<p> When a traumatic event such as intimate partner violence occurs, resilience can help define recovery from that event. Women who experience the adverse event of intimate partner violence suffer injury, loss of physical and mental health, and possible death. Specifically, numerous women suffer injury and adverse health as a result of experiencing intimate partner violence (Krug, Mercy, Dahlberg, &amp; Zwi, 2002). The internal quality of resilience is what allows a person to mend or heal from trauma (Wagnild, 2009). Resilience is demonstrated by hardiness of spirit and a person's ability to return to their lifestyle (Atkinson, Martin, &amp; Rankin, 2009; Earvolino-Ramirez, 2007). This study is designed to explore resilience scores among older women who have been exposed to intimate partner violence earlier in life as well as investigate resilience scores with type of violence exposure. In addition, the self-reported health status among older women exposed to IPV earlier in life will be compared with the self-reported health status of women who have not been exposed to IPV. Finally, it will be determined if resilience scores in older women vary by demographic variables. A quantitative design will use The Resilience Scale, The Severity of Violence Against Women instrument, and a health status 1 questionnaire will be utilized to collect data. Participants will be obtained through convenience and snowball sampling from women 65 and older living in southern New Mexico.</p><p> These study findings show that older women who have been exposed to IPV between 10-49 years ago have the same resilience scores as older women who have not been exposed to IPV. In addition, self-reported health status is the same. Finally, demographic variables do not impact resilience scores among the two groups of older women. These findings indicate older women are able to recover from the trauma of IPV. They arc able to bounce back and go on with their lives and their long-term self-reported health recovers. When considered as a whole, the findings of this study lend hope to the idea that women are able to recover from the trauma of IPV exposure.</p><p> <i>Keywords</i>: abuse, health, intimate partner violence, older women, resilience</p><p>

<p> Nurse Residency programs have been developed to ease the transition for new graduates to the workplace, one in which they face fast-paced patient encounters such as emergency response situations. During this one year educational experience, nurse residents persistently cite caring for deteriorating patients as a clinical challenge. There is a paucity of research on the unique needs of nurse residents when encountering such challenges. Philosophically underpinning this Hermeneutic study were tenets of Heidegger and Gadamer within which nurse residents' lived experiences of caring for a deteriorating patient were explored. In-depth interviews with eight nurse residents were analyzed and interpreted using Diekelmann's process for narrative analysis. The <i>Journey from Uncertainty to Salient Being</i> described the ontological-existential meaning of participants' lived experiences of caring for a deteriorating patient during their residency year. Three distinct constitutive patterns were identified each with themes: <i>dwelling with uncertainty</i>, <i>building me up</i>, and <i>a new lifeline: salient being.</i> Dwelling with <i>uncertainty</i> was experienced during encounters with deteriorating patients with its deeply felt impact upon nurse residents as they transitioned from student to professional nurse. The pattern of <i>building me up</i> was influenced by the participants' expressed need for, and importance of, trusted relationships with preceptors, nurse colleagues, and/or mentors. Because of these relationships, and through reflection on their experiences, they were able to develop a sense of <i> salience.</i> To situate and explain the study's findings within existing nursing knowledge, these patterns were then compared and contrasted with nurse residency research findings, and theories and research in nursing and sociology such as transition, socialization, professional role development, and role formation. The findings from this study extend and support role adaptation and transition theories. Implications from the study's findings can be used to improve the transition to the professional role, for preceptor development, and for refining nurse residency curricula.</p>

<p> In the United States, 40% of the contemporary nursing workforce is comprised of women of childbearing age, 65% of whom are employed full-time. Hence, the likelihood of pregnancy occurring for this population at some point in their employment is high. A holistic exploration of how nurses integrate pregnancy and full-time employment has been lacking. The purpose of this research was to explore how primiparous nurses managed pregnancy and full-time employment. Using a grounded theory approach, nurses who were pregnant and delivered their first baby, while employed full-time on 12-hour work shifts, provided a firsthand account of how they incorporated pregnancy with employment. </p><p> Nurses, as social actors, experience many interactions in their workplace environment. The basic social process, <i>becoming someone different </i>, emerged to explain those interactions and allowed a substantive grounded theory to be developed. From that exploration, the researcher will present the basic social process, <i>becoming someone different</i>, and the four core categories that arose from the analysis: 1) <i> looking different, feeling different</i> &ndash; to explain how the physical and emotional changes of pregnancy result in nurses looking and feeling differently about themselves as nurses; 2) <i>expectations while expecting</i> &ndash; where the nurse, with previous experiences and ideas about what is expected of her and what she expects from others, changes how she sees herself, based upon her interactions in the workplace with her peers and coworkers; 3) <i>connecting differently</i> &ndash; explains how the nurse, while pregnant, develops new relationships and interactions with the people in her environment, specifically her peers, coworkers and patients, and 4) <i>transitioning labor</i> &ndash; where, despite challenges from interactions within the workplace from coworkers or tasks, the participant nurses began to focus on their eventual maternity leave and working as long as possible up to the time of delivery in order to prolong that maternity leave.</p>

