The Association Between Sexual Initiation and Membership in Dyadic Profiles of Perceived Shared Power.

There is scarce empirical evidence examining whether sexual initiation and power are associated with each other. Utilizing latent profile analyses, we examined in a nationally representative sample of US newlywed heterosexual couples (N = 1,948 couples) whether wives' and husbands' sexual initiation patterns and satisfaction with these patterns were associated with membership in different profiles of wives' and husbands' perceptions of shared relational power while accounting for both partner's satisfaction with sexual frequency. We found four profiles of wives' and husbands' perceptions of power. The most common profile was when both wives and husbands perceived high levels of power compared to other profiles, but wives had significantly higher reports of perceived power than husbands (High Power, Wife Higher; 40.8%). Husbands' sexual initiation patterns were not associated with profile membership. Wives who reported equal sexual initiation patterns had a higher probability of being in the High Power, Wife Higher profile compared to the Wife Low Power, Husband Moderate Power profile. Both wives' and husbands' satisfaction with sexual initiation patterns were associated with profile membership. Wives and husbands that were satisfied with sexual initiation patterns had a higher probability of being in the High Power, Wife Higher profile compared to the profile where both wives and husbands had high perceptions of shared relational power compared to other profiles, but their scores were not significantly different from each other (High Power, Equal).

Religiosity, sexual behaviors, sexual motivations, and gender: A three-year longitudinal study.

Longitudinal data are critical for examining associations of religiosity with sexual behaviors and motivations during college. We use hierarchical linear modeling on five semesters of data from a diverse sample of college students (N = 735) to examine within- and between-person associations between religious service attendance and importance of religion and sexual behaviors and motivations for and against sex and consider gender as a moderator. Between-person religiosity was associated with sexual behaviors and motivations whereas within-person religiosity was not. Students' sexual motivations co-varied across semesters with their religious service attendance and importance of religion. Our results indicated more restrictive associations between religiosity and sexual motivations for women than for men.

Is Kissing a Bellwether of Sexual and Relationship Satisfaction and Dissatisfaction?

In this study we explored how the amount of kissing during the most recent sexual experience (specific kissing) and amount of kissing during the last year (global kissing) were both associated with the quality of the sexual relationship and overall relationship satisfaction and dissatisfaction. To understand these associations, we obtained surveys from a national sample of 878 participants who had been in a romantic relationship for at least two years. We evaluated their results through a structural equation model and found that for women the rates of specific kissing were associated with their ability to orgasm, sexual frequency, and indirectly to sexual satisfaction. For both men and women, measures of global kissing were associated with both sexual and relationship satisfaction but more strongly with measures of sexual and relationship dissatisfaction. These findings suggest that measures of kissing could be used as a bellwether of both the quality of the sexual relationship for women and of feelings of dissatisfaction about both the sexual and overall relationship for both sexes.

Communication strategies for nursing research with older adults diagnosed with schizophrenia using life course theory.

PURPOSE: To explore effective communication strategies that may be used to promote efficacious research with older adults diagnosed with schizophrenia. DESIGN: A theoretical framework of Life Course Theory was used to examine the problems of communicating in research settings with older adults diagnosed with schizophrenia and present potential effective solutions to these problems. METHODS: Using Life Course Theory as an underpinning, a literature review was conducted regarding communication strategies/methods commonly used in psychiatric nursing. This paper deductively presents how these strategies/methods could theoretically improve nursing research with older adults diagnosed with schizophrenia. RESULTS: Four main potential effective strategies for communication with older adults diagnosed with schizophrenia in nursing research were identified which were (1) giving space; (2) shortened intervals; (3) the use of simple, meaningful phrases; and (4) showing engagement. CONCLUSIONS: Older adults diagnosed with schizophrenia may be given more opportunities to share their input regarding their perceptions and valuable input regarding health care systems if these effective strategies of communication are used when conducting nursing research. CLINICAL RELEVANCE: There is a need to gain more information regarding the perceptions of older adults diagnosed with schizophrenia as they are living longer and are entering into a health care system that is often at a quandary as to how to best care for them. The strategies delineated in this paper are part of an ongoing project to co-develop a model with older adults diagnosed with schizophrenia specifically tailored to improve their health outcomes and quality of life.

Missing Piece of the Puzzle: Evaluating a General Meaning of Sex Measure.

