Health Advocacy Project: Evaluating the Benefits of Service Learning to Nursing Students and Low Income Individuals Involved in a Community-Based Mental Health Promotion Project.

Poverty, along with other factors such as unemployment, work and life stressors, interpersonal violence, and lack of access to high quality health and/or social services all play a role in determining who develops a mental illness and for whom those symptoms persist or worsen. Senior nursing student preparing to enter the field and working in a service learning capacity may be able to influence early recovery and symptom abatement among those most vulnerable to mental illness. A consortium of community stakeholders and researchers collaboratively designed a 10-week mental health promotion project called the Health Advocacy Project (HAP). The project combines case management and system navigation support delivered by trained and highly supervised nursing students to individuals experiencing major depressive disorder (MDD) and/or post-traumatic stress disorder (PTSD). In this article, we present the findings of a qualitative fidelity evaluation that examines the effectiveness of nursing students in delivering the health advocacy intervention at the level and with the intensity originally intended. The findings demonstrate how the services of senior nursing students may be optimized to benefit our healthcare system and populations most at risk for developing MDD and PTSD.

The influence of psychosomatic symptoms, physical and sexual abuse, and coping strategies on delinquent behavior among Korean adolescents.

PURPOSE: This cross-sectional study was undertaken to examine the contributing factors related to juvenile delinquency, as well as to identify the effect of psychosomatic symptoms, physical abuse, sexual abuse, and coping strategies on delinquent behavior among Korean adolescents. METHODS: To investigate the research problem, 2,146 adolescents, including 1,350 student adolescents and 796 delinquent adolescents, were assessed using a cross-sectional descriptive design study via anonymous, self-reporting questionnaires. Almost all research variables were measured using the Mental Health Questionnaire for Korean Adolescents. RESULTS: Our results revealed that delinquent adolescents showed a greater incidence of psychosomatic symptoms, higher levels of physical and sexual abuse, and a higher level of less effective coping strategies compared with student adolescents. Our path analysis revealed that the likelihood of delinquent behavior among adolescents appeared to be influenced mainly by sexual abuse, Psychosomatic Symptoms I, and physical abuse, with these three variables having the highest total effect. CONCLUSIONS: This study confirms the relationships previously identified among stress, somatic complaints, and ineffective coping. In addition, we demonstrated that these relationships cover a wide spectrum, ranging from psychosomatic symptoms to behavioral problems. Further implications of the results and research limitation were discussed.

Relationship among employment status, stressful life events, and depression in single mothers.

This purpose of this study was to extend our understanding of employment status as a social determinant of psychological distress among single mothers. A cross-sectional survey assessing stressful life events and depression was completed with 96 single mothers (48 employed and 48 social assistance [SA] recipients) between November 2003 and March 2004. The prevalence of depressive symptoms was significantly higher for the SA recipients. Mild, moderate, and severe depressive symptoms were reported by 2%, 23%, and 67%, respectively, of SA recipients. Total stressful events were markedly greater for SA recipients. In addition, SA recipients reported larger numbers of housing, health, social, and financial stressors. Regression analysis indicated that 40.6% of the variation in depressive symptoms among single mothers was explained by their employment status and stressful events. The findings suggest that women's employment status significantly impacts on their psychological well-being. Implications for nursing practice, policy development, and future research are identified and discussed.

Health Status and Health Determinants of Older Immigrant Women in Canada: A Scoping Review.

Increasing international migration in the context of aging populations makes a comprehensive understanding of older immigrant women's health status and determinants of their health particularly urgent. Using Arksey and O'Malley's framework, we conducted a scoping review to examine the available literature on the health of older immigrant women in Canada. We searched CINAHL, PsycINFO, Embase, Medline, and Cochrane databases for the period of 1990 to 2014 for Canadian-based, peer-reviewed studies on the topic. A total of 20 articles met the inclusion criteria. These articles were divided into six areas of focus: physical health; mental health; abuse; health promotion and chronic disease prevention; barriers to healthcare access and utilization; and health beliefs, behaviours, and practices. Our results show that the health of older immigrant women is affected by the interplay of various social determinants of health including the physical and social environment; economic conditions; cultural beliefs; gendered norms; and the healthcare delivery system. Our results also revealed that older immigrant women tend to have more health problems, underutilize preventive services, such as cancer screening, and experience more difficulties in accessing healthcare services.

Rethinking social support and conflict: lessons from a study of women who have separated from abusive partners.

Relationships have both positive and negative dimensions, yet most research in the area of intimate partner violence (IPV) has focused on social support, and not on social conflict. Based on the data from 309 English-speaking Canadian women who experienced IPV in the past 3 years and were no longer living with the abuser, we tested four hypotheses examining the relationships among severity of past IPV and women's social support, social conflict, and health. We found that the severity of past IPV exerted direct negative effects on women's health. Similarly, both social support and social conflict directly influenced women's health. Social conflict, but not social support, mediated the relationships between IPV severity and health. Finally, social conflict moderated the relationships between social support and women's health, such that the positive effects of social support were attenuated in the presence of high levels of social conflict. These findings highlight that routine assessments of social support and social conflict and the use of strategies to help women enhance support and reduce conflict in their relationships are essential aspects of nursing care.

Employment status, depressive symptoms, and the mediating/moderating effects of single mothers' coping repertoire.

OBJECTIVE: Single mothers, especially those on social assistance, report significantly more depressive symptoms than the general public. This article examines the relationships among employment status, stressful life events, and depressive symptoms among single mothers, with a special focus on the potential mediating and moderating roles of coping repertoire. DESIGN: Cross-sectional survey design. SAMPLE: Ninety-six single mothers (48 employed and 48 single mothers on social assistance) who were the primary caregiver for at least 1 child 4-18 years old. MEASUREMENTS: Mailed questionnaires that included an adapted version of the Social Readjustment Rating Scale, the Coping Strategy Inventory, and the Beck Depression Inventory, 2nd ed. were completed by study participants. RESULTS: Coping repertoire did not mediate the relationship between either employment status or stress exposure and depressive symptoms. Coping had an antagonistic and differential moderating effect on the association between employment status and depressive symptoms for employed single mothers and mothers receiving social assistance. CONCLUSION: Effective strategies aimed at promoting single mothers' mental health need to address both the severity of depressive symptoms found among single mothers, and the social-system factors that threaten single mothers' psychological well-being. The implications for practice and policy are discussed.