Consequences of high school bullying on stress and health of Arab American college students.

PROBLEM: Existing bullying research among Arab Americans is limited, focusing mainly on school-age adolescents and victimization. There is a lack of studies that examine retrospective bullying perpetration, bullying victimization, and physical fights during high school and their effect on current Arab American college students' stress and health outcomes. This study examines if bullying perpetration, bullying victimization, and physical fights during high school predict current stress and the physical and mental health of Arab American college students. In addition, we examined if perceived psychological stress mediates the relationships between bullying and fighting involvement and health. METHODS: One hundred and sixty-two undergraduate Arab American college students were recruited from a Midwestern university and completed self-report measures of bullying, stress, and health (both physical and mental). FINDINGS: Controlling for demographic variables, only high school victimization was significantly associated with current stress and physical and mental health. Stress fully mediated the relationship between victimization and health (both physical and mental). CONCLUSIONS: Victimization during high school years may result in serious physical and mental health consequences during college years. However, perpetration and fighting may not have similar effects. Addressing stress among bullying victims may reduce the negative impact of this experience on immigrant Arab American college students. Implications for practice and future research are discussed.

Association of adversities and mental health among first- and second-generation Arab American young adults.

The prevalence of mental health problems among young adults is widely recognized. However, limited research has examined the mental health of Arab American young adults specifically. To address this gap in the literature, this study aimed to investigate the effects of multiple stressors including adverse childhood experiences (ACEs), discrimination, and bullying victimization on the mental health of first- and second-generation Arab American young adults. The participants (N = 162) were recruited from a Midwest university using online and in-person methods. They were screened and completed a demographic questionnaire and self-report measures of ACEs, discrimination, bullying victimization, and mental health. Hierarchical multiple regression analysis was conducted to examine the effect of psychosocial stressors on mental health and the moderating effect of generation (first vs. second) on that relationship. Female gender, increased perceived discrimination, and more ACEs were associated with lower mental health scores (ß = -0.316, p < 0.001, ß = -0.308, p < 0.001, and ß = -0.230, p = 0.002, respectively). There was a significant negative relationship between victimization and mental health for first-generation Arab Americans (ß = -0.356, p = 0.010). However, that association all but disappeared for second-generation participants (ß = 0.006, p = 0.953). The results highlight the impact of multiple adversities on Arab American young adults' mental health and indicate important nuances related to their generation in the association between bullying victimization and mental health. Implications for practice and future research are discussed.

Exploring the linkage between family financial struggle and children's bullying victimization: Implications for nursing and psychotherapeutic practices.

PURPOSE: A few studies have found that children whose families are economically disadvantaged and financially struggling are at an elevated risk of victimization by their peers. However, extant research is largely descriptive. To address this gap, this study empirically tested the proposed pathways from family financial struggle to children's bullying victimization, including the role of barriers to healthcare access in this association using a nationally representative sample. DESIGN AND METHODS: The study utilizes the 2016 National Survey of Children's Health, a survey of a cross-sectional, weighted probability sample of US children (ages 0-17 years) living in 50 states and the District of Columbia, and their caregivers. The sample used for the current study included 14,374 racially and ethnically diverse caregivers of children, aged 6-11 years. RESULTS: Positive significant associations between family financial struggle and children's bullying victimization, and between financial struggle and barriers to healthcare access were found. Barriers to healthcare access mediated the association between family financial struggle and bullying victimization. PRACTICE IMPLICATIONS: Given the documented effects of bullying victimization on children, findings point to the importance of developing psychotherapeutic practices that are appropriate for children who are flagged as "high-risk."

The Relationship of Adverse Childhood Experiences and Emotional Distress in Young Adults.

