Ethnic differences in posttraumatic stress disorder after musculoskeletal trauma.

BACKGROUND: Psychological distress is known to contribute to poor outcomes in orthopedic patients. Limited information exists concerning ethnic differences in psychological sequelae after musculoskeletal injury. This study examined ethnic variations in prevalence of posttraumatic stress disorder (PTSD) after musculoskeletal trauma. METHODS: A secondary analysis was conducted using data collected for a study examining PTSD after musculoskeletal trauma. Two hundred eleven consecutive patients with musculoskeletal injuries were enrolled. Psychological status was assessed using the Revised Civilian Mississippi Scale for PTSD. A chart review was completed to gather demographic and injury information. Independent samples t tests, Fisher's exact, Chi-square, and logistic regression analyses were performed to assess differences. RESULTS: Ninety-six (45.5%) Hispanic and 115 (54.5%) non-Hispanic White adults participated. Few significant demographic or health differences were found. No significant differences were found regarding injury characteristics. Fisher's exact tests indicated a higher prevalence of PTSD symptomatology among Hispanics than non-Hispanic Whites (p < 0.01). Additionally, U.S. born Hispanics were more likely than non-U.S. born Hispanics to have PTSD symptomatology (p = 0.004). Odds ratios indicated that women (OR = 2.2), persons with a psychiatric comorbidity (OR = 5.1), Hispanics (OR = 6.6), and persons born in the United States (OR = 3.7) had an increased likelihood of PTSD symptomatology. CONCLUSIONS: Results indicate an ethnic difference in prevalence of PTSD symptomatology after musculoskeletal injury. Hispanic participants were nearly seven times more likely to be positive for PTSD symptomatology. Furthermore, U.S. born Hispanic participants had a higher prevalence of PTSD symptomatology. Future research should explore factors contributing to these differences.

Understanding runaway teens.

PROBLEM: Large numbers of teenagers become "runaways" and put themselves at risk for physical and emotional harm. During the year 2002, an estimated 1.6 million U.S. youth aged 12 to 17 had run away from home and slept on the streets. METHODS: A qualitative exploratory method was used to study a sample of primarily ethnic minority youth found in a Midwestern inner city detention center. This study examined run behavior from the teenager's own perspective to identify why they ran, how they kept themselves safe, and what factors contributed to ending a run. FINDINGS: Teens ran to gain control of their lives by changing their situation. They developed new affiliations to meet safety and sustenance needs and learned from experience that one cannot run from your problems. With experience, running became habitual. CONCLUSIONS: Safer alternatives are needed for youth who cannot live at home.

Nursing students' personal experiences involving alcohol problems.

This article discusses the views and beliefs of nursing students toward people who abuse alcohol. An original study published in a separate article [Archives of Psychiatric Nursing , (2003); (4) 17 : 156-164.] examined this relationship with both a quantitative and a qualitative design. Three open-ended questions allowed for further qualitative exploration about relationships with others who have alcohol problems and beliefs about recovery. The chronic nature of alcoholism was clearly identified by students who described it as a lifelong process. Most students (79%) expressed belief that recovery was possible whether they had personal experience with people who have alcohol problems or not. The level of optimism was surprisingly high in this sample of nursing students, especially because many had had a personal experience with someone who abused alcohol. Students come to the educational setting with a clear and accurate view of the lifelong commitment that may be needed to recover from alcohol addiction, but they also come with an overly optimistic view of recovery. How this optimism impacts future care is unknown. If nursing students hold an unrealistically positive view of recovery, they may be ill prepared to handle the disappointments associated with treatment such as relapse, interpersonal conflict, health deterioration, or other related sequelae.

Examining the relationship of addiction education and beliefs of nursing students toward persons with alcohol problems.

This study examined the effectiveness of two methods of teaching nursing students about alcohol addiction. Each student who agreed to participate was given pretests, posttests, and 3-month follow-up tests that measured knowledge about and beliefs held toward people who abuse alcohol. Group 1 received lecture only, whereas group 2 received lecture and discussion with a person who had been sober for many years. Both groups showed improved scores in knowledge and certain aspects of beliefs, however, group 2 showed greater knowledge and more accurate beliefs overall toward this population than group 1. The introduction of a person successfully remaining sober was shown to be an even more effective teaching strategy than lecture alone.