The increased intensity and complexity of cancer treatment has an impact on the lives of the adolescents undergoing such treatments. Living with cancer is a distinct experience for them which include physical, psychological, spiritual and social dimensions. The cancer experience comprises more than the measurement of symptom occurrence, frequency, duration and severity, or the ratings of quality oflife. The meanings of the lived experience from the adolescent's perspective and self-report can give a more accurate, holistic picture of the nature and scope of the experience. Practitioners need to know and understand the meaning of the experience from the adolescent's perspective in order to design appropriate interventions to prevent or relieve distress in these patients. The purpose of this study was to describe the meanings of the lived experience ofhaving cancer for adolescents undergoing treatment. Phenomenology was the qualitative research methodology used. As outlined by Patricia Munhall, this methodology seeks to understand the meaning of lived experiences. Seven adolescents, 14 to 18 years of age, in treatment for cancer were interviewed. Six males and one female participated in this study. Six were receiving treatment for acute lymphocytic leukemia and one for a solid tumor. All participants were of Pacific Island origin; two live in Hawaii and five were temporary residents. The audio taped interviews were transcribed and analyzed to understand the meaning of the cancer experience. The essence of the experience for the individual adolescent was described and a composite interpretation of the meaning derived. Recommendations to healthcare providers for improving communication with adolescents in treatment for cancer are provided, including discussing death and dying early in the illness trajectory. The interdisciplinary concept of care is stressed, as well as the importance of a thorough physical examination. The importance of social support and techniques to potentially strengthen and increase this support are outlined. Solutions to the problems of school reintegration are introduced.

This research was a pilot study at improving the medical, psychiatric and addiction care provided to women detainees at the jail. Few studies have been completed with women atjail intake, yet the population is suspected of having a multitude of medical, psychiatric and addiction in jail treatment and community reentry needs. Utilizing a descriptive, cross-sectional survey design, the following aims were completed for this pilot study: documented the creation of a nursing research infrastructure within a large jail; compared the results of the traditional 16- item paper and pencil Intake Service Center Screen with the 8-item paperless Brief Jail Mental Health Screen obtained via Audio Computer Assisted Self Interviewing (ACASI) technology; compared Addiction Severity Index scores and addiction treatment motivation and readiness scores obtained via ACASI technology with normative data; assessed the frequency of HIV risk behaviors and the medical, psychiatric and addiction treatment needs obtained via ACASI technology; while assessing the frequency and the average length of time for screening by providers at the jail via medical chart review. The results showed that the ACASI technology proved to be more effective than paper and pencil methods. This technology not only assessed detainee treatment needs, but simultaneously created reentry/discharge plans. The study demonstrated that HIV risk behaviors and the prevalence of past suicide attempts were high among the participants. The Addiction Severity Index scores and the Circumstance Motivation and Readiness scores demonstrated that methamphetamine addiction, and mental health severity is high among this population however motivation and readiness for treatment arc low. Therefore, recommendations for the most suitable jail psychiatric Advanced Practice Registered Nurse candidates could be given as a result of the study. This study was the first phase at improving the medical, psychiatric and addiction care provided to detainees at the jail. In future phases of this study more valid and reliable assessment tools and treatment planning aimed at reduced recidivism rates will be established. Future phases will build on the lessons learned here about working with security staff, collaborating with experienced researchers in the community, and seeking advice from the Department of Justice recognized experts.

This study investigated attitudes toward personal use of premarital contraception among sexually active adolescent males and females. All students within the selected classrooms were asked to complete questionnaires assessing attitudes toward contraception, contraceptive knowledge, and sociodemographic and sex-related life history variables. Subjects were rated with regard to their effectiveness of contraception (high, moderate, or low). Separate univariate analyses indicated the following: The low effectiveness group was more likely to perceive responsibility for contraception as belonging to the "opposite gender." Contraception attitudes and knowledge were positively related. Females were more knowledgable about contraception and has more favorable attitudes than males.

