Johns Hopkins Nursing Research News, July-August 2013

Newswise — Discrimination and Depression. An eye-opening study by Johns Hopkins Nursing instructor Kelly M. Bower, PhD, MPH, RN, and colleagues provides a reminder that racial discrimination can be experienced by anyone, with potential negative effects on physical and emotional health. The study explores perceptions of racial discrimination among low-income whites in a racially mixed inner-city neighborhood. The findings affirm that discrimination affects any individual’s emotional health and wellbeing. Critically, the stress associated with perceived experiences of discrimination exacts a great emotional toll—heightened anxiety, depression, and their debilitating symptoms. “We need to be aware that the mental health effects of lived experiences of discrimination among poor urban whites, like those of minority populations, can be significant and damaging,” says Bower. [“Perceived racial discrimination and mental health in low-income urban-dwelling whites.” International Journal of Health Services, Summer 2013]Questioning Routine Herpes Screening. In a provocative viewpoint article in JAMA Pediatrics, assistant professor Hayley D. Mark, PhD, MPH, RN, argues against screening sexually active teens and young adults for genital herpes. The risk of spreading this incurable-but-manageable virus may be heightened since 8 in 10 are unaware they have it. And active herpes infection can increase the risk of acquiring HIV/AIDS. However, Mark says, universal screening for herpes has downsides: A diagnosis can have serious emotional fallout, like depression or social isolation, and false-positive rates are unacceptably high. Also no data suggest that a diagnosis results in behavior changes like condom use or taking medications to suppress the virus. Thus, Mark says, “Universal screening for the herpes virus may not accomplish the most good for adolescents and young adults [and could] can cause unnecessary harm and waste valuable health care resources.” [“Asymptomatic sexually active adolescents and young adults should not be screened for herpes simplex virus.” Published online June 2013.]

Bringing Up Baby. A nurturing, engaged mother can have a profound positive impact on a child’s social, emotional, and cognitive development. In contrast, a depressed or stressed mom who is emotionally insecure or distant can have the opposite effect. According to assistant professor Jeanne L. Alhusen, PhD, CRNP, professor Deborah Gross, DNSc, RN, and a colleague, less-stressed and depressed mothers-to-be often experience a greater attachment during pregnancy, a pattern that continues after the birth and yields a generally healthy child physically, emotionally, and developmentally. Gross says, “Particularly in low-income urban environments, assessments of the psychological well-being of pregnant women may be one of the best ways to help identify at-risk mothers.” Alhusen adds, “Strong, responsive mother-child relationships are the bedrock on which healthy development, healthy families, and, ultimately, healthy communities are built.” [“A longitudinal study of maternal attachment and infant developmental outcomes.” Archives of Women’s Mental Health, June 2013.]

And, to improve parent participation in a parenting skills program, Gross and a colleague assess the use of personal tablets and a Web-based program as an alternative to face-to-face engagement. [“Web-based delivery of a preventative parent training intervention,” Journal of Child and Adolescent Psychiatric Nursing, 2013.]

In Other Nursing Research News. Globally, over one-third of homicides of women are perpetrated by intimate partners, according to a 66-nation study by an international team including professor Jacquelyn Campbell, PhD, RN. [“The global prevalence of intimate partner homicide: A systematic review.” Lancet. Published online June 20, 2013.] In Forensic Science, Medicine and Pathology [July 2013], Campbell, associate professor Daniel J. Sheridan, PhD, RN, and others identify standards to help forensic clinicians estimate the age of bruises in victims. “Evaluating change in bruise colorimetry and the effect of subject characteristics over time.”] Professor Cynda H. Rushton, PhD, RN, and colleagues offer an approach to help critical care nurses and others maintain compassion, resilience, and emotional health in the face of patient suffering. [“A framework for understanding moral distress among palliative care clinicians.” Journal of Palliative Medicine. Published online June 18, 2013.] Associate professor Sarah Szanton, PhD, CRNP, and colleagues explore how the home environment and need for assistive devices may help or hinder the ability to “age in place.” [“Assistive devices in context,” Gerontologist. Published online April 24, 2013.] In “Challenges in providing preventive care to inner-city children with asthma,” Johns Hopkins Schools of Nursing and Medicine professor Arlene M. Butz, ScD, MSN, associate professor Joan Kub, PhD, APHN, and colleagues pose community-centered solutions to improve early intervention and prevention. [Nursing Clinics of North America, June 2013.] Better implementation of infection control procedures and occupational health policies can help lower the risk of TB among health care workers in South Africa, according to doctoral graduate Carrie Tudor, PhD, RN, Dean Martha N. Hill, PhD, RN, assistant professor Jason E. Farley, PhD, MPH, CRNP; and a colleague. [“Occupational health policies and practices related to tuberculosis in health care workers in KwaZulu-Natal, South Africa,” Public Health Action, June 2013.] In-depth interviews with Ethiopian refugees led professor Nancy Glass, PhD, MPH, RN, and colleagues to identify components of a screening tool to better assist survivors of conflict-related sexual violence. [“Development of a screening tool to identify female survivors of gender-based violence in humanitarian setting,” Conflict and Health, July 2013.] According to faculty associate Susan Appling, PhD, CRNP, and colleagues, use of a specialized device can halve the duration of bed rest and immobility following angioplasty and other procedures involving blood vessels. [“Wire vascular closure device: Evaluating an evidence-based protocol for post-endovascular procedure patients.” Journal of Vascular Nursing, June 2013.] In Nurse Leader [August 2013], professor MaryAnn Fralic, DrPH, RN, abstracts and annotates key business articles of importance for nurses at the cutting edge of care, research, and education. [“Upskilling for new-era healthcare.”]