BACKGROUND: Emerging evidence notes increased depression, anxiety, and stress among the general population during the COVID-19 pandemic. However, little is known about populations at increased risk for emotional distress as the pandemic continues. Persons with adverse childhood experiences (ACE) are one group that may be at higher risk for emotional distress. AIM: The aim of this study is to examine whether young adults, particularly Black young adults, with histories of ACEs report more emotional distress during the pandemic than those with no ACE exposure. METHOD: Using a cross-sectional, quota sampling approach, 100 Black and 100 White young adults were recruited using online sources (e.g., University website, Facebook). Due to the pandemic, participants were screened via Zoom and, if eligible, completed a demographic questionnaire, emotional distress measures (i.e., anxiety, depression, stress), and the ACE Questionnaire online via a Qualtrics survey. Structural equation modeling (SEM) analysis examined the ACE and emotional distress relationship, and multigroup SEM assessed racial differences. RESULTS: High levels of both emotional distress and ACEs were observed. Black young adults reported significantly more ACEs than Whites. ACEs were significantly associated with each measure of emotional distress regardless of race or other covariates. CONCLUSIONS: Findings reveal that during the pandemic, persons exposed to ACEs reported greater emotional distress than those with no ACE exposure. Nurses must screen patients for both emotional distress and ACE to target those at higher risk for early intervention and initiate treatment as needed to mitigate long-term mental health consequences.

Current and Cumulative Stress Experiences: A Model for Arab American Young Adults.

BACKGROUND: The effect of multiple stressors on immigrant young adults' endocrine functioning and health outcomes has not been comprehensively investigated. AIMS: This study tested a theoretical model of cumulative and current stressor effects on the hypothalamic-pituitary-adrenocortical (HPA) axis functioning and health-related quality of life (HRQL) among Arab American young adults. METHODS: Using a cross-sectional design, we recruited 160 participants, ages 18 to 24 years, from an urban university in the Midwest. Cumulative stress was assessed by self-report measures of childhood adversity, bullying victimization, and perceived ethnic discrimination. Current perceived stress was measured using the Perceived Stress Scale (PSS) while cortisol levels were measured in participants' hair. Structural equation modeling tested the effects of cumulative and current stress on cortisol and HRQL. RESULTS: Cumulative stress was negatively associated with HRQL (standardized path coefficient = -.51, p < .05). Interestingly, however, cumulative stress was inversely associated with hair cortisol level (standardized path coefficient = -.51, p < .05). Current stress was positively associated with cortisol level (standardized path coefficient = .43, p < .05) and negatively associated with the mental HRQL (standardized path coefficient < -.37, p < .05). CONCLUSION: Cumulative stress exhibited a different effect on HPA functioning from current perceived stress. Mental health was significantly impaired by both cumulative and current perceived stress. Implications for mental health nursing practice and research among Arab Americans are discussed.

Exploring Whether Talking With Parents, Siblings, and Friends Moderates the Association Between Peer Victimization and Adverse Psychosocial Outcomes.

The purpose of this study is to explore whether talking with parents, siblings, and friends will moderate the association between peer victimization and adverse outcomes (internalizing problems, alcohol/tobacco use, and delinquent friend affiliation). Data were derived from the Health Behavior in School-Aged Children, 2009 to 2010 cohort study in the United States (n = 12,642). Bivariate, logistic regression and ordinal least squares regression analyses were conducted. Peer victimization was found to be associated with all the adverse outcomes. Although ease of talking with parents had a lower likelihood of alcohol/tobacco use, it increased alcohol/tobacco risk when peer victimization increased. Ease of talking with friends showed a higher likelihood of alcohol/tobacco use, but the likelihood was lower when peer victimization increased. Ease of talking with parents and ease of talking with friends both lowered the likelihood of delinquent friend affiliation; however, ease of talking with parents increased the risk of delinquent friend affiliation when peer victimization increased. Moreover, ease of talking with friends decreased the risk of internalizing problems, although it increased the risk of such behaviors when peer victimization increased. Talking with siblings did not buffer the association between peer victimization and adverse outcomes. Implications for practice are also discussed.

A Descriptive Study of Bullying Victimization Among Arab American Adolescents in Southeast Michigan Middle and High Schools.

PURPOSE: This cross-sectional study examined the frequency of different forms of bullying victimization (verbal, physical, and social), predictors of victimization, and whether bullying is reported to an adult. DESIGN AND METHODS: The study utilized a community sample of 150 Arab American adolescents, age 12 to 16 years. The Adolescent Peer Relations Instrument-Victimization Scale was used to determine the participant's experiences of victimization in the past year. The adolescents indicated where bullying occurred, why, and whether they reported the incidence to an adult. RESULTS: Approximately 30% of the study sample reported that victimization occurred occasionally (once a month or more frequent). Classrooms and hallways were the most common locations where bullying had occurred. Country-of-origin and obesity were the most frequent reasons for victimization. Predictors varied among the different forms of victimization; however, cyber-victimization [OR = 24.5; 95% CI 5-119.5)], perceived problematic attire [OR = 8.4; 95% CI 2.2-31.9)], female gender [OR = 5.2; 95% CI 1.2-22.7)], and being overweight [OR = 0.14; 95% CI 0.01-2.6)] all predicted overall victimization. CONCLUSIONS: Our findings provide a foundation for future research focusing on Arab American adolescents, an underrepresented population, more research is needed to understand the scope of bullying victimization among Arab American adolescents. PRACTICE IMPLICATIONS: This study will inform future intervention research and practice to consider victimization and related factors among Arab American adolescents. Culturally sensitive and multilevel interventions are imperative to decrease bullying victimization among Arab American adolescents and prevent negative effects on their health and families.

