The aim is to clarify the concept of “obstetric violence in the United States of America.” Obstetric violence (OV) is a poorly defined and rarely applied concept in the United States that causes significant harm and requires recognition. The design is a concept analysis to examine the structure and function of OV in the United States. An English language literature review with no date restrictions was performed using CINAHL, PubMed, and Google search. The search was expanded to the related terms “birth rape” and “birth trauma.” The concept analysis was conducted using the method outlined by Walker and Avant. The synthesized definition proposed is: Obstetric violence is abuse or mistreatment by a health care provider of a female who is engaged in fertility treatment, preconception care, pregnant, birthing, or postpartum; or the performance of any invasive or surgical procedure during the full span of the childbearing continuum without informed consent, that is coerced, or in violation of refusal. It is a sex‐specific form of violence against women (VAW) that is a violation of human rights. A clear definition and understanding of OV in the United States will allow for its recognition. A conceptual basis for naming it can lead to better knowing its prevalence, further studies, and operationalizing the term to create pathways for accountability and restitution. Nurses are in a unique position to minimize OV risk and to promote individual and unit‐based responses for zero‐tolerance.
The dual purpose of this article is to present a formal theory analysis combined with recommendations for the use of social justice in nursing as a framework for the study of obstetric violence in US hospitals. A theory analysis of emancipatory nursing praxis as a middle-range theory of social justice in nursing was conducted using the strategy by Walker and Avant. The theory of social justice in nursing was determined to be logical, useful, and generalizable. The soundness and usability of the theory support the recommendations made for it to be applied to the study of obstetric violence, plus quality and outcome problems in maternity care that have been resistant to sustained progress and may benefit from a new paradigm for continued study. The alignment for obstetric violence to be studied with a social justice framework is linked to the theory’s origins in critical social theory and the evolving concept of obstetric violence as a sex-specific form of violence against women that is a violation of human rights. The postmodern expansion of the body of work based on critical theory provides examples from emancipatory and feminist researchers for recognizing how the study of obstetric violence is compatible with a theoretical framework for social justice in nursing. The suitability of this framework to guide the further research needed to better understand, identify, and minimize harms from the occurrence of obstetric violence is argued. In addition, “The Code” for the American Nurses Association (ANA) is cited as a professional reference that outlines nurses’ responsibilities for practice based on ethics, human rights, and social justice that are antithetical to the occurrence of obstetric violence.
Problem One in seven children, aged 3–17, have a mental health diagnosis with suicide being the second leading cause of death in the United States in persons aged 10–24. Adolescents are at high risk for mental health disorders, substance use, and risky behaviors, yet most adolescents never receive treatment. Research is needed to answer the question, “What are adolescents' perceived barriers and facilitators to engaging in mental health treatment?” Methods A four‐step qualitative meta‐synthesis design included: A structured research question and search strategy, data immersion through quality appraisal, thematic synthesis of primary research studies, and reciprocal translation of derived themes. Findings Eight studies met inclusion criteria. Autonomy was the primary theme that emerged. Meta‐synthesis produced five subthemes: (a) choice as integral to engagement, (b) stigma as barrier to engagement, (c) quality of the therapeutic relationship as integral to engagement, (d) systemic influences as both barrier and facilitator to engagement, and (e) mental health literacy as crucial factor in decision to engage. Conclusion Adolescents require autonomy to engage in mental health treatment. Improving treatment engagement in adolescents requires interventions that address their ability to be autonomous.
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