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Nurse scholar Karen J. Foli has had an unconventional trajectory. She has written everything from mysteries to thrillers to peer-reviewed journal manuscripts and Food and Drug Administration documents. She conceptualized and disseminated two middle-range theories, one surrounding parental postadoption depression and one surrounding nurses' psychological trauma. Foli's research has revealed a new type of nurse-specific trauma, insufficient resource trauma, which calls for efforts at the organizational level. Winner of several book of the year awards, she is now working on a third middle-range theory. Dr. Foli shares her journey and encourages nurses to give theory a shot. [ABSTRACT FROM AUTHOR]

Background: Individuals diagnosed with autism spectrum disorder (ASD) without intellectual disability (ID) may have advanced mental reasoning; however, symptomology may vary within the population. Possible symptomology includes communication problems, difficulty relating to people, things, and events, and sensory sensitivity. Current concepts in determining health behavior are not applicable to the ASD without ID population. Aim: The aim of this analysis is to define the concept of egocentric norm in the context of health‐based decisions of adults diagnosed with ASD without ID and to support improved nursing practice with this population. Design: The Walker and Avant approach was used. Model, borderline, and contrary cases are offered. Data Source: Literature search yielded 47 peer reviewed papers that were included in the analysis. Review Methods: Uses of the concept were reviewed, following the Walker and Avant approach. Results: Egocentric norm is defined as an individual's ability to perceive, adapt, and respond to information and potential consequences of personal health behavior based on self‐evaluation and the immediate environment with limited regard to peer and family influence. Conclusions: The new concept of egocentric norm may account for the unique dynamics presented by adults with ASD without ID, which may impact health behaviors and actions. [ABSTRACT FROM AUTHOR]

Purpose: Information about nontraditional (kinship, foster, and adoptive) families is typically scattered or overlooked both in nursing education and nursing practice settings. Using a nursing‐centric, population‐focused lens, the current state of nontraditional families in the United States is briefly described. An overview of the challenges and psychological dynamics involved when a nonbiological parent assumes the role of caregiver is provided. Conclusion: Based on the 2010 Census findings and other indicators, we now understand that nontraditional families and their children make up a considerable portion of the population. Nurses, regardless of level of practice, have the potential to positively impact health outcomes of nontraditional parents and their children. Knowledge of the formation and needs of nontraditional families can inform, and improve, culturally safe, trauma‐informed nursing care. Practice implications: This discussion is a first step in appreciating the formation of nontraditional families and the importance of trauma‐informed, unbiased, nonstereotypic discourse in nursing care. By describing the heterogeneity of how families are built through kinship care, foster placements, and adoptive homes, nurses' assessments and interventions will be informed and through a lens of the high potential for past traumas. With this foundational knowledge, nurses interfacing with nontraditional families are better prepared to provide much needed support and relevant care for this unique population. [ABSTRACT FROM AUTHOR]

This concept analysis aims to define the concept of health‐seeking behaviour in relation to the homeless population. The altered experiences of individuals who are homeless suggest that the concept of health‐seeking behaviours has distinct attributes and therefore, a new definition of this concept is needed when compared with other populations. The framework outlined by Walker and Avant was used for this analysis with model, borderline and contrary cases. Databases searched were: CINAHL, Sociological Abstracts, PsycInfo, Google Scholar and PubMed. Because of the limited literature on the overall health‐seeking behaviours of the homeless population, the most relevant 15 sources were selected from these databases for the literature review. Critical attributes derived from the literature were: (a) distrust in healthcare services, emerging from feelings of judgement or stigma from healthcare providers; (b) prioritising physiological needs such as food, shelter and clothing over the safety needs of health; (c) delaying seeking care until physical symptoms are severe; and (d) having decreased access to healthcare because of being uninsured or having no money, requiring transportation, experiencing long wait times for appointments, or lacking knowledge of available healthcare services. We define health‐seeking behaviours in the homeless population as a complex process where a homeless individual seeks out healthcare for a problem or illness, but must first meet his or her physiological needs and then deem current symptoms severe enough to seek medical treatment despite his or her distrust in the healthcare system and barriers to accessing healthcare. Homeless individuals may face unique physiological hardships and emotional stressors compared to the general population, which results in distinct attributes surrounding health‐seeking behaviours. Healthcare providers need to be aware of current barriers to care and perceived access to care in order to reduce the barriers to care that the homeless population faces. [ABSTRACT FROM AUTHOR]

