Identification of four patterns for self-management behaviors in clients with schizophrenia: A cross-sectional study.

This study aimed to describe different patterns of self-management behaviors among clients with schizophrenia in China. Two hundred twenty-eight clients with schizophrenia living in eight communities of Beijing were investigated using the Self-Management Instrument for Persons with Schizophrenia and a Demographic and Clinical Characteristics Questionnaire. Cluster analysis was performed to categorize the data. Four distinct self-management behavior patterns and variables of clients associated with non-adherent self-management were identified. The self-management behaviors and demographic characteristics were similar in each pattern but different among patterns. These findings could guide the development of more personalized and cost-effective self-management interventions for different patterns of clients in the future.

Habit and Routine Interventions with Emerging Adults with Diabetes: An Integrative Review.

Although theoretical and empirical writings on habits and routines are a promising body of science to guide interventions, little is known about such interventions among emerging adults with type 1 diabetes. Thus, an integrative review was conducted to describe interventions in relation to habits and routines, their influence on outcomes, and users' perspectives. A medical librarian conducted a search. Teams screened titles, abstracts, and articles based upon predefined criteria. Evidence from the final 11 articles was synthesized. A minority of investigators explicitly articulated habits and routines theoretical underpinnings as part of the interventions. However, text messaging or feedback via technology used in other interventions could be implicitly linked to habits and routines. For the most part, these interventions positively influenced diabetes self-management-related behaviors and health outcomes. In general, the interventions were perceived positively by users. Future research is advocated using habit and routine theoretical underpinnings to guide interventions.

A Scoping Review of Transitions, Stress, and Adaptation Among Emerging Adults.

This scoping review examined research on transitions among emerging adults, 18- to 30-year-olds, to identify designs, populations, frameworks, transition types, and transition outcomes. A librarian conducted the search, yielding 2067 articles. Using predefined criteria, teams screened abstracts and reviewed articles, with 82% to 100% interrater agreement. Data from the final 160 articles were placed in evidence tables and summarized. Most frequently, the studies had exploratory-descriptive designs (69%), nondiagnosed samples (58%), no theoretical frameworks (58%), developmental transitions (34%), and health-related behavior outcomes (34%). This transition research is in an early stage of knowledge development and would benefit from further theory development.

Social Support, Parenting Competence, and Parenting Satisfaction Among Adolescent, African American, Mothers.

This secondary analysis explored how social support changed during the first 6 months postpartum and examined the relationships among social support, parenting competence, and parenting role satisfaction. Single, low-income, adolescent, new mothers ( N = 34) completed measures of perceived parenting competence, parenting role satisfaction, and four types of received social support (emotional, informational, tangible, problematic) from the entire social network at 1 week, 6 weeks, 3 months, and 6 months postpartum. Results indicated that social support did not change over time. Emotional, informational, and tangible social support were significantly correlated, concurrently and predictively, with perceived competence and satisfaction at most data collection points. Future social support intervention studies using social support as a modifiable variable with this high-risk group of African American adolescent new mothers are advocated. Health care professionals are encouraged to examine existing social support within these mothers' identified family units.

Enhanced New Mothers Network Cell Phone Application Intervention: Interdisciplinary Team Development and Lessons Learned.

Single, low-income, African American mothers experience challenges caring for themselves and their infants. Nurse researchers, providing creative and theoretically based approaches for complex client health care, are increasingly becoming interdisciplinary leaders on research teams. The first purpose of this article was to describe this interdisciplinary team's development of a cellular (cell) phone application (app), the Enhanced New Mothers Network (ENMN). The second purpose of this article was to describe lessons learned by nursing members of the interdisciplinary team members about developing a cell phone app for delivery of the ENMN intervention. Interdisciplinary research is beneficial where providing interventions to assist patients to achieve optimal health outcomes is rarely dependent on the work of one profession.

Social Support and Psychosocial Well-being Among Low-Income, Adolescent, African American, First-Time Mothers.