The presence of and search for meaning has divergent and salient outcomes for individuals' physical, mental, and emotional well-being. Although numerous domains of meaning have been examined, the literature on the meaning of sex is sparse and lacks a quantitative measure. In this study, we evaluated a new general Meaning of Sex (MOS) Measure that captured the presence of (MOS-P) and search for (MOS-S) the meaning of sex by analyzing how these subscales were associated with important relational and sexual outcomes (i.e., relationship stability and satisfaction and sexual satisfaction) in two samples. For Sample 1, all participants (N = 865) reported engaging in what they considered to be sexual intercourse and were either single or in a relationship. For Sample 2, all participants (N = 884) reported being in a committed relationship for at least two years. With both samples, confirmatory factor analyses showed good construct validity as the two subscales were distinct from one another and had good reliability. The analyses also demonstrated divergent validity between both scales and meaning in life, sexual motivations, sexual beliefs, and religiosity. The MOS-S had a strong (and negative) association with relationship stability in both samples. The MOS-P had a strong (and positive) association with relationship satisfaction in both samples.

La presencia y la búsqueda de significado tiene consecuencias divergentes y prominentes para el bienestar físico, mental y emocional de las personas. Aunque se han analizado varios componentes de significado, la bibliografía sobre el significado del sexo es escasa y carece de un instrumento de medición cuantitativo. En este estudio, evaluamos un nuevo instrumento general de medición del significado del sexo que captó la presencia y la búsqueda del significado del sexo analizando cómo estas subescalas estuvieron asociadas con resultados sexuales y relacionales importantes (p. ej.: la estabilidad y la satisfacción en la relación y la satisfacción sexual) en dos muestras. En la muestra 1, todos los participantes (N = 865) informaron participar en lo que consideraron relaciones sexuales y estaban solteros o en una relación. En la muestra 2, todos los participantes (N = 884) informaron estar en una relación de pareja estable durante al menos dos años. Con ambas muestras, los análisis factoriales confirmatorios indicaron una buena validez de constructo, ya que las dos subescalas eran distintas entre sí y tenían buena fiabilidad. Los análisis también indicaron una validez divergente entre ambas escalas y el significado en la vida, las motivaciones sexuales, las creencias sexuales y la religiosidad. La búsqueda del significado del sexo tuvo una asociación fuerte (y negativa) con la estabilidad de la relación en ambas muestras. La presencia del significado del sexo tuvo una asociación fuerte (y positiva) con la satisfacción en la relación en ambas muestras.

Pursuing Well-Being Among Rural-Dwelling Adults With Disabilities.

Through this constructivist grounded theory study, it was our purpose to create a substantive theory to explain how rural-dwelling, working-age adults with disabilities define and pursue well-being. Twelve rural-dwelling participants were interviewed up to 3 times to understand the processes involved in defining and pursuing well-being. From this exploration, we suggest that well-being is not a set state to be achieved and then enjoyed, rather well-being results from establishing and maintaining membership in the rural community. Membership facilitated access to the array of material and psychological supports needed for a sense of well-being. Findings support the assumption that urban models of care are insufficient for rural areas. This study also provides an understanding of how individuals in this population mobilize resources to overcome functional limitations and environmental barriers to establish group membership and create a sense of well-being. Implications for health care practice and policy are discussed.

Exploration of the Influence of Factors Identified in the Literature on School-aged Children's Emotional Responses to Asthma.

Approximately 6.3 million US children suffer from asthma. The purpose of this study was to explore factors on school-aged children's emotional responses to asthma, N=85, ages 6-12. Correlations included Asthma related child emotional functioning QOL and (a) asthma severity, r=-0.30, p<0.01, (b) child internalizing behaviors, r=-0.26, p<0.05, (c) child externalizing behaviors r=-0.43, p<0.001; Caregiver emotional functioning QOL and (a) asthma severity, r=-0.39, p<0.001, (b) child internalizing behaviors, r=-0.22, p<0.05, (c) child externalizing behaviors, r=-0.25; p<0.05. Multiple regression analysis revealed that asthma severity and child externalizing problems accounted for 26% of the variance in asthma related child emotional functioning QOL, F (4, 79)=7.051, p<0.001 (asthma severity, ß=-0.31, p<0.01; child externalizing problem behaviors, ß=-0.43, p<0.001). Findings imply that asthma research should consider problem behaviors of school-aged children when addressing asthma related emotional functioning QOL.

Life Course Perspectives of Aging With Schizophrenia Spectrum Disorders in Psychiatric and Long-Term Care Facilities.

