Intimate Partner Violence: ‘Troubling Knowledge and Practice Gaps’ among Rural Providers

By Sylvia Foley, AJN senior editor

Table 8. Perceived self-efficacy on a 1-to-5 scale (mean score above 2.5 indicates greater sense of self-efficacy). Table 8. Perceived self-efficacy on a 1-to-5 scale (higher score indicates greater self-efficacy).

Intimate partner violence (IPV) remains a widespread health and social problem in the United States, affecting an estimated one in three women during her lifetime.

Health care providers can make a critical difference in the lives of these women, yet a lack of IPV-related knowledge, negative attitudes and beliefs, and low rates of screening are common. And women in rural areas face particular challenges.

To learn more about rural providers with regard to IPV, nurse researchers Karen Roush and Ann Kurth conducted a study. They report their findings in this month’s CE–Original Research feature, “Intimate Partner Violence: The Knowledge, Attitudes, Beliefs, and Behaviors of Rural Health Care Providers.” Here’s an overview:

Methods: Health care providers working in a large rural health network were asked to complete electronic surveys that examined their IPV-related knowledge, attitudes, beliefs, and behaviors. Descriptive and correlational statistical analyses of the data were conducted.
Results: A total of 93 providers returned completed surveys. In general, the respondents demonstrated good overall knowledge, judicious attitudes, and beliefs congruent with the available […]

The Real and Evolving Threat of Superbugs: A Primer

pillsinspaceJust how super is the latest superbug? The good news is that the infected U.S. patient has recovered. The bad news:  mcr-1, the resistance gene identified in this strain of E. coli, has brought us another frightening step closer to a “post-antibiotic” era.

In recent years, antimicrobial resistance among Gram-negative bacteria (E. coli, Klebsiella, Pseudomonas, Acinetobacter, Salmonella, and others) has been a growing public health concern. Most of the increase in resistance has been the result of mobile genetic elements that can easily transfer resistance from one bacterium to another, allowing bacteria to “catch” antibiotic resistance from one another.

To make matters worse, resistance enzymes are often packaged together. One genetic “cassette” can carry multiple resistance determinants, thereby spreading resistance to more than one class of antibiotics at the same time.

Early on, we relied on the carbapenem class of antibiotics to treat infections caused by multidrug-resistant (MDR) organisms such as the “ESBLs” (extended-spectrum beta-lactamase-producing organisms). But carbapenemase-producing organisms soon developed, and resistance to carbapenems spread quickly.

In 2009, the emergence of a “super” kind of carbapenem resistance gene, ndm-1 (New Delhi metallo-beta-lactamase) was found to be highly resistant to many antibiotic classes, including:

  • the carbapenems and other beta-lactams (penicillin derivatives and cephalosporins)
  • the fluoroquinolones (ciprofloxacin, levofloxacin, et al)
  • the aminoglycosides (gentamicin, amikacin, et al).

These antibiotic classes include the main drugs used to treat […]

Not a Nurse but Her Mother Was, and Now It Really Matters

June_Refl_Illustration Illustration by Lisa Dietrich for AJN

The loss of Emily Cappo’s mother, a competent and supportive parent and an accomplished nurse, leaves an enormous gap in her daughter’s life. Then her own son gets sick.

Cappo writes about these events in “I’m Not a Nurse, But My Mother Was,” the Reflections essay in the June issue of AJN.

Without her mother to turn to for help and guidance, Cappo has no idea how she’ll handle the situation. “There I was,” she writes,

the nonmedical person in my family, the person who hated blood and needles, being thrown into a situation demanding courage, stamina, and role modeling.

But we rise to the situation that presents itself, if the stakes are high enough. Cappo discovers what many nurses already know: the nurses who care for her son make all the difference in his care, and provide her with essential support as well. […]

AJN Hits the Road: From Wall Street to New Orleans

AJN’s editor-in-chief watches the nursing profession get a chance to ring the New York Stock Exchange bell, is exhorted to courageous action by critical care nurses in the Big Easy, records a podcast conversation with two nursing leaders.

May is always busy with professional meetings. I attend many of them, scouting out issues, trends, and authors. And then, of course, there’s Nurses Week, with its own flurry of activities.

NYSE JJ Podium Group 1 courtesy of Diane Mancino

Nurses ring the bell! This Nurses Week included a first for nursing: recognition by the New York Stock Exchange (NYSE). Johnson & Johnson’s Campaign for Nursing’s Future was invited to ring the closing bell of the NYSE on May 12, the official end of Nurses Week and the birthday of Florence Nightingale. Andrea Higham and Lorie Kraynak of the J&J campaign, along with Sue Hassmiller (Robert Wood Johnson Foundation), Beverly Malone (National League for Nursing), Diane Mancino (National Student Nurses Association), and other representatives of nursing organizations crowded the bell platform to watch the CFO of Johnson & Johnson ring the bell. I watched from the trading floor along with other nurses, nursing students, and organization […]

AJN in June: IPV, Late Effects of Breast Cancer Treatment, Nurse Activists, More

AJN0616 Cover Online

This month’s cover photo evokes the isolation faced by victims of intimate partner violence (IPV). According to Karen Roush, PhD, RN, lead author of the study in this issue that reports on the perceptions of rural health care providers who care for these victims, “ [i]solation is one of an abuser’s biggest weapons,” especially for those who live in rural areas.

Health care providers are positioned to provide support for victims of IPV, but knowledge and practice gaps get in the way. For more on this topic, read this month’s original research CE, “Intimate Partner Violence: The Knowledge, Attitudes, Beliefs, and Behaviors of Rural Health Care Providers.”

Some other articles of note in the June issue:

CE Feature: “Late and Long-Term Sequelae of Breast Cancer Treatment.” More than 12% of women will be diagnosed with breast cancer at some point in their lives; 78% of them can be expected to survive for at least 15 years. There are more than 2.8 million breast cancer survivors in the United States and as many as 90% of them report physical problems that can reduce functional ability, produce or exacerbate emotional problems, negatively affect body image, and diminish quality of life.

This third article in a series on cancer survivorship care from the […]

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