AIMS: The aims of this study are to describe for single, low-income, adolescent, African American new mothers how (1) primary sources of social support changed over time, (2) the level of social support (emotional, informational, tangible, and problematic) from these primary sources changed over time, and (3) social support from the primary supporter was associated with mothers' psychosocial well-being (self-esteem and loneliness) over time. DESIGN: A secondary analysis was conducted of data from a previous social support intervention study. SAMPLE: The sample consisted of 35 single, low-income, adolescent (mean [SD] age, 18.3 [1.7] years), African American new mothers. METHODS: Mothers completed social support, self-esteem, and loneliness instruments at 1 and 6 weeks and 3 and 6 months postpartum. RESULTS: Most mothers (64.7%) had changes in their primary social support provider during the first 6 months postpartum. The combination of the adolescent's mother and boyfriend provided the highest level of support, no matter the type, relative to any other source of support. At every time point, positive correlations were found between emotional support and self-esteem and between problematic support and loneliness. CONCLUSION: Single, low-income, African American, adolescent new mothers are at risk for not having a consistent source of support, which may lead to lower self-esteem and greater loneliness. IMPLICATIONS: Clinical nurse specialists could facilitate care guidelines for these new mothers to identify their sources of support at each home visit and advocate for the adolescent's mother and boyfriend to work together to provide support. Bolstering the mothers' natural sources of support can potentially improve self-esteem and reduce loneliness. Improvement in these sources of support could prevent a decline in the mothers' psychosocial well-being. Development and testing support interventions are advocated; findings could guide clinical nurse specialists in addressing these new mothers' needs.

Low-Income, African American, Adolescent Mothers' Depressive Symptoms, Perceived Stress, and Social Support.

The purpose of this descriptive repeated-measures study was to describe depressive symptom patterns and report changes over time in levels of perceived stress and social support depending on patterns of depressive symptoms in single, low-income, African American, adolescent mothers during the initial, 6-month postpartum period. Thirty-five adolescent subjects between the ages of 16 and 22 years old were recruited at health care clinics in two Midwestern cities. Data collections by advanced practice nurses were completed at 1 week, 6 weeks, 3 months, and 6 months postpartum at mothers' homes. Established instruments were used to measure depressive symptoms, perceived stress and social support. Results indicated 63% of adolescent mothers' experienced depressive symptoms sometime during this transition period and 11.4% of these subjects had depressive symptoms at all 4 time points. Depressive symptoms were associated with perceived stress at each time point. Emotional support was inversely associated with depressive symptoms at 2 of the 4 time points. Depressive symptoms and problematic support were significantly related at 3 months and 6 months. Although single, low-income, African American, adolescent mothers are considered a high risk group, some are at even greater risk. This extremely high risk group have depressive symptoms throughout the first 6 months postpartum with the highest level of perceived stress and the most variability in social support relative to groups that were never depressed or were in and out of depression. More studies are needed to understand how to best help these high risk adolescents successfully transition to motherhood.

Health promotion text blasts for minority adolescent mothers.

PURPOSE: To examine use of technology for delivering a health promotion intervention via text blasts in single, low-income, adolescent, minority mothers and to describe their perceptions and experiences with the intervention. STUDY DESIGN AND METHODS: A qualitative descriptive design was used for this study. Health promotion information was sent weekly in the form of text blasts and/or pictures to five mothers during the first 6 months postpartum. Topics included promotion of breastfeeding, effects of breast milk on infant growth and development, information about infant immunizations, and reminders about infant and maternal follow-up and well-being. Qualitative interviews occurred monthly with mothers about their perceptions and experiences with the health promotion intervention and their health promotion behaviors. Data were analyzed using qualitative analytic techniques to generate themes from the mothers' interviews. RESULTS: Four themes emerged: (a) Trustworthy Support System, (b) Overcoming Barriers to Health Promotion, (c) Parenting Validation, and (d) Preferred Mode of Communication. All mothers used breast milk through 6 months postpartum and were adherent with childhood immunizations and maternal and infant follow-up appointments, unlike lower proportions in the general population. CLINICAL IMPLICATIONS: Health promotion text blasts can improve single, low-income, adolescent, minority mothers' health behavior outcomes such as adherence with recommended immunizations for their infants, breastfeeding success, and recommended maternal and infant healthcare visits. Further, it is the preferred mode of communication for these mothers. Future studies are needed for examining the use of technology to deliver healthcare to a larger sample of minority adolescent mothers.

