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Johns Hopkins Nursing Research News--October/November 2010

Posted: 11/2/2010

Women as Aggressors in Intimate Partner Violence
Women are not just victims of intimate partner violence (IPV); they also can be perpetrators, though not as often as men. What factors motivate women to this kind of physical violence? What role might anger play? And, what about the use of violence as self-defense against an abusing partner? Johns Hopkins University School of Nursing (JHUSON) researcher and professor Jacquelyn Campbell, PhD, RN, FAAN, and colleagues at the JHU School of Medicine reason that knowing the causes is key to finding solutions and better interventions. Campbell notes, "When we provide interventions, they must depend on the motivations behind the actions." Their in-depth examination of the existing literature ("Why do women use intimate partner violence? A systematic review of women's motivations") makes clear that there are no simple answers. No single factor alone can explain this phenomenon. Control is not an issue among women who use IPV against a male partner. Rather, women's motivations to become violent -- feelings of anger, powerlessness, and being ignored -- most often are responses to a partner's abuse. "The more knowledge we have about the reasons underlying IPV by women," Campbell says, "the better the tools nurses have to help identify and assist women who are at risk for using IPV against an abusing partner." [Trauma, Violence and Abuse, October 2010.]

Nurse Educators Rock their Ages
Just as 60-something rock icons Mick Jagger, Tina Turner, and Paul McCartney aren't letting their age stop the show, neither are a group of JHUSON faculty, among them associate professor Anne E. Belcher, PhD, RN, CNE, FAAN, ANEF, assistant professor Sarah J.M. Shaefer, PhD, RN, and instructor Kathie J. Guth, MS, RN. Like the iconic rockers, they're not letting accumulating years dampen their enthusiasm and energy. Their audience: nursing students. With the shortage of nurse educators, they've returned to clinical nursing instruction to help grow the next generations of nurses. Writing in Nursing Education Perspectives [September/October 2010], the trio relate stories of their challenges and opportunities, from fears about sore feet and keeping pace with students 30 or more years their junior to staying on their toes and being able to roll with the punches and bring a big picture perspective to clinical teaching.  With evident infectious enthusiasm, these self-professed ageless wonders (also the title of their article) encourage other older or retired nurses to join them and rock on.

When "Feminine Care" Isn't Healthy Care
Two decades ago, magazine ads encouraged women to get that "clean feeling" with vaginal douches. Today, we know the practice increases a woman's risk for bacterial infection, pelvic inflammatory disease, HIV, and even cervical cancer. Yet, a significant number of women of childbearing age report douching regularly. The practice is most common among African-American women at 58.5%, over twice the rate of Caucasian women.
 
Recognizing that most women begin douching at the suggestion of a female relative, JHUSON assistant professor Hayley Mark, PhD, MPH, RN, and colleagues at the JHU School of Public Health, in a first-of-its-kind intergenerational study, gathered experiential data about the practice from 41 pairs of African-American mothers and daughters to help design and test an intervention to reduce or eliminate the practice. This very first step in the study, reported in "What has changed about vaginal douching among African-American mothers and daughters?" [Public Health Nursing, September/October 2010] yielded important findings. Foremost, women are hearing and heeding the message from health professionals that douching is a risky business. A quick message about the risks often means daughters do not start; mothers may slow or curtail the practice altogether. Mark says, "From our Baltimore-based sample, it's clear that many moms and daughters are getting the message and changing their behavior for the better. The goals now are to keep the current message going for younger women and to identify others that can speak clearly to older women, too." 

Helping Rape Victims Stay on HIV Prevention Meds
In South Africa, a nation with one of the highest rates of rape and HIV worldwide, when a woman is raped by someone who is HIV positive, the implications can be lethal, despite the national recommendation of an immediate, preventive 28-day course of anti-retrovirus (HIV) medications. According to a recent study by JHUSON professor Jacquelyn Campbell, PhD, RN, FAAN, and South African colleagues, even when women receive extra help and follow-up support, most simply don't stay on their medications for the full time. ["Impact of telephonic psychosocial support on adherence to post-exposure prophylaxis after rape," AIDS Care, October 2010.]  "HIV and rape are a fact worldwide, not just in South Africa. Clearly, we must find better ways to help all such women at risk stay on course with their anti-HIV medications, despite the side effects. Since we nurses are on the front lines of care, we're ideally positioned to support women through new interventions that, we hope, will prove more successful."

In Other Nursing Research News
JHUSON Center for Interdisciplinary Salivary Bioscience Research director Douglas A. Granger, PhD, and colleagues discuss differences in adult and child salivary stress enzyme response to a stress induction test and implications of the findings for measuring children's stress. ["Children's and adults' salivary alpha-amylase responses to a laboratory stressor and to verbal recall of the stressor," Developmental Psychobiology, September 2010.] In a NASA-supported study, JHUSON assistant professor Matthew J. Hayat, PhD, and others created a statistical model assessing the potential variable impact of the anti-nausea medication promethazine on decision-making and performance. ["Joint modeling of performance and subjective reporting to assess sensitivity to drug-induced sleepiness," Statistics in Medicine, September 2010].