Patients' perspectives on the role of prepared childbirth education in decision making regarding elective labor induction

The purpose of our study was to explore reasons why nulliparous women chose to have an elective labor induction and to identify the influence of prepared childbirth classes on their decision. The study included 1,349 nulliparous women at term who participated in a survey regarding their choices for childbirth, their attendance at prepared childbirth classes, and their experience with labor and birth. Sixty-three percent of women who attended childbirth classes and did not have elective induction reported that classes provided helpful information to assist in their decision-making process. Study results suggest attendance at prepared childbirth classes can be an effective source of information regarding elective labor induction and influential in women's decisions regarding whether or not to have elective labor induction. Women perceive prepared childbirth classes positively and find the information provided valuable.     

Understanding and supporting the motivation of students from low-income families

Motivational development in low-income adolescents has been insufficiently studied, due to the difficulties involved in accessing the target population. Nevertheless, previous research suggests that some specific developmental patterns might be particular to this group. On the basis of Self-Determination Theory (SDT) and using latent growth modeling (LGM), we investigated the trajectories of intrinsic and extrinsic motivations in low-income students during adolescence, and we identified the role of parents, teachers, and classmates in determining these trajectories. The participants were 228 adolescents (M_age = 12.8; SD_age = 1.74; 43.4% girls; 17.1% immigrants) officially certified by the Italian government as being below the poverty threshold. Data was collected by means of a four-wave research design over a period of two years.Our findings revealed a significant drop in levels of identified regulation over time, while all other forms of motivation, including intrinsic motivation, remained stable during the period considered. Low-income students therefore appear to experience a specific form of motivational decline during adolescence, so that they perceive studying as being less and less meaningful in relation to their goals, values and identities. This decline is even more pronounced for second-generation and male low-income adolescents.However, parents and teachers were significant predictors of identified regulation at each point in time, suggesting that their support for autonomy fosters identified regulation throughout adolescence. As regards the role of classmates, peer acceptance appears to support identified regulation, while having many friendships seems to have a negative impact on this kind of motivation.     

Factors associated with labor support behaviors of nurses

Labor support is known to support progress of normal labor. Nurses are encouraged to provide labor support yet may encounter barriers to the practice of labor support. The purpose of this secondary data analysis was to examine individual and institutional factors associated with labor support behaviors. Age and experience were individual factors related to labor support. Older and more experienced nurses reported providing more labor support. Institutional factors associated with labor support were lower rates of epidural analgesia use and cesarean surgery. These findings indicate birthing families should understand that the birth environment may influence the care that nurses give during labor. Choosing an environment that supports normal birth may be the best place for receiving labor supportive nursing care.     

The role of social support in well-being and coping with self-reported stressful events in adolescents

OBJECTIVE: This study investigated the role that social support plays in well-being and in coping after a stressful event in a group of non-clinical adolescents. Furthermore, this study aimed at replicating the finding that adolescents who reported sexual abuse reported more symptoms and less adequate coping strategies than adolescents who reported another type of stressful event or no stressful episode. METHOD: Eight hundred and twenty adolescents between 12 and 18 years of age filled out questionnaires assessing social support (Social Support Questionnaire, Sarason, Shearin, Pierce, & Sarason, 1987), trauma-related symptoms (Trauma Symptom Checklist for Children, Briere, 1996), behavior problems (Youth Self-Report, Achenbach, 1991), and coping (How I Cope Under Pressure Scale, Ayers, Sandler, West, & Roosa, 1996). RESULTS: 42% of the adolescents reported a stressful experience, and 4.4% reported sexual abuse. Sexually abused adolescents reported more stress-related symptoms and used more avoidance and fewer support-seeking coping strategies than the other adolescents. The main-effect hypothesis of social support was sustained, but social support did not moderate the relation between a stressful event and coping. Yet, a trend was found suggesting that high support from the family was associated with less avoidance coping and more support-seeking in adolescents who reported a non-sexually abusive, stressful event. CONCLUSIONS: Our findings show that a highly perceived availability of social support is directly associated with fewer trauma-related symptoms, especially in adolescents who are non-sexually abused. For adolescents who reported a sexual or another type of stressful event, social support did not play a different role in coping.     

Symptomatology in adolescents following initial disclosure of sexual abuse: The roles of crisis support, appraisals and coping

