Moral distress during COVID-19: The importance of perceived organizational support for hospital nurses.

Moral distress, or the inability to act congruent with moral beliefs, has been of concern for healthcare professionals especially since the COVID-19 pandemic. Hospital nurses are particularly affected in their roles with mounting administrative pressures and demands. We examined whether general and COVID-specific support in employing healthcare organizations predicted moral distress in a sample of inpatient hospital nurses. A total of 248 nurses completed the Measure of Moral Distress for Healthcare Professionals, Survey of Perceived Organizational Support, COVID Organizational Support survey, and the Hospital Ethical Climate Scale. We found that general and COVID-related organizational support were predictors of moral distress after controlling for age, gender, working in an intensive care unit setting, and ethical climate. Findings support the need for a comprehensive strategy to address moral distress, including institutional efforts to convey support and commitment. Strategies moral distress may be experienced differently based on gender identity.

Enhancing Provider Delivery of Tobacco Treatment Within the Inpatient Psychiatric Setting.

People with mental illnesses (MI) smoke at higher rates than the general population. However, few mental health providers (MHPs) deliver tobacco treatment to patients with MI especially within inpatient psychiatric settings. According to evidence, fewer than half of MHPs in the US mental and behavioral health settings provide the recommended evidence-based tobacco treatment interventions to their clients with MI. This paper uses the theory of planned behavior to examine factors associated with provider intentions to deliver and their experiences in providing evidence-based tobacco treatment to clients with MI. Data were obtained from a cross-sectional survey of 219 providers in a state psychiatric hospital in Kentucky. Attitudes, subjective norms, and perceived behavioral control were associated with providers' intentions to deliver tobacco treatment when controlling for demographic and work-related variables. However, only profession, subjective norms, and attitudes were associated with reported provision of evidence-based tobacco treatment. Given the underuse of routine tobacco treatment for this vulnerable population, understanding factors influencing provider delivery of tobacco treatment is needed to guide strategies for reducing the disproportionate rates of tobacco use and related burden among people with MI.

A survey of moral distress and end of life care in mechanical circulatory support nurses.

BACKGROUND: Patients receiving left ventricular assisted device (LVAD) require the expertise of specialty trained nurses referred to as VAD coordinators. The long-term use of these devices has created morally distressing situations for VAD coordinators. OBJECTIVE: This pilot study sought to explore the association between ventricular assistance device (VAD) coordinators' unique roles and responsibilities and moral distress. METHODS: An online survey was distributed to VAD coordinators through a listserv. The non-probability sample consisted of 36 nurses across the United States. RESULTS: Bivariate analyses identified a number of areas of difference in respondent's levels of moral distress based on specific responsibilities associated with their role as a VAD coordinator. CONCLUSION: These findings indicate team communication, competence, and location of VAD discontinuation may be important factors related to VAD coordinators' distress. Future research is needed with larger sample sizes and continued exploration of the impact of specialized training and curricula content.

Survivors' conceptualizations of human trafficking prevention; An exploratory study.

The purpose of this study was to explicate a conceptual framework for the prevention of human trafficking from the perspective of those most impacted: human trafficking survivors. In doing so establishing an empirical foundation for human trafficking prevention research. To achieve this aim, researchers employed Group Concept Mapping (GCM). GCM is an integrated, mixed-method, research design that analyzes qualitative data via quantitative approaches, namely multidimensional scaling and hierarchical cluster analyses. All participants (N = 35) identified as human trafficking survivors from one of four states in the United States. Results indicate that survivors in this sample conceptualize prevention via a 10-cluster solution. Furthermore survivors rated the cluster on Education and Awareness (9) as the most Important (4.60), as well as the most Feasible (4.28). This paper will review extant literature related to human trafficking, explicate results from this study, and discuss pragmatic prevention implications related to findings.

Gender Equality, Patriarchal Cultural Norms, and Perpetration of Intimate Partner Violence: Comparison of Male University Students in Asian and European Cultural Contexts.

This study examined the relationship between patriarchal cultural norms and violence perpetration by male partners using a subsample of university students in Asia ( n = 784) and Europe ( n = 575) from the International Dating Violence Study (IDVS) data set. Bivariate analyses indicated Asian students scored significantly higher than Europeans on dominance, hostility to women, jealousy, negative attribution, and violence approval as well as perpetration of severe physical assault in dating relationships. Logistic regression models demonstrated that dominance and violence approval were significant predictors of severe physical and psychological aggression against dating partners. Implications for culturally relevant programming for intimate partner violence prevention are discussed.

Violent Victimization and Substance Dependency: Comparing Rural Incarcerated Heterosexual and Sexual Minority Women.