Substance use disorders (SUDs) in nursing have individual well-being, patient safety, and licensure/regulatory implications. Literature is scarce related to predicting SUDs in registered nurses; this study included specific items surrounding nurses' psychological trauma. An online survey, consisting of validated scales and investigator-generated items was distributed to 4,000 registered nurses in Indiana with a yield of 1,478 surveys. The World Health Organization: Alcohol, Smoking and Substance Involvement Screening Test (ASSIST) was used as the dependent variable to assess risk of SUDs. Three multivariate regression models with predictive variables for risk of tobacco (R 2 = 0.08), alcohol (R 2 = 0.09), and other substances (R 2 = 0.10) use were found. Of concern, nurses are at moderate risk for tobacco use at 11.6%; alcohol use at 11.6% and for other substances at 10.4%. Each regression model contained distinct predictor variables; however, variables occurring in all three models were: depression, anxiety, and items surrounding psychological trauma (adverse childhood experiences, life events, lateral workplace violence). [ABSTRACT FROM AUTHOR]

Aim: To describe the experiences of frontline nurses who are working in critical care areas during the COVID‐19 pandemic with a focus on trauma and the use of substances as a coping mechanism. Design: A qualitative study based on content analysis. Methods: Data were collected from mid‐June 2020 to early September 2020 via an online survey. Nurses were recruited through the research webpage of the American Association of Critical Care Nurses as well as an alumni list from a large, public Midwest university. Responses to two open‐ended items were analysed: (1) personal or professional trauma the nurse had experienced; and (2) substance or alcohol use, or other mental health issues the nurse had experienced or witnessed in other nurses. Results: For the item related to psychological trauma five themes were identified from 70 nurses' comments: (1) Psychological distress in multiple forms; (2) Tsunami of death; (3) Torn between two masters; (4) Betrayal; and (5) Resiliency/posttraumatic growth through self and others. Sixty‐five nurses responded to the second item related to substance use and other mental health issues. Data supported three themes: (1) Mental health crisis NOW!!: 'more stressed than ever and stretched thinner than ever'; (2) Nurses are turning to a variety of substances to cope; and (3) Weakened supports for coping and increased maladaptive coping due to ongoing pandemic. Conclusions: This study brings novel findings to understand the experiences of nurses who care for patients with COVID‐19, including trauma experienced during disasters, the use of substances to cope and the weakening of existing support systems. Findings also reveal nurses in crisis who are in need of mental health services. Impact: Support for nurses' well‐being and mental health should include current and ongoing services offered by the organization and include screening for substance use issues. [ABSTRACT FROM AUTHOR]

This concept analysis aims to define affordability within the context of healthcare decision making. Affordability is a complex concept that influences an individual's healthcare decision making. In the year's post‐Affordable Care Act, the United States has seen an increase in insured individuals, but also an increase in underinsured healthcare consumers. Evidence for the concept attributes was found by searching the Cumulative Index of Nursing and Allied Health Literature, EconLit, Family & Society Studies Worldwide, Humanities Full Text, and PsychINFO databases. Literature was synthesized using the Walker and Avant approach. A new definition was derived with four defining attributes, as well as antecedents and consequences. Three cases are forwarded: the model, borderline, and contrary. In healthcare decision making, affordability is a subjective measure that individuals use in determining the ability to engage in a healthcare service or a durable good transaction. Affordability varies based on circumstances. The context of healthcare decision making of individuals stands in contrast to the decision‐making in health systems and to decisions unrelated to one's health. Affordability is a determinant of an individual's ability to engage in a transaction. As such, nurses and policymakers should attempt to understand affordability from the patient's perspective. [ABSTRACT FROM AUTHOR]

