Rick Zoucha’s research while affiliated with Duquesne University and other places

Introduction Suicide is a Latinx leading cause of death. A deeper understanding of the cultural factors that can inform suicide prevention efforts among specific Latinx subgroups, such as Puerto Ricans, is needed. This study aimed to explore the cultural values and beliefs of Puerto Rican adults pertaining to suicide and its prevention. Methodology The Ethnonursing Research Method, a qualitative approach, was used for this study. Semi-structured interviews were conducted via Zoom with 27 Puerto Rican adults in the U.S. Southwest. Data were analyzed using Leininger’s four phases of data analysis. Results Three major themes were abstracted: (a) family should play a central role in suicide prevention, (b) a concern for what people will say or think can influence help-seeking, and (c) suicide prevention includes the provision of care that fosters confianza (relational trust, safe space). Discussion Culture care values, such as confianza and familismo, must inform suicide prevention efforts and stigma campaigns targeting Puerto Rican communities in the U.S. mainland.

People of Mexican heritage are a very diverse group geographically, historically, and culturally and are difficult to adequately describe. Although no specific set of characteristics can fully describe people of Mexican heritage, some commonalities distinguish them as an ethnic group, with many regional variations that reflect subcultures in Mexico and in the United States. A common term used to describe Spanish-speaking populations in the United States, including people of Mexican heritage, is Hispanic. However, the term can be misleading and can encompass many different people clustered together owing to a common heritage and lineage from Spain. Many Hispanic people prefer to be identified by descriptors more specific to their cultural heritage, such as Mexican, Mexican American, Latin American, Spanish American, Chicano, Latino, or Latinx. This chapter follows the dominant values and beliefs according to the 12 domains of the Purnell Model for Cultural Competence: overview/heritage, communication, family roles and organization, workforce issues, biocultural ecology, high-risk behaviors, nutrition, pregnancy, death rituals, spirituality, health-care practices, and health-care practitioners.

Introduction Widowhood cultural practices are detrimental to the health and well-being of widows in Nigeria. They are associated with a higher rate of morbidity and mortality than for single and married individuals. Purpose To explore and synthesize the literature on widowhood cultural practices and their effects on the health and well-being of Nigerian women in Nigeria and in the US to inform future research. Methods A comprehensive search of CINAHL, PubMed, Google Scholar, and Embase databases was performed using the Whittmore and Knafl Integrative Review Model. Critical appraisal was used to select the final 20 studies that met the inclusion criteria. Results Seven themes were identified: Inhumane treatment of widows, poor socio-economic status, support for detrimental widowhood cultural practices driven by culture, physiological well-being, psychosocial issues, support, and empowerment. Discussion Further research is needed to explore the practice and its impact in the Nigerian American population in the US.

Purpose: To explore the experiences of lung cancer survivors (LCSs) and their informal and professional caregivers with post-treatment care and to empower them to implement action-based study findings. Participants & setting: Participants were recruited using purposeful and snowball sampling from patients at a National Cancer Institute-designated cancer center in the northeastern United States. Methodologic approach: This study used a participatory action research (PAR) four-phase design. Phase 1 was a focused ethnography; phase 2 consisted of a core group of participants deciding on an action, which was implemented in phase 3; and phase 4 consisted of an evaluation of the action. Findings: The study found 28 categories, eight patterns, and three themes. The themes were the need for resources and education, involvement in mentoring and advocacy, and the value of living versus surviving. The action was creating two flyers focused on resources and advocacy for post-treatment support for LCSs. All participants agreed with the themes and action. Tobacco management and smoking-related stigma for LCSs were the only topics of dissent. Implications for nursing: Oncology nurses can use PAR to empower survivors in their post-treatment care. Future PAR cycles should focus on creating support groups and alleviating stigma for LCSs and their caregivers.

Active service members and Veterans with a combat-related traumatic brain injury (TBI) are four times more likely to attempt suicide than those without a TBI. TBIs are the signature injuries of the Post-9/11 conflicts and Combat Veterans (i.e., current and former service members who deployed in support of a combat mission) with these injuries are entitled to receive the Purple Heart medal. However, potentially tens of thousands of Combat Veterans did not receive, or were denied the Purple Heart during the first decade of the Global War on Terrorism because a TBI was not documented during the deployment. To our knowledge, this is the first study to explore the meaning of the Purple Heart and examine the impact of the Purple Heart on Army Combat Veterans with a combat-related TBI. Findings from this mixed methods study revealed that not receiving the Purple Heart is associated with increased suicide risk and lower quality of life after a brain injury. Additionally, thwarted belongingness, perceived burdensomeness, and perceived military institutional betrayal are associated with increased suicide risk in Army Combat Veterans with a TBI. This mixed methods study provides important insights into how Army culture is perceived and the power of the Purple Heart among this high-risk group of Combat Veterans.

Background: The threat of a disaster or potential for a disaster is something that may be experienced by individuals globally. Schools are places of daily mass gatherings which make them an ideal target for mass casualty, natural disasters, and biological incidents. Methods: An integrative review using Whittemore and Knafl's model was conducted to explore peer-reviewed publications about K-12 schools and natural disasters and pandemic preparedness and planning. Results: Themes identified from the systematic review of 12 articles reflected determinants and level of school preparedness, disaster plan components, compliance with government requirements, emergency equipment, supplies, drills, and training, collaboration with outside agencies, and perceptions of school preparedness. Preparedness for disasters and biological events among schools varies and multiple factors contribute to the level of preparedness. Perceptions of school preparedness differ among school community members. Schools perceive more preparedness for disasters than their actual level. Conclusions: Our nation's schools are not adequately prepared for disasters. There is a need for further research in schools to identify and understand preparedness for disasters.

Purpose: Parents' inability to speak English proficiently is associated with communication barriers in the care process of their children, social determinants of health, and poor child health outcomes. Research exploring perspectives of Spanish speaking parents with limited English proficiency (SSP-LEP) whose children are hospitalized in the context of culture is lacking in the literature. The purpose of this study was to explore the cultural experiences, values, and beliefs of SSP-LEP, of Mexican origin, whose children were hospitalized and to understand nurses' roles in providing culturally congruent care. Design and methods: Leininger's qualitative, ethnonursing method was used for this study. The Theory of Culture Care Diversity and Universality provided a guiding framework. Eleven SSP-LEP, of Mexican origin, participated in interviews conducted in-person and via Zoom. Data was analyzed using Leininger's four phases of qualitative analysis. Results: Three themes emerged: 1. role of the mother