"I loved interacting with this younger generation": Exploring the impact of a virtual service-learning program on social connectedness among older adults during the COVID-19 pandemic

Pervasive feelings of social isolation and loneliness have been longstanding among up to half of older adults, and have received increased attention amid the COVID-19 pandemic. Programs to address loneliness and facilitate meaningful connections are vital for physical and mental wellbeing. The purpose of this study was to explore older adults' experiences participating as volunteers in the Aging is Very Personal (AIVP) service-learning program in relation to feelings of social connectedness. As part of an interprofessional gerontology course, 112 undergraduate students interviewed 55 older adult volunteers via Zoom on the lived experience of aging. Older adult volunteers were surveyed on their experiences with the COVID-19 pandemic and the virtual AIVP program. Data were analyzed using descriptive statistics and reflexive thematic analysis of open-ended questions. Participants reported participation in AIVP had a positive effect on their mood (86%) and made them feel more socially connected (71%). Six themes summarized their experiences: reduced feelings of social isolation; brought me joy; created meaningful intergenerational relationships; gave me a sense of purpose; facilitated genuine engagement; and created important learning opportunities for future health professionals. Virtual AIVP was identified as a valuable program to improve mood and feelings of social connectedness.

Digital Storytelling: Sharing Palliative Care Experiences as an Innovative Educational Approach

ABSTRACT

When students are exposed to digital stories about a particular nursing field, they feel more prepared to practice in that field. The purpose of this innovative teaching project was to introduce undergraduate nursing students to palliative care nursing through digital storytelling. Digital interviews with experienced nurses from five specialties were compiled and shared with students. Student responses indicated a positive impact on their professional identity and greater awareness about palliative care. Students benefited from hearing about "real" experiences and exploring diverse specialties and reported that this activity helped decrease their fear, find beauty in death, and value nursing presence.

"We Operate as an Organ": Parent Experiences of Having a Child With Type 1 Diabetes in a Rural Area

PURPOSE

The purpose of this study is to explore the experiences of parents of children with type 1 diabetes mellitus (T1DM) who are living in rural areas. Individuals living in rural areas face barriers to accessing health care that lead to significant health disparities with increased morbidity and mortality. There is a need to understand the unique experiences of those living in rural communities to support their health needs.

METHODS

In this qualitative study, a convenience sample of 11 parents of children who were diagnosed with T1DM in the last 10 years living in Vermont were recruited through connections with local health professionals and family support networks and interviewed about their experiences. Interviews were transcribed verbatim and analyzed using Braun and Clarke's 6-step approach to reflexive thematic analysis.

RESULTS

Five themes were identified to capture the experience of parenting a child with T1DM in a rural community, including enduring emotional traumas, living life on call, adapting to everyday challenges, lacking a safety net for support, and finding a rhythm.

CONCLUSIONS

Although findings echo many themes found in previous studies on experiences of parents of children with T1DM, participants also identified unique barriers such as physical distance from formal and informal support systems, unreliable and/or insufficient technological resources, and lack of understanding of T1DM by their communities, including among child care and schools. Diabetes care and education specialists working with families living in rural areas must explore ways to educate key supports to these families to minimize isolation, stigma, and burnout among parents.

Autism as a difference or a disorder? Exploring the views of individuals who use peer-led online support groups for autistic partners

LAY ABSTRACT

Individuals who use peer-led online support groups for partners of autistics describe diverse views of autism, with some describing autism as a difference and others describing it as a disorder. I conducted online interviews with 162 non-autistics who believed they were in relationships with autistics and who participated in online support groups on social media. I analyzed their responses by constantly comparing each interview to previous interviews to develop a theory about their social experiences. As many as one-third of autistics participate in romantic relationships, and many of their partners seek support through groups on social media. Few studies explore what it is like to be a non-autistic person who is in a relationship with an autistic person. The way that participants viewed autism influenced the way that they viewed themselves, their partners, and their relationships. Many participants who were dissatisfied in their relationships shared that they believed their partners were autistic, but their partners had never been formally evaluated and did not self-identify as autistic. Future research should explore ways that autism labels are (mis)applied by the general public based on negative stereotypes about autism.