BACKGROUND AND OBJECTIVES: Individuals with schizophrenia spectrum disorders must manage residual symptoms as they age, and they may experience premature or accelerated aging in comparison with those without their diagnosis. To explore their life course perspectives, we interviewed institutionalized adults aging with schizophrenia spectrum disorders in middle and older age. RESEARCH DESIGN AND METHODS: We used an exploratory descriptive design and qualitative methods. Participants answered semistructured, open-ended questions about perceptions of their mental illness along the life course. RESULTS: Participants (N = 30, age 45-83 years) were from an acute care psychiatric facility and a long-term care facility: 16 (53%) men, 14 (47%) women; 6 (20%) Hispanic, 10 (33%) African American, 14 (47%) non-Hispanic White. Participants' life course included traumas from violence, homelessness, and stigma; psychiatric symptoms such as worry and sadness; and age-related physiological symptoms including illness, loss of strength, falls, and incontinence, with falls and incontinence reported only in long-term care. Aging within institutionalization included lack of privacy and autonomy, and isolation (less socialization). Participants provided insights for potential improvements. DISCUSSION AND IMPLICATIONS: Because these aging adults are experts on their own care, researchers should continue to seek their input to inform their healthcare.

Is the association of sexual quality with relationship satisfaction really stronger when the sexual relationship is functioning poorly?

The purpose of this article is to bring empirical evidence to the oft-quoted assumption that sexual quality has a stronger association with the overall relationship when sexuality is dysfunctional as compared to when it is optimal. Using three national samples to analyze a structural equation model, the results verified this assumption with some adaptations. There was an interaction between the association of sexual quality and the overall relationship depending on how sexually satisfied couples were in the sexuality area. However, it was when sexuality was only moderately satisfying rather than at high or low levels that it had the strongest associations with relationship satisfaction. Also, female sexual quality had a significant association with both partner's relationship satisfaction whereas male's sexual quality only had actor effects. Additionally, the sexual relationship had a stronger association with relationship satisfaction and dissatisfaction for couples who reported both low levels of sexual satisfaction and dissatisfaction.

Orgasm Consistency in Mixed-Gender Couples: Actor, Partner, and Discrepancy Effects from Dyadic Response Surface Analysis.

The potential link between orgasm consistency (i.e., the percentage of time an individual experiences orgasm during sexual interactions with a partner) and sexual satisfaction in mixed-gender sexual relationships remains underexamined in the literature. We combined two dyadic samples (N = 725 couples) and utilized Dyadic Response Surface Analysis (DRSA) to examine how both partners' orgasm consistency and their discrepancy of orgasm consistency predict both partners' sexual satisfaction. We found that partners' discrepancy in orgasm consistency was not uniquely connected to higher sexual satisfaction for either women or men; rather, the overall consistency of orgasm was connected to better sexual satisfaction for both partners. In addition, there was some evidence tentatively suggesting that men were more likely than women to report lower sexual satisfaction if his partner was orgasming more consistently than he was, as opposed to her reporting lower sexual satisfaction from him orgasming more consistently than she was; though this appears to be a rare scenario as only 5.9% of couples had women who orgasmed more consistently than men. This study may assist educators and clinicians as they help couples consider the sexual scripts surrounding orgasm consistency, and how they can attend to each others' desires in a way that maximizes sexual satisfaction for both partners.

Minority caregivers' emotional responses and perceptions of the emotional responses of their children to asthma: comparing boys and girls.

Approximately 7.1 million children in the US suffer from asthma. An exploratory qualitative study using a stratified purposive sampling method was conducted. The sample included four Latina and four African American female caregivers of children (ages 6-12) who had asthma. Caregivers were asked open-ended questions about perceptions of their children's emotional responses to asthma. Major themes and subthemes were identified with content analysis. Sons were reported as quiet when experiencing asthma. Daughters were described as being verbal, worried, excited. A question from the study was whether the children's responses were related to caregivers' (a) actions, (b) responses to asthma, and/or(c) race/ethnicity.

An Online Mindfulness-based Intervention for Certified Nursing Assistants in Long-term Care.

Purpose: Certified nursing assistants (CNAs) make up the largest segment of the long-term care (LTC) setting workforce, however, they are at high risk of job dissatisfaction and burnout. Evidence suggests that mindfulness-based interventions (MBIs) might be particularly relevant and useful for CNAs in reducing psychological distress, improving job satisfaction, and reducing burnout, but little research has investigated this possibility. A feasibility study of an online MBI for CNAs in LTC settings was therefore conducted. Methods: CNAs completed assessments at baseline and posttest. Paired t-tests assessed changes in mindfulness, psychological distress (i.e., depressive and anxiety symptoms, and stress), and professional quality of life. Results: Of the 19 CNAs who started the intervention, N = 13 (68%) completed it and provided postintervention data. Depressive symptoms were significantly decreased postintervention (F = 6.26, p = .036, d = .47). Conclusions: MBIs may have beneficial effects for CNAs in LTC settings. Further research with a larger CNA population will increase the power and relevance of these findings, ultimately contributing to the improvement of patient outcomes in LTC.

