The association between psychological distress, abusive experiences, and help-seeking among people with intimate partner violence.

BACKGROUND: Intimate partner violence (IPV) is a serious public health problem associated with countless adverse physical and mental health outcomes. It places an enormous economic and public health burden on communities. The aim of this study was to examine the associations between psychological states (such as depression or hopeless) and help-seeking experiences of IPV survivors after experiencing IPV, based on the Allegheny County Health Survey (ACHS). METHODS: Data from 2015 to 2016 Allegheny County Health Survey with N = 8,012 adults were analyzed. The 6-item version of the Kessler Psychological Stress Scale, located in Module 11 of the ACHS questionnaire, was used to measure psychological stress in participants. Module 12 of the ACHS questionnaire collected information on participants' experiences of intimate partner violence and help-seeking in the past 12 months. Descriptive statistical analysis, Pearson's chi-square or two sample independent t-tests statistical analysis, and multivariate binary logistic regression models were used to analyze the relationship between IPV experience and psychological distress. RESULTS: A total of 212 of the 8,012 participants had IPV experience, with age, marital status, education, income, and race significantly different from those without IPV experience. The psychological stress of participants feeling hopeless (OR = 2.02, 95% CI = 1.37-2.99), restless or fidgety (OR = 1.83, 95% CI = 1.27-2.65), perceiving everything was an effort (OR = 1.55, 95% CI = 1.08-2.22) and worthless (OR = 1.49, 95% CI = 1.01-2.20) was associated with the IPV experience. Help-seeking behaviors of IPV survivors were associated with psychological distress, such as hopelessness (OR = 6.71, 95% CI = 1.38-32.60). CONCLUSIONS: This study explored the association between IPV experience, help-seeking and psychological distress, and the need to expand community support. It is necessary to implement targeted interventions, enhance training of professionals, and promote the identification of early IPV cases as well as collaboration between healthcare and social support departments to reduce the occurrence of IPV or psychological distress following IPV.

Harnessing Machine Learning in Tackling Domestic Violence-An Integrative Review.

Domestic violence (DV) is a public health crisis that threatens both the mental and physical health of people. With the unprecedented surge in data available on the internet and electronic health record systems, leveraging machine learning (ML) to detect obscure changes and predict the likelihood of DV from digital text data is a promising area health science research. However, there is a paucity of research discussing and reviewing ML applications in DV research. METHODS: We extracted 3588 articles from four databases. Twenty-two articles met the inclusion criteria. RESULTS: Twelve articles used the supervised ML method, seven articles used the unsupervised ML method, and three articles applied both. Most studies were published in Australia (n = 6) and the United States (n = 4). Data sources included social media, professional notes, national databases, surveys, and newspapers. Random forest (n = 9), support vector machine (n = 8), and naïve Bayes (n = 7) were the top three algorithms, while the most used automatic algorithm for unsupervised ML in DV research was latent Dirichlet allocation (LDA) for topic modeling (n = 2). Eight types of outcomes were identified, while three purposes of ML and challenges were delineated and are discussed. CONCLUSIONS: Leveraging the ML method to tackle DV holds unprecedented potential, especially in classification, prediction, and exploration tasks, and particularly when using social media data. However, adoption challenges, data source issues, and lengthy data preparation times are the main bottlenecks in this context. To overcome those challenges, early ML algorithms have been developed and evaluated on DV clinical data.

Transcending human frailties with technological enhancements and replacements: Transhumanist perspective in nursing and healthcare.

As human beings age, they become weak, fragile, and feeble. It is a slowly progressing yet complex syndrome in which old age or some disabilities are not prerequisites; neither does loss of human parts lead to frailty among the physically fit older persons. This paper aims to describe the influences of transhumanist perspectives on human-technology enhancements and replacements in the transcendence of human frailties, including those of older persons, in which technology is projected to deliver solutions toward transcending these frailties. Through technologies including genetic screening and other technological manipulations, intelligent machines and augmented humans improve, maintain, and remedy human-linked susceptibilities. Furthermore, other technologies replace parts fabricated through inorganic-mechanical processes such as 3D-printing. Advancing technologies are reaching the summit of technological sophistication contributing to the transhumanist views of being human in a technological world. Technologies enhance the transcendence of human frailties as essential expressions of the symbiosis between human beings and technology in a transcendental world.

Resilience, Trauma, and Cultural Norms Regarding Disclosure of Mental Health Problems among Foreign-Born and US-Born Filipino American Women.

