An Empowerment-Based Intervention for Chinese Immigrant Women Experiencing Intimate Partner Violence: Feasibility and Acceptability.

BACKGROUND: Intimate partner violence (IPV) is a significant public health concern, particularly in vulnerable populations such as Chinese immigrant women. AIM: This study aimed to assess the feasibility and acceptability of an empowerment-based intervention integrated with relaxation and self-compassion techniques for Chinese immigrant women experiencing IPV. METHODS: The present study was a part of a pilot randomized controlled trial (RCT). A total of 50 Chinese immigrant women who had experienced IPV in the past year were recruited online and randomized to either the intervention or the control group. The intervention group engaged in seven weekly sessions delivered with a phone call and a mobile application. Quantitative and qualitative data were collected through surveys and interviews to evaluate intervention adherence, participants' perceptions, and areas for improvement. RESULTS: 64% of the participants completed each weekly session, demonstrating favorable intervention adherence. The intervention was perceived to be helpful by most participants, with reported decreases in stress, anxiety, fatigue, pain, and family conflicts, and with reported improvements in emotion regulation and self-compassion. However, technical issues with the mobile platform and lack of personalization were identified as limitations. CONCLUSION: This study demonstrates the feasibility and acceptability of the intervention for Chinese immigrant women experiencing IPV and warrants a full-scale RCT to determine its efficacy. It will be essential to personalize the intervention and reduce any barriers to participation.

"Get Stuck and Can't Walk Out": Exploring the Needs for Support Among Chinese Immigrant Women Experiencing Intimate Partner Violence in the United States.

Chinese immigrant survivors of intimate partner violence (IPV) in the United States have been overlooked and underserved. The purpose of this study was to explore their perceptions of resources for assistance as well as their priority needs. We conducted phone interviews with 20 Chinese immigrant women who had experienced IPV in the past year. The women expressed their needs for emotional support, culturally specific services, a variety of online resources to meet different demands, being empowered, raising the Chinese community's awareness about IPV, and batterer intervention programs. These women's testimonies shows that greater effort should be directed toward addressing those needs in order to reduce IPV and its impacts on health in this vulnerable group of women.

Rural young males' acceptance & receptiveness to technology-based interventions for dating violence prevention: A qualitative descriptive study.

INTRODUCTION: Rural youth are twice as likely as urban youth to experience some forms of teen dating violence (TDV), and significant barriers to accessing support services for physical, psychological, sexual violence. However, rural youth remain understudied and undersampled. Rural young men, in particular, are at risk for experiencing or perpetrating dating violence influenced by regional and sociocultural risk factors that promote male supremacy ideals while also impeding male help-seeking. Technology-based interventions circumvent some of these risk factors by offering confidential and reliable support. This study investigates rural young males' acceptability of technology-based interventions for fostering healthy relationships and preventing dating abuse, including their preferences for intervention content and features. METHODS: Three online focus groups (n = 14) and phone interviews (n = 13) were conducted with rural young males. Participants were stratified by age (15-17 and 18-24 year-olds). Most were White (81%) from the United States Midwest (65%). Semi-structured interview data were analyzed using Qualitative Description (QD), guided by the Unified Theory of Acceptance and Use of Technology (UTAUT). RESULTS: Three themes identified were (1) Scarcity of Useful Resources, (2) Socio-Structural Challenges for Intervention Uptake, with two subthemes (2a) Rural-Specific Structural Barriers and (2b) Rural Masculinity Disrupting Help-seeking; (3) Finally, participants discussed Functionality and Design Needs, itemizing their intervention "must-have" in terms of content, resources, and features. CONCLUSION: This qualitative study identified obstacles and facilitators to using technology-based interventions for dating violence prevention among young rural males and offers pragmatic "ready-to-use" recommendations for the development of technology-based anti-dating violence interventions for rural youth.

Stress, stigma, violence experiences and social support of US infertile women.

Objectives: Previous studies investigated the physical, psychological and sociological effects of infertility; however, stigma and violence experiences of infertile women haven't yet been studied in the US. The objective of the study is to examine the perceived stress, stigma, violence experiences, and social support of US infertile women and to compare with fertile women in order to understand the effects of infertility on stress levels, violence exposures, and support. Methods: The descriptive, cross-sectional study was conducted with fertile and infertile women who use social media for an online support group. A convenience sample of 786 women completed an online survey. Results: In the study, 41.6% of participants were fertile and 58.4% were infertile. We found infertile women experienced high levels of stigma and moderate stress. One in five infertile women has been exposed to emotional or physical violence. Compared to fertile women, infertile women had significantly higher perceived stress levels and were less likely to experience emotional or physical violence. Conclusion: These findings highlight that infertile women have experienced stigma and high levels of stress in a developed country. They are also exposed to emotional or physical violence, but surprisingly infertile women are less likely to report violence than fertile women.