Background: Disclosure of family caregiving to work supervisors is needed for nurses to access work support for family caregiving. Little is known about characteristics of nurses who decide to/not to disclose family caregiving to supervisors. Objective: The objective was to examine characteristics of nurses based on whether they disclosed caregiving responsibilities to their nursing supervisors and describe reasons for non-disclosure. Methods: This was a secondary analysis of a cross-sectional survey. Registered nurses who had a work supervisor and cared for an older adult family member completed a survey including demographics, work and caregiving characteristics, and disclosure. Descriptive statistics and binary logistic regression were conducted. Results: The sample included 162 nurses. Participants were on average 50 years old, 90.1% female, 65.4% married, and 80.9% were caring for a parent or parent-in-law. The disclosure was more likely among nurses who provided higher intensity care (hours of care), cared for a parent or in-law, or had a quality caregiver-care recipient relationship. Reasons for non-disclosure included wanting to separate personal and work life, discomfort, and fear of consequences. Conclusions: Nurses struggle with similar disclosure challenges as other family caregivers. Care intensity, caregiver-care recipient relationships, and care stress were associated with disclosure behaviors. [ABSTRACT FROM AUTHOR]

Abstract: The purpose of this clinical concept report is to describe a public health project in rural Indiana that addressed the complex social issue or “wicked problem” of childhood trauma. The project was implemented through a unique partnership between nursing faculty and Cooperative Extension Educators, community‐based workers who are associated with fulfilling the mission of Land Grant Universities. The core focus of the project entailed a nurse and a Cooperative Extension Educator co‐teaching trauma‐informed parenting classes to rural dwelling, kinship caregivers. Kinship caregivers are often grandparents who assume the parenting role after the child has been removed from the birth parents’ care. The trauma‐informed curriculum was developed by experts in child trauma and is available through the National Child Traumatic Stress Network. The unique partnership provided insight into the different missions of the two organizations, different values and workflow metrics, and different schedules, which at times proved to be barriers to implementation. This discussion focuses on deconstructing the goals and objectives of the project and retrospectively, describing recommendations so that public health nurses may partner with Extension Educators in their communities for optimal project success. [ABSTRACT FROM AUTHOR]

Background: Approximately 10-15% of birth mothers and fathers experience postpartum depression, but reports of depressive symptoms in adoptive parents are more variable. Findings from investigators range from 10% to 32%, which may mask the experiences of distinct groups of adoptive parents from pre-to post-placement of a child.Methods: We performed latent class growth analysis using the Center for Epidemiologic Studies-Depression scores of 129 primarily heterosexual, adoptive parents (50% females) for three time points: 4-6 weeks pre-placement of the child, 4-6 weeks post-placement, and 5-6 months post-placement. Mixed effects models by parent depressive trajectories were also conducted for three types of variables: interpersonal, psychological symptoms, and life orientation.Results: Five classes of depressive symptom trajectories were found. The majority of parents (71%) belonged to a class with low levels of depressive symptoms across time. However, two classes of parents were above the threshold for depressive symptoms at placement, and three classes of parents were above the threshold at 6 months post-placement. The majority of interpersonal, psychological symptom, and life orientation variables were significant across classes and by time.Limitations: The homogeneity of the sample calls for replication of study findings.Conclusions: An explanation for inconsistencies in the range of adoptive parent depressive symptoms may be explained by different subgroups of parents who vary by their trajectory of depressive symptoms before and after placement of the child. Adoption and mental health professionals should be aware that select adoptive parents may struggle pre-and post-placement of a child. [ABSTRACT FROM AUTHOR]

aim The purpose of this study was to determine leadership behaviors developed by nursing students and peers before and after a service-learning experience. background Nurses have been called to fill growing needs in the health care setting, rendering care to vulnerable and diverse populations in a wide range of organizations. Leadership behaviors are therefore essential. method Baccalaureate students (N = 65) completed the Student Leadership Practices Inventory-Self at the beginning and end of the semester. The students also rated peers using the Leadership Practices Inventory-Observer and answered six questions about service-learning. results Repeated measures of analysis of variance for pre- and posttests revealed that leadership behaviors improved (p < .0001). A significant correlation was found (p = .02) between the overall posttest scores for both instruments. conclusion Integrating service-learning into a leadership course is an effective approach to the development of leadership behaviors. [ABSTRACT FROM AUTHOR]

