Impact of the COVID-19 Pandemic on U.S. Women's Mental Health.

Background: Women are more likely than men to be diagnosed with depression and anxiety with rates increasing since the COVID-19 pandemic. This study sought to understand how women's intersecting identities, personal strengths, and COVID-19-related stressors were associated with their anxiety, depression, and post-traumatic stress disorder (PTSD) symptoms early in the pandemic. Methods: During May-June 2020, American women (N = 398) recruited via MTurk completed an online questionnaire assessing mental health (PTSD, anxiety, and depression), demographic characteristics, personal strengths (coping, hope, social support), and experiences with COVID-19-specific stressors. Results: Women who had a child younger than 18 years of age, lived in rural or urban areas (compared with suburban), and identified as sexual minority reported increased levels of PTSD, depression, and anxiety symptoms. Social support and hope (Agency) were associated with fewer mental health symptoms. Engagement in maladaptive coping and greater perception of COVID-19 threat and perceived stress was associated with more PTSD, depression, and anxiety symptoms. COVID-19-related illness events and difficulty accessing living essentials were associated with increased anxiety symptoms. COVID-19-related disruption to living and income were associated with increased PTSD symptoms. Loneliness was associated with increased anxiety and depression symptoms. Conclusions: Results of this study can inform prevention and intervention efforts to address depression and anxiety among women with intersecting identities during times of stress. Specifically, supporting the development of women's resilience and adaptive coping and intervening to address maladaptive coping strategies, such as drinking, provide paths to supporting women's mental health.

American Women's Experiences With Intimate Partner Violence during the Start of the COVID-19 Pandemic: Risk Factors and Mental Health Implications.

In an online survey, women self-reported high prevalence of intimate partner violence during the early days of the pandemic. Risk factors for experiencing intimate partner violence (IPV) included having a child under the age of 18, being a sexual minority, living in a rural community, and stressors related to healthcare access, income/employment stress, and COVID-19 exposure or illness. Women who worked during the pandemic and were older were less likely to experience IPV. Women who reported IPV also reported increased anxiety and depression. The results are discussed in terms of clinical and policy implications for supporting women who are victims of IPV.

Exploring American Parents' Lived Experiences During the COVID-19 Pandemic: Ramifications for Well-Being.

OBJECTIVE: The objective of this study was to document the direct impact of the COVID-19 pandemic on parents and families in the United States. METHODS: Parents' experiences during the pandemic were examined using an online survey (N = 564) collected during May and June 2020. RESULTS: Parents reported experiencing a high frequency of COVID-19-related events (e.g., job loss and health concerns) and impact on their lives. Parents' experiences with COVID-19, as well as self-reported perceived increase in home labor, experiences with assisting children with remote schooling, and work-life conflict were all significantly associated with higher levels of parental role overload. COVID-19-related events and impact, as well as parental role overload, significantly predicted parents' anxiety and depression, even after controlling for demographic factors. CONCLUSIONS: The findings suggest the importance of providing support for parents and families through direct services and public policy changes.

Is it just me, or was that sexist? The role of sexism type and perpetrator race in identifying sexism.

Despite sexism occurring frequently, people often do not identify it as such. Using a vignette design, the current project explored whether sexism was identified at a different rate and intensity depending on the specific form of sexism enacted (hostile or benevolently sexist behavior) and race (Black or White) of the man perpetrating sexist behaviors. When a Black man engaged in a benevolently (paternalistic) sexist behavior he was perceived as more sexist than a White man. However, White and Black men were perceived similarly when they engaged in a hostile (overtly negative and derogatory) sexist behavior. Overall, female participants identified sexism more often and viewed it as more sexist than male participants did, especially in the context of benevolent sexism. These findings suggest there are significant effects of perceiver gender and perpetrator race in the perception of sexism. This demonstrates the importance of examining both race- and gender-based discrimination together.

Perceptions of Blame in Intimate Partner Violence: The Role of the Perpetrator's Ability to Arouse Fear of Injury in the Victim.