Prevalence and risk factors of intimate partner violence among Chinese immigrant women.

AIMS: To investigate the prevalence and risk factors of intimate partner violence among Chinese immigrant women residing in the USA. DESIGN: A cross-sectional study using the online survey approach. METHODS: A total of 475 Chinese immigrant women were recruited online between April-June 2019. We measured past year intimate partner violence, sociodemographic, relationship-related and immigration-related factors, religion, social support, acculturation, adverse childhood experiences, and gender role beliefs. RESULTS: Twenty-one percent of Chinese immigrant women experienced past year intimate partner violence. Younger age, cohabiting relationship, lower levels of relationship satisfaction and social support, older age at arrival, longer length of stay, religious belief, and adverse childhood experiences were associated with the occurrence of intimate partner violence. CONCLUSION: Chinese immigrant women experience higher rates of intimate partner violence compared with other populations of women. Future research is still needed to elucidate abused Chinese immigrant women's violence experiences, help-seeking behaviours, availability of resources and needs for services to tailor prevention and intervention programs culturally. IMPACT: The findings added to our understanding of intimate partner violence among this largest Asian immigrant group. Modifiable risk factors such as social support should be targeted in future preventions and interventions for abused Chinese immigrant women residing in the USA.

Adverse Childhood Experiences and Mental Health among Women Experiencing Intimate Partner Violence.

This study described the frequency of different adverse childhood experience (ACE) types described by women with recent IPV and examined the effects of each ACE type on women's mental health. Over 70% of women reported parental separation or divorce, over 40% reported childhood sexual assault, and around 40% had a mother who was treated violently. Childhood physical abuse and sexual assault were associated with more severe posttraumatic stress disorder or depressive symptoms. Comprehensive interventions that address not only the effects of IPV but also the enduring effects of ACEs are needed to promote mental health for survivors of IPV.

Self-Compassion, Health, and Empowerment: A Pilot Randomized Controlled Trial for Chinese Immigrant Women Experiencing Intimate Partner Violence.

Chinese immigrant survivors of men's violence experience both significant mental health impacts from abuse and barriers to formal services. Therefore, we examined the preliminary efficacy of an innovative mobile-based empowerment-based intervention (self-compassion, health, and empowerment; SHE) that specifically focuses on abused Chinese immigrant women in the US. This pilot study used a two-arm randomized controlled design with repeated measures. A convenience sample (N = 50) of Chinese immigrant women who experienced past year intimate partner violence (IPV) were recruited online and randomly assigned to the intervention or control group (25 per group). We assessed IPV exposure, safety behaviors, depressive symptoms, anxiety symptoms, post-traumatic stress disorder (PTSD) symptoms, and self-compassion at baseline, post-intervention, and 8-week follow-up. Of 95 eligible participants, 50 (52.6%) agreed to participate and completed baseline data collection; intervention completion rate was 64%. We found a significant group and time interaction for self-judgment (a self-compassion component), with a significant reduction seen in the intervention group compared to the control group. Despite no other significant group differences observed over time, the intervention group showed consistent trends toward improvements in most outcome measures, including specific types of IPV (i.e., negotiation, psychological aggression, and sexual coercion), depressive and PTSD symptoms, self-compassion, and certain components of self-compassion (i.e., isolation and over-identification) when compared to the control group. Our findings suggest that the SHE intervention shows promise in improving the mental health well-being of Chinese immigrant survivors. However, a fully powered randomized controlled trial is warranted to determine its efficacy. Our intervention has the potential to be translated in the Chinese immigrant populations with the necessary organizational support.

Optimism and other psychosocial influences on antenatal depression: a systematic review.

Antenatal depression is a debilitating experience for many women with significant personal and familial sequelae. Low-income pregnant women living in rural settings are especially vulnerable because of isolation, decreased resources, and stressful living environments. This systematic review summarizes what is known about antenatal depression and synthesizes the evidence regarding the role psychosocial variables could play in the development of safe, effective, and culturally-acceptable non-pharmacological interventions. Searches of the CINAHL, MEDLINE, PSYCHINFO, and ERIC databases, as well as the Cochrane Library, were conducted in September 2010 to identify articles relevant to our topic of study. Psychosocial variables have a significant association with antenatal depression. Optimism has been shown to be inversely correlated with depression, and directly correlated with improved birth outcomes. Optimism is a potentially modifiable variable that could be used to design antenatal prevention and treatment programs. As depression continues to increase in prevalence, and treatment options for pregnant women remain limited, effective interventions must be developed that address the psychosocial variables examined in this review.