Background: Most of the 2 million adoptive parents in the United States make the transition to parenting successfully. Adoptive parents who do not make the transition easily may put their children at risk for negative outcomes. Objectives: The aim of this study was to further refine Foli's midrange theory of postadoption depression, which postulates that fulfillment of expectations is a principal contributor to parental emotional health status, aggravation, and bonding. Methods: The linked dataset (National Survey of Children's Health and National Survey of Adoptive Parents) was used for structural equation modeling. The sample consisted of 1,426 parents with adopted children who had been placed in the home more than 2 years before survey completion. Results: Special services and child's behaviors were direct determinants of parental expectations, and parental expectations , were direct determinants of parental aggravation and parental bonding. As anticipated, parental expectations served as a mediator between child-related variables and parental outcomes. A path was also found between child's behaviors and special services and parental emotional health status. Child's past trauma was also associated with parental bonding. Discussion: Parental expectations showed direct relationships with the latent variables of parental aggravation and bonding. Future research should examine factors associated with early transition when children have been in the adoptive home less than 2 years and include specific expectations held by parents. [ABSTRACT FROM AUTHOR]

Background: Most of the 2 million adoptive parents in the United States make the transition to parenting successfully. Adoptive parents who do not make the transition easily may put their children at risk for negative outcomes. Objectives: The aim of this study was to further refine Foli's midrange theory of postadoption depression, which postulates that fulfillment of expectations is a principal contributor to parental emotional health status, aggravation, and bonding. Methods: The linked dataset (National Survey of Children's Health and National Survey of Adoptive Parents) was used for structural equation modeling. The sample consisted of 1,426 parents with adopted children who had been placed in the home more than 2 years before survey completion. Results: Special services and child's behaviors were direct determinants of parental expectations, and parental expectations , were direct determinants of parental aggravation and parental bonding. As anticipated, parental expectations served as a mediator between child-related variables and parental outcomes. A path was also found between child's behaviors and special services and parental emotional health status. Child's past trauma was also associated with parental bonding. Discussion: Parental expectations showed direct relationships with the latent variables of parental aggravation and bonding. Future research should examine factors associated with early transition when children have been in the adoptive home less than 2 years and include specific expectations held by parents. [ABSTRACT FROM AUTHOR]

The article discusses a study on the paternal post-adoption depression published online in the December 3, 2012 issue of the journal "Psychology of Men and Masculinity." The researchers Karen J. Foli, Susan C. South, and Megan Hebdon conducted descriptive statistics evaluating demographics, postpartum depression predictors inventory-revised, and the mother-to-infant bonding scale. They conclude adoptive fathers should be assessed for depressive symptoms.

Relationship satisfaction has been widely studied among biological parents; however, concomitant research on adoptive parents is relatively lacking. The current study reports on a survey completed by 251 mothers who had adopted a child in the past 24 months. Participants completed measures of several aspects of the vulnerability–stress–adaptation model of marital satisfaction. Results indicated that satisfaction, as measured by a short form of the Dyadic Adjustment Scale (DAS-7), was related to several enduring vulnerabilities, adaptive processes, and stressors. Significant individual predictors of relationship satisfaction included: socioeconomic status, partner support, enthusiasm of partner for being a parent, and feelings of rest. Findings suggest that the relationship satisfaction of adoptive mothers is not affected by infertility or factors related to the adoption process, but rather by aspects of mental health, well-being, and support that are common to the parenting experience. [ABSTRACT FROM PUBLISHER]