Effects of an internet intervention on mothers' psychological, parenting, and health care utilization outcomes.

AIMS AND OBJECTIVES: The purpose of this pilot study was to test the effects of an Internet-based intervention, the New Mothers Network, on single, low-income, adolescent, African American mothers' psychological, parenting, and health care utilization outcomes. BACKGROUND: The study was based on social support theory. METHODS: For mothers in the Intervention Group, MSNTV™ was installed in subjects' homes and connected to the Internet. Data were collected at 1 week, 6 weeks, 3 months, and 6 months following the infant's birth. RESULTS: For infant health services utilization, 70.6% of those in the Control Group took their infant to the emergency room at least once during the study compared to 35.7% of mothers in the Intervention Group. The New Mothers Network allowed mothers to share their experiences and acquire information from nurses about caring for themselves and their infants. CONCLUSION: The New Mothers Network Web site is well poised for nursing driven social support intervention via the Internet, even though access devices are evolving over time.

Online support for single, low-income, African American mothers.

PURPOSE: To enhance understanding of the phenomenon of being a single, low-income, African American mother through their discussions and use of an Internet-based social support intervention. STUDY DESIGN AND METHODS: The New Mothers Network discussion forum was made available to 20 mothers in their homes for 6 months after the infant's birth. Nineteen mothers posted 174 messages to research nurses and to one another. Thematic analysis of the written messages was completed. RESULTS: The following themes emerged from discussion forum comments: (a) dealing with the father of the baby, (b) mourning losses, (c) positive and negative support, (d) financial needs and concerns, (e) career and educational goals, (f) balancing act, (g) trust issues, and (h) tuned in to baby. CLINICAL IMPLICATIONS: The New Mothers Network allowed these African American mothers to share their experiences and assimilate information from nurses about caring for themselves and their infants. Other nurses can create similar Internet discussion forums for the purposes of providing social support to mothers who have access to computers. Computer software for creating discussion forum sites can be purchased at a reasonable cost, and some are available free of charge.

Community leaders' perceptions of Hispanic, single, low-income mothers' needs, concerns, social support, and interactions with health care services.

Hispanic, single, low-income mothers are a vulnerable population who are often identified as having difficult transitioning to motherhood and successfully using the U.S. health care system. The purpose of this study was to examine needs, concerns, and social support of Hispanic, single, low-income mothers during the transition to motherhood through the eyes of community leaders serving this population in the U.S. Two focus groups were conducted, and 16 Midwestern community leaders working or volunteering with the Hispanic population expressed their opinions. Two investigators and two graduate nursing students evaluated the data. The process of word and context interpretation was completed using a combination of Tesch (1990) and Creswell (2007) techniques. Data were compared to field notes and debriefing summaries were completed during focus group discussions. Four themes and 12 subthemes evolved from the group discussions. Themes were (a) mothers' social support, (b) interactions with health care providers, (c) barriers in trust, and (d) practical life issues. A conclusion was drawn from these data that these women have difficulty accessing social support and information regarding care of themselves and their newborn infants due to limited social networks and barriers to health care. Nurses are in key positions to offer culturally sensitive social support and identify health care barriers with Hispanic, single, low-income mothers during the transition to motherhood. Further research is needed on interventions that effectively deliver information, lower health care barriers, and meet social support needs of Hispanic, single, low-income mothers and their infants.