This exploratory study examines the relationship between sexual identity and violent victimization experiences as predictors of differences in illicit substance and alcohol use and substance use problems among a sample of incarcerated women in rural Appalachia (N = 400). Results indicated that, compared to heterosexual women, sexual minority women were more likely to have a lifetime history of weapon, physical, and sexual assault, and were younger at the time of their first violent victimization. Sexual minority women were younger than heterosexual women at the age of onset for intravenous drug use and at the time they first got drunk, and were more likely to report having overdosed. Multivariate analysis found violent victimization to be the strongest predictor of a history of overdose and substance use problems.

Social stress, economic hardship, and psychological distress as predictors of sustained abstinence from substance use after treatment.

Social characteristics associated with disadvantage, such as racial/ethnic minority status, female gender, and low socioeconomic status (SES), are often associated with increased psychological distress and substance use disorders. This project tests a conceptual model derived from Pearlin's social stress theory for predicting abstinence from substance use between baseline and 1-year follow-up in secondary data from a large statewide sample of Kentucky substance abuse treatment participants (N = 1,123). Racial minority status, employment, and higher education level were predictive of substance use at follow-up, while female gender was predictive of abstinence. Limitations, implications for practice, and suggestions for future research are discussed.

An examination of intimate partner violence and psychological stressors in adult abortion patients.

The purpose of this article is to describe an exploratory study examining the relationship between intimate partner violence and psychological stressors in a sample of 188 adult abortion patients. Results indicate the almost 15% of respondents report a history of abuse by the coconceiving partner. In addition, women who reported having had one or more past abortions were more likely to also report that the person involved in the current pregnancy had also emotionally abused them. Women reporting one type of partner abuse were significantly more likely to also report other types of abuse. Women reporting abuse were less likely to report informing their coconceiving partner of their appointment at the clinic, less likely to report that their partner contributed financially to the abortion cost, and more likely to report partner refusal to wear a condom. Women who reported emotional abuse were more likely to score higher on all but one of the psychological stressor scales. The implications of these findings are discussed.

Perceptions of victimization risk and fear of crime among lesbians and gay men.

Research on fear of crime has evolved to suggest the existence of a complex relationship between individual, lifestyle, and contextual factors. Past work generally focuses on predominantly heterosexual populations; this study examines correlates of fear of crime and perceptions of risk among a sample of 272 self-identified lesbians and gay men. Higher levels of perceived risk and fear of victimization were found among females, persons in neighborhoods characterized by incivility, and persons who had experienced previous victimization. Perceived risks of personal and property victimization were similar for males and females. Contrary to past research, women did not seem to view all types of potential victimization as opportunities for sexual assault. Instead, fear of victimization was offense specific--past personal victimization predicted fear of future personal victimization, and past property victimization predicted fear of future property victimization. Similarities and differences between current findings and suggestions for future research are discussed.

Impact of mental health on perception of relationship satisfaction and quality among female same-sex couples.

Using data from both partners in female same-sex couples, individual and dyadic (individual/actor-partner) level analyses were conducted to determine the associations between couple members' global mental health, internalized homophobia, and perceptions of relationship qualities and satisfaction (N = 90). Findings at the dyadic level indicated that an individual's global mental health was uniquely associated with her partner's assessment of relationship satisfaction and qualities, beyond the effects of the individual's own mental health and internalized homophobia. Implications for further research on the strengths and challenges within female same-sex couple relationships are discussed.

An exploratory study of differences in views of factors affecting sexual orientation for a sample of lesbians and gay men.

An exploratory study of lesbians (70) and gay men (118) from a rural state in the mid-South was conducted using a self-administered, mail-out survey. The nonrandom sample was drawn from organizational mailing lists, snowball sampling, and a convenience sample at a community event. Respondents were asked to indicate the extent to which each of the following affected sexual orientation: genetics, relationship between parents, relationship with parents, birth order, peers, growing up in a dysfunctional family, growing up in a single-parent family, negative experiences with the opposite sex, and positive experiences with the same sex. Similar to studies of heterosexual men and women, these gay men were more likely to view sexual orientation as a result of genetics than the lesbian respondents. Further, the lesbian group were more likely to view positive relationships with the same sex to have a great influence on sexual orientation. These data indicate there are sex differences in views on factors that affect sexual orientation.

The effect of childhood maltreatment on adult criminality: a tobit regression analysis.

This article reports on the results of an analysis of a data set containing information on 667 nonmaltreated and 908 maltreated children. The data also contain information on whether the study subjects were arrested in early adulthood. Because adult arrests are an imperfect and censored measure of antisocial behavior, tobit regression analysis was used to examine the effect of the subjects' experiences of child maltreatment on later arrests while controlling for those subjects' demographic characteristics. The analysis finds that children's age, race, and sex and experiences of child neglect all have an impact on subsequent adult arrests. However, physical abuse and sexual abuse do not emerge as statistically significant predictors of arrests in this model. The study also illustrates a method for the decomposition of tobit coefficients to extract more information from them.