PURPOSE: This study describes the practice settings and interventions of nurses who care for members of the adoption triad (AT; birth parents, adoptive parents, child). DESIGN AND METHODS: A 28-item, descriptive, cross-sectional survey was used. FINDINGS: Ninety-seven (97) nurses provided complete (65) or partial (32) responses. Most frequently reported practice settings were labor, delivery or postpartum unit, and pediatrics. Assessed needs varied by AT members. However, interventions for all members of the triad included emotional support and therapeutic communication. PRACTICE IMPLICATIONS: The unique placement of advanced practice nurses in various clinical settings allows for contact with members of the AT in vulnerable and crisis periods. [ABSTRACT FROM AUTHOR]

Despite understanding of the negative outcomes for children in a household with a depressed parent, fathers who experience postadoption depression have not been studied. This exploratory study describes adoption professionals' perceptions of fathers' experiences with postadoption depression. Twenty-five professionals who interact with adoptive families returned completed web-based survey data. Overall, respondents reported that fathers who experienced postadoption depression, were perceived as more likely to become disengaged from the family, and more likely to display anger and frustration rather than sadness or melancholy. Respondents appear divided on whether the adoptive father's depression was a reaction to the mother's depression. Mental health professionals should consider gender differences in depressive symptoms when assessing and treating adoptive fathers. [ABSTRACT FROM AUTHOR]

A limited number of studies have explored parental depression in the postadoption time periods and these studies frequently lack a social context of the adoptive parent experience. The objective of this study is to form a midrange theoretical interpretation of parental postadoption depression as shared by adoptive parents and experts through a grounded theory approach. Semistructured interviews of adoptive parents, who acknowledge being depressed after the child is placed in the home, and adoption experts are audiotaped, transcribed, and coded to reveal themes. In total, 30 interviews are conducted. Researchers are also participant-observers during an adoptive parent support group meeting. Data reveal recurrent themes in relation to postadoption depression. These themes take into account the various contexts of adoption (international and domestic, public and private, etc.). Parents express unfulfilled and unrealistic expectations in the domains of self, child, family or friends, and society or others. A theoretical model is presented to facilitate the understanding of depression reported by adoptive parents. [ABSTRACT FROM AUTHOR]

PURPOSE. This discussion presents central auditory processing disorders to pediatric nurses who can influence decisions, educate parents and children, and advocate for children and families in the healthcare and educational settings. CONCLUSIONS. Nurses' understanding of central auditory processing disorders and their signs and symptoms may help prevent misdiagnosis or underdiagnosis in the pediatric population. PRACTICE IMPLICATIONS. The common indicators of central auditory processing disorders often mimic other childhood disorders such as attention deficit hyperactivity disorder. Testing for central auditory processing disorders is optimized when children are on the appropriate medication at the time of testing. [ABSTRACT FROM AUTHOR]

Transracial/transcultural adoption is defined as a child of one race or ethnic group placed with parent(s) of a different race or ethnic group. An estimated 2 million children in the United States were identified as adopted in the 2010 census, and approximately one-fourth of these were transracial adoptions. Both a history of adoption and a strong ethnic or racial identity are specifically associated with health-related risk and protective factors for psychosocial, academic, and health behavior outcomes. A patient with a history of transracial adoption presents unique and important considerations for culturally responsive nursing care. This article begins with nursing practice considerations for transracially adoptive patients and provides an overview of epidemiology; relevant trauma informed nursing care; laws and racial identity formation, and a mental model of health disparities to guide future directions. We synthesize information relevant to nursing care of individuals who are transracially adopted and racial/ethnic identity formation, including socialization and a merging model to conceptualize identities. The article also discusses principles of trauma informed care and health disparities and future improvements in the context of this population. [ABSTRACT FROM AUTHOR]