Men are more likely to be blamed more for intimate partner violence (IPV) than are women who commit the same offense. However, because men are typically stronger and perceived as more physically aggressive than women are, perpetrator sex is confounded with masculinity and the ability to arouse fear in the victim. This study disentangled the construct of gender in understanding bystanders' attributions of blame in IPV. Participants (N = 639) read a scenario in which the perpetrator's sex (male/female) and gender identity (masculine/feminine), and the victim's sex (male/female) were manipulated and rated how much they blamed the perpetrator and the perpetrator's ability to arouse fear of injury in the victim. Results showed that male perpetrators (regardless of gender identity) who assaulted a female victim were attributed the most blame and were perceived as having the greatest ability to arouse victim fear. In contrast, feminine female perpetrators were attributed the least blame and perceived as arousing the least victim fear regardless of the victim's gender. Furthermore, controlling for the perpetrator's ability to arouse fear in the victim resulted in the elimination of the interaction effects for blame. This finding suggests that perpetrators' ability to arouse fear is an underlying factor in bystanders' attributions of blame.

Validation of the Registered Nurse Assessment of Readiness for Hospital Discharge Scale.

BACKGROUND: Statistical models for predicting readmissions have been published for high-risk patient populations but typically focus on patient characteristics; nurse judgment is rarely considered in a formalized way to supplement prediction models. OBJECTIVES: The purpose of this study was to determine psychometric properties of long and short forms of the Registered Nurse Readiness for Hospital Discharge Scale (RN-RHDS), including reliability, factor structure, and predictive validity. METHODS: Data were aggregated from two studies conducted at four hospitals in the Midwestern United States. The RN-RHDS was completed within 4 hours before hospital discharge by the discharging nurse. Data on readmissions and emergency department visits within 30 days were extracted from electronic medical records. RESULTS: The RN-RHDS, both long and short forms, demonstrate acceptable reliability (Cronbach's alphas of .90 and .73, respectively). Confirmatory factor analysis demonstrated less than adequate fit with the same four-factor structure observed in the patient version. Exploratory factor analysis identified three factors, explaining 60.2% of the variance. When nurses rate patients as less ready to go home (<7 out of 10), patients are 6.4-9.3 times more likely to return to the hospital within 30 days, in adjusted models. DISCUSSION: The RN-RHDS, long and short forms, can be used to identify medical-surgical patients at risk for potential unplanned return to hospital within 30 days, allowing nurses to use their clinical judgment to implement interventions prior to discharge. Use of the RN-RHDS could enhance current readmission risk prediction models.

Pediatric Oncology Nurses' Experiences With Prognosis-Related Communication.

OBJECTIVES: To examine nurses' experiences of prognosis-related communication (PRC) with parents of children with cancer. SAMPLE & SETTING: Cross-sectional, correlational study in the pediatric oncology setting involving 316 members of the Association of Pediatric Hematology/Oncology Nurses. METHODS & VARIABLES: Online survey regarding individual nurse factors, PRC, interprofessional collaboration, moral distress, and perceived quality of care. RESULTS: Nurses strongly agreed that prognostic disclosure is critical for decision making, but they are challenged in determining their role. Nurses with more years of experience and training in PRC, those working in an outpatient setting, and those with higher levels of nurse-physician collaboration reported more positive experiences with PRC. Positive experiences with PRC and collaboration were significantly associated with higher nurse-perceived quality of care and reduced nurse moral distress. IMPLICATIONS FOR NURSING: Nurses should work to be active participants in the process of PRC by collaborating with physician colleagues. When nurses sense that prognostic discussions have been absent or unclear, they should feel confident in approaching physician colleagues to ensure parent understanding and satisfaction with communication.

Men's Sexual Coerciveness, Perceptions of Women's Attachment, and Dating Preferences.

