, which correlated with physical and psychosocial factors. Health professionals need to perform multifaceted intake assessments on women with urinary leakage to customize their health promotion regimen.

Sexual activities, sexual and life satisfaction, and successful aging in women.

INTRODUCTION: Sexuality for women at all ages is a vital aspect of life satisfaction and is based upon continuing growth, development, and adaptation. The successful aging model includes physical, mental/emotional, and social well-being. There is no known published literature on the topic of sexual activities of older women and its implications on life and sexual satisfaction. AIM: To investigate the sexual activities of older women in Israel, their levels of sexual satisfaction and life satisfaction, and to examine the relationship between the level of sexual activities, sexual satisfaction, and life satisfaction. MAIN OUTCOME MEASURE: Components of the Derogatis Sexual Functioning Inventory, and the Life Satisfaction Index. METHODS: A descriptive, correlational study guided by the theory of "successful aging" by Havighurst (1961) was conducted using a convenience sample of 127 women who attended a menopause clinic for routine and follow up care. RESULTS: The research findings described older women as being involved in varied, though limited, sexual activities. There was no significant relationship discovered between the number of sexual activities and age. The level of sexual satisfaction of the studied sample was found to be above the mean score. Most of the women reported good sexual/intimate communication with their partners. Women were not satisfied with the limited variety in their sex life. Women reported a high level of life satisfaction. Ultimately, a positive significant correlation was discovered between sexual satisfaction and level of current sexual activity, and between sexual satisfaction and life satisfaction. CONCLUSIONS: Older women are interested in continuing their sexual activities. It is a component of life satisfaction. The desire for sexual variety suggested an important area for patient education. Couple communication was deemed a priority. Health providers should include sexual health issues in their discussions with clients of all ages.

First degree relatives of women with breast cancer: who's providing information and support and who'd they prefer.

INTRODUCTION: Mothers, sisters, and daughters of women diagnosed with breast cancer have an increased need for factual information, counseling, and emotional support. The purpose of this exploratory, descriptive study was to identify the information and support needs of Israeli women with a family history of breast cancer; discover whether these needs have been met, by whom, and who is the preferred source for them. METHODS: 128 healthy Israeli women, aged 18-65, with a first degree relative with breast cancer completed the adapted Information and Support Needs Questionnaire (ISNQ). RESULTS: Information needs were ranked above support needs, especially information about disease prevention. The degree to which the needs were met was generally ranked as low, with response to the information needs ranking higher than the response to the support needs. The doctor was the prime source of choice for the information and support needs. CONCLUSION: This study contributes to the understanding of the needs of patients' families, provides a framework for the improvement of methods of communication, and a basis for constructing information and support systems. In addition, it highlights the need for a multidisciplinary, proactive approach in health promotion for cancer patients' families.

Cultural competence and ethnic attitudes of midwives concerning Jewish couples.

OBJECTIVE: To examine nurse-midwives' general cultural competence and ethnic attitudes toward Jewish couples of varying degrees of religious identification during the birth process and the relationship between background data, ethnic attitudes, and cultural competence. DESIGN: Descriptive, correlational study. SETTING: Academic tertiary care health facility. PARTICIPANTS: Thirty staff nurse-midwives employed at a university hospital in Israel. METHODS: Participants completed Campinha-Bacote's Inventory for Assessing the Process of Cultural Competence among Healthcare Professionals-Revised, Ethnic Attitude Scale-Adapted, and a midwifery demographic survey. RESULTS: General cultural competence scores were consistent with previous studies of nurses who did not receive formal cultural education. Midwives' ethnic attitude differed significantly among Secular, Traditional, Religious, and Ultra-Orthodox Jewish patient scenarios. The most positive attitudes and lowest bias scores occurred for midwives when the patient scenarios were similar to or congruent with their religious identification. CONCLUSIONS: The results of this study indicate a need to establish educational and practice content with clinical experiences to improve midwives' cultural competence and ethnic attitudes toward women and their families with dissimilar cultural backgrounds. These results have global implications for nursing/midwifery care considering patients' varying degrees of religious adherence.

Jewish laws, customs, and practice in labor, delivery, and postpartum care.

Many communities throughout the world, especially in the United States and Israel, contain large populations of religiously observant Jews. The purpose of this article is to provide a comprehensive, descriptive guide to specific laws, customs, and practices of traditionally, religious observant Jews for the culturally sensitive management of labor, delivery, and postpartum. Discussion includes intimacy issues between husband and wife, dietary laws, Sabbath observance, as well as practices concerning prayer, communication trends, modesty issues, and labor and birth customs. Health care professionals can tailor their practice by integrating their knowledge of specific cultures into their management plan.

Sexual milestones and factors associated with coitus initiation among Israeli high school students.