Affective states, such as feelings of anger and excitement, are linked to health outcomes and behaviors. The benefits of physical activity for individual affect is known; however, how affect influences physical activity participation is less understood. Using Whittemore and Knafl's framework, this integrative review examines the influence of affect on adult physical activity. using six databases, 19 articles published between 1997 and 2019. Themes found include support for the influence of positive affect on increased physical activity, a temporal aspect of affect, a variety of measurement tools, and varying uses of theoretical frameworks across studies. Advanced practice nurses and registered nurses may improve patient health behaviors, such as physical activity, by incorporating affect-focused assessments. Review findings support consideration of affect in physical activity counseling. Further research using theory-driven methods and consistent affect assessments is needed to test the complex relationship between affect and physical activity. [ABSTRACT FROM AUTHOR]

Background: Only 21% of U.S. women meet the recommended physical activity guidelines, placing them at increased risk for long-term conditions such as heart disease and diabetes. Physical activity is influenced by individual and interpersonal factors (e.g., romantic partners). Individual factors, such as positive affect, are associated with lower mortality risk and improved health behaviors. Objectives: This secondary data analysis, guided by Fredrickson's Broaden and Build Theory, aims to examine the relationship between positive affect of married women (n = 115 couples) and their physical activity behavior on the same- and next- day, while also considering their spouses' positive affect. Methods: Two population average models assessed the relationship of calm and happy (positive affect) to physical activity. Physical activity was assessed as the sum of the minutes of moderate-to-vigorous physical activity (MVPA) over the prior 24 hours. Covariates of age, baseline activity frequency, education, marital quality, and race/ethnicity were also included. Results: Women's happiness (β = 0.15, p <.005), not calmness (β = −0.03, p =.60), was found to have a significant association with same-day MVPA. Spouses' happiness (β = 0.11, p =.045) was significantly associated with women's next-day MVPA while their calmness (β = −0.04, p =.44) was not. Conclusions: The results of this study support that incorporating positive affect could be valuable for improving physical activity behaviors. Spouse reports provide additional context to consider in physical activity promotion research. [ABSTRACT FROM AUTHOR]

AIM To report an analysis of the concept of pediatric assent. BACKGROUND The concept of assent is poorly defined in current literature which may lead to potentially flawed practices in obtaining pediatric assent. DESIGN The Walker and Avant (2011) method is used to provide clarity to the concept of pediatric assent. DATA SOURCES Data were collected from PubMed, Academic Search Premier, PhilPapers, Wikipedia, and Google. REVIEW METHODS Data were collected from 2014 to 2015. Twenty-three sources published between 2011 and 2015, nine sources published between 2003 and 2009, the Belmont Report (1979), and the American Academy of Pediatrics' report (1995) were included for pertinent contributions to this multidisciplinary concept analysis. RESULTS Elements of assent include a patient's thoughtful review of the proposed treatment and rational decision in choosing the best course of action. There may be social, familial, and cognitive development factors influencing this process. CONCLUSION This framework uses nurses' knowledge of cognitive development and ethics to inform practice. Assent is respectful of minor patients and ensures their rights are protected. Policies and procedures can be developed to incorporate assent, researchers have a stronger conceptual base, and educators can train nurses to help pediatric patients develop medical decision making skills. [ABSTRACT FROM AUTHOR]

In this article the author discusses the need for social support systems for adoptive parents and her experience struggling with depression during her own adoption proceedings. Topics include an overview of two articles the author read that empowered her, which both dealt with the issue of depression in adoptive parents and the research that led her to co-author a book with her husband titled "The Post-Adoption Blues: Overcoming the Unforeseen Challenges of Adoption."

Rising healthcare costs and the management of diabetes are financially straining to healthcare organizations. The study purpose was to examine whether a direct relationship existed between the cost of hospitalization, length of stay, excess admission days, and discharge blood glucose (DC-BG) levels and utilizing a standardized glycemic protocol. A retrospective cohort analysis was conducted of adult diabetes mellitus type 2 (DM-2) patients’ pre-diabetic protocol (January 1, 2011-December 31, 2011) and post-diabetic protocol (August 1, 2012-October 31, 2012). The sample included DM-2 inpatients aged ≥18 years admitted without complications and/or with abnormal fasting blood glucose. Pre-protocol sample comprised n = 346 subjects and post-protocol sample comprised n = 149 subjects. Patients who received the diabetic protocol in 2012 experienced a decrease in the DC-BG (p < .05) and decrease in excess admission days (p < .05). Evidence supports that utilizing a standardized glycemic protocol improves glycemic control and reduces healthcare cost. [ABSTRACT FROM AUTHOR]