<p> Lived experiences and the power of memories of significant personal events to influence an individual's choice of career path is well documented in studies of students pursing careers in nursing. Less researched are the personal motivators that influence students' choices of specialization within career paths. Gerontology focused educational research provides a growing body of evidence pointing to the attitudinal disposition of students based on their life experiences and attachment to family members or significant others, not classroom exposure, as the primary predictor of vocational choice. What remain unclear are the types of naturally occurring motivators that propel students either toward or away from professional involvement with the elderly and in particular, the chronically and terminally ill. The questions of what motivates so many non-traditional nursing students, in particular, to work with elderly patients and what might motivate others who have shown no interest in this patient group to specialize in gerontology, is central to this interpretative phenomenological inquiry and frames the methodology used to define and interpret motivators among nursing students expressing an interest in or selecting gerontology as a career specialization. A synthesis of seven themes identified and analyzed from data collected through 30 in-depth interviews with 15 nursing students and other individuals closely associating with nursing education, suggests familial attachments, maturity, and traumatic or transformative experience, as the primary three motivators fueling an expressed desire to work with older patients. Conclusions also suggest motivators are identifiable and may be artificially replicated, and that strategic recruitment may also provide a solution for meeting geriatric nursing shortfalls. The purpose of the study has been to understand this complex phenomenon and to add to the body of knowledge surrounding nursing students' motivations and preferences for career specialization. The goal of the study has been to understand what elements might lead to new ways of increasing interest in the field of gerontology and specifically in direct care to elderly patients. Improvement in the numbers of BSN graduates electing to pursue early careers in geriatric direct care would provide a systemic remedy to the real-world problem of inadequate numbers of qualified nurses with adequate competencies to serve this high needs patient population. </p>

Thesis (Ph.D.)--University of California, San Francisco, 2009. / Source: Dissertation Abstracts International, Volume: 71-02, Section: B, page: . Adviser: Sandra J. Weiss.

<p> Factor H is a newly identified phenomenon which describes a constellation of attributes of the new graduate nurse reflecting personality traits, intellectual abilities, and clinical judgment. In a previous pilot study conducted by this researcher nurse managers and experienced Registered Nurse (RN) preceptors described characteristics demonstrated by new graduate nurses demonstrating Factor H and the new graduate nurse's ability to transition quickly and successfully into the RN role in the acute care environment. There is currently no instrument available to measure this phenomenon. The specific aim of this research was to develop and psychometrically test a scale designed to identify the presence of attributes of Factor H in the new graduate nurse. The Sims Factor H Assessment Scale (SFHAS) was developed and piloted with a sample of one hundred one new graduate nurses within three months of completing the their nursing program at one of three nursing schools in central and south central Indiana. Evidence of content validity was demonstrated through the use of the Content Validity Index conducted with a panel of four experts. Evidence of face validity was demonstrated through interviews with a group of new graduate nurses, nurse managers, and experienced RN preceptors. Principle Axis Factoring with Varimax rotation was used to demonstrate evidence of construct validity and the scale was found to have a single component which was identified as nursing personality. Evidence of criterion-related validity was demonstrated utilizing analysis of the SFHAS and the criterion scale for personality traits (NEO-FFI). Evidence of internal consistency reliability was demonstrated through analysis of inter-item correlations, Cronbach's coefficient correlations, and item-total correlations. Test re-test reliability using interclass correlation was also conducted to demonstrate stability of the scale. The SFHAS was found to be reflective of nursing personality and not general mental ability or clinical judgment. Use of the SFHAS will allow organizations to evaluate the nursing personality of the new graduate nurse for fit into the work environment. Further study is recommended to gain clarity around the attributes which support successful transition of the new graduate nurse into practice in the acute care environment, also known as Factor H.</p>

