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.

Adherence in chronic disease.

Nonadherence to treatment regimen is a prevalent problem of patients with chronic disorders. Approximately half of the patients with a chronic disease have problems following their prescribed regimen to the extent that they are unable to obtain optimum clinical benefit. This chapter reviews the state of knowledge regarding adherence to chronic disease regimens across the life span and demonstrates that the extent and nature of the adherence problems are similar across diseases, across regimens, and across age groups. Adherence to the commonly prescribed regimens is addressed, including pharmacological therapies, therapeutic diets, and therapeutic exercise. Randomized, controlled studies focusing on various educational, behavioral, cognitive, and affective interventions to improve adherence are included. Based on this review, further work is needed to better understand and improve adherence. New strategies for analysis and measurement will support these needed advances in the field of adherence.

Promotion of sexual health in the American cultural context: implications for health promotion in school age African-American girls.

African-American girls are at greater risk of engaging in sexual behavior at earlier ages, and putting themselves at risk for pregnancy and sexually transmitted disease. It may also lead to more limited successful life trajectory. The purpose of this article is to present an overview of some of the issues facing African-American girls today as they leave preadolescence and enter early adolescence. Research and health promotion strategies are identified that need to be examined and addressed when providing care to this population.

Multicultural issues and ethical concerns in the delivery of nursing care interventions.

Nurses are beginning to recognize the importance of understanding the values, beliefs, and health practices of different cultures in order to provide care that is appropriate and culturally relevant to diverse patient populations. Individuals from other cultures may have different languages and customs. These cultural factors are important to the nurse's understanding of the specifics of health care practice. Culture and ethnicity may influence one's physical development and exposure to health compromising environments and conditions. This article uses a case study to describe a process that health care providers can use when faced with ethical dilemmas that arise when caring for patients from different cultures. Nursing strategies to promote culturally sensitive care are discussed, and include cultural assessment, heightening sensitivity to ethical issues in cultural diversity, and the role of continuing education in providing culturally competent care.

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.

Career mobility: equipping nurses for health care beyond the year 2000.

Nurses are faced with uncertain employment in today's rapidly changing work place. The key to survival in this environment is to provide innovative, cost-effective, yet outcome-oriented methods of patient care delivery. Professional nurses and nursing students should make career mobility their watchword. Career mobility defines a planned trajectory which is flexible, role-expandable, and capable of adjusting to the sudden changes in direction which arise as nurses progress through their professional career. Nursing students must carefully examine the educational program they chose, and, once graduated, should use an innovative approach to the health care job market, with emphasis on professional nursing careers outside the traditional employment roles.

The use of focus groups to examine pubertal concerns in preteen girls: initial findings and implications for practice and research.

This article presents the findings of four focus groups aimed at discovering the concerns a group of 9- to 12-year-old African American and Hispanic girls (N = 38) had about puberty, the transition to adolescence, and growing up. Among the factors these girls liked about growing up were increasing independence from parents, widening social relations with same- and opposite-sex friends, and an increase in decision making regarding clothes and activities. What they reported as not liking about growing up were an increase in peer pressure, high parental expectations, and more responsibility for their actions in home, school, and recreational activities. Health care for this group must include systematic monitoring of pubertal development and concerns in order to aggressively educate preadolescents to negotiate this period smoothly and to avoid high-risk behaviors that could have negative health and social sequelae during adolescence and adulthood.

Nursing research needs of black Americans: 1989 and beyond.

This article identifies problems considered to be among the most important for Black American health and suggests specific areas of research to address these problems. Black professional nurses are urged to become active researchers in order to be effective in the treatment and/or prevention of these problems.