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Clinical Judgment Development: Six Steps to Establish Professional Identity and Role-Specific Competencies in Caring for a Sexual Assault Survivor

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Health 2022年第1期14卷 23-37页

作者： rose eva constantino Larissa C. Allen Vivian Hui Kelly M. Nitowski Brayden Kameg Amy S. Bowser Rebecca Burkart Betty Braxter Department of Health and Community Systems School of Nursing University of Pittsburgh Pittsburgh Pennsylvania USA School of Nursing University of Pittsburgh Pittsburgh Pennsylvania USA

Background: Clinical judgment is a specific role that establishes a professional identity. The purpose of this paper is to prepare nursing students to make better judgments in the clinical setting and realign learning and teaching. Methods: We used six steps to arrive at a competent clinical judgment suggested by the National Council State Board of Nursing (NSCBN) as a clinical judgment model 1) recognizing cues, 2) analyzing cues, 3) prioritizing hypotheses, 4) generating solutions, 5) taking an action, and 6) evaluating outcomes during the head-to-toe examination of the patient. Results: The primary outcomes are stabilization of the hemodynamics of the patient and prevention of further blood loss. Fluids are being given to help keep the vascular volume from being depleted, but they cannot solve the underlying problem. Continued assessment, intervention, and monitoring of vital signs through the course of the hospital stay ending with the patient’s discharge. Discussion: Survivors of sexual assault are unique for a nurse to provide care. The nurse needs to assess, intervene, monitor, and pay attention to detail of the 6 steps to clinical judgment, resulting in positive outcomes for their patient. Conclusions: Forensic nursing is a field of nursing that focuses on sexual assault survivor care and works to make the aftermath of their tragic situation easier to cope with. Strengthening clinical judgment skills could remedy significant mistakes made by novice forensic nurses. Critical thinking and clinical ethical reasoning are the building blocks of clinical judgment.

关键词： Analyze Cues Clinical Judgment evaluate Outcomes Generate Solutions Prioritize Hypotheses Recognize Cues

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Is Intimate Partner Violence a Risk Factor for Cardiovascular Disease in Women? A Review of the Preponderance of the Evidence

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Health 2019年第6期11卷 841-854页

作者： rose eva constantino Alona D. Angosta Andrew Thomas Reyes Brayden Kameg Linden Wu Jordan Cobb Vivian Hui Daisy Palompon Reema Safadi Mayada Daibes Elizabeth Schlenk Department of Health and Community Systems School of Nursing University of Pittsburgh Pittsburgh USA School of Nursing University of Nevada Las Vegas Las Vegas USA School of Nursing Cebu Normal University Cebu City Philippines School of Nursing University of Jordan Amman Jordan Philadelphia University Amman Jordan

This paper examines the relationship between intimate partner violence (IPV) experience in women and cardiovascular disease (CVD), and determines if there is a preponderance of literature evidence. Research is reviewed dealing with the different biopsychosocial factors affecting the relationship between IPV and CVD. As a result of our review, we propose a framework on the biopsychosocial pathway of IPV as a risk factor of CVD of women. Our proposed framework portrays how IPV experiences contribute to long-term biopsychosocial changes that increase the risk of CVD among female victims of IPV. These biopsychosocial changes include chronic inflammation and hypothalamus-pituitary-adrenal axis dysfunction, metabolic or endocrine dysfunction, and mood symptomatology. In our framework, we also included strategies to prevent risks in developing CVD through the three levels of prevention. Because gender disparities exist when examining CVD risk and development, the correlation between IPV and CVD risk in women must be explored. This framework may provide a theoretical foundation for further research on the relationship between IPV and CVD among women.

关键词： Intimate Partner Violence Cardiovascular Disease Women

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Resilience, the 6th Vital Sign: Conceptualizing, Contextualizing, and Operationalizing All Six Vital Signs