This study examined whether sexually coercive men are uniquely drawn to certain attachment styles in women. Specifically, it employed an experimental design to investigate what sorts of inferences men draw about women based on women's attachment styles and whether a woman's attachment style may serve as an indicator of vulnerability, rendering sexually coercive men more attracted to some women than to others. One-hundred thirty-six college men completed a measure of sexual coerciveness and answered questions about personal ads experimentally manipulated for portrayed attachment style. Findings suggest that sexually coercive men may be more attracted to women with characteristics associated with sexual vulnerability. Additionally, men perceive women differently based on their attachment styles, and sexually coercive men may perceive women differently than do other men.

Labeling Sexual Victimization Experiences: The Role of Sexism, Rape Myth Acceptance, and Tolerance for Sexual Harassment.

This study investigated whether attitudinal variables, such as benevolent and hostile sexism toward men and women, female rape myth acceptance, and tolerance of sexual harassment are related to women labeling their sexual assault experiences as rape. In a sample of 276 female college students, 71 (25.7%) reported at least one experience that met the operational definition of rape, although only 46.5% of those women labeled the experience "rape." Benevolent sexism, tolerance of sexual harassment, and rape myth acceptance, but not hostile sexism, significantly predicted labeling of previous sexual assault experiences by the victims. Specifically, those with more benevolent sexist attitudes toward both men and women, greater rape myth acceptance, and more tolerant attitudes of sexual harassment were less likely to label their past sexual assault experience as rape. The results are discussed for their clinical and theoretical implications.

Psychometric Properties of the Family Caregiver Delirium Knowledge Questionnaire.

A valid, reliable measure of family caregivers' knowledge about delirium was not located in the literature; such an instrument is essential to assess learning needs and outcomes of education provided. The purpose of the current study was to (a) develop a family Caregiver Delirium Knowledge Questionnaire (CDKQ) based on the Symptom Interpretation Model; and (b) establish validity and reliability of the measure. The 19-item CDKQ was developed and administered to 164 family caregivers for community-dwelling older adults. Descriptive statistics were examined for all variables. Psychometric testing included confirmatory factor analysis, item-to-total correlations, and internal consistency reliability. A three-factor model provided the best fit for the data. The findings support initial validity and reliability of the CDKQ with family caregivers. Although the CDKQ was developed for use with family caregivers, it has potential for use with other caregivers, such as home health aides.

Predictors of engagement in postpartum weight self-management behaviours in the first 12 weeks after birth.

AIM: To explore factors that influence postpartum weight self-management behaviours. Transitions Theory and the Integrated Theory of Health Behaviour Change guided selection of variables. Transition conditions, level of patient activation and social facilitation were examined for association with postpartum weight self-management behaviours. BACKGROUND: Retention of pregnancy weight increases risk of overweight and obesity later in life. Little is known about what women do to self-manage return to pre-pregnant weight and how providers can influence their behaviours. DESIGN: Prospective, longitudinal, correlational. METHODS: Data collection occurred from March through October, 2013. One hundred and twenty-four women completed surveys during postpartum hospitalization; telephone interviews were completed by 91 women at 6 weeks and 66 women at 12 weeks. Standard and hierarchical multiple regression methods were used for analyses. RESULTS: Transition difficulty was negatively associated with patient activation and immediate postbirth patient activation was positively associated with eating behaviours at 6 weeks, eating behaviours at 12 weeks and physical activity at 12 weeks. Social support and social influence were not significant predictors in the regression models. CONCLUSION: Patients experiencing a difficult postpartum transition have lower activation levels; those less activated are less probably to engage in weight self-management behaviours in the 12 weeks following their baby's birth. Patient activation level should be considered in tailoring promotion of healthy postpartum weight management.

A system justification view of sexual violence: legitimizing gender inequality and reduced moral outrage are connected to greater rape myth acceptance.

