Health-related behaviors and weight-related outcomes within sibling pairs: A systematic review.

BACKGROUND: Siblings reciprocally contribute to mutual social and physical development. The aim of this review was to examine the health-related behaviors and weight-related outcomes within child-sibling pairs and to determine how these factors vary by sibling composition. METHODS: Following the PRISMA guidelines, a systematic review of studies published since 2000 obtained from MEDLINE, CINAHL, PubMed, Cochrane Reviews, Web of Science, PsycINFO, Health and Wellness, and Science Direct was performed. The eligibility criteria for inclusion were: 1) peer-reviewed and published in English; 2) included children ages 2 to 20 and their siblings; and 3) explored health-related behaviors (i.e., diet) and/or weight-related outcomes (i.e., body weight) within child-sibling dyads. RESULTS: A total of 13 studies were included in the review. The study findings are summarized according to three major themes: 1) sibling concordance in health-related behaviors and weight-related outcomes, 2) differences in health-related behaviors within weight-concordant/weight-discordant sibling dyads, and 3) influence of sibling composition on health-related behaviors and weight-related outcomes. CONCLUSIONS: Family-based interventions for childhood obesity may benefit from including siblings as key family members in promoting children's health-related behaviors and preventing excessive weight gain. Future studies should explore variable sibling dynamics (e.g., adoptive siblings) in more culturally/racially diverse families to further explore the role of a sibling in a child's health. IMPLICATIONS TO PRACTICE: The findings of this study may help healthcare providers in developing effective family-based obesity interventions for families with more than one child in their household.

eMental Health Literacy and Knowledge of Common Child Mental Health Disorders among Parents of Preschoolers.

The purpose of the study was to assess the eMental health literacy of parents of preschool children and explore the relationships between their eMental health literacy skills and their knowledge of common child mental health disorders and their child difficulties. Online survey data were collected using Mechanical Turk (MTurk). Parents of preschool children completed questionnaires related to internet-based mental health information seeking behavior, knowledge of common child mental health disorders using case vignettes, and child difficulties. Data were analyzed using descriptive statistical methods. eMental health literacy of parents was high but knowledge of the child mental health disorders was low. Only 14% of parents correctly identified all three disorders; 41.1% identified attention deficit hyperactivity disorder (ADHD), 64.9% recognized autism spectrum disorder (ASD), and 19.1% identified separation anxiety disorder (SAD). Parents with high eMental health literacy (≥30) were more likely to endorse professional help and seek information on how to manage problem behaviors for all three disorders. Parents with low eMental health literacy (<30) were more likely to have a child with a high risk of a mental health disorder. The findings will be used to inform educational initiatives on the use of online resources and recognition of child mental health disorders to promote early intervention and appropriate help seeking.

Depressive Symptoms and Influencing Factors in Low-Risk Mothers.

INTRODUCTION: Depressive symptoms burden not only postpartum women, but can also compromise partner relationships and mother-infant interactions. With approximately 15% of women affected by perinatal mood and anxiety disorders (PMADs) each year, maternity care providers must be sensitive to personal characteristics and complaints that influence women's potential to develop postpartum depression (PPD). The purpose of the study was to identify personal characteristics and modifiable factors associated with depressive symptoms in low-risk postpartum women. METHODS: A descriptive, correlational design was used to identify predictors of depressive symptoms among mothers who were considered to be at low risk for PPD. Self-report data related to mood, stress, sleep disturbance, and fatigue were collected near the sixth week post-delivery from women (N = 62) in a southern US state. RESULTS: The levels of stress and reports of sleep disturbance approached clinical concern in the low-risk sample (n = 62), in addition to being positively correlated depressive symptoms. Cesarean delivery was also associated with increased depressive symptoms and predictive of depression symptoms when combined with perceived chronic stress, sleep disturbance, and fatigue. DISCUSSION: The findings underscore the importance of assessing maternal mental health and adjustment during the postpartum period. While some mothers may not report depressive symptoms at post-delivery visits, they may be experiencing symptoms that predispose them to a mood disorder. Using a more holistic approach to postpartum care, with concern for both physical and mental well-being, may be a necessary shift to promote health in new mothers and families.

A Pilot Study to Assess the Feasibility of Group Exercise and Animal-Assisted Therapy in Older Adults.

