Effects of Schema-Enriched Communication in Teams With Diverse Hearing Status.

This study examined the effects of (a) schema-enriched communication and (b) computer-based messaging on the sharing of knowledge and problem solving in teams with deaf or hard of hearing (DHH) and typical hearing (TH) postsecondary students. Four-member teams comprising either all DHH, all TH, or two DHH and two TH postsecondary students solved a complex problem. Measures consisted of (a) shared written information, (b) creation of a matrix with information for solving the problem, (c) recognition of information shared by team members, and (d) quality of the team's problem solution. A total of 126 DHH and 126 TH postsecondary students participated in the study in teams with one of the three combinations of hearing status. Enriched communication increased teams' sharing of written information, creation of a matrix, recognition of information shared by teammates and quality of the problem solution in teams.

Attitudes of adult/adolescent sexual assault nurse examiners and caring for younger patients.

INTRODUCTION: Sexual Assault Nurse Examiners (SANEs) are specialized nurses who provide sexual assault (SA) examinations and forensic evidence collection. Currently, Adult/Adolescent (A/A) SANEs in Massachusetts are trained and certified to care only for patients 12 years and older who present acutely to EDs. The purpose of this study was to describe the attitudes of SANEs regarding the possibility of cross-training to care for younger patients (<12 years). METHODS: This qualitative, descriptive study included a sample of 45 A/A SANEs who participated in a series of 6 focus groups. The focus groups were audiotape-recorded and transcribed verbatim. Content analysis was used to analyze the raw data. Units of in vivo coding assisted in the identification of initial broad categories that were winnowed to represent final themes that described the participants' attitudes. RESULTS: Although the majority of SANEs enthusiastically endorsed the option of pediatric cross-training, a smaller portion of participants expressed strong opposition to the proposal. The SANEs' concerns included the emotional toll of caring for children who have been sexually assaulted, and the need for an adequate infrastructure within the SANE Program to educate, train, and support the cross-training effort. DISCUSSION: This research fills a gap in the forensic and ED nursing literature by providing insights into the attitudes and concerns of SANEs who care for some of the most vulnerable patients. The findings of this study can inform the acute care and evidence collection practices that are used when caring for pediatric patients who have experienced SA.

Regret and police reporting among individuals who have experienced sexual assault.

BACKGROUND: Sexual assault (SA) and the underreporting of SA are highly prevalent in the United States. Since regret is a complex, negative emotion linked to decision making, studying regret within the context of reporting SA is important. OBJECTIVE: To describe decisional regret regarding SA reporting. DESIGN: A cross-sectional, descriptive study design was used. The sample included 78 individuals, aged 18 to 25 years, who experienced SA during the past 5 years and completed an electronic questionnaire. A multiple regression model was generated to describe how selected independent variables explain variation in levels of regret. RESULTS: In the final model, four independent variables accounted for 33.3% (adjusted R (2)) of the variation in regret: weight change, stranger assailant, professional treatment, and police reporting. CONCLUSIONS: The findings inform clinical practice by describing post-decisional regret about the reporting of SA, and they provide a foundation to develop strategies (e.g., decision aids) that can assist clinicians to help patients as they struggle to make difficult health care decisions.

Pain Assessment Clinical Practice Improvement: An Educational Approach in the Home Healthcare Setting.

In the 2 decades since The Joint Commission on Accreditation of Healthcare Organizations designated pain as the fifth vital sign, practitioners have become increasingly aware of the numerous challenges associated with the assessment and management of pain in older adults. Comprehensive pain assessment relies not only on the availability of assessment tools, but also on a clinician's knowledge, training, prior experience, and keen awareness of their own implicit bias and how it may influence their assessment and decisions. The purpose of this project was to develop, implement, and evaluate outcomes of a two-part online learning module on home healthcare clinicians' knowledge of pain. A quasi-experimental, one-group pretest posttest design was used. Of the 94 clinicians who volunteered, 54 participants completed all modules and surveys. Mean posttest scores (58.7%) were significantly higher than pretest scores (50.7%; n = 54, T = 3.08, p-value = 0.003). The strongest gains in learning occurred for those with lower pretest scores. The mean difference between posttest and pretest scores did not vary among job titles. There was no significant difference in posttest scores among job titles. A higher mean pretest score was associated with greater years of clinical experience, but did not significantly affect mean posttest scores. These findings suggest elearning is an effective educational approach to improve home healthcare clinicians' pain knowledge, particularly those who lack a sufficient knowledge base at the outset.

Myometrial hyperplasia in pediatric, adolescent, and young adult uteri.

OBJECTIVES: To evaluate if myometrial hyperplasia is a congenital variation in myometrial differentiation, or an acquired structural disorder of the myometrium, this study evaluated whether myometrial hyperplasia was present in uteri of children, adolescents, and young adults. METHODS: We studied 19 pediatric/young adult uteri in cases with no clinical history of uterine disease. Random photomicrographs at 100x, taken at 1, 5, and 10 mm beneath the endometrium, were assessed for increased cellularity and nucleus/cell ratio, as compared to normal myometrium in the outer third of the same uterus. RESULTS: Myometrial hyperplasia was generally absent in prepubertal uteri, first appeared in adolescent uteri just beneath the endometrium, and was found at 5 mm depth only after age 18. It decreased with depth beneath the endometrium (P<0.05). CONCLUSIONS: Myometrial hyperplasia is not a congenital anatomic variation in myometrial differentiation, but rather an age-related acquired structural variation. Its relationship to common adolescent symptoms of dysmenorrhea and anovulatory bleeding remains unknown and unexplored.