The Conceptualization and Measurement of Sexual Self-Concept and Sexual Self-Schema: A Systematic Literature Review.

Sexual self-concept and sexual self-schema are multidimensional constructs critical to developing a more holistic theoretical understanding of the sexual self. With an increased amount of research exploring these constructs over the past few decades, a systematic review was warranted to highlight next steps for future research in this area. Therefore, utilizing a staged systematic review, we aimed to explore how these parallel concepts are measured and among which populations they are used. The evaluation of 236 unique manuscripts published 1990-2020 revealed the use of 38 established or constructed measures of sexual self-concept, and 16 established or constructed measures of sexual self-schema. Three distinct measures were used in more than one-fifth of the studies reviewed, although the use of full-form measures vs. subscales differed across studies. Although there was diversity in the samples used in the studies reviewed, these studies were conducted most commonly with samples consisting of individuals who were primarily, if not solely, cisgender, women, heterosexual, White, non-college attending, U.S. residents, and/or had no unique characteristics identified (e.g., cancer patient/survivor, pregnant). The largest proportion of studies reviewed examined sexual self-concept during emerging adulthood, followed by early adulthood and middle adulthood. Suggested directions for future research in this area include (a) reexamining and testing how current measures are capturing these constructs and among whom; (b) expanding samples to include and/or target specifically gender, sexual, and racial/ethnic minoritized groups as well as individuals with unique characteristics that would affect sexual well-being; and (c) utilizing samples in childhood, adolescence, and late adulthood.

LGBTQ+ College Students' Relationship Satisfaction During the COVID-19 Pandemic.

Research suggests that COVID-19-related restrictions affected individuals' ability to engage in relationship maintenance behaviors and have led to poorer romantic relationship quality. Poor relationship quality may be especially problematic for lesbian, gay, bisexual, transgender, queer or questioning, and otherwise non-heterosexual or-cisgender (LGBTQ+) college students, who often lack family support and are at greater risk for mental health issues. We used a social exchange theory lens to examine correlates of relationship satisfaction for LGBTQ+ college students during the early months of the pandemic. The analytic sample consists of 175 LGBTQ+ students (Mage = 20.5) who completed an online survey and reported being in a romantic relationship. Our findings demonstrate that LGBTQ+ students with more supportive partners were more satisfied with their relationships. These results can inform clinicians how to better support LGBTQ+ college couples when they experience relationship stress.

Black Sexual Minority Men's Stigma-Based Experiences Surrounding Pre-exposure Prophylaxis in the Southern United States.

Purpose: Intersecting experiences of stigma related to pre-exposure prophylaxis (PrEP) influence PrEP uptake among Black sexual minority men (BSMM) living in the southern United States; however, it is unclear what stigmatized identities and behaviors are impacted when accessing human immunodeficiency virus prevention options. To inform identity-specific PrEP interventions, this study examined stigma in BSMM's lives relating to intersecting experiences of PrEP stigma. Methods: We conducted 32 virtual, semistructured qualitative interviews with BSMM residing in the southeastern United States between February and April 2019. Results: We identified three themes (anticipated stigma, experiences of prejudice and stereotyping, and negative attitudes) and one subtheme within negative attitudes (othering social/sexual groups). Across all themes, PrEP stigma was often manifested through stigma against BSMM's sexual orientation or sexual behavior. BSMM in othering social/sexual groups displayed instances of cognitive dissonance by regularly expressing negative attitudes about and explicitly distancing themselves from social/sexual groups based on sexual orientation and sexual behavior. BSMM's race and gender were rarely mentioned as being stigmatized. Conclusions: Interventions focused on PrEP use could benefit from expanding their definition of PrEP stigma to include a stronger emphasis on intersecting identities and work to reduce cognitive dissonance in BSMM in the form of internalized homophobia.

"This Is To Help Me Move Forward": The Role of PrEp in Harnessing Sex Positivity and Empowerment Among Black Sexual Minority Men in the Southern United States.

