The Experiences and Perspectives of Documented Hispanic Immigrants Dealing With Survivor’s Guilt

Hispanic immigrants are understudied and underserved; this is a population that continues to battle injustices and discriminatory actions due to immigration policy. The Hispanic population struggles with immigration stress and deportation, which contributes to difficulties such as psychological distress, physical health problems, acculturative stress, employment difficulties, and decreased access to support and services. In this study, a generic qualitative design was utilized to explore immigration stress and the experiences of documented Hispanic immigrants dealing with survivor’s guilt as it relates to the deportation of their loved ones. Relational cultural theory as used in the study to explore the Hispanic population, their connections, and their disconnections due to deportation. The research question addressed how documented Hispanic immigrants describe the challenges of immigrant stress and their experiences dealing with survivor’s guilt as it relates to the deportation of their loved ones. A generic qualitative design was used to collect and analyze the data into themes. Inductive analysis was utilized to analyze repeating patterns, and thematic analysis with constant comparison was utilized to analyze and compare data as they were collected. Themes and categories that emerged included family connections, stress of immigration, stress of deportation, dealing with survivor’s guilt, death of loved ones, family support, and giving back. This study may change the delivery of culturally sensitive services within organizations. The study adds to the field from a diversity and inclusion perspective, promoting a positive social change

The Experiences and Perspectives of Documented Hispanic Immigrants Dealing With Survivor’s Guilt

Hispanic immigrants are understudied and underserved; this is a population that continues to battle injustices and discriminatory actions due to immigration policy. The Hispanic population struggles with immigration stress and deportation, which contributes to difficulties such as psychological distress, physical health problems, acculturative stress, employment difficulties, and decreased access to support and services. In this study, a generic qualitative design was utilized to explore immigration stress and the experiences of documented Hispanic immigrants dealing with survivor’s guilt as it relates to the deportation of their loved ones. Relational cultural theory as used in the study to explore the Hispanic population, their connections, and their disconnections due to deportation. The research question addressed how documented Hispanic immigrants describe the challenges of immigrant stress and their experiences dealing with survivor’s guilt as it relates to the deportation of their loved ones. A generic qualitative design was used to collect and analyze the data into themes. Inductive analysis was utilized to analyze repeating patterns, and thematic analysis with constant comparison was utilized to analyze and compare data as they were collected. Themes and categories that emerged included family connections, stress of immigration, stress of deportation, dealing with survivor’s guilt, death of loved ones, family support, and giving back. This study may change the delivery of culturally sensitive services within organizations. The study adds to the field from a diversity and inclusion perspective, promoting a positive social change

The Experiences and Perspectives of Documented Hispanic Immigrants Dealing With Survivor’s Guilt

Hispanic immigrants are understudied and underserved; this is a population that continues to battle injustices and discriminatory actions due to immigration policy. The Hispanic population struggles with immigration stress and deportation, which contributes to difficulties such as psychological distress, physical health problems, acculturative stress, employment difficulties, and decreased access to support and services. In this study, a generic qualitative design was utilized to explore immigration stress and the experiences of documented Hispanic immigrants dealing with survivor’s guilt as it relates to the deportation of their loved ones. Relational cultural theory as used in the study to explore the Hispanic population, their connections, and their disconnections due to deportation. The research question addressed how documented Hispanic immigrants describe the challenges of immigrant stress and their experiences dealing with survivor’s guilt as it relates to the deportation of their loved ones. A generic qualitative design was used to collect and analyze the data into themes. Inductive analysis was utilized to analyze repeating patterns, and thematic analysis with constant comparison was utilized to analyze and compare data as they were collected. Themes and categories that emerged included family connections, stress of immigration, stress of deportation, dealing with survivor’s guilt, death of loved ones, family support, and giving back. This study may change the delivery of culturally sensitive services within organizations. The study adds to the field from a diversity and inclusion perspective, promoting a positive social change

Use of Medicare claims to rank hospitals by surgical site infection risk following coronary artery bypass graft surgery