Rape is a pervasive social problem that causes serious physical and psychological repercussions. Rape victims' recovery is often complicated by the public's failure to believe the victim and restore justice. This study applied system justification theory to examine whether the justification of gender inequality is related to moral outrage (an emotional precursor to corrective action) and rape myth acceptance; we also examined whether rape myth acceptance is associated with moral outrage at injustice. Results showed that gender-specific system justification correlated with less moral outrage at human suffering as well as greater rape myth acceptance. The relationships between these variables were similar for men and for women, a finding that suggests that rape myths are system justifying for women. When we controlled for gender-specific system justification, rape myth acceptance correlated with less moral outrage. Results are discussed in the context of how legitimizing ideologies reduce moral outrage at injustice and perpetuate a system of sexual violence.

Evaluations of sexual assault: perceptions of guilt and legal elements for male and female aggressors using various coercive strategies.

This study examines the extent to which verdict, guilt, and legal components associated with jury instructions of sexual assault differ as a function of aggressor gender, participant gender, and sexual strategy used (consensual, verbal coercion, alcohol, or physical aggression) to obtain sex. Participants (N = 423; 276 women and 147 men) read a vignette depicting either a couple having consensual sex (control), or a male or female aggressor who initiates sexual intercourse via verbal coercion, use of alcohol, or physical abuse. College students were provided with legal instructions of sexual assault then asked to provide a verdict, degree of guilt, and legal components. Female participants rated guilt and coercion higher than did male participants. Ratings of guilt were highest in the physical assault condition followed by the alcohol, verbal, and control conditions. Female aggressors were rated less guilty than male aggressors. Results are explained in relation to sexual scripts and legal decision making. Lack of significance in verdict decisions and interaction effects suggests male and female aggressors are evaluated similarly using coercive strategies; yet, consent for sex was assumed and attributions of guilt was lower when the aggressor was female. Implications for jury instructions and future research are discussed.

Power, sex, and rape myth acceptance: testing two models of rape proclivity.

Power and sex are thought to be important factors associated with sexual aggression. The goal of this study was to offer a dual-process model to determine how both an implicit power-sex association and explicit power-sex beliefs contribute to rape myth acceptance and rape proclivity. In Study 1, an explicit measure of power-sex beliefs was developed using a participant sample of 131 college students (54% female; age: M = 20.2 years, SD = 3.5 years). In Study 2, 108 male college students (age: M = 19.1 years, SD = 1.3 years) completed a power-sex implicit association test and three explicit measures assessing power-sex beliefs, rape myth acceptance, and rape proclivity. Two models of rape proclivity were compared. The best-fitting model showed that rape myth acceptance mediated the relationships between rape proclivity and an implicit power-sex association, as well as explicit power-sex beliefs.

Male rape myths: the role of gender, violence, and sexism.

This study investigates the structure of Struckman-Johnson and Struckman-Johnson's Male Rape Myth Scale, examines gender differences in rape myth acceptance, and explores the underlying ideologies that facilitate male rape myth acceptance. A three-factor model, with rape myths regarding Trauma, Blame, and Denial as separate subscales, is the best fitting solution. However, the results indicate that additional scale development and validity tests are necessary. In exploratory analyses, men are more accepting of male rape myths than are women. Benevolent sexism toward men and acceptance of interpersonal violence are strong predictors of male rape myth acceptance for both men and women. Thus, the attitudes that facilitate rape myth acceptance against men appear to be similar to those that facilitate rape myth acceptance against women. Suggestions for future scale development are outlined and theoretical implications of the findings are discussed.

Perceptions of sexual coercion in heterosexual dating relationships: the role of aggressor gender and tactics.

A large body of research has found a concerning prevalence rate of sexual coercion in heterosexual college student dating relationships; however, little research has examined how college students perceive and interpret these behaviors. In the current study we examined the impact of initiator gender and sexually coercive strategy (verbal pressure, purposeful intoxication, physical force, or control/mutual consent) on perceptions of the aggressor, victim, behavior, and relationship quality. Results indicated that men who coerce are viewed as aggressive; women who coerce are viewed as promiscuous. Targets of sexual coercion are not perceived as experiencing high levels of victimization following the incident. These findings suggest that college students do not perceive sexually coercive behaviors to be highly problematic. The results are discussed in terms of gender roles and practical implications for college student relationships.