The indelible role of the interpretive researcher's fore-structure in traversing the hermeneutic circle.

Phenomenological researchers are obliged to grasp the epistemological and ontological differences between the Husserlian and Heideggerian branches of phenomenology to avoid misappropriating phenomenological terms or mischaracterizing study design. To that end, we spell out the key differences between both phenomenological traditions as background for describing the indelible role that the researcher's background assumptions, or fore-structure, play in interpretive studies. We draw on our four studies to illustrate how we traversed the hermeneutic circle to disclose, challenge, and refine the personal, cultural, clinical, and scientific assumptions hidden in our fore-structures. Our reflections highlight how understanding evolves, not by bracketing or disengaging ourselves from the phenomena we study, but by engaging in an open dialog that seeks understanding as lived by patients and families.

Reproductive Justice as an Alternative to the Pregnancy Planning Paradigm for Teens.

In this critical commentary, we describe the many limitations of the pregnancy planning paradigm as applied to pregnant and parenting teens. We describe how this paradigm, in characterizing pregnancies as intended or unintended, has shaped campaigns to prevent teen pregnancy and remains largely embedded in formal sex education and family planning programs in the United States. We argue that a paradigm shift is long overdue and describe how the reproductive justice framework addresses the limitations of the pregnancy planning paradigm. Although reproductive justice is endorsed by a growing number of organizations, recommended policies face formidable obstacles given that comprehensive sex education, contraception, and legal abortion are increasingly at risk in a post-Dobbs world.

An Integrative Review of the Research on Teen Mothers' Resilience.

Greater attention to teen mothers' strengths and aspirations has generated interest in their resilience. An integrative review of the research was undertaken to determine how teen mothers' resilience, risks, and protective factors are conceptualized across methodological approaches. In total, 10 databases were searched in 2021 to identify relevant studies. Of the 32 studies meeting criteria, the majority were conducted in the United States. Qualitative studies mined teen mothers' accounts for resilient processes, adversities, and protective factors while quantitative studies operationalized variables based on the resilience framework. The studies in this review present a more balanced and contextual perspective on teen mothers and suggest broader notions of their competence, success, and vulnerabilities. Several studies draw attention to the potential costs of resilience and the heterogeneity of teen mothers. Unfortunately, this research shows little cross-fertilization across methods. Implications of the findings for future research, policy, and practice are described.

Evidence for Revising the Adverse Childhood Experiences Screening Tool: a Scoping Review.

The relationship between adverse childhood experiences (ACEs) and risky behavior, chronic illness, and premature mortality is well documented. Despite this evidence, screening for ACEs in primary care settings remains limited. Objections to widespread screening include concerns that the original ACE screening tool limited childhood adversities to family and household dysfunction. The purpose of this scoping review is to describe current knowledge for expanding ACEs categories and revising the formatting and scoring of the screening tool. With the assistance of a medical librarian, we used a two-step process to conduct a systematic search in three databases (CINAHL, OVID Medline, PsycINFO). Our aim was to focus on articles that expanded ACE categories and/or revised the scoring or formatting of the ACE tool. Eighteen articles (reporting 19 studies) met criteria. A minimum of two authors extracted the relevant characteristics of the studies independently and conferred to reach agreement. The majority of studies broadened ACEs to include community and systemic categories; three studies revised the formatting or scoring of the ACE tool. Exposure to community violence (ECV) was the most frequently added category (15), followed by economic hardship in childhood (EHC) (13); bullying (10); absence/death of parent or significant others (9); and discrimination (7). This evidence supports the expansion of ACE screening tools for assessment of childhood trauma and timely treatment.

Adverse Childhood Experiences as Public Health Threat.

Toxic stress has long-term effects on health and well-being.

Screening for Adverse Childhood Experiences: Literature Review and Practice Implications.

Adverse childhood experiences (ACEs) are linked with negatively impacting child and adult health outcomes. Clinicians are integral in identifying childhood adversities and offering supportive measures to minimize negative effects. This systematic literature review included 13 ACE studies that examined the acceptability, feasibility, and implementation of ACE screenings from the perspectives of clinicians and patients. The findings of this review can assist clinicians in considering the appropriateness of ACE screenings for their patients and the ethical and practical issues that must be addressed for effective screening implementation.

An Umbrella Review of Qualitative Research on Teen Mothering.

The sheer volume of qualitative research on teen mothering over three decades has generated numerous scientific reviews. This umbrella review synthesizes the findings of these reviews and describes the utility of this evidence for improving clinical practice and policy. A comprehensive search of six electronic databases performed through October 2019 yielded 17 articles from 15 independent reviews. Data were extracted and key findings were synthesized to yield the following paradox: mothering has the potential for transforming and redirecting teens' lives in positive ways because of, and despite, difficult childhoods, constricted pathways to adulthood, fragile partner relationships, social inequities, and stigma. By bringing visibility to the paradox that teen mothering simultaneously transforms and imperils, this review extends the science on teen mothering and enhances the generalizability and utility of small-scale qualitative studies for reframing practice, policy, and behavioral interventions.

The quest for workload equity in nurse faculty teaching.

BACKGROUND: While nurse faculty may believe that they teach more than faculty in other academic departments, their perceptions are difficult to corroborate when workload policies are not transparent at institutions. PURPOSE: This descriptive study was designed to examine inequities in teaching workloads between nurse faculty and their academic colleagues from the perspectives of Deans and Directors of Nursing Programs. METHODS: A web-based, investigator-developed survey was emailed to Nurse Unit Leaders in spring, 2019. The final sample included 224 respondents. Data were analyzed with descriptive statistics. FINDINGS: Nurse Unit Leaders perceived that nurse faculty teach larger classes and more courses than their academic peers. Survey respondents attributed these and other variations at their institutions to the complexity of teaching responsibilities in nursing units and the limited understanding of these responsibilities by university administrators. DISCUSSION: Ensuring equitable teaching workloads requires transparent policies and an organizational culture committed to faculty governance.