ObjectiveThe present study examined possible explanations for symptom development and variability in sexually abused adolescents. A theoretical model of sexual abuse, in which appraisal, coping and crisis support play prominent roles, was tested in a clinical group of 100 sexually abused adolescents.MethodParticipants, aged 12–18 years, completed questionnaires regarding severity of abuse, negative appraisals, crisis support, coping strategies, and trauma-related stress symptoms.ResultsSince severity of abuse had no influence on the association between appraisals and symptoms it was eliminated from our model. Structural equation modeling analyses showed a significant interrelationship between the examined concepts. Adolescents who appraised the abuse as more threatening showed more internalizing and externalizing trauma symptoms. Moreover, more negative appraisals were associated with more avoidance as well as with more active coping strategies. Direct crisis support was associated with less negative appraisals and with the use of more active coping strategies.ConclusionsThe study showed that especially the buffering role of crisis support and the role of negative appraisals explained symptom development and variety in sexually abused adolescents.Practice implicationsAdaptation to sexual abuse includes the ways in which adolescents perceive the event as threatening and harmful, how they cope with the abusive experience, and how they receive direct support from their family. Clinicians, therefore, need to expand the focus of their assessments beyond age- and trauma-specific symptoms, to age- and trauma-specific appraisals, coping, and social support. The assessment of these factors should take place as soon as possible after the disclosure of the abuse. Individualized treatment plans and clinical interventions need to be based on these personal and environmental variables, rather than reliance on the influence of abuse-related characteristics, such as the severity or type of abuse.     

Childhood physical and sexual abuse: prevalence and correlates among adolescents living in rural Taiwan

OBJECTIVE: The aims of this cross-sectional survey study were to examine the prevalence and correlates of childhood physical and sexual abuse in adolescents living in the rural areas of Taiwan. METHOD: A sample of indigenous (n=756) and non-indigenous (n=928) adolescents was randomly selected from junior high schools in the rural areas of southern Taiwan. Structured questionnaires were used to collect data anonymously. The prevalence of childhood physical and sexual abuse was examined and their correlates were examined using univariate and multivariate logistic regression. RESULTS: A total of 374 (22.2%) adolescents reported experience of physical abuse and 42 (2.5%) reported sexual abuse in their childhood. Multivariate logistic regression analyses revealed that the adolescents who perceived poor family function, frequent family conflicts and whose parents drank habitually were more likely to experience physical abuse. The adolescents who were indigenous and perceived frequent family conflicts were more likely to experience childhood sexual abuse. Further analyses indicated that indigenous boys had a higher risk of being the victims of sexual abuse than non-indigenous boys, while no difference was found between indigenous and non-indigenous girls. CONCLUSION: The results remind clinical workers of the importance of taking abuse histories from adolescents on a routine basis, and this is especially important in the case of dysfunctional families. PRACTICE IMPLICATIONS: Adolescents who live in rural areas have less social and medical resources for early detection and intervention of physical and sexual abuse. Correlates of physical and sexual abuse identified in this study may be helpful for the design and implementation of preventive intervention.     

Selling normal birth: six ways to make birth easier

In this column, a reader expresses concern at the declining number of women attending childbirth classes and her inability to influence a woman's decision to choose normal birth. It may be more effective to market Lamaze as a way to have an easier birth rather than a normal birth. The six care practices that promote, support, and protect normal birth are suggested as a framework for teaching Lamaze classes with the goal of having an easier labor and birth.     

Peer attachment, coping, and self-esteem in institutionalized adolescents: the mediating role of social skills

This study analyzes the contribution of peer attachment in predicting active coping and self-esteem in a sample of 109 institutionalized adolescents. It also explores the mediating role of social skills in the association between peer attachment, coping, and self-esteem. Structural equation modeling identified a model able to predict a positive and direct contribution of peer relationships on self-esteem. Results confirmed the mediating role of social skills but only between quality of peer attachment and the development of active coping. From an ecological perspective, quality of relationships with significant peer figures can contribute to the development of a secure base, especially in adolescents without family support. Consequently, institutionalized adolescents who perceive quality in their peer relationships seem to be more able to express their feelings and ideas. As a result, they can become able to establish positive and empathic relationships with others, which can lead to the development of active coping skills. The quality of peer relationships can also increase the self-esteem of these adolescents because they feel they have a source of personal support and can share their difficulties.     

An Exploration of Themes That Influence the Counselor Education Doctoral Student Experience

The purpose of the present study was to explore the themes that counselor education doctoral students perceive as influencing their experience. The results of an exploratory qualitative study in which counselor education doctoral students provided their perceptions of what helped or hindered their progress are presented. Themes identified as both positively and negatively influencing their experiences were departmental culture, mentoring, academics, support systems, and personal issues. Recommendations are provided for counselor educators to consider in their work with doctoral students.     

Examining Online Instruction in Undergraduate Nursing Education

Web-based courses have increased in number as one of the primary modes of distance education in undergraduate nursing programs across the United States. An online survey of 171 nursing faculty in the United States with experience teaching Web-based courses served as the primary data source. Interviews and a review of course Web sites provided additional comparative information. Results of this study indicated online faculty spent significantly more time in planning and implementing a Web course than they did a traditional course. Despite this time commitment respondents perceived the teaching experience to be a successful and effective form of instruction that they felt could be used to deliver any type of nursing course. The online teaching experience was described as both collaborative and highly interactive. Most respondents indicated they preferred online teaching to traditional face-to-face instruction. This positive reaction to teaching online supports the future viability of Web-based instruction at colleges of nursing.     

Do not disturb: the importance of privacy in labor

In nature, when a laboring animal feels threatened or disturbed, the stress hormone catecholamine shuts down labor. Similarly, when a laboring woman does not feel safe or protected or when the progress of her normal labor is altered, catecholamine levels rise and labor slows down or stops. This column discusses the importance of providing labor support that respects the woman's privacy, protects her from unnecessary interventions, insures her safety, and allows her to trust her inherent ability to give birth normally.     

Dropping out of school as a meaningful action for adolescents with social,emotional and behavioural difficulties

This study examines and discusses dropping out of school related to adolescents with social, emotional and behavioural difficulties (SEBD). It is based on in‐depth interviews of 10 adolescents between the ages of 16 and 20, three girls and two boys with internalised problems, and two girls and three boys with extroverted behavioural problems. Given this group of students' challenges at school, the aim of this paper is to explore the narratives of this adolescent group as they relate to the significance they attach to their dropout behaviour. An additional objective is to draw attention to what these findings are likely to mean for implementing preventive practices in school. Results show that adolescents with SEBD perceive a non‐supportive classroom environment to be a primary explanation for why they are dropping out from school. Additionally, lack of support from teachers and parents and family problems are, according to the adolescents, an important reason for dropping out. Findings are discussed in relation to future implications for this group of adolescents in the context of school.     

护理劳作课程的实践和探索

借鉴台湾高校劳作课程的实施经验结合护理专业的人才培养目标和本校仿真医院的具体情况．制定护理劳作课程的实施内容、评价标准和实施方案,总结护理劳作课程的理论支撑和实施目的意义。     

Pathway to success: using students’ insights and perspectives to improve retention and success for university students from low socioeconomic (LSE) backgrounds

In an increasingly complex landscape of diversification and massification, universities are grappling with challenges of student attrition. This paper presents findings from a project investigating how students from low socio-economic backgrounds at a regional Australian university perceive challenges and supports associated with retention and success. Twenty-seven students received intensive one-to-one support from a Faculty-embedded ‘academic advisor’, and reflected on this support, their overall student experience, and strategies to enhance student success. Students identified a range of challenges that they experienced across an academic year (personal circumstances, lack of preparedness for university study, timely access to support, course/programme difficulties) and what worked well for them (academic advisor, University support services, growing confidence in self as competent student, peer support). A range of strategies for enhancing student success were identified by students, namely consistency across teaching design and delivery, transparency of delivery modes, mandatory orientation, access to a dedicated academic advisor, and increased peer connectedness. The applicability and viability of the proposed strategies within current higher education settings are explored.     

Perceptions of learning-support teachers and resource teachers of each other's role in Irish primary schools

This article reports findings from an exploratory study of how learning support and resource teachers perceive each other's role. The study was conducted during the debate on the proposed changes to allocation and deployment of support teachers, following the publication of Circular 24/03 by the Department of Education and Science. It sought to test the hypothesis that learning-support and resource teachers perceive each other's roles differently in terms of their distinctiveness, type of children they support, working arrangements and training. The findings confirmed this and the implications of this for more whole-school collaborative models of support are discussed.     

Hearing mothers and their deaf children: the relationship between early, ongoing mode match and subsequent mental health functioning in adolescence

In the few studies that have been conducted, researchers have typically found that deaf adolescents have more mental health difficulties than their hearing peers and that, within the deaf groups, those who use spoken language have better mental health functioning than those who use sign language. This study investigated the hypotheses that mental health functioning in adolescence is related to an early and consistent mode match between mother and child rather than to the child's use of speech or sign itself. Using a large existing 15-year longitudinal database on children and adolescents with severe and profound deafness, 57 adolescents of hearing parents were identified for whom data on language experience (the child's and the mother's) and mental health functioning (from a culturally and linguistically adapted form of the Achenbach Youth Self Report) was available. Three groups were identified: auditory/oral (A/O), sign match (SM), and sign mismatch (SMM). As hypothesized, no significant difference in mental health functioning was found between the A/O and SM groups, but a significant difference was found favoring a combined A/O and SM group over the SMM group. These results support the notion of the importance of an early and consistent mode match between deaf children and hearing mothers, regardless of communication modality.     

Experimenting with global governance: understanding the potential for generational change

The appropriate role for the United Nations in international dispute resolution is a matter of high profile discussion and controversy. This paper begins with this ambivalence about the appropriate role for the United Nations in the world and examines several sets of issues that relate to the future of support for the UN within the US and the prospects for global governance more generally. First, we briefly review two thematic strands in previous and contemporary scholarship:(1) arguments for increased global governance in contemporary world affairs, driven by perceptions of the changing nature of the political, social, economic and military challenges in the contemporary world system. This debate is also put in the context of the relevance of public support for global governance institutions; and (2) why it is valuable to study how the current generation of adolescents perceive issues of global governance and the impact that their views may have on that nexus in the coming years. We then move to an analysis of data generated from an experimental study of American adolescents and their attitudes toward global governance.