Journal of Psychosocial Nursing and Mental Health Services
Vol. 47 No. 6 June 2009
Caregivers of Victimized Children: Differences Between Biological Parents and Foster Caregivers
Elizabeth B. Dowdell, PhD, RN; Deborah J. Cavanaugh, MA/MHC
ABSTRACT
Caregivers of children who have been sexually abused often find the experience challenging, especially when the child begins to act out in the home. Many children who have engaged in sexually aggressive, sexually inappropriate, or coercive behaviors with other children are placed in foster care. The purpose of this article is to describe the characteristics of biological parents and their significant others and foster caregivers of sexually aggressive and abusive children. A descriptive, exploratory study was conducted involving 3,149 caregivers (1,764 of them foster caregivers) of more than 800 youth ages 3 to 20. Findings suggest that while the foster caregivers were a more stable group than the biological parents and their significant others, the children experienced significantly high levels of instability in foster care placement. Provision of emotional and psychosocial support, coupled with education and periodic health evaluations, for the foster caregivers may be focal points of interventions. Nurses are in an ideal position to provide positive health promotion strategies and lifestyle choices for both foster caregivers and the children.
AUTHORS
Dr. Dowdell is Associate Professor, Villanova University, College of Nursing, Villanova, Pennsylvania, and Ms. Cavanaugh is Program Coordinator/Senior Researcher, Justice Resource Institute, Research and Clinical Practice Program, Taunton, Massachusetts.
The authors disclose that they have no significant financial interests in any product or class of products discussed directly or indirectly in this activity, including research support.
The authors gratefully acknowledge Dr. Robert A. Prentky for providing them access to the dataset on caregivers.
Address correspondence to Elizabeth B. Dowdell, PhD, RN, Associate Professor, Villanova University, College of Nursing, Driscoll Hall, 800 Lancaster Avenue, Villanova, PA 19085; e-mail: elizabeth.dowdell@villanova.edu.
doi:10.3928/02793695-20090428-02
Clinical Practice Guideline: 1-Hour Face-to-Face Assessment of a Patient in a Mechanical Restraint
Marlene Nadler-Moodie, MSN, APRN, PMHCNS-BC
ABSTRACT
Face-to-face assessment within 1 hour after placing a patient in a restraint has been the standard of care following regulatory requirements set forth by the federal government in 1999. This rule, although widely followed and applauded as optimum patient care, has little evidence of a standardized format for what constitutes the examination. Health care providers agree that a face-to-face assessment is warranted; however, no set parameters exist for what constitutes the key elements of such an assessment. This clinical practice guideline offers a specific outline to follow that emphasizes the safety of the patient being placed in a mechanical restraint for a behavioral health emergency.
AUTHORS
Ms. Nadler-Moodie is Clinical Nurse Specialist in Adult Psychiatric and Mental Health Nursing, Sharp Mesa Vista Hospital and Scripps Mercy Hospital, San Diego, California.
The author discloses that she has no significant financial interests in any product or class of products discussed directly or indirectly in this activity, including research support.
Address correspondence to Marlene Nadler-Moodie, MSN, APRN, PMHCNS-BC, 4864 Bradshaw Court, San Diego, CA 92130; e-mail: moodienurse@yahoo.com.
doi:10.3928/02793695-20090428-01
Suicide Risk Assessment: 6 Steps to a Better Instrument
Brenda Hermes, RN, BC; Kathy Deakin, RNBC, BA; Kathy Lee, MS, APN, PMHCNS-BC, GCNS-BC; and Sherry Robinson, PhD, GCNS-BC
ABSTRACT
Recent research indicates that commonly used instruments to assess suicidal ideation identify patients at chronic risk for suicide but do not identify those who are at acute (imminent) risk for suicide while hospitalized. Items to measure anxiety and agitation, identified as more appropriate risk factors, should be incorporated into suicide risk assessments. The purpose of this article was to develop an evidence-based imminent suicide risk instrument for an inpatient psychiatric unit. The Iowa Model of Evidence-Based Practice to Promote Quality Care guided development. Two validated instruments, the Hamilton Anxiety Scale (to measure anxiety) and the Behavioral Activity Rating Scale (to measure agitation) were applied to 75 patients to help create an evidence-based instrument, which should more accurately identify hospitalized patients at risk for imminent suicide.
AUTHORS
Ms. Hermes and Ms. Deakin are Clinical Nurses III, Adult Medicine/Psychiatry (5 A/G), Ms. Lee is Director of Clinical Operations, Department of Psychiatry, Memorial Medical Center, and Dr. Robinson is Assistant Professor and Gerontological Clinical Nurse Specialist, Southern Illinois University School of Medicine, Springfield, Illinois.
The authors disclose that they have no significant financial interests in any product or class of products discussed directly or indirectly in this activity, including research support.
Address correspondence to Brenda Hermes, RN, BC, 701 N. 1st Street, Springfield, IL 62781; e-mail: Hermes.Brenda@mhsil.com.
doi:10.3928/02793695-20090428-03
