Mikki Meadows-Oliver

Abstract

Reflective functioning (RF), the capacity to envision thoughts, feelings, needs and intentions within the self and others, is thought to be central to sensitive parenting, yet this capacity has been unexamined among pregnant adolescents. We explored how RF was related to the emotional experience of adolescent pregnancy. Design and Methods: This qualitative study was guided by interpretive description. Participants were 30 Latina and African-American adolescents (mean age 17.7 + 1.5 years) residing in a low-income urban community. All adolescents were interviewed with the Pregnancy Interview (a 22 question semi-structured interview) in their third trimester of pregnancy. Interview transcripts had been previously coded for levels of RF (1-9 with higher levels denoting higher reflectiveness), and this secondary analysis focused on the teens' experience of pregnancy and their emerging reflective capacities. We used a priori and inductive coding with all interviews and developed patterns and themes. Results: These interviews provided an in-depth understanding of the complex adolescent emotional experiences of pregnancy. We identified five themes that create a picture of how the participants reflected upon their pregnancies, unborn babies, emerging parental roles, and complicated relationships with family and partners. Conclusions and Practice Implications: Adolescent developmental issues and harsh family and neighborhood environments permeated the teens' experience of pregnancy and limited capacity for RF. Understanding distinctive features of RF in pregnant adolescents may contribute to developing conceptual models and tailored clinical approaches for enhancing parental reflectiveness and sensitivity in these vulnerable young women as they enter into the transition to parenthood.

Abstract

Background. Asthma is the most prevalent chronic illness affecting 10% of the pediatric population. The internet is a useful tool for acquiring information on health topics. In a recent Harris Poll, 154 million adults searched the Internet for health information. The usefulness of asthma materials on the Internet depends on the ability to read and comprehend the information. The goal of this study was to assess the readability of asthma Web sites. Methods. The authors studied the readability of 6 asthma Web sites that have been previously evaluated for quality and accuracy of information. The Flesch/Flesch-Kincaid tools were used to evaluate readability and reading ease of the materials on each of the Web sites with the use of Microsoft Office Word software. Results. Materials included in the 6 Web sites were analyzed. The information included in the Web sites had a readability index between 46.6 and 63.5, with a mean of 54.33 on the Flesch reading ease. The mean Flesch-Kincaid grade level was found to be between 8.0 and 10.3, with an average grade level of 9.73. Conclusions. Findings suggest that readability scores on asthma Web sites are high for the average consumer. Research has shown that patient educational materials should be no higher than a sixth-grade reading level. Practice Implications. Asthma educational materials on the Internet carry the risk of having incomprehensible materials disseminated to patients and their families. Asthma educators need to understand the role of the Internet and health information and guide their patients and their families to accurate, comprehensible, and readable Web sites.

Abstract

Background: Nurses from low-income countries (LICs) face extreme nursing shortages, faculty shortages and a lack of professional development opportunities. Nurses from high-income countries (HICs) can leverage their wealth of resources to collaborate with nursing colleagues in LICs to expand clinical, education and research capacity. In turn, nurses from HICs gain stronger competency in the care they provide, improved communication skills and an increased understanding of global health issues. Aim: The purpose of this literature review is to identify international nursing clinical, education and research partnerships among nurses from LICs and HICs and to analyse the degree of collaboration involved in each partnership using DeSantis' counterpart concept. Methods: We conducted a systematic review of international nursing partnerships in the scientific literature from January 2001 to July 2012. A total of nine articles met inclusion criteria for analysis. Findings: All of the articles discuss lessons learnt in building international nursing partnerships among nurses from HICs and LICs. However, the articles failed to meet the criteria set forth by DeSantis' counterpart concept to achieve fully collaborative nursing partnerships. Conclusions: International nursing partnerships require more foresight and planning to create partnerships in which the benefits derived by nurses from LICs equal those of their colleagues from HICs. By striving for such collaboration, international nursing partnerships can help build nursing clinical, education and research capacity in LICs.

Abstract

Puerto Ricans have been found to have higher asthma prevalence rates than non-Hispanic whites, blacks, and all other Hispanic subgroups. They also have the highest rates of emergency department (ED) use for the management of their asthma. Using a hermeneutic phenomenological approach, the aim of this study was to describe the lived experience of Puerto Rican families caring for their child's asthma and using the ED for asthma care. Six themes were generated from in-depth interviews with 10 Puerto-Rican caregivers: (1) The Folklore of Asthma, (2) Culture and the Medicine Woman, (3) In Awe of Asthma, (4) Praying to God, (5) The Decision-Time to Go, and (6) The ED Environment. The findings emphasize the necessity of establishing and maintaining a therapeutic partnership between primary care providers and families of children with asthma. The results may be used as a foundation for understanding motivations for seeking asthma care in the ED.