New mothers network: the provision of social support to single, low-income, African American mothers via e-mail messages.

Electronic mail (e-mail) is being investigated as a health care intervention for mothers caring for their infants. The purpose of this study is to describe themes representing the content of e-mail messages written by 12 single, low-income, African American mothers to nurses participating in the New Mothers Network Study. Three themes that emerged were (a) life's logistics: day-to-day concerns; (b) relationships of support; and (c) personal reflections about being a new mother. Reported themes support the social support theory based on works by House and Revenson, Schiaffano, Majerovitz, and Gibofski used to develop the nursing intervention. Nurses are in key positions to offer social support to African American mothers adjusting to single parenting. Nurses can provide social support to single, low-income African American mothers via e-mail messages to assist them with caring for themselves and their infants.

New Mothers Network: the development of an Internet-based social support intervention for African American mothers.

Many single, low-income, African American mothers lack social support, experience psychological distress, and encounter difficulties caring for their infants during the transition to parenthood. The purpose of this article is to describe the development of a theoretically-based social support Internet intervention, the New Mothers Network, for improving single, low-income, African American mothers' health and parenting abilities. Conceptual and practical information is provided to describe the evolution of the intervention. The development of the New Mothers Network is described in six stages. The New Mothers Network may be an effective social support nursing intervention for improving single, low-income, African American mothers' psychological health outcomes, parenting outcomes, and health care utilization outcomes.

Community leaders' perceptions of single, low-income mothers' needs and concerns for social support.

Purposes of this study were to (a) assess and describe needs and concerns of single, low-income mothers during their transition to parenthood from the perspective of 16 Midwestern community leaders working closely with families and (b) evaluate social support mechanisms that are available for families. Focus group questions were organized around social support theory to gather information. The following themes evolved from focus group discussions: (a) social support issues (emotional, tangible, informational, and appraisal support; positive and negative support); (b) personal barriers to success (stress, low self-esteem, isolation, and inadequate parenting competence); and (c) system barriers (fear of the system and insensitive and ineffective services). Community health nursing strategies were identified that include assessment and interventions for this vulnerable population throughout their infants' 1st year of life and beyond.

Needs, concerns, and social support of single, low-income mothers.

The purposes of this qualitative pilot study were to describe needs and concerns of single, low-income mothers and to evaluate social support mechanisms these mothers valued during the transition to parenthood. Qualitative analysis consisted of word and context interpretation from focus group data. The following themes resulted from the discussion: (a) transition: resilience, finding new direction, and an array of emotions and mixed feelings; (b) stress: loss, isolation, and barriers; and (c) social support: positive and negative social support, and the need for informational, appraisal, emotional, and tangible support. Nursing interventions are discussed.

Effects of the New Fathers Network on first-time fathers' parenting self-efficacy and parenting satisfaction during the transition to parenthood.

The effectiveness of an Internet-based intervention, the New Fathers Network, was tested in improving first-time fathers' parenting self-efficacy and parenting satisfaction during the first 8 weeks following their infants' birth as compared with no intervention (Comparison Group). Parenting self-efficacy and satisfaction scores for the Intervention Group significantly improved from 4 to 8 weeks; parenting self-efficacy and satisfaction scores for the Comparison Group to which no intervention was given did not change significantly. Participants were primarily satisfied with the New Fathers Network.

Chewing tobacco use: perceptions and knowledge in rural adolescent youths.

The purposes of this pilot study were to describe the incidence of chewing tobacco use among rural midwestern adolescents and to describe rural midwestern adolescents' perceptions and knowledge about chewing tobacco use. A Smokeless Tobacco Use Survey was administered to 34 adolescent subjects who attended 5th-8th grades in two rural towns. None of the subjects reported trying chewing tobacco products. However, a group of male subjects who stated they may chew tobacco sometime in the future, performed less well on the test about chewing tobacco facts and perceptions of use, indicating some education needs are warranted. Risk factors and deterrent factors to using chewing tobacco are reported.