This pilot study assessed the feasibility of incorporating animal-assisted therapy teams (ATT) into a 6-week group exercise program for older adults (77 ± 6 years). Fifteen participants were randomly assigned to an exercise with ATT (E+ATT; n = 8) or exercise only (E; n = 7) group. Groups exercised 3x/week for 45 min. Feasibility was assessed by three objectives: (1) ATT will not need extensive preparation beyond their original therapy training; (2) the study will require minimal cost; and (3) ATT must not impair the effectiveness of the exercise program. By the study conclusion, all objectives were met. Time and cost were minimal for ATT, and adherence was 93% and 90% for E+ATT and E, respectively. There were significant improvements in both groups (p ≤ .05) for arm curls, get-up and go, and 6-min walk. The results of this pilot study suggest that it is feasible to incorporate ATT into group exercise programming for older adults.

Identifying Health Consumers' eHealth Literacy to Decrease Disparities in Accessing eHealth Information.

The increasing amount of health information available on the Internet highlights the importance of eHealth literacy skills for health consumers. Low eHealth literacy results in disparities in health consumers' ability to access and use eHealth information. The purpose of this study was to assess the perceived eHealth literacy of a general health consumer population so that healthcare professionals can effectively address skills gaps in health consumers' ability to access and use high-quality online health information. Participants were recruited from three public library branches in a Northeast Florida community. The eHealth Literacy Scale was used. The majority of participants (n = 108) reported they knew how and where to find health information and how to use it to make health decisions; knowledge of what health resources were available and confidence in the ability to distinguish high- from low-quality information were considerably less. The findings suggest the need for eHealth education and support to health consumers from healthcare professionals, in particular, how to access and evaluate the quality of health information.

Demographic, Social Support, and Community Differences in Predictors of African-American and White Men Receiving Prostate Cancer Screening in the United States.

OBJECTIVE: To examine demographic, social support, and community factors from a national dataset that influence African-American (AA) and White men to receive prostate cancer screening (PCS) via the Digital Rectal Exam (DRE) or Prostate Specific Antigen Test (PSA). DESIGN AND SAMPLE: A cross-sectional secondary analysis from the National Health and Nutrition Examination Survey (NHANES) provided the sample of AA (N = 377) and White (N = 971) men over the age of 40 years. Regression analysis with confidence intervals was utilized to examine the factors associated with AA and White men receiving PCS. The Social Ecological Model provided the theoretical framework. MEASURES: Questionnaires from the NHANES dataset provided data for this study. RESULTS: Age, education, and access to health care was associated with AA and White men receiving the DRE. Income and church attendance was only associated with White men receiving the DRE. Only White men had an association of income with receiving the PSA test and only AA men had an association of marital status with receiving the PSA test. CONCLUSIONS: Cultural evaluations of PCS behaviors among AA men are necessary to decrease the health disparity of prostate cancer among the AA population.

How parents make decisions to use medication to treat their child's ADHD: a grounded theory study.

BACKGROUND: Despite evidence of efficacy, a substantial percentage of children with attention deficit hyperactivity disorder (ADHD) either do not begin medication prescribed for their core symptoms or fail to continue treatment. OBJECTIVE: The purpose of this study was to understand (a) how parents decide to use medication to treat their child's ADHD and (b) the factors that influence their adherence to medication over time. DESIGN: Grounded theory guided data collection and analysis. Sixteen semistructured interviews with parents (13 mothers, 3 fathers) of children with ADHD were conducted. RESULTS: The substantive theory developed from the data demonstrates that in seeking to help their child and restore a sense of stability around family life, parents engage in a process of "doing what helps most" in deciding to use medication to treat their child's ADHD. CONCLUSIONS: Interventions to support and guide parents throughout the decisional process are critical to meet the needs of families of children with ADHD.

College Students' eMental Health Literacy and Risk of Diagnosis with Mental Health Disorders.

BACKGROUND: This study investigated college students' eMental health literacy (eMHL), knowledge of common mental disorders and risk of being diagnosed with a mental health disorder and compared their knowledge of mental disorders and concurrent risk of diagnosis with high and low eMHL; Method: A total of 123 college students completed an online survey through Amazon's Mechanical Turk (MTurk). Data were analyzed using descriptive statistics and chi-square tests; Results: eMental health literacy scores were higher when students had a history of prior mental health problems, were female, and graduate students. College students with high eMHL were more likely to recognize symptoms, recommend professional help, and be at lower risk for common mental health disorders compared to low eMHL students; Conclusions: eMHL was associated with mental health status and demographic variables. Level of eMHL was associated with knowledge of mental disorders and risk of diagnosis. IMPLICATIONS: The results highlight the need for targeted interventions to enhance eMHL of college students, support mental health resilience and prevent mental health disorders.

Factors influencing parental decision making when parents choose to deviate from the standard pediatric immunization schedule.

