Valuing Joyful Teaching Moments: Nursing Faculty Experiences in Texas.

Purpose: Studies of joyful experiences in teaching nursing and related implications are lacking in the literature. The concept of joy seems undervalued yet critical to the theoretical basis for improving holistic faculty experiences and potentially affecting students and patients. The purpose of this study is to give voice to instances of joyful teaching identified by nursing faculty and to consider related implications, including advancing holistic nursing education. Design: In this sequential exploratory multimethod study, faculty discussed joyful teaching, responded to survey questions, and completed a Likert-type measure of outcomes. Eleven faculty were interviewed; interviews were digitally recorded and professionally transcribed. Interviews were coded using qualitative content analysis; quantitative data provided frequency counts. Findings: Four main themes emerged: "aha" moments, faculty validation, witnessing transformation, and planting seeds. Faculty shared experiences with peers, students, or both, and occasionally with others. Three outcome themes of joy were identified: transcendence, meaning, and activity. The most frequently reported significance of joy was hope and resilience. Conclusions: Joyful experiences belong in the literature and can inform holistic practice. Our results suggest that joyful moments support faculty and that students and patients may also benefit from this emotion, even though it has been undervalued in nursing research.

Exploring health care experiences of transgender people living in Texas.

BACKGROUND: Although the transgender population in the United States is greater than 1.4 million, health care experiences in this group are underaddressed. PURPOSE: To explore the health care experiences of transgender people in Texas. METHODS: This was an exploratory, sequential multimethod study. In Phase 1, to identify key health-related topics, a self-selected sample of 14 participants completed an online survey. In Phase 2, the focus was understanding care experiences for 12 participants using audio-recorded interviews and theme identification. NVivo software was used for data management. FINDINGS: In Phase 1, findings included needing to: educate providers (89%), correct care staff on pronoun use (75%), tolerate staff's refusal to use one's preferred pronoun (50%). In Phase 2, four themes emerged: discrimination, provider practices, challenges to navigating the health care system, and gender identity. DISCUSSION: Valuing transgender experiences is a first step in addressing care gaps. Change will require provider introspection and application of care guidelines.

Focusing on the "T" in LGBT: an online survey of related content in texas nursing programs.

BACKGROUND: As nurses, we advocate for the most vulnerable and underserved, who, within the lesbian, gay, bisexual, and transgender (LGBT) community, are transgender individuals. Yet, the existence of LGBT education in nursing schools has not been examined. METHOD: After approval by the university institutional review board, 113 nursing programs in Texas were surveyed between November 2013 and January 2014, with a 12-question, Web-based questionnaire. A Verisign certificate and 128-bit encryption program supported compliance with the Health Insurance Portability and Accountability Act of 1996. RESULTS: Nineteen percent of the surveys were returned. Ten (47.62%) of 21 respondents addressed transgender or transsexual individuals. Fifteen (71.43%) of 21 answered a free-text question to estimate the number of hours spent addressing LGBT content, reporting an average of 1.6 hours. CONCLUSION: Our study suggests that, in Texas, nursing students may not be receiving sufficient content, nor do they understand transgender health needs or how to best deliver competent, compassionate care to this population.

Maternal worries, home safety behaviors, and perceived difficulties.

PURPOSE: The aim of the study was to explore the worries, safety behaviors, and perceived difficulties in keeping children safe at home in a purposive sample of low-income, predominantly non-English speaking mothers as a foundation for later nursing interventions. DESIGN: This study was a qualitative, descriptive design with content analysis to identify maternal concerns, behaviors, and perceptions of home safety as part of a larger study. METHODS: Eighty-two mothers, 64% of whom were monolingual Spanish-speakers, responded in writing to three semistructured interview questions. When mothers were unable to read and write the researcher wrote the responses, then read the content aloud for verification. A standardized probe for each question was posed to obtain richer responses. Data management included use of the software program NUD*IST and coding analyses following the Miles and Huberman guidelines (1994). Interpretations were translated into English for this report. FINDINGS: The major worries were falling, health, kidnapping, and being hit by a car. The leading maternal behaviors were coded as being physically, verbally, and environmentally preventive. Mothers said that it was their role to provide safety, and that this role could be wearisome, such that constant supervision was difficult. CONCLUSIONS: Low-income mothers described their worries for their 1 to 4 year-old children, explored their behaviors for preventing injury, and discussed what made keeping children from harm difficult. Understanding how mothers keep children safe, the barriers to home safety, and effective safety behaviors are important to the health of children. CLINICAL RELEVANCE: The clinical relevance of this study includes building trust as clinicians plan assessment, intervention and evaluation of home safety to encourage dialog about concerns, safety behaviors, and barriers to keeping children from injury.

Video recruitment of non-English-speaking participants.

Recruitment of underserved participants begins to close the disparity gap evident within disadvantaged communities, and innovative approaches to recruitment support this effort. Literacy, communication, and credibility barriers distance potential research participants. The literature search from 1975 to 2005 included the Cochrane Review, MEDLINE, EBSCO, PsycINFO, Google Scholar, and CINAHL for the terms video recruitment, videotaped, minority recruitment, and research subject recruitment with no documented use of videotape recruitment of non-English-speaking (NES) participants. Based on this review, an innovative recruitment video was developed and targeted to monolingual Hispanic mothers to explain a study using home safety visits. Community assistants collaborated on the script. In 4 minutes, potential participants, some illiterate, saw what they could not read, and also whom they should expect at their door if they decided to participate. A total of 82 women were recruited, and with a retention rate of 95%. Classic minority recruitment barriers are reducible with this approach.

Beyond translation ... cultural fit.

Reaching non-English-speaking families, the economically disadvantaged, and those who are disproportionately represented in disease and injury statistics is challenging. This article describes the process of making a questionnaire developed in English, culturally appropriate for low-income, monolingual, Mexican and Mexican American mothers. The questionnaire, guided by the Health Belief Model, assesses maternal childhood injury health beliefs and was originally used with a 96% African American, English-speaking sample in the Eastern United States. Two research assistants from the target population worked with the non-Hispanic, bilingual investigator to redesign the questionnaire's language and presentation and to collect data. Sixty monolingual Latina mothers participated in the study to determine the internal consistency of the 42-item Spanish language Maternal Childhood Injury Health Belief Questionnaire (MCIHB). Cronbach's alpha coefficients ranged from .76 (Benefits subscale) to .90 (Consequences subscale).

Broadening the understanding of injury prevention: a case study.

The death or injury of a loved one is tragic, especially if that injury could have been prevented. Programs to reduce the incidence and severity of neurological trauma are traditionally driven by injury statistics, and the literature on neurological injury prevention often fails to capture individual experiences. Understanding community members' concerns about injury and safety efforts can move injury-prevention programs to a new level by assessing injury-related beliefs and refining interventions suited to the community. Pediatric injury is an especially complex problem that is influenced by developmental, environmental, sociopolitical, economic, geographic, parental, and child-related factors. Recognition of injury as a public health concern supports updating program development. The following case study, based on an in-depth parent interview, offers a unique perspective on pediatric injury. The audiotaped interview was transcribed verbatim following qualitative guidelines. Three main themes emerged from the analysis: (a) sources of parental concern for children's safety, (b) private versus public safety influences, and (c) behaviors making children vulnerable to injury. As this case study illustrates, parents may consider children susceptible to injury as a result of factors often not considered by injury prevention programs, for example, being "injury prone." Parents also have access to resources, grandparents, for example, not typically considered when programs are marketed. The challenge is to identify how programs become an accepted public safety influence and to address real-life parental concerns.