The lived experience of meltdowns for autistic adults

LAY ABSTRACT

There is not a lot known about what it feels like for autistic people to have a meltdown. Past research has focused on what meltdowns are like for parents and what meltdowns look like from the outside without understanding what it is like for the person having the meltdown. We asked 32 autistic adults about what it is like for them to have a meltdown. We asked them to tell us about their thoughts and feelings about having a meltdown. Then, we looked for themes in their responses that summarized the meltdown experience. Our findings showed that meltdowns hold different meaning to different people. During a meltdown, we found that most autistics described feeling overwhelmed by information, senses, and social and emotional stress. They often felt extreme emotions, such as anger, sadness, and fear, and had trouble with thinking and memory during the meltdown. Participants described trying to stay in control of themselves, often feeling like they were not themselves during meltdowns. They described the meltdown as a way of letting go of or releasing the extreme emotions they felt. Participants tried to stay away from things or people that might trigger a meltdown or tried to make sure they were alone if they felt a meltdown may be coming as a way of avoiding harm-including harm to their bodies, their emotions, and their relationships. These findings offer an important look into what it is like for autistic adults to have meltdowns from their own point of view.

Exploring the Birth Stories of Women on the Autism Spectrum

OBJECTIVE

To explore birth stories of autistic women to understand how they make sense of the experience of childbirth.

DESIGN

Narrative analysis.

SETTING

Online interviews.

PARTICIPANTS

Sixteen women on the autism spectrum shared 19 birth stories.

METHODS

Participants were recruited from online autism forums and were invited to share their birth stories via online asynchronous interviews. Using Burke's approach to narrative analysis, we identified five elements within each story, including Scene (when/where), Agents (who), Act (what), Agency (how), and Purpose (why). We explored parts of the narratives where two or more elements were out of balance with each other.

RESULTS

Tension most often occurred when actions taken by the health care team (Act) were out of balance with their approach to care (Agency), which left participants feeling that their concerns were minimized, their wishes were ignored, and they were left out of critical communication and education. Participants also struggled when their own autistic traits (Agent), such as sensory sensitivities, were out of balance with the birth environment (Scene), which impaired their ability to communicate with providers and participate in the birth.

CONCLUSION

Poor communication, untreated pain, and sensory overload dominated the birth narratives of participants. Nurses should trust women's reports of pain and anxiety because autistic women may appear calm even when in severe distress. Environmental adjustments, such as dimming the lights, can help minimize sensory overload. Nurses need to provide thorough and nonjudgmental education about the birth process to ensure that autistic women feel safe and in control and do not withdraw from care.

Meta-Ethnography of Qualitative Research on the Experience of Being a Partner to an Individual with Schizophrenia Spectrum Disorder

Several qualitative studies explore the experience of being a partner to an individual with schizophrenia spectrum disorder, but these studies remain isolated "islands of knowledge." This meta-ethnography aimed to synthesize current qualitative studies using Noblit and Hare's method. Thirteen studies were identified for inclusion. Three overarching themes were revealed: unmet expectations of relationship, renegotiating relationship roles, and separation versus togetherness. Themes interacted as a cycle with separation versus togetherness as temporal endpoints. Partners also renegotiated relationships with mental health professionals to accommodate unmet expectations. Leverage points for intervention were identified.

Exploring the Experience of Self-Diagnosis of Autism Spectrum Disorder in Adults

One in 68 Americans has autism spectrum disorder (ASD), and diagnosis is often delayed into adulthood in individuals without comorbid intellectual disability. Many undiagnosed adults resort to self-diagnosis. The purpose of this descriptive phenomenology was to explore the experience of realizing a self-diagnosis of ASD among 37 individuals who were not formally diagnosed. Results revealed five themes: feeling "othered," managing self doubt, sense of belonging, understanding myself, and questioning the need for formal diagnosis. Healthcare professionals must have an understanding of self-diagnosis to help individuals transition to formal diagnosis and to adequately educate, support, and screen this population for comorbidities.