Purpose: The aim of this article is to use Walker and Avant's methodological approach to provide clarity and a definition of optimum function as it relates to patients with heart failure (HF). Background: Understanding optimum function in patients with HF can help advanced practice nurses (APNs) identify clinical signs of deterioration. Interpreting patient descriptions of signs and symptoms may be the first cues prior to diagnosis. Data Source: Literature searches included electronic scientific databases and a manual search. Literature from 2005 to 2013 was reviewed. Themes were searched for function. The text was limited to English language peer‐reviewed articles, resulting in 43 articles and 3 books in the analysis. Conclusion: A definition of optimum function was developed from a synthesis of the literature's common themes. The four defining attributes include: multidimensional aspect (physical, cognitive, psychosocial, physiological, and spiritual), achieving a desired goal, dynamic and relative change (compared with previous functioning), and most favorable level of functioning. Defining optimum function in patients with HF provides clarity of patient communication to and between APNs. The concept promotes patient‐centered care, enabling goal adjustment by the patient and APN. The concept analysis facilitates a deeper understanding of communication during the patient encounter. [ABSTRACT FROM AUTHOR]

Although there is an extensive research literature examining the change in relationship quality of birth parents during the transition to parenthood, there is comparatively less work on how the relationship of adoptive parents fares from pre- to postplacement of the adopted child. In the current study, we examine the relationship quality (global satisfaction, feelings of love, feelings of ambivalence) of 127 adoptive parents across the transition from preplacement to approximately 6 months postplacement of the adopted child. Following the vulnerability-stress-adaptation (VSA) model of marital quality and stability, we examined various intrapersonal vulnerability factors, couple adaptive processes, and stressful factors primarily related to the adoption process as predictors of relationship quality across 3 waves (4 to 6 weeks prior to placement of the adopted child, 4 to 6 weeks postplacement of the adopted child in the home, and 5 to 6 months post-postplacement). Results indicated that, in general, relationship satisfaction and feelings of love decreased, and relationship ambivalence increased, from pre- to postplacement across the sample. Significant predictors of greater relationship satisfaction, regardless of time, included higher self-esteem, greater relationship maintenance, a better sexual relationship, and more partner support; love was significantly predicted by greater maintenance and sexual relationship, lower conflict, and a history of infertility; and higher conflict significantly predicted higher ambivalence. Our findings suggest that, in general, adaptive processes between couples are the most consistent predictors of marital quality over the transition to parenthood in adoptive parents. (PsycINFO Database Record (c) 2019 APA, all rights reserved). [ABSTRACT FROM AUTHOR]

Background: Minority providers are more likely to practice in underserved areas with minority populations. Currently the representation of minorities in healthcare professions is less than that of the United States population. More research is needed to examine specific variables associated with educational success of minority students. Purpose: The purpose of this study is to examine, and increase the understanding of, current factors that influence success among ethnic and minority nursing students. Methods: The revised Minority Student Nurse Questionnaire (MSNQ) was utilized for this study with a sample of 31 students from 2 entry-level nursing programs in the Midwest. Results: Minority students were slightly older than traditional college students and consisted of African-American/Black, Native (American) Indian, Asian, Hispanic/Latino, and Hawaiian. Students reported multiple factors that influenced their higher education experience. Academic services and cultural organizations were available, free, but were used by less than half of the students. Several sources of financial assistance are important, including scholarships, federal subsidized and unsubsidized loans, and grants. Students most strongly disagreed with the statement that 'the number of minorities in this program is representative of the number of minorities overall.' Students felt that several services were supportive and helpful strategies for success. Conclusion: Although progress has been made to improve success of minority students, numbers continue to lag between demographic population overall. [ABSTRACT FROM AUTHOR]