PURPOSE: The purpose of this article is to present the results of a study focusing on the basis for parental decisions to refrain from the standard pediatric immunization schedule. DESIGN AND METHODS: The study was based upon open-ended qualitative items that were subjected to content analysis to identify the prominent themes cited by parents. RESULTS: The results of the study demonstrate the presence of a variety of continuing misperceptions regarding the risks represented by common pediatric immunizations. PRACTICE IMPLICATIONS: The study demonstrates the need for intensive efforts designed to apprise families of the risks and benefits associated with pediatric immunization.

An exploration of the relationship between knowledge and performance-related variables in high-fidelity simulation: designing instruction that promotes expertise in practice.

Increasingly, high-fidelity patient simulation (HFPS) is becoming essential to nursing education. Much remains unknown about how classroom learning is connected to student decision-making in simulation scenarios and the degree to which transference takes place between the classroom setting and actual practice. The present study was part of a larger pilot study aimed at determining the relationship between nursing students' clinical ability to prioritize their actions and the associated cognitions and physiologic outcomes of care using HFPS. In an effort to better explain the knowledge base being used by nursing students in HFPS, the investigators explored the relationship between common measures of knowledge and performance-related variables. Findings are discussed within the context of the expert performance approach and concepts from cognitive psychology, such as cognitive architecture, cognitive load, memory, and transference.

A study of the relationship of nursing interventions and cognitions to the physiologic outcomes of care in a simulated task environment.

This study, based on the Expert Performance Approach, examined the clinical nursing performance of participants who were introduced into a simulated task environment requiring them to administer care to a client experiencing an exacerbation of Congestive Heart Failure. This was undertaken to identify cognitive and physiologic variables that differentiate performance levels among participants. Data on participant actions and verbal reports were coded to characterize their relationship with physiologic responses of the Human Patient Simulator. The results demonstrated that physiologic responses to nursing interventions reflect a reliable pattern that can be used to differentiate performance levels.

Cognitions and clinical performance: a comparison of high and low performing baccalaureate nursing students.

Studies to date have employed a variety of methods to elucidate the cognitive processes that underlie nursing actions in clinical situations. Most studies relied on clinical case scenarios rather than actual patient care situations, and did not supplement cognitive measures with quantitative measures of performance or physiologic outcomes of care. The present study employed a quasi-experimental design to describe and compare the verbal report data of baccalaureate nursing students who were assigned to high and low performing groups based on their ability to alter the physiological trajectory of the patient in a simulated task environment. Low performing participants observed many irrelevant cues and failed to perform vital actions in lieu of extraneous actions that were not directly related to the patient's condition. Higher performing students were better able to recognize salient symptoms suggestive of deterioration in the patient's condition and were more expeditious intervening to improve the patient's physiological status.

Attention deficit/hyperactivity disorder: a review and update.

Attention deficit/hyperactivity disorder (ADHD) is a prevalent, chronic, and pervasive childhood disorder characterized by developmentally inappropriate activity level, impulsivity, and inability to sustain attention and concentration. Core symptoms of the disorder are associated with impairment in multiple domains of functioning and often coexist with other psychiatric disorders, the most prevalent being oppositional defiant disorder, conduct disorder, depression, and anxiety disorders. Concerns have been expressed about the overdiagnosis of ADHD, an upsurge in prescription of stimulant medication, and wide variations in practice patterns related to diagnosis and treatment of children with ADHD among primary care providers. Clinical research and expert consensus guidelines over the past decade have increasingly clarified the most effective approaches to diagnosis and treatment of the disorder. Hence, the purpose of this article was to provide primary care providers with the most current, evidence-based information on the assessment and treatment of children with ADHD.

Factors influencing decision-making regarding contraception and pregnancy among nursing students.

The current nursing shortage, now referred to as a 'global crisis', is having a widespread impact on health systems around the world. In view of the international nursing shortage, the retention and matriculation of nursing students who gain entry to nursing programs is a vital facet of nursing education that has broad ramifications. Although enrollment in higher institutions in the United States has increased in the last two decades; graduation rates have not increased at the same rate. Yet the impact of pregnancy on the progression and matriculation of what remains a female dominated nursing student population in her child bearing years has not been adequately addressed. This exploratory study used grounded theory methodology to identify and describe the decision-making processes and coping of African American nursing students who become pregnant. Five interrelated themes emerged from the data. Participants reported inconsistent use of contraceptives but experienced discovery of the pregnancy as highly traumatic. Participants also described the decision to keep the pregnancy as conflict-ridden and difficult as a result of family values and religious beliefs and ultimately driven by maternal support. Maternal and faculty support was central to successful coping and matriculation while in nursing school. With the changing profile of the nursing student, it is important for educational institutions to become more pregnancy friendly in their endeavors to retain and matriculate nursing students.