Resilience refers to a set of personal qualities and abilities that allow an individual to confront challenges, risks, or traumatic experiences in an integrated manner and to thrive in the face of significant adversities. This cross-sectional study explores resilience, posttraumatic stress disorder (PTSD), and family norms with disclosure of mental health problems (FNAD) in a sample of 182 Filipino American women (FAW). Participants completed survey measures of resilience, PTSD, and FNAD and open-ended questions about beliefs and reasons for (not) disclosing mental health problems outside the family. Previous research found that the rates of psychological trauma and depression among FAW are higher than those in other Asian ethnic groups, which makes it necessary to investigate the protective characteristic of resilience among FAW. According to our results, foreign-born FAW had a significantly lower PTSD and greater resilience as compared to their US-born counterparts. A significant negative relationship between PTSD and resilience was observed only among foreign-born FAW. We also found a conditional moderating effect of FNAD on the negative relationship between resilience and PTSD. The results of our qualitative analysis of the participants' responses to the open-ended questions of the survey showed that FAW's family norms of nondisclosure are related to the cultural value of "saving face," a salient cultural construct among Asian family members. Results suggest that protective properties of resilience against PTSD are influenced by cultural factors, such as FNAD. Taken together, our findings underscore the importance of considering the impact of collectivistic cultural values (e.g., FNAD) in future research on resilience among Asian Americans.

Comparing student achievement in traditional learning with a combination of blended and flipped learning.

Aim: The aim of this study was to investigate the effectiveness of blended learning with a flipped classroom design on student academic achievement in a Bachelor of Science in Nursing course. Design: A quasi-experimental study. Method: Students were split into an experimental blended learning with a flipped classroom design group and a control group using the traditional, teacher-centred learning method. Data were collected during spring 2018 (13.3 weeks) and student's grades for the registered course and their grade point average (GPA) were recorded. Results: Findings showed statistically significant increases in student grades in the experimental group. Predictability calculations also showed better achievement of learning outcomes if a blended learning with a flipped classroom design is continued to be used in the future.

Precision health: A nursing perspective.

Precision health refers to personalized healthcare based on a person's unique genetic, genomic, or omic composition within the context of lifestyle, social, economic, cultural and environmental influences to help individuals achieve well-being and optimal health. Precision health utilizes big data sets that combine omics (i.e. genomic sequence, protein, metabolite, and microbiome information) with clinical information and health outcomes to optimize disease diagnosis, treatment and prevention specific to each patient. Successful implementation of precision health requires interprofessional collaboration, community outreach efforts, and coordination of care, a mission that nurses are well-positioned to lead. Despite the surge of interest and attention to precision health, most nurses are not well-versed in precision health or its implications for the nursing profession. Based on a critical analysis of literature and expert opinions, this paper provides an overview of precision health and the importance of engaging the nursing profession for its implementation. Other topics reviewed in this paper include big data and omics, information science, integration of family health history in precision health, and nursing omics research in symptom science. The paper concludes with recommendations for nurse leaders in research, education, clinical practice, nursing administration and policy settings for which to develop strategic plans to implement precision health.

Resilience and psychological trauma among Filipino American women.

AIMS: To explore the types of traumatic exposure, prevalence of posttraumatic stress disorder (PTSD), and level of resilience in a community sample of Filipino American women (FAW), as well as to investigate the relationships between their PTSD symptoms, history of traumatic exposure, and resilience. METHOD: A cross-sectional study with a total of 188 adult FAW. RESULTS: We observed high levels of resilience and low levels of PTSD symptom severity. The most common form of traumatic exposure was non-interpersonal trauma occurring after the age of 18 years old. We also found a significant correlation between history of traumatic exposure and PTSD and between resilience and PTSD. Resilience was found to have a significant moderating effect on the relationship between traumatic exposure and PTSD. CONCLUSIONS: The results provide preliminary evidence on the buffering and protective properties of FAW's resilience to PTSD despite traumatic exposure.

Assessing Intimate Partner Abuse: Associated Factors and Health Consequences among Jordanian Women.

In this cross-sectional study, we assessed levels and types of psychological and physical intimate partner abuse (IPA), and the association of IPA with socio-demographic factors and health consequences. The Abusive Behavior Inventory was completed by 471 Jordanian women. IPA was higher among older women who were: of older age, of younger age at marriage, married to unemployed spouses, living in urban residence, and of lower educational level. IPA was associated with most of the health problems except dental injuries and burns. We recommend educational programs that raise women's awareness to their rights to education, free choices in marital age, and policies that mitigate IPA in Jordan and similar patriarchal societies.

'Half a woman, half a man; that is how they make me feel': a qualitative study of rural Jordanian women's experience of infertility.