ObjectiveTo evaluate whether longitudinal insurer claims data allow reliable identification of elevated hospital surgical site infection (SSI) rates.DesignWe conducted a retrospective cohort study of Medicare beneficiaries who underwent coronary artery bypass grafting (CABG) in US hospitals performing at least 80 procedures in 2005. Hospitals were assigned to deciles by using case mix-adjusted probabilities of having an SSI-related inpatient or outpatient claim code within 60 days of surgery. We then reviewed medical records of randomly selected patients to assess whether chart-confirmed SSI risk was higher in hospitals in the worst deciles compared with the best deciles.ParticipantsFee-for-service Medicare beneficiaries who underwent CABG in these hospitals in 2005.ResultsWe evaluated 114,673 patients who underwent CABG in 671 hospitals. In the best decile, 7.8% (958/12,307) of patients had an SSI-related code, compared with 24.8% (2,747/11,068) in the worst decile ([Formula: see text]). Medical record review confirmed SSI in 40% (388/980) of those with SSI-related codes. In the best decile, the chart-confirmed annual SSI rate was 3.2%, compared with 9.4% in the worst decile, with an adjusted odds ratio of SSI of 2.7 (confidence interval, 2.2-3.3; [Formula: see text]) for CABG performed in a worst-decile hospital compared with a best-decile hospital.ConclusionsClaims data can identify groups of hospitals with unusually high or low post-CABG SSI rates. Assessment of claims is more reproducible and efficient than current surveillance methods. This example of secondary use of routinely recorded electronic health information to assess quality of care can identify hospitals that may benefit from prevention programs

Virtual reality interventions designed to support parents during and throughout the first year after birth:A scoping review

ObjectiveVirtual reality (VR) has become increasingly popular in clinical and health settings where it has been used for a wide range of purposes. A recent scoping review explored VR applications to assist pregnant women and found that VR was a useful method to be used for a range of different purposes in both pregnancy and labour. However, no such review exists for the period after birth.MethodWe aimed to search for studies that used VR to support parents during birth and in the first year postpartum (Population) in different settings (Context), and finally provided data on the characteristics, reported effectiveness and experience of VR interventions (Concept). Two hundred and fifty-one studies were identified, of which ten were eligible. Two authors independently extracted data including study design, participants and results.ResultsFindings indicate that VR has been used effectively in this context to alleviate depression anxiety, and multiple domains of pain and to improve childbirth satisfaction. The majority of the studies explored the use of VR technology on outcomes such as pain and anxiety during labour and birth. The studies included used a broad range of VR hardware and software. All of the studies reported positive experiences of using VR.ConclusionsAcross these studies, VR was found to be effective in terms of both physiological and psychological outcomes. There are many unexplored maternal and infant focused applications of VR which warrant further investigation as emerging evidence indicates this is becoming an increasingly accessible method to improve maternal and infant health outcomes from pregnancy through to parenthood

A protocol for the development and validation of the Postpartum Specific Anxiety Scale – Preterm Birth [PSAS-PTB] and the Postpartum Specific Anxiety Scale – Neonatal Intensive Care Unit [PSAS-NICU]

Objectives: To describe the development and the methodology for validation of a new scale for postpartum anxiety for mothers of preterm infants, and a ‘Velcro’ sub-scale of the Postpartum Specific Anxiety Scale for use with mothers who have had infants admitted to the Neonatal Intensive Care Unit.Methods: We undertook three forms of iterative psychometric development: 1) Patient and public involvement and engagement discussions with key clinical, academic, and lay stakeholders to understand the needs for modifying the Postpartum Specific Anxiety Scale – Research Short Form for use in this population; 2) Expert panel ratings with clinical and academic stakeholders; and 3) Cognitive interviews with mothers to ensure items were relevant, comprehensive, and understandable. Planned studies must ensure the psychometric properties of these two new scales.Results: Patient and Public Involvement and Engagement discussions identified clear avenues for modification of the PSAS-RSF, but the need for an additional NICU-specific scale was clear. Experts rated the new items highly on their relevance. Cognitive interviews further ensured that items were well understood and that meaning was being interpreted in the intended manner. Only minor changes to the scales were implemented after each change.Conclusions: This is the first study to describe the process of developing and the subsequent proposed validation of postpartum-specific tools for use with mothers of preterm infants and those with infants in the Neonatal Intensive Care Unit. Clear avenues have been identified for the validation and implementation of both measures

Associations between prematurity, postpartum anxiety, neonatal intensive care unit admission, and stress