Using deconstruction to educate Generation Y nursing students.

Nurse educators are obligated to use creative strategies to educate a post-modern generation of students who possess distinct characteristics, particularly related to teaching and learning. The complexity of today's health care system, related to changing sociological factors and the differences in this generation, gives reason to tap into the strengths of this generation and consider how a postmodern perspective can influence nursing and nursing education. Derrida, to whom deconstruction is attributed, approached postmodern philosophy as a form of textual criticism. Deconstruction denotes a particular practice of reading, criticism, and analytical inquiry, factors that are important to nursing education. This article describes how deconstruction can be used to enhance nursing education of Generation Y students, and its application to reading comprehension and writing skills is explored.

Diet and child behavior problems: fact or fiction?

Dietary treatment of children with behavioral disorders has had wide public appeal and been a source of controversy since the 1920's. Yet, to date, there is little empirical evidence supporting the effectiveness of dietary restrictions in treating child psychiatric disorders, in particular, autism and attention deficit hyperactivity disorder (ADHD). Thus, the purpose of this article is (a) to provide historical background information regarding dietary treatment in children with behavioral disorders, (b) review the evidence-based literature for common dietary interventions, (c) discuss limitations in the research, including challenges inherent in conducting well-controlled dietary studies, and (d) provide recommendations regarding how nurses in primary care settings can assist families in making informed decisions.

Health Consumers eHealth Literacy to Decrease Disparities in Accessing eHealth Information.

The purpose of this study was to assess the perceived eHealth literacy of a general health consumer population so that health care professionals can effectively address skills gaps in health consumers' ability to access and use high quality online health information. Participants were recruited from three public library branches in a Northeast Florida community. The eHealth literacy scale (eHEALS) was used. The majority of participants (n = 108) reported they knew how and where to find health information and how to use it to make health decisions; knowledge of what health resources were available and confidence in the ability to distinguish high from low quality information was considerably less. The findings suggest the need for eHealth education and support to health consumers from health care professionals, in particular, how to access and evaluate the quality of health information.

Cognitions associated with nurse performance: a comparison of concurrent and retrospective verbal reports of nurse performance in a simulated task environment.

BACKGROUND: Cognitions represent the computations associated with human thought processes. Verbal protocols offer a method by which to record these processes. While concurrent and retrospective verbal reporting of cognitions have been used extensively within nursing and other domains, the use of this methodology in nursing has been characterized by inconsistencies in its application. OBJECTIVES: The primary objective of this study was to describe and compare the content of concurrent and retrospective verbal reports provided by nurses during and after administering care in a simulated task environment. DESIGN: The study utilized a laboratory based quasi-experimental research design. SETTING: The study was based in a simulation laboratory designed specifically for use in studies designed to measure nursing performance. The laboratory integrated extensive instrumentation that facilitated the comprehensive audio and video recording of participant actions. PARTICIPANTS: The participants (N=15) were recruited from a College of Nursing at a large university in the Southeastern United States. METHODS: Research participants were asked to admit a patient experiencing an acute exacerbation of congestive heart failure in a simulated task environment, during which they were required to prioritize and provide care. Participants were trained in the method for providing verbal reports of thoughts, and concurrent and retrospective report data were collected during and after the simulation exercise. The data were then coded for the purposes of descriptive analysis. RESULTS: The results indicated that the concurrent verbal reports provide a more complete representation of the cognitions of research participants providing care in a simulated task environment. However, the results reflect that additional unique data is present in the retrospective reports, exclusive of the concurrent reports. CONCLUSIONS: The findings support the utility of concurrent and retrospective verbal reports as a method of gathering data in studies that address nursing performance in a clinical context.

Down low sex, older African American women, and HIV infection.

The phenomenon of down low sex, wherein men involved in monogamous relationships with women seek extrarelationship sexual relations with men, has gained recognition in recent years. This study addressed the issue of down low sex in a group of African American women whose long-term sexual partners had become infected with HIV during extramarital sexual encounters with men. A grounded theory methodology was used to explore the experiences of 11 women in individual interviews that were sensitive to the intimate nature of their experiences. Themes shown in the data focused on (a) being betrayed and losing trust; (b) reflecting upon the features of the past relationship; (c) seeking the positive aspects of the past relationship; (d) being ashamed before God, community, and family; and (e) assuming the caregiver role and sharing the burden of illness. The study identified the strong influence of positive long-term relationships on life decisions of women following a diagnosis of HIV, despite the extrarelationship sexual activities of their partners.