Infertility is a health problem encompassing physical, psychological and social consequences that may threaten women's quality of life. Few studies have been conducted in Jordan examining rural women's experiences of infertility. This study aimed to explore responses to infertility and its consequences in the Jordanian rural sociocultural context. Using a descriptive qualitative design, data were collected between April and September 2016 from a fertility clinic in a military hospital in Northern Jordan. Semi-structured interviews were conducted with 14 purposively selected Jordanian women. Data were analysed using thematic analysis. Findings revealing women's responses to infertility included: submission and docility, self-isolation, internalisation and persistence in getting pregnant by seeking modern and traditional methods of treatment. The impact of infertility complicated women's everyday living through their experiences of violence, kinship and patriarchal interference, stigma, negative perceptions of the infertile woman, and other's surveillance of their sexuality. Women living in rural areas of Jordan have negative experiences of infertility that are ingrained in sociocultural beliefs about fertility and reproduction. Healthcare professionals are encouraged to raise public awareness about infertility's adverse consequences and to help families by enhancing positive responses to infertility.

Resilience, Acculturative Stress, and Family Norms Against Disclosure of Mental Health Problems Among Foreign-Born Filipino American Women.

The present study explores the relationships between resilience, acculturative stress, and family norms against disclosure of mental health problems among foreign-born Filipino American women. The sample consisted of 159 foreign-born Filipino American women aged 18 years and above and residing in Las Vegas, Nevada, United States. Participants completed paper-and-pencil questionnaires. Results indicated high levels of resilience and moderate levels of acculturative stress. Findings also showed a significant negative correlation between resilience and acculturative stress, and a significant predictive effect of resilience on acculturative stress. We also found a significant negative relationship between resilience and family norms against disclosure of mental health problems but no significant mediating effect of resilience on the relationship between acculturative stress and family norms. This lack of significant findings related to the mediating effect of resilience on the relationship between acculturative stress and family norms against disclosure of mental illness may be due to the absence of theoretical models and research regarding the role of resilience in the context of acculturation among Filipino American women. Our findings imply the need to further explore underlying mechanisms that explain the relationships between resilience, acculturative stress, and family norms. The findings of the study also confirm the need to develop interventions and resources that ameliorate acculturative stress and promote an increase of the disclosure and reporting of mental health problems among Filipino American women.

Exploring Challenges in Conducting E-Mental Health Research Among Asian American Women.

In this discussion paper, we explore the challenges of conducting e-mental health intervention research among Asian American women and propose a model for addressing these barriers. Based on an extensive literature review, we identify two main types of barriers to conducting e-mental health intervention research among Asian American women: recruitment barriers and adherence barriers. Recruitment barriers are further subcategorized into those related to (1) stigmatized cultural beliefs about mental illness and mental health services; (2) lack of awareness about mental health services; and (3) language barrier. As to adherence barriers, the two identified subtypes concern (1) acuity and severity of mental health condition; and (2) lack of time. In order to enhance recruitment and adherence in e-mental health intervention research among the studied population, we formulate the following three main research strategies, namely: (1) considering the cultural and social contexts of Asian American women in the development of e-mental health interventions; (2) determining appropriate program length; and (3) conducting feasibility studies to test e-mental health interventions. We suggest that nurse researchers integrate our proposed model in conducting e-mental health interventions among Asian American women. Our proposed model also implies that nurses play an important role in encouraging Asian American women's acceptance of and adherence to e-mental health interventions. In order to overcome the obstacles to conducting e-mental health research among Asian American women, we recommend that nurses familiarize themselves with credible, relevant, and evidence-based e-mental health resources and integrate online mental health services and information within their nursing practice.

Comparing Online with Face-to-Face HELPP Intervention in Women Experiencing Intimate Partner Violence.

Intimate partner violence (IPV) is a public health problem. The purpose of this study was to compare the effectiveness of the HELPP (Health, Education on Safety, and Legal Support and Resources in IPV Participant Preferred) intervention among IPV survivors. A sequential, transformative mixed-methods design was used. Participants were randomly assigned to one of three study groups: Online (ONL), Face-to-Face (FTF), and Waitlist Control (WLC). The HELPP intervention was offered to 32 adult female participants who were 45.2% Asian, 32.3% White, and 22.5% Black. Outcome measures were anxiety, depression, anger, personal, and social support. In total, 64% (n  =  20) of the participants reported having experienced IPV before the age of 18. The anger mean score pre-test to post-test difference was significant for ONL (p < 0.001) and WLC (p  =  0.01). The personal and social support pre-test to post-test mean score differences were significant for ONL (p < 0.001; p < 0.001) and WLC (p  =  0.01; p  =  0.006), respectively. The HELPP intervention (1) decreased anxiety, depression, anger, and (2) increased personal and social support in the ONL group. The HELPP information and intervention was shown to be feasible, acceptable, and effective among IPV survivors compared with participants in the WLC group. The WLC participants displayed (1) increased levels of anxiety, depression, and anger and (2) decreased levels of personal and social support, post-intervention. Further research could be conducted to determine if e-mail alone or e-mail plus mobile devices are more useful modes of delivering interventions.