In view of the developmental approach to sexual behavior, this article presents the stages of sexual behavior leading to coitus in four grades of high school students in Israel and the sociodemographic factors associated with initiating coitus. Analyses were based on data from the first national study dealing comprehensively with sexuality in 30 years. A self-administered questionnaire was completed by a random sample of 4,609 students of the General Educational (secular) system that included 68% of the Hebrew-speaking sector or 55% of all students in Israel. Our findings indicated a progressive set of stages of sexual behavior forming a Guttman scale, from kissing and petting over the clothes though petting under the clothes and genital touching to coitus. In comparison to results of a 1970 Israeli survey, we found an increase in practice in all Guttman scale stages of sexual behavior, as well as a diminished gap between genders. The gap fully disappeared in the three lower stages. Predictive variables of coitus initiation included gender, religiosity, immigration status, family structure, perceptions of academic achievements, and the proportion of peers practicing coitus. In addition to gender, perception of the proportion of peers that already practiced intercourse was the best predictor followed by grade, perception of academic achievement, and family structure. Marked differences were noticed between genders regarding associations with religiosity and immigration status. The discussion focused on comparisons to findings in other countries, the contribution of the findings to the understanding of Israeli adolescents' sexual behavior, and practical educational implications.

Social, marital, and sexual adjustment of Israeli men whose wives were diagnosed with breast cancer.

PURPOSE/OBJECTIVES: To explore the psychosocial adjustment of Israeli men whose wives were diagnosed with breast cancer. DESIGN: Descriptive study. SETTING: An urban tertiary medical center. SAMPLE: A convenience sample of 50 Israeli men whose wives had been diagnosed with breast cancer. The average age was 53.8 years. All of the men spoke and wrote Hebrew. METHODS: Husbands completed a demographic and wives' health-related questionnaire, the Social Support Questionnaire to measure social support from their wives, the Psychosocial Adjustment to Illness Scale to measure adjustment to a serious disease of the wives, and the Locke Wallace Marital Adjustment Scale to measure marital and sexual adjustment. MAIN RESEARCH VARIABLES: Psychosocial adjustment, social support, relationships with their partners, and relationships with the healthcare system. FINDINGS: A fifth of the men reported various levels of stress and concern. Half described financial difficulties. Three-quarters of the men noted changes in their relationships. More than a third of the husbands experienced a reduction in communication with their families. All of the men expressed satisfaction with the healthcare system, although some of them expressed a need to receive more information. CONCLUSIONS: Husbands of women with breast cancer grapple with multiple issues on several fronts. They need support and information from the healthcare team even if they do not request it in a timely or direct manner. IMPLICATIONS FOR NURSING: Response to the unspoken needs of men whose wives have breast cancer necessitates education and ongoing staff education to develop strategic support and communication.

Social support as experienced by Chinese and Israeli husbands of women with breast cancer: a comparative study.

The purpose of this research was to compare the experience of social support of Israeli and Chinese husbands of women with breast cancer. Social support was examined from three different sources: wives, friends and family, and the healthcare team. This study is part of a larger descriptive comparative study investigating the husbands' adjustment to their wives' diagnosis of cancer. A convenience sample of 50 husbands from each cultural framework was selected. Support from family and friends and the healthcare team was measured by items from the Social Support Questionnaire (SSQ), the Psychosocial Adjustment to Illness Scales (PAIS) and questions developed by the authors. Israeli husbands reported significantly higher levels of support in all three areas. Chinese husbands were significantly more interested in joining a support group. The results of this study show that culture has an impact on spousal responses to their wives' illness. In developing appropriate breast cancer nursing, nurses need to practice sensitivity and awareness of the cultural differences in order to provide culturally sensitive family oriented nursing care. This study is an ongoing effort of collaboration between nursing professionals from the far east and the middle east.

Breast cancer: reactions of Israeli men to their wives' diagnosis.

The purpose of this research was to describe Israeli husbands' reactions to their wives' diagnosis of breast cancer. This quantitative, descriptive, preliminary study employed a convenience sample of 20 men and investigated their perception of the information they received, their psychosocial responses, the effects on their marital relationship, and their perceived spousal social support. The study instruments included the Locke Wallace Marital Adjustment Scale, the Psychosocial Adjustment to Illness Scale, and a Social Support Questionnaire. This subject has not been researched in Israel previously. Husbands voiced total trust in the health-care delivery system, even though they reported a need for more information on the disease, treatment, and issues concerning their marital relationship. Husbands had difficulties with their day-to-day activities, and almost half of them cited problems both at work and at home. They described stress, including depression and sleep disturbances. They reported changes in their sexual interest and sexual functioning as well. In general, husbands felt the support of their wives. Husbands whose wives have breast cancer need a network of support to address their specific issues and concerns. The Breast Care Clinical Nurse Specialist is cited as being a pivotal component of such a support network.