Self-reported physical and psychological symptoms among victims and perpetrators of bullying in Arab American Adolescents.

PROBLEM: The adverse effects of bullying victimization among adolescents have been examined extensively. However, few studies have examined how bullying perpetration affects health. Moreover, ethnic or religious minorities are particularly at risk for bullying involvement, but little is known about bullying among Arab Americans. The purpose of this study is to examine how bullying perpetration and victimization are related-independently and concurrently-to physical and psychological problems among Arab American adolescents. METHOD: Arab American adolescents (N = 150), ages 12-16, were recruited from a community center and a mosque located in Southeast Michigan. Participants completed the Adolescent Peer Relations Instrument, the Children's Somatization Inventory, the Kessler Psychological Distress Scale, and the Perceived Stress Scale. FINDINGS: Both bullying perpetration and victimization correlated positively with physical and psychological symptoms. Hierarchical regressions indicated that both perpetration and victimization simultaneously and significantly predicted physical and psychological symptoms, and these relationships were independent of the demographic factors and general life stress. CONCLUSIONS: Bullying perpetration and victimization are associated with adverse health outcomes in Arab American adolescents, independent of life stress. These findings are among the first ones in this population and pave the way for future research and intervention programs.

The Impact of Cyberbullying on Physical and Psychological Health of Arab American Adolescents.

Utilizing a community-based, cross-sectional design, the present study explored Arab American adolescents' experiences in cyberbullying and its effect on their health. A convenience sample of 150 Arab American adolescents, ages 12-16, were recruited from two community centers located at Southeast Michigan. The survey focused on cyberbullying victimization and perpetration in the past year including frequencies and types of technology used. Thirty-four percent of adolescents reported cyberbullying victimization and 26.7% reported cyberbullying perpetration at least once in the past year. Males were significantly more involved in both victimization and perpetration. Text messaging, Instagram and Facebook were most commonly used. Perpetration predicted physical complaints (p = .001), whereas, victimization predicted psychological distress (p = .014) after controlling for all demographic variables. Arab American adolescents reported significant cyberbullying perpetration and victimization. Perpetrators experienced more physical symptoms while victims experienced more psychological distress. Implications for future research are discussed.

A Quality Improvement Project: What First-year Nursing Students Include in Their Nursing Care Plans for Patients With Acute or Chronic Wounds.

Nursing education research is lacking with regard to nursing care plans for patients who have a wound and use of the nursing diagnosis impaired skin integrity. The purpose of this quality improvement project was to inform teaching about nursing care planning for patients with wounds by examining what rst-year nursing students attending a fundamentals of nursing course in a Bachelor of Science in Nursing program included in a nursing process assignment when caring for an assigned patient who had an acute or chronic wound. Because they were in their clinical rotation, students had access to the patients' medical records to facilitate composing the care plan; they also could ask the patient for information. Assessment data were entered on a predetermined form based on Gordon's Functional Patterns. Using this information, students had to provide 3 possible diagnoses and select 1 upon which they developed the care plan intended to include patient description, wound description, dressing, and nursing diagnoses and impressions. The forms then were ana- lyzed for assessment completeness. Thirty-eighty (38) care plans completed by students were collected on patients that included 23 men and 28 African-Americans; mean age of the patients was 60.11 ± 14.17 (range 20-87) years. Wounds included 25 surgical incisions, 4 pressure ulcers/injuries, 7 "other" wounds, and 2 not identi ed. None of the students' assessments provided a detailed wound description. The most common wound descriptors were location (n =19) and drainage (n = 15). For 8 patients, students stated the wound was covered by a dressing. Thirty (30) nursing diagnoses were listed. The most common nursing diagnoses were impaired physical mobility or activity intolerance, impaired com- fort, impaired skin integrity, imbalanced nutrition, and risk for infection. These nursing students had beginning skills in patient and wound assessment and writing nursing care plans about patients with impaired skin integrity. Students need to increase their depth of wound assessment and need more experience planning care for patients with wounds.