Rural pregnant women's stressors and priorities for stress reduction.

Rural residence and maternal stress are risk factors for adverse maternal-child health outcomes across the globe, but rural women have been largely overlooked in maternal stress research. We recruited low-income, rural pregnant women for qualitative interviews to explore their stress exposures during pregnancy, reactions to stress, and priorities for stress reduction. We also used quantitative measures (Perceived Stress Scale, Center for Epidemiologic Studies of Depression Scale-Revised, Posttraumatic Stress Disorder Checklist-Civilian, Lifetime Exposure to Violence Scale) to describe stress exposures and reactions. We interviewed 24 pregnant rural women from a Midwestern US state, who were primarily young, white, partnered, and unemployed. Women's predominant stressor was financial stress, compounded by a lack of employment, transportation, and affordable housing options; extended family interdependence; small-town gossip; isolation/loneliness; and boredom. Quantitative measures revealed high levels of global perceived stress, violence exposure, and symptoms of depression and posttraumatic stress disorder among the sample. Women most commonly reported that employment and interventions to increase their employability would most effectively decrease their stress, but faced numerous barriers to education or job training. Tested maternal stress interventions to date include nurse-case management, teaching women stress management techniques, and mind-body interventions. Pregnant women's own priorities for stress-reduction intervention may differ, depending on the population under study. Our findings suggest that rural clinicians should address maternal stress, violence exposure, and mental health symptoms in prenatal care visits and that clinicians and researchers should include the voices of rural women in the conceptualization, design, implementation, and evaluation of maternal stress-reduction interventions.

Pregnant women experiencing IPV: impact of supportive and non-supportive relationships with their mothers and other supportive adults on perinatal depression: a mixed methods analysis.

The current study explored the views of women experiencing interpersonal violence (IPV) and their relationship with their mothers or other supportive adult, and determines how this relationship affected perinatal depressive symptoms. The sample consisted of 30 urban and rural pregnant women enrolled in a larger ongoing randomized controlled trial. Data from quantitative instruments that measured depressive symptoms were examined in combination with qualitative interview data collected at baseline and six months post-natal. Women describing positive relationships with their mothers or another supportive adult reported statistically significant lower depressive symptoms scores (p < .05).

Exploring help-seeking experiences of Chinese immigrant survivors of intimate partner violence in the U.S.

OBJECTIVE: Immigrant women are vulnerable to intimate partner violence (IPV), and differences in immigration history, language, and culture impact their trauma responses. Although Chinese are the largest Asian immigrant subgroup in the U.S., little IPV research has specifically focused on this population. Therefore, we aimed to gain a better understanding of help-seeking experiences of Chinese immigrant women who had IPV. METHOD: Twenty female Chinese immigrant survivors of recent IPV completed a Mandarin-language qualitative phone interview about their IPV experiences, help-seeking behaviors, and barriers to services. Interviews were analyzed using thematic analyses. RESULTS: Women in our sample relied on family, friends, and self-help strategies to cope with IPV. They experienced feelings of shame, stigma, and "losing face," and had little social support. They also faced significant sociocultural and immigration-specific problems with formal services (e.g., culturally incongruent therapists, language, financial and transportation barriers, concerns about partner's reputation and legal status), lacked knowledge about available services, and rarely engaged with them. CONCLUSIONS: Abused Chinese immigrant women may be exceptionally isolated, and culturally specific barriers may substantially impact both their understanding of their IPV experiences and their use of services. Practitioners need training and support to engage survivors in culturally competent ways. While safety planning and other formal IPV services are critical to safety and trauma recovery, these survivors underutilize them, and community outreach is needed to U.S. Chinese communities to raise awareness regarding available IPV resources and services. Finally, research is needed to develop and test culturally competent, evidence-based interventions for this isolated and vulnerable population. (PsycInfo Database Record (c) 2022 APA, all rights reserved).

Unique perspectives of women and their partners using the Prenatal Psychosocial Profile Scale.