<p> The experience of anxiety and depression can have detrimental effects on the body, especially that of a developing fetus. Depression and anxiety have been linked to the experience of greater pregnancy symptoms, miscarriage, poorer birth outcomes and difficult deliveries. Despite their detrimental effects, depression and anxiety may be common during the prenatal period. A history of miscarriage may heighten normally occurring symptoms, adding a layer of difficulty to an already stressful time period.</p><p> Mind-body practices have been linked to a number of health benefits, including attenuation of psychiatric symptoms and improved pregnancy outcomes. While many of these practices have received increasing attention in popular literature, lacking are studies utilizing large, randomized clinical trials empirically validating the efficacy of these interventions.</p><p> The purpose of the original study was to examine whether miscarriage status and the engagement in mind-body practices were associated with lower levels of depression and anxiety in pregnant women. Forty-three (N=43) pregnant women in the second and third trimesters were recruited and questioned about their pregnancy, their engagement in mind-body practices (past and present) and were asked to complete the Center for Epidemiological Studies Depression Scale (CES-D) and the State Trait Anxiety Inventory (STAI). It was anticipated that women with a miscarriage history would report higher levels of anxiety and depression and that women engaging in mind-body practice, past or present, would report lower levels of depression and anxiety. When statistical analyses failed to yield significant results, this author chose to explore the process of generating new knowledge through autoethnography. This dissertation moved from an empirical study to a qualitative, autoethnographic exploration of pregnancy loss in which the themes of meaning making, personhood and the expression of feelings were explored through the literature, the author's personal experience and through participation in an online pregnancy loss support group.</p>

<p> Monitoring bodies in the District of Columbia articulated that people diagnosed with an intellectual and developmental disability (IDD) who reside in community-based group home settings are vulnerable to safety issues, poor quality of care from registered nursing services, and poor oversight. Those monitors have identified the lack of knowledge of roles and responsibilities among registered nurses (RNs) in these settings as a significant risk factor. The District of Columbia Developmental Disabilities Administration (DDA) has no formal orientation or training for RNs that encompasses the multifaceted needs of people diagnosed with IDD. This capstone project aimed to identify the effectiveness of an educational intervention and the effect of continuing education on RNs' perception of their practice in the field of IDD. After review of current literature, an educational presentation addressing all facets of entry-level registered nursing was developed. The presentation focused on the fundamentals of IDD nursing. A group of RNs working in the District of Columbia IDD community participated in an all-day educational program and completed a pre- and posttest evaluation to measure their knowledge prior to the intervention and their knowledge gain immediately after the intervention. A standard five-point Likert scale survey was delivered on the third and sixth months after educational intervention (EI). The survey asked the participants to rate the impact of the EI at three and six months post intervention to measure their perceived confidence level and actual practice changes. Eighty-seven percent of the RNs that participated in the EI and responded to the questionnaire reported that their role as an IDD nurse had changed because of participating in this training, and 93.8% reported that they would recommend this training to other RNs entering or working in this subspecialty.</p>

<p> <b>Introduction:</b> Psychological pain is a frequently observed symptom in depression, and escape from unbearable psychological pain is often mentioned as the reason for suicide. We explored the relationship between psychological pain and two potential biomarkers: heart rate variability (HRV) and frontal EEG &alpha;-asymmetry. As both markers have successfully been used as feedback to alter mood state, knowledge about the relationship between HRV, frontal EEG, and psychological pain may be of particular interest for interventions to alleviate psychological pain. </p><p> <b>Methods:</b> Adults with a history of depression (<i>N </i> = 35) participated in six 5-minute sessions during which heart rate and EEG were recorded, while the participants sat upright with their eyes closed. In addition, participants completed the Beck scales for depression, hopelessness, and suicide ideation, and two measures of psychological pain: the Psychache Scale and the Orbach &amp; Mikulincer Mental Pain (OMMP) Questionnaire. </p><p> <b>Results:</b> Mean age of the participants was 35.0 (<i> SD</i> 11.84) and their average level of depression and hopelessness was moderate. The intraclass correlation coefficient indicated excellent agreement of neurophysiological variables across successive measurements. In separate hierarchical regression models, after controlling for depression and hopelessness, low-frequency HRV and right midfrontal delta power contributed significant variance (&Delta; <i>R </i>² = 8.8%, &beta; = -.30, <i> p</i> = .02 and &Delta;<i>R</i>² = 7.0%, &beta; = -.26, <i>p</i> = .03, respectively) to the prediction of current psychological pain on the OMMP. For worst-ever psychological pain on the OMMP, midfrontal delta power contributed significant variance (&Delta;<i>R </i>² = 20.5%, &beta; = -.45, <i>p</i> = .004), after controlling for depression. Suicidal desire moderated the relationships of low-frequency HRV and midfrontal delta power to psychological pain on the Psychache Scale. High-frequency HRV and frontal &alpha;-asymmetry did not correlate with the Psychache Scale or OMMP scores. EEG asymmetry based on fractal dimensions decreased (greater left than right complexity) with increasing current and worst-ever psychological pain on the OMMP. </p><p> <b>Conclusion:</b> Findings suggest that greater psychological pain is associated with increased sympathetic nervous system activity, rather than with reduced parasympathetic nervous system activity. Psychological pain may affect the right frontal cortex more adversely than the left frontal cortex. </p>

Thesis (Ph.D.)--University of California, San Francisco, 2009. / Source: Dissertation Abstracts International, Volume: 71-02, Section: B, page: . Adviser: Kathryn A. Lee.