Realizing a diagnosis of autism spectrum disorder as an adult

Many individuals with autism spectrum disorder are not diagnosed until adulthood, yet little is known about their experiences. This descriptive phenomenological study aimed to explore the experience of realizing a diagnosis of autism spectrum disorder in adulthood. A purposive sample of 77 adults was asked to describe their experiences of realizing a diagnosis as adults via an open-ended online survey. Data were analysed using Colaizzi's method and six themes were derived: feeling different from others, riding an emotional rollercoaster, striving to accept themselves, strategizing to improve their lives, maintaining normalcy, and wandering into the future. Nurses must realize the importance of screening for depression following a new diagnosis. Barriers to reaching a formal diagnosis should also be evaluated.

Balancing Competing Needs: A Meta-Ethnography of Being a Partner to an Individual With a Mood Disorder

BACKGROUND

More than 20% of individuals experience a mood disorder in their lifetime. Qualitative studies have explored the experience of being a partner to an individual with a mood disorder, but these studies remain isolated pieces of a larger puzzle.

AIMS

In this metasynthesis, I aimed to integrate current qualitative research to describe the experience of being a partner to an individual with a mood disorder.

METHOD

A systematic search was conducted to identify qualitative research. Noblit and Hare's meta-ethnography was used to translate key metaphors from individual studies into a single set of metaphors to describe the experience.

RESULTS

Results indicated that these partners are disenfranchised caregivers balancing their own needs with partners' perceived and reported needs to strive for a stasis of guarded stability.

CONCLUSIONS

Future research must explore ways to support these partners and include them in the health care team.

Caregiving for a loved one with dementia at the end of life: an emergent theory of rediscovering

Millions face the challenges of caregiving for a loved one with dementia. A classic Glaserian grounded theory methodology was used to discover the problem that caregivers of individuals with dementia face at the end of life and how they attempt to resolve that problem. Data were collected from a theoretical sample of 101 participants through in-person interviews, online interviews, book and blog memoirs of caregivers, and participant observation. Constant comparative method revealed a basic social psychological problem of role entrapment. Caregivers attempt to resolve this problem through a 5-stage basic social psychological process of rediscovering including missing the past, sacrificing self, yearning for escape, reclaiming identity, and finding joy. Health care professionals can support caregivers through this journey by validating, preparing caregivers for future stages, and encouraging natural coping strategies identified in this process. This study provides a substantive theory that may serve as a framework for future studies.

Caregivers' experiences seeking hospice care for loved ones with dementia

As the prevalence of dementia continues to grow, informal caregivers face unique challenges as they approach the end of life, and access to support and palliative care is often limited. I used a phenomenological approach to explore the experiences of caregivers actively seeking formal end-of-life care, in particular hospice care, for a loved one with dementia. In-depth interviews with 11 caregivers about 14 patients revealed five themes, including: setting the stage for heartbreak, reaching the boiling point, getting through the front lines, settling for less, and welcoming death. Nurses must recognize the complex needs of caregivers, educate caregivers on the disease process, and adjust to palliative goals sooner to meet the needs of caregivers. Prevalence of these issues must be further examined through quantitative study to evaluate the need to reconsider current hospice eligibility criteria based on prognosis.

A second community outbreak of waterborne giardiasis in Canada and serological investigation of patients

A waterborne outbreak of giardiasis which occurred 5 years after another in the same town in Canada was investigated. Sera from residents defined as cases or non-cases were tested by enzyme-linked immunosorbent assay (ELISA) and compared with sera from symptomatic and asymptomatic control groups. The outbreak-associated Giardia isolate was retrieved from contaminated drinking water and antigen from this strain was used in the serological investigation. Up to 84% of cases were identified by ELISA. More cases were identified by elevated immunoglobulin (Ig) G than by either elevated anti-Giardia IgA or IgM levels. Residents of the community infected during the first outbreak were significantly less likely to have been reinfected during the second outbreak. This is the first report of a second waterborne outbreak occurring in a community and results of the investigations are consistent with an acquired, protective immunity lasting at least 5 years.