AIM: This paper is a report of a study to examine the underlying factors of the Prenatal Psychosocial Profile as a composite measure of stress, support from partner, support from others and self-esteem; and compares factor structures between pregnant women and men. BACKGROUND: In order to promote positive pregnancy outcomes, addressing unique differences in psychosocial factors between women and men is important. There is very little information or data directly collected from both groups. METHODS: As part of a larger smoking cessation study during pregnancy, a sample of 66 low-income couples (n =132) living in rural Missouri--the Midwestern region of the United States of America--was selected between 2006 and 2008. Principal component analysis was used to evaluate the factor structure of the composite measure. RESULTS: Similarities and unique differences in the Prenatal Psychosocial Profile subscales between the two groups were found. For the stress subscale, 'problems related to family', 'the current pregnancy' and 'feeling generally overloaded' loaded as financial stressors for men but as emotional stressors for women. For the partner support subscale, women perceived they were receiving more tangible support from their partners whereas men perceived receiving more emotional support. The support from others subscale was similar for both partners. The self-worth factor explained more of the variance in self-esteem among pregnant women, while the self-criticism factor explained more of the variance among men. CONCLUSION: Assessment of psychosocial well-being in both women and men during pregnancy, especially careful assessment of stressors of pregnancy should be part of nursing practice.

Pregnancy and intimate partner violence: how do rural, low-income women cope?

We conducted 32 in-depth interviews with 20 rural, low-income, women residing in the United States who were pregnant (n = 12) or 3 months postpartum (n = 8) and had experienced intimate partner violence (IPV). Using purposive sampling and the grounded theory method, we generated a conceptual model of coping. The urge to protect the unborn baby was the primary influence for participants' decisions about separating from or permanently leaving an abusive relationship. Implications include universal screening for IPV in child-bearing women, inquiry into maternal identity development during pregnancy, and improved resource access for rural, low-income women.

Keeping it together for the kids: New mothers' descriptions of the impact of intimate partner violence on parenting.

BACKGROUND: Intimate partner violence (IPV) affects 1 in 3 US women with the effects of IPV detectable for several generations. While IPV is known to have significant impacts on maternal-child outcomes, little is known about the mother's perspectives of the interplay between perinatal IPV exposure, parenting styles, and safety strategies. METHODS: This secondary analysis of semi-structured, longitudinal qualitative interview data explored with pregnant women their histories of IPV, their parenting practices, and safety strategies. Data were derived from a randomized controlled trial, DOVE, with 22 interviews from 11 women collected during pregnancy and 12 or 24 months postpartum. RESULTS: Data were analyzed using constant comparative analysis resulting in three themes: "broken spirit," "I want better for my kids and me," and "safety planning as an element of parenting." Women described at baseline having a "broken spirit" due to their experiences with household and family chaos and childhood abuse. However, when mothers ended the abusive relationship, they described a better life and several strategies to protect themselves and their children. During their final interviews, mothers discussed how their lives improved after ending the relationship as well as safety planning strategies they employed like looking for "red flags" in potential partners, struggles with finding trustworthy childcare, and stockpiling money should they choose to end the relationship. CONCLUSION: These rich data add new information about how mothers of very young children navigate difficult parenting and safety decisions in the context of lifetime traumatic events and provide insights relevant for practice and research with this highly-vulnerable group of IPV survivors.

Supporting Rural Women During Pregnancy: Baby BEEP Nurses.

PURPOSE: The aim of this study was to characterize nursing care provided by the research nurses from the Baby Behavioral Educational Enhancement of Pregnancy (Baby BEEP) study as they delivered a telephone social support intervention to low-income, pregnant women in the Midwestern United States. STUDY DESIGN AND METHODS: This was a descriptive qualitative study that used Peplau's Theory of Interpersonal Relations to frame and interpret the analysis. RESULTS: Research nurses from the Baby BEEP study found a novel way to reach a vulnerable population through weekly telephone interactions. Acting in several of Peplau's nursing roles, the care they provided led to a remarkable retention rate and therapeutic nurse-patient relationships. The Baby BEEP study demonstrated the provision of a well-received psychosocial support intervention that can be used to help underserved women throughout pregnancy. CLINICAL IMPLICATIONS: Telenursing care provided to low-income, rural women was well received and reflected the principles in Peplau's Theory of Interpersonal Relations. Nurses may use this type of nursing care to support women who are difficult to reach and typically experience low levels of support. This article describes the nursing care provided by the Baby BEEP nurses and provides a model for future, novel approaches to social support in a vulnerable and difficult-to-reach population.

Comparison of abuse experiences of rural and urban African American women during perinatal period.