In the United States (U.S.), Black sexual minority men (BSMM) are disproportionately burdened by HIV. Prevention advances, such as HIV pre-exposure prophylaxis (PrEP), play a key role in reducing HIV transmission and improving our understanding of sexual expression and health. Despite these advances, little is known regarding the potential link between PrEP use and positive sexuality, including the benefits that BSMM see in accessing PrEP. We conducted a thematic analysis of 32 interviews with BSMM in the Southern U.S. regarding their PrEP beliefs. We developed five themes: (1) Sexual freedom, (2) Agency and empowerment, (3) Making PrEP normative, (4) Behavioral health practices, and (5) Committed relationship tensions. Our findings suggest that BSMM are increasingly concerned about freedom of choice and invested in sexual empowerment as related to their PrEP use. Further, unanticipated benefits, community support, and relationship tensions are salient factors in considerations of PrEP use among BSMM. These findings have implications for how we might understand a broader movement toward sexual empowerment and positivity, and the pivotal role that PrEP serves in this movement.

Is rural school-aged children's quality of life affected by their responses to asthma?

The unpredictable nature of asthma makes it stressful for children and can affect their quality of life (QOL). An exploratory analysis of 183 rural school-aged children's data was conducted to determine relationships among demographic factors, children's responses to asthma (coping and asthma self-management), and their QOL. Coping frequency, asthma severity, and race/ethnicity significantly predicted children's asthma-related QOL. Children reported more frequent coping as asthma-related QOL worsened (higher scores). Children with more asthma severity had worse asthma-related QOL. Post hoc analyses showed that racial/ethnic minorities reported worse asthma-related QOL scores than did non-Hispanic Whites.

Factors related to emotional responses in school-aged children who have asthma.

A systematic review of the literature was performed to answer the following questions (a) What factors contribute to the emotional responses of school-age children who have asthma? (b) What are the potential gaps in the literature regarding the emotional responses of school-age children (ages 6-12) who have asthma? (c) Are children with a lower socioeconomic status (SES) and those who are minorities represented in the literature proportionate to their prevalence? Two main focus areas regarding emotional responses were identified: (a) factors related to children who have asthma and (b) factors related to caregivers of children who have asthma. Internalizing disorders were reported consistently for children and caregivers of children who have asthma. Negative consequences of asthma for children included panic and asthma attacks, missed school days, and behavioral problems. Issues for caregivers included higher levels of anxiety and depressive symptoms, asthma management deficits, and lower caregiver warmth and involvement. Gaps in the literature included separated studies for children ages 6-12, a lack of a standardized method to define SES, studies that were of a more experimental nature, and a disparate number of studies of minority children and caregivers relative to their asthma prevalence.

Elder's life course theory and person-centered research: A lens for conducting ethical nursing research and mental health nursing practice with older adults aging with the diagnosis of schizophrenia.

INTRODUCTION: Older adults diagnosed with schizophrenia are a vulnerable population owing to the manifestations of their illness, which can include decreased reality orientation, paranoia, hallucinations and delusions. This paper presents ethical principles of vulnerability, veracity, non-maleficence and autonomy for person-centered care in mental health nursing research and practice, focused with the lens of Elder's life course theory (LCT). AIM: To present Elder's LCT as an ethical lens for person-centered care as nurses engage with older adults aging with the diagnosis of schizophrenia in clinical practice and/or research. METHOD: Four ethical principles fundamental to nursing research and mental health practice are presented, with Elder's LCT as a theoretical lens for person-centered care. RESULTS: A model for ethical research and mental health practice with older adults diagnosed with schizophrenia. DISCUSSION: Nursing research and mental health nursing practice with an ethical LCT lens for person-centered can help nurses envision, explore and generate interventions to address the special needs of older adults aging with schizophrenia. IMPLICATIONS FOR PRACTICE: The use of a LCT lens for person-centered care can encourage nurses in research and mental health practice to seek information collaboratively with older adults diagnosed with schizophrenia in a thoughtful, ethical manner, to inform the improvement of their health outcomes and health policy.

Older Adults Diagnosed With Schizophrenia in Long-term Care Facilities: Life Course Theory for Holistic Nursing Research and Practice.

Older adults diagnosed with schizophrenia (OADWS) often enter long-term care facilities with unique challenges related to trauma and stress experienced throughout their life course. Health care workers often report that when they work with this population, they feel unprepared due to limited training. In this article, life course theory is presented as a lens for holistic nursing research and as a way for nurses to adapt interventions already used with cognitively impaired older adults (e.g., those diagnosed with Alzheimer's disease) for OADWS in long-term care. It is hoped that these ideas will facilitate discussion of ways to inform training for holistic long-term care of OADWS. Holistic principles of nursing addressed with life course theory as a lens include the following: (a) accounting for strengths and challenges; (b) honoring experiences, values, and health beliefs; (c) viewing interrelationships with the environment; and (d) nurturing of peace, wholeness, and healing.