Introduction: It is well established that a premature birth increases the likelihood of developing anxiety during the postpartum period, and that the environment of the neonatal intensive care unit (NICU) might be a contributing factor. Mothers of earlier premature infants may experience these anxieties to a higher degree compared to mothers of later premature infants. The aim of this study was to explore the association between prematurity and postpartum-specific anxiety, and the relationship between postpartum-specific anxiety and stress in the NICU. Materials and methods: Mothers (N = 237) of infants aged between birth and 12 months completed an online survey containing the Postpartum Specific Anxiety Scale – Research Short Form (PSAS-RSF) and the Parental Stressor Scale: Neonatal Intensive Care Unit (PSS:NICU). Structural equation modeling was used to analyze the relationship between gestational age and postpartum-specific anxiety, with one-way ANOVAs used to analyze this relationship with respect to categories of gestational age. Hierarchical regression models analyzed the relationship between postpartum-specific anxiety and stress in the NICU. Results: For the PSAS-RSF, Practical Infant Care Anxieties (p = 0.001), Maternal Competence and Attachment Anxieties (p = 0.033), and Infant Safety and Welfare Anxieties (p = 0.020) were significantly associated with week of gestation. Practical Infant Care and Infant Safety and Welfare Anxieties were significantly higher for mothers of late premature infants, compared to mothers of term infants (p &lt; 0.001; p = 0.019). There were no significant between-group differences with respect to Maternal Competence and Attachment Anxieties. After controlling for potential confounders, Infant Safety and Welfare Anxieties were significantly associated with increased stress in the NICU (p &lt; 0.001) as measured by the PSS:NICU. Conclusions: Our findings highlight the need for interventions for mothers with premature infants, which specifically target anxieties reflected in the PSAS-RSF, such as routine care and increasing maternal self-efficacy.</p

Psychometric evaluation and validation of the Postpartum Specific Anxiety Scale for the Spanish-speaking population:PSAS-ES

ObjectiveThe transition to motherhood is a period of risk for the development of mood disorders. Postpartum anxiety has not been as thoroughly studied as other emotional disorders despite its impact on mothers and their babies. The absence of standardized programmes for early detection and specific tools for its diagnosis means postpartum anxiety is often underestimated or overshadowed. This study aimed to translate and validate the Postpartum Specific Anxiety Scale [PSAS] for the Spanish population and to analyse its reliability as an exploratory tool for specific anxiety in mothers.MethodFour stages were followed in this research: translation and back-translation to obtain the Spanish version [PSAS-ES]; preliminary pilot study to explore the comprehensibility and ease of responding the items (n = 53); convergent validity analyses (n = 644); and test-retest reliability (n = 234).ResultsThe PSAS-ES has shown to have good acceptability, convergent validity and high internal consistency with a Cronbach's α coefficient of 0.93 for the overall scale of PSAS. The four factors had good reliability. The results of test-retest was 0.86, indicating excellent stability over time in the first 16 weeks.ConclusionThe psychometric results show that the PSAS-ES is a valid tool to explore and detect anxiety in Spanish mothers between 0 and 16 weeks postpartum

Nurses and information technology

[Executive Summary]: Synopsis: A study of 10,000 nurses in Australia (44% response rate) on their use of information technology has clearly identified that nurses recognise benefits to adopting more information technology in the workplace. They are however frustrated by limitations of access to the technology; software that is not always fit for purpose; and lack of opportunities for training. The level of use of information technology and information management systems is generally low and confidence in use is low even among those nurses who are users. There is evidence that familiarity, use and confidence in use are slightly higher in nurses who have recent tertiary education. Nurses feel poorly informed about information technology health initiatives and poorly consulted about implementation of these initiatives. Workload, number of computers, inadequate technical support and lack of training are principal barriers to the use of information technology. Technical support is especially poor in more remote locations. Neither the full potential of information technology in the provision of health and aged care nor the recognition by all nurses that information technology is an integral part of nursing will be realised until these limitations are addressed

Exploring the Reasons Why Mothers Do Not Breastfeed, to Inform and Enable Better Support

Introduction: Infant and maternal breastfeeding benefits are well documented, globally. Despite efforts to increase global breastfeeding rates, the majority of high-income settings fall short of recommended targets. Breastfeeding rates in the UK are especially poor, and physiological difficulties (e.g., inverted nipples), fail to account for the observed breastfeeding intention-behaviour gap.Method: The current online study sought to investigate the infant feeding experiences of 624 UK formula feeding mothers, through open text survey responses.Results: A content analysis identified the following clusters of reasons for formula feeding: Feeding Attitudes, Feeding Problems, Mental Health, and Sharing the Load.Discussion: Feeding Attitudes explained a large percentage of reasons given for formula feeding. Recommendations are made to improve antenatal breastfeeding education and to develop an intervention with an aim to improve maternal breastfeeding attitudes and subsequent practice. Feeding Problems also explained a large portion of combination feeding and started but stopped infant feeding accounts. The current paper calls for more comprehensive and tailored antenatal breastfeeding education to refine practical breastfeeding skills necessary for successful breastfeeding establishment and maintenance. Mental Health explained relatively small coverage. Suggestions are therefore made to train mental health practitioners on infant feeding with an aim to provide more extensive support, which may serve to disrupt the bidirectional relationship between poor mental health and poor breastfeeding outcomes. Finally, Sharing the Load explained moderate coverage across never breastfed, combination fed, and started but stopped feeding groups. Recommendations are made, in light of these findings, to tighten workplace legislation to protect breastfeeding women