A subsample of 12 African American women (6 urban and 6 rural) were selected from a larger longitudinal, randomized control trial, Domestic Violence Enhanced Home Visitation (DOVE-R01 900903 National Institute of Nursing Research [NINR]/National Institutes of Health [NIH]). All African American women were chosen to control for any racial- and/or race-related cultural differences that may exist among women across geographical areas. The experiences of abuse during the perinatal period are drawn from in-depth interviews conducted at five points in time during pregnancy and the post-partum period. The analysis describes three major themes that highlight the similarities and differences among rural and urban women. The main themes found were (1) types of abuse, (2) location of abuse, and (3) response to abuse. In addition, two sub-themes (a) defiance and compliance and (b) role of children were also identified. Implications for universal screening for women of reproductive age, safer gun laws, and the need for further research are discussed.

Breastfeeding and employment: an assessment of employer attitudes.

Both research and anecdotal reports suggest that maternal employment is associated with failure to initiate breastfeeding and early breastfeeding attrition. The objective of this study was to describe the experience with and attitudes toward breastfeeding of a sample of employers in a small Midwestern city in the United States. Based on an analysis of 85 mail-out questionnaires, we found that less than half of the employers had personal experience with breastfeeding. A large percentage of the sample, however, indicated that they would be willing to facilitate women who wished to breastfeed or express milk in the workplace. However, these employers also stated that they saw little value to their business of supporting breastfeeding in the work environment. Thus, enhancement of breastfeeding opportunity in the work environment may come as a result of public and employer education but, more likely, will require some type of directive from official sources.

Telephone social support for low-income pregnant women.

OBJECTIVE: To assess whether social support can be provided to low-income pregnant women by telephone. DESIGN: A qualitative pilot study. SETTING: Nonurban prenatal clinics. PARTICIPANTS: Convenience sample of 20 pregnant women who were eligible for Medicaid, spoke English, were at least 24 weeks gestation, and had a telephone or access to a telephone. RESULTS: The Baby-Beep pilot program provides strong evidence that a telephone social support intervention is feasible and highly acceptable to a group of low-income pregnant women. Through the use of the telephone, a strong rapport appeared to develop between the health care provider and the women because nonverbal cues were eliminated. The study also found that collaboration between mental health nurses and prenatal care providers could help create safe, cost-effective psychosocial care for pregnant women. CONCLUSION: The Baby-Beep pilot study provides important information about one way to deliver social support to low-income women who may have little or no social support and feel alienated in a clinical setting.

Are nurses acting as role models for the prevention of SIDS.

PURPOSE: To examine nurses' knowledge, attitude, and practice in positioning healthy newborns for sleep in the hospital setting. DESIGN AND METHODS: A cross-sectional descriptive design was used to survey a convenience sample of practicing maternal child nurses in 58 Missouri hospitals. A 24-item investigator designed questionnaire was developed with input from SIDS Resources in Missouri. RESULTS: A total of 528 surveys were analyzed. These nurses reported no longer placing infants in the prone position for sleep, but almost 75% of those answering the survey used either the side-lying position or a mixture of side and back positioning, even though 96% of the nurses said they were aware of the AAP Guidelines recommending "back to sleep." Forty-five percent of the nurses thought the infant would be at risk for aspiration if only placed on his/her back. Only 53% of the nurses knew their hospital's policy about newborn positioning; 80% of those who knew about the policy said it included the lateral position as being acceptable practice. CLINICAL IMPLICATIONS: Nurses are the role models for new parents regarding newborn sleep position, and are in a unique position to influence parents' decisions about how to place their infants for sleep at home. Because nurses continue to worry about aspiration when newborns are placed on their backs, it is clear that more education is needed for hospital nurses about newborn sleep position and hospital policies, as well as AAP Guidelines.

Emerging issues on the impact of smoking on health-related quality of life in patients with lung cancer and their families.

Compelling evidence exists that continued smoking after a diagnosis of lung cancer adversely affects treatment effectiveness, survival, risk of recurrence, second malignancy, and health-related quality of life (HRQOL). The importance of HRQOL to patients with cancer and their families has been well documented. Because of increasing evidence of the benefits of smoking cessation, more research has focused on the impact of smoking on HRQOL. Smoking is a behavior that clusters in families; patients who smoke are likely to have family members who smoke, and together they experience impaired HRQOL. This article describes the evidence regarding HRQOL measurement in individuals diagnosed with lung cancer and their family members who smoke and explores the implications for nursing practice. Oncology nurses are in a critical position to advocate for the integration of HRQOL assessment into clinical settings, monitor patient and family member smoking status and environmental tobacco smoke exposure, and support development of smoking cessation interventions to enhance HRQOL.