Jordan has a higher fertility rate (3.8) than the averages of countries similar in income to Jordan (2.2) and compared to the Middle East and North Africa region as a whole (2.8) (WHO, WB, UNICEF, & DHS, 2011). The findings of the 2009 Jordanian Population and Family Health Survey demonstrated that the total fertility rate (TFR) has stopped declining in the country since 2002 (DOS, 2010b; USAID, 2010). The prevalence of contraceptive use has also shown little change in Jordan over the last decade (DOS, 2010b; USAID, 2010). Given that contraception is one of the proximate determinants of fertility (Rahayu et al., 2009), the main purpose of this study was to investigate which factors are contributing to women's current contraceptive behavior and intention for future contraceptive use. Research questions were developed in a comprehensive framework that considers women's intention and actual behavior as outcomes of various interactive factors within a socio-cultural context. In particular, the study's framework was directed by a theoretical basis adapted from Ajzen and Fishbein's Theory of Reasoned Action (TRA) and an extensive review of the available literature in the research area. Obviously, the social set-up and cultural norms in the study setting, together with attitudes toward children and family, represent a traditional scenario that could help explain the consistency of fertility and contraceptive use in the country. Further, the influences of background characteristics on women's contraceptive behaviors and intentions provide another scenario that could help assess the current situation of family planning (FP) in Jordan. In this study, demographic factors, spousal communication variables and healthcare system-related factors are all defined as background characteristics. Attitudes and social norms reflect the women's behavioral determinants and represent the main constructs of the TRA. In fact, involving a set of factors related to women's beliefs and social norms in the study's framework provided an opportunity to explore how these factors might promote or inhibit a woman's intentions and behaviors in respect to contraceptive use. In a three-manuscript format, this research was designed to achieve a number of objectives. The first manuscript aimed at identifying the major factors associated with the current use of contraception among women of childbearing age in northern Jordan. The second manuscript focused on investigating the main factors that are associated with women's contraceptive method preference (e.g. the choice of modern contraceptives as effective methods in preventing pregnancy versus the choice of traditional contraceptives as methods with high failure rates). The third manuscript attempted to explore the key factors associated with women's intention for future contraceptive use since the existence of such an intention would consequently translate into an actual behavior later. In 2010, original cross-section data were collected by means of a face-to-face interview using a structured pre-tested survey. The study sample included women who were currently married and were between 18 and 49 years old. Applying a systematic random sampling procedure, all respondents were recruited from the waiting rooms of five randomly selected Maternal and Child Health (MCH) centers in the Governorate of Irbid, northern Jordan. Using a list provided by the Ministry of Health, all centers in the Governorate were stratified according to the region (urban vs. rural) and randomly selected in proportion to their number in each region. The final sample size for this research consisted of 536 women surveyed, giving a response rate of 92.4 percent. Utilizing logistic regression analyses, the results of the dissertation manuscripts indicate that women's behaviors and intentions toward the use of contraception are affected by a number of factors at the individual, familial and institutional levels. The findings that emerged from the three manuscripts provide health professionals and policy makers with important information to assist in the design of FP programs and campaigns aimed at increasing current contraceptive use, enhancing the adoption of modern contraception and motivating the intention for future contraceptive use. This research strongly suggests that health professionals develop health policies that both expand the availability of MCH centers and strengthen the role of healthcare providers to dispel the numerous rumors and misconceptions surrounding the use of contraceptives, particularly modern ones. Health workers at the MCH centers need to ensure that women have sufficient information about the benefits and side effects of different types of contraception by offering proper FP counseling. The messages that religious leaders can use in advocating for FP would also help make contraceptive use socially acceptable since their opinions are often followed by the majority. This would be a key step toward removing the barriers to contraceptive use. Moreover, to design effective FP interventions, planners should take into account women's attitudes toward the use of contraceptive methods and the components of those attitudes (e.g. women's approval of contraceptive use for birth spacing and perceptions regarding the value of large family sizes and the importance of having male children in Jordanian families). / Graduation date: 2012 / Access restricted to the OSU Community at author's request from May 9, 2012 - May 9, 2013