An ethnographic-feminist study of Jordanian women's experiences of domestic violence and process of resolution.

We interviewed 12 Jordanian women who had experienced domestic violence (DV) and were receiving assistance at the Jordanian Women's Union (JWU). Our aim was to explore the history and factors supporting attainment of freedom from DV. Narratives revealed themes of DV toward girls; forced marriage; physical, psychological, or sexual abuse before and during marriage; and escalation and enduring DV. Escaping from DV required family and JWU support. In the context of a strongly patriarchal, religious society, we observed a process of resolution by shifting cultural values and themes of empowerment, with an undercurrent of suffering blamed on inequalities in the legal process.

Transitioning to transradials: a collaborative process in the cardiac catheterization laboratory.

As transradial approaches to cardiac catheterizations and percutaneous coronary interventions steadily rise in the United States, we reviewed evidence-based studies to compare the radial and femoral approaches to cardiac catheterization. The purpose of this article was to provide an overview of transradial and femoral approaches for cardiac catheterizations and percutaneous coronary interventions, preparation for the procedure, and nursing management of these patients. The strategies used to develop the transition process are also discussed.

Evaluating the mental health of Jordanian women in relationships with intimate partner abuse.

This study evaluated the mental health consequences of abuse among Jordanian women and tested the effectiveness of using cognitive behavioral interventions to change the level of depression and level of stress among Jordanian women experiencing intimate partner abuse (IPA). A mixed methods design using phenomenology and quasi-experimental research data collection and analysis was implemented. The most commonly reported form of abuse was psychological abuse. Prior to cognitive behavioral intervention, participants demonstrated moderate to severe levels of depression, low levels of perceived social support, moderate to high levels of self-efficacy, and used approach coping skills more frequently than avoidance coping. Cognitive behavioral interventions resulted in decreased depression (p = .003) and decreased stress levels, although this finding did not reach significance (p > .05). Cognitive behavioral interventions are effective interventions when working with women experiencing IPA.

The right to pain treatment: a reminder for nurses.

Critical care units are frequently the setting for the delivery of end-of-life care. A case study describing pain management for a terminally ill woman in an intensive care unit is used to illustrate conflicts that may be experienced by critical care nurses. The application of standards of professional organizations and regulatory bodies is described, as well as the ethical principles of autonomy, veracity, beneficence, nonmalfeasance, and double effect. Important legal and sociocultural considerations are included.

A transdisciplinary team acting on evidence through analyses of moot malpractice cases.

A transdiciplinary team is crucial for healthcare systems to act based on evidence in responding to the global demand of the business of caring and patient safety. The purpose of this paper is to outline a transdisciplinary team led by nurses that examines linkages between moot malpractice cases filed against a healthcare system and to the quality of the healthcare system's ecology, caregiver, and patient safety outcomes.

Root cause analysis and nursing management responsibilities in wrong-site surgery.

The most fundamental reason for the failure or inefficiency of a process, in any work setting, is referred to as a root cause. Root cause analysis is the process of learning from consequences wherein healthcare providers take a step back and gain knowledge from near-misses, adverse events, or sentinel events in the operating room and all areas of healthcare. This article discusses root cause analysis and nursing management responsibilities as they relate to wrong-site surgery.

Use of the Interpersonal Support Evaluation List (ISEL) to guide intervention development with women experiencing abuse.

Effective intervention strategies for abused women must be developed that match women's perceived needs. The purpose of this study was to examine the associations among age, race, employment status, education levels, and women's perceptions of social support. Women (n = 40) from 19 to 68 years of age in a family court setting or domestic violence shelter completed the Interpersonal Support Evaluation List (ISEL), which was used to measure subscales of companionship, self-esteem, emotional support, and instrumental support. Abuse was documented by patient reports and protocols of the referring agencies. Significant associations were found between age and self-esteem (r = 0.47, p = 0.002) companionship (r = 0.29, p = 0.07) and emotional support (r = 0.27, p = 0.09). Also significant were the associations between race and self-esteem (r = 0.27, p = 0.10) and employment and instrumental support (r = -0.32, p = 0.08). These significant findings may aid in the development of interventions for abused women that are matched to their social support needs, particularly if the findings are consistent in larger studies.