Challenges and strategies for conducting sensitive research with an Arab American population.

Recruiting minority groups such as Arab Americans (Ar-Am) for research studies has been challenging. To date no studies were found that explicitly addressed challenges to recruit Ar-Am for sensitive research. The purpose of this article is to present the challenges across three pilot studies that involved Ar-Am samples and the strategies that were implemented to overcome these challenges. The challenges faced with conducting studies with Ar-Am included difficulty for participants to express emotions, influence of male/female authority to consent for the study, lack of trust to disclose sensitive information, language barrier, and slow recruitment. Having bilingual female recruiters of Arabic descent, engaging the women's family members in the consent process, and addressing the sensitive topics in culturally appropriate language were effective strategies to overcome these challenges. These strategies might be helpful for other researchers who recruit Ar-Am for sensitive research.

Arab American Adolescents' Perceived Stress and Bullying Experiences: A Qualitative Study.

In 2012, 20% of high school students were bullied in the United States. Bullying is more prevalent among minority populations. Arab American adolescents receive little research attention and are described as the invisible population. This descriptive qualitative study was conducted with 10 Arab American adolescent bullying victims to describe their bullying experiences and related stress. In addition to being bullied because of health problems or social disadvantages, Arab American adolescents reported that they were bullied because of their ethnic/racial background and religious affiliation. Victims described high stress levels and anxiety which compromised their ability to function. They reported feeling sad, angry, overwhelmed, helpless, and hurt when they were bullied. They also lost control over their lives and self-confidence. Family and friends were sources of support but school administrators and teachers were not supportive. Implications for practice and future research were discussed.

A Cross-sectional, Descriptive, Quality Improvement Project to Assess Undergraduate Nursing Students' Clinical Exposure to Patients With Wounds in an Introductory Nursing Course.

Because nurses frequently participate in decisions related to wound care, learning about wounds and their care during undergraduate education is critical. A cross-sectional, descriptive, quality improvement project was conducted in an introductory baccalaureate nursing course to identify: 1) the types of patients with wounds assigned to beginning students, 2) patient wound care procedures and dressings, and 3) student level of participation in wound care. Data were collected from the weekly notes recorded about students' (N = 49) patient care experiences in 3 acute care hospitals for 9 clinical days during 1 semester. Data were recorded on a paper-and-pencil form by instructors at the end of the clinical day and included type of wound, wound irrigation, dressing, technique of care, and student's participation. Descriptive statistics were used to examine the frequency and distribution of the wound characteristics and care assessed. Of the 284 patients assigned to students, 75 (26.4%) had a wound. The most common wound was a surgical incision (49, 65%) and was closed (36, 73.5%). Twenty-six (26) patients had a pressure ulcer, most commonly Stage II. The most common dressing was dry gauze (29). Damp gauze was used on 18 wounds. Wound irrigation was recorded for 24 wound protocols and performed with a bulb syringe or by pouring the solution from a container. Generally, nonsterile wound care was performed. Twenty-five (25) students performed wound care with the instructor, 16 watched the care performed by another clinician, and 10 participated with another nurse in the wound care. For 22 patients, the wound care was neither observed nor performed because either it was not time for the dressing to be changed or it was only to be changed by a medical team. From these data, it was concluded beginning nursing students had some, but limited, clinical experience with patients with wounds. Students' wound care experiences need further examination, especially across multiple educational courses.

Bullying and victimization among African American adolescents: a literature review.

TOPIC: Bullying among African American adolescents. PURPOSE: This article reviews the current literature on bullying and victimization among African American adolescents. It highlights bullying and violence disparity among African American adolescents, associated risk and protective factors, and effects of bullying on adolescent health. SOURCES USED: Twenty-three English language peer-reviewed articles from CINAHL, Pubmed, and Psyc-INFO databases. CONCLUSION: African American adolescents have higher rates of bullying and victimization compared to other adolescent populations. This review found strong associations among bullying involvement, substance abuse, and family factors. Bullying also had a significant impact on adolescent health, particularly psychological symptoms and school performance.