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Health 2024年第7期16卷 657-673页

作者： rose E. constantino Betty J. Braxter Chi Ching Vivian Hui Larissa C. Allen Lillian J. Wolfe Katherine H. Endres Jezyl Cempron Cutamora Laurence L. Garcia Daisy R. Palompon Kathleen Thimsen Brayden N. Kameg Margarete L. Zalon Department of Health and Community Systems School of Nursing University of Pittsburgh Pittsburgh PA USA Undergraduate Affairs School of Nursing University of Pittsburgh Pittsburgh PA USA The Hong Kong Polytechnic University Hong Kong China School of Nursing Adjunct Faculty at the University of Pittsburgh Pittsburgh PA USA School of Nursing University of Pittsburgh Pittsburgh PA USA Department of Health Promotion and Development School of Nursing University of Pittsburgh Pittsburgh PA USA College of Nursing Cebu Normal University Cebu City Philippines School of Nursing University of Nevada Las Vegas USA Department of Health and Community Systems University of Pittsburgh PA USA Department of Nursing University of Scranton Scranton PA USA

There are five vital signs that healthcare providers assess: temperature, pulse, respiration, blood pressure, and pain. Normal levels for the five vital signs are published by the American Heart Association, and other specialty organizations, however, the sixth vital sign (resilience) which adopts the measure of immune resilience is suggested in this paper. Resilience is the ability of the immune system to respond to attacks and defend effectively against infections and inflammatory stressors, and psychological resilience is the capacity to resist, adapt, recover, thrive, and grow from a challenge or a stressor. Individuals with better optimal immune resilience had better health outcomes than those with minimal immune resilience. The purpose of this paper is to conceptualize, contextualize, and operationalize all six vital signs. We suggest measuring resilience subjectively and objectively. Subjectively, use a 5-item guided interview revised from the Connor-Davidson Resilience Scale (CDRC), a scale of 10 items. The revised CDRC scale is a 5-item scale. The scale is rated on a 5-point Likert scale from 0 (not true) to 4 (true all the time). The total score ranges from 0 to 20, with higher total scores indicating greater resilience. The scale demonstrated good construct validity and internal consistency (α = 0.85) during the development of the scale. The CD-RISC had a good Cronbach’s alpha level of 0.85. The Revised CD-RISC can be completed in 2 - 4 minutes. To measure resilience objectively, we suggest using Immune Resilience (IR) levels, the level of resilience to preserve and/or rapidly restore immune resilience functions that promote disease resistance and control inflammation and other inflammatory stress. IR levels are gauged with two peripheral blood metrics that quantify the balance between CD8 and CD4 T-cell levels and gene expression signatures tracking longevity-associated immunocompetence and mortality- or entropy-associated inflammation. IR deregulation i

关键词： Conceptualization Contextualization Operationalization Body Temperature Pulse Respiration Blood Pressure Pain Resilience

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Barriers and Promoting Strategies to Sexual Health Assessment for Patients with Coronary Artery Diseases in Nursing Practice: A Literature Review

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Health 2017年第3期9卷 473-492页

作者： Izzeddin A. Abu Bdair rose E. constantino School of Nursing The University of Jordan Amman Jordan School of Nursing University of Pittsburgh Pittsburgh Pennsylvania USA

Background: Sexual health is an important and integral part of human health. Patients often voice their concerns regarding their sexual health after experiencing coronary artery diseases. Nurses face many barriers to conduct sexual health assessment. Although many sexual health instructions have been developed, nurses still pay little attention to sexual health assessment. Purpose: The purpose of this literature review was to identify the barriers and strategies that promoted sexual health assessment in clinical nursing practice. Design: A comprehensive search of the recent literature related to barriers and promoting strategies to sexual health assessment was undertaken. Methods: A review of literature published over the last 10 years on a wide variety of recent studies in nursing and related discipline in the field of sexual health was performed. Findings: Most studies indicated that sexual health was poorly addressed in clinical settings. Barriers to addressing sexual health are multifactorial;we classified them into four categories: patients related barriers, nurses related barriers, organizational related barriers and value related barriers. Many strategies to enhance sexual health assessment and counseling in clinical setting are summarized. Conclusion: Overall, it is evident that nurses encounter many barriers to sexual health assessment. Therefore, investigating these barriers and developing appropriate interventions are recommended.

关键词： Sexual Health Barriers Nurses Jordan Coronary Artery Diseases

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Caring for Older Persons in a Technologically Advanced Nursing Future

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Health 2019年第5期11卷 439-463页

作者： Joseph Andrew Pepito Rozzano C. Locsin rose E. constantino Cebu Doctors’ University Cebu City Philippines University of the Visayas Cebu City Philippines Tokushima University Tokushima Japan Florida Atlantic University Boca Raton FL USA Department of Health and Community Systems School of Nursing University of Pittsburgh Pittsburgh USA

As people live longer, a larger percentage will live with multiple chronic conditions and functional impairments such as difficulties with activities of daily living, mobility, and the management of one’s household. The purpose of this paper is to examine the care of older persons in a technologically advanced nursing future by discussing roles and responsibilities of nurses who practice gerontological nursing, and explaining how a technologically advanced future would change the delivery of home health care for older persons in the community. The theory of Technological Competency as Caring in Nursing grounds 3 processes of nursing as knowing persons as caring, wholeness is oneness, and caring as a multi-dimensional process. Harnessing technology for the health of older persons would enable them to live independently, socially engaged, and safely. A technologically advanced nursing future leads to concomitant sustainable disruptive and frugal innovations in healthcare. Nurses in practice must take advantage of these disruptions and consider frugal innovations as the futures of nursing education, practice, and research are here.

关键词： Big Data Competency Gerontology Nursing Older Persons Technologically Advanced Nursing Future

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Child Abuse during the Pandemic and Trauma-Informed Care: A Review of Evidence-Based Literature

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Health 2023年第9期15卷 1003-1012页

作者： Allison J. DiPlacido Linda Leitzel Brayden Kameg Betty J. Braxter rose constantino School of Nursing University of Pittsburgh Pittsburgh USA

Abuse of infants and children is a public health problem that warrants immediate attention. It is estimated that over 7 million children are affected by child abuse yearly, with the highest rate of abuse in those less than one year of age. Approximately 60% of child abuse victims are children under the age of three years, making infants and young children a particularly vulnerable population. Interventions targeting the perinatal period can be effective in mitigating child abuse, including parent education programs and trauma-informed care services. This paper provides an overview of the current evidence base related to child abuse following the COVID-19 pandemic, with a focus on prevention and intervention strategies that can be utilized to increase caregiver support and reduce child abuse rates during the perinatal period.

关键词： Neonates Newborn Infant Child Abuse Perinatal Trauma-Informed Care

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Linking axon transport to regeneration using in vitro laser axotomy

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Neural Regeneration Research 2018年第3期13卷 410-412页

作者： Bart Nieuwenhuis Richard eva John van Geest Centre for Brain Repair Department of Clinical Neurosciences University of Cambridge Cambridge UK Laboratory for Regeneration of Sensorimotor Systems Netherlands Institute for Neuroscience Royal Netherlands Academy of Arts and Sciences (KNAW) Amsterdam The Netherlands

Spinal cord injury has devastating consequences because adult central nervous system （CNS） neurons do not regenerate their axons after injury. Two key reasons for axon regeneration fail- ure are extrinsic inhibitory factors and a low intrinsic capacity for axon regrowth. Research has therefore focused on overcom- ing extrinsic growth inhibition, and enhancing intrinsic regeneration capacity. Both of these issues will need to be addressed to enable optimal repair of the injured sp＋inal cord.

关键词： CNS ARF Linking axon transport to regeneration using in vitro laser axotomy EFA

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Exploring the Feasibility of Text Messaging Intervention in Intimate Partner Violence

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Open Journal of Nursing 2014年第7期4卷 528-537页

作者： rose constantino Linden Wu Dominique de la Cruz Joseph Burroughs JuHae Grace Hwang Amanda Henderson Betty Braxter Department of Health and Community Systems University of Pittsburgh School of Nursing Pittsburgh USA Department of Health Promotion and Development University of Pittsburgh School of Nursing Pittsburgh USA UPMC Shadyside Emergency Department University of Pittsburgh School of Nursing Pittsburgh USA

Introduction: Intimate Partner Violence (IPV) is defined as controlling, abusive, and aggressive behavior in a romantic relationship. Women between the ages 16 and 24 experience the highest rate of IPV. IPV costs US society at least $13.6 billion annually and is expected to rise to $15.6 billion by 2021. The purpose of this study is to explore the feasibility of Text Messaging Intervention (TMI) in recognizing, responding and preventing IPV among college students. The research questions are: Will TMI 1) improve participant knowledge of warning signs of IPV? (Knowledge) and 2) improve participant confidence to intervene in IPV? (Confidence). Methods: A mixed methods design in data collection and data analysis was used. One-way ANOVA and Chi-square test were used to analyze quantitative data from the pre and post TMI survey. Results of the qualitative data analysis are included verbatim. Results: Results showed that knowledge level pre to post test increased from 2.00 ± 1.00 to 2.7 ± 0.48 (p evaluating the feasibility and effectiveness of IPV prevention programs that uses mobile devices to create the best optimal health outcomes.

关键词： Disruptive Innovations (DI) Intimate Partner Violence (IPV) Primary Prevention Strategy Text Messaging Intervention (TMI) Violence Prevention

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Assessing the Readability and Usability of Online H-E-L-P Intervention for IPV Survivors

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Open Journal of Nursing 2014年第3期4卷 150-157页

作者： rose E. constantino Ayman M. Hamdan-Mansour Amanda Henderson Bonnie Noll-Nelson Willa Doswell Betty Braxter Department of Community and Health Systems University of Pitts-burgh School of Nursing Pittsburgh USA Department of Health Promotion and Development University of Pittsburgh School of Nursing Pittsburgh USA Mental Health Nursing Community Health Department Faculty of Nursing The University of Jordan Amman Jordan RN-BSN Department Mount Aloysius College of Nursing Cresson USA University of Pittsburgh School of Nursing Pittsburgh USA

Purpose: The purpose of this study was to assess the readability and usability of an online HELP (Health, Education, and Legal Program) intervention for women experiencing IPV (Intimate Partner Violence) by asking graduate nursing students to review in class nine online HELP intervention modules. Design: A descriptive online survey administered to 15 graduate nursing students was used to assess the readability and usability of an online HELP intervention. Methods: Participants were asked to perform the following activities: 1) reading the nine HELP modules on PowerPoint as posted on Blackboard (a web-based course management program), 2) filling in five blank lines under each heading (HEALTH, EDUCATION, LEGAL, and PROGRAM), by writing words or terms on the line after each heading, 3) ranking the words within each heading (with #1 as the highest and #5 as the lowest), 4) engaging in a class discussion of the rationale for the ranking, 5) re-ranking, and 6) voting on the ranking. The results were compiled to yield a master rank and vote order for each heading between 12 (received 12 votes) and 15 (received 15 votes) of the words that were ranked #1. Results: The words that were ranked #1 under each heading and the number of votes received were: Under HEALTH: Depression (15), Anger (14), Anxiety (13), and Pain (12);EDUCATION: Safety (15), Injury (14), Social Support (13) and Parenting/Child Care (12);LEGAL: Protection from Abuse (15), Attorney (14), Court/Hearing (13), and Rights (12);PROGRAM: Internet (15), Online (14), Intervention (13) and Resources (12). Conclusions: HELP intervention is readable and usable however, HELP needs to be piloted to ensure that survivors of IPV participants can access and benefit from HELP intervention.

关键词： Intimate Partner Abuse HELP

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Evidence Collection for the Unconscious and Unconsented Patient

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Open Journal of Nursing 2014年第4期4卷 287-295页

作者： rose constantino Carol Stewart Polly Campbell Barbara Moynihan Susan Kagan Patricia Daugherty Kathleen Thimsen Lynda Tiefel Colleen O’Brien Jennifer Johnson Collarborative BScN Nursing Program Seneca College of Applied Arts & Technology King City Canada Community Nursing Services Southern Illinois University School of Nursing Edwardsville USA Department of Health and Community Systems University of Pittsburgh School of Nursing Pittsburgh USA Forensic Assessment Consultation and Treatment Program Shawnee Mission Medical Center Merriam USA Harborview Medical Center Seattle USA International Association of Forensic Nurses Sexual Assault Forensic Examiner Program Office of the Attorney General Augusta USA Quinnipiac University Hamden USA Tennessee Department of Health Health Related Boards/Office of Investigations Greeneville USA Tiefel Legal Consulting Tallahassee USA Wisconsin Department of Justice Ridgeway USA

Forensic nurses are faced with making an ethical decision when an unconscious patient presents with signs of sexual assault. If the patient is unable to consent, the nurses need to decide whether or not to perform a forensic exam. Hospitals have policies in place regarding consent for emergency care, but not all of them consider the collection of forensic evidence. The window of opportunity for forensic collection may disappear before contacts are made or proper consent is established. Ethical, legal, and policy considerations that complicate this scenario are discussed.

关键词： Forensics Forensic Nursing Sexual Assault Ethical Considerations in Sexual Assault Legal Aspect of Sexual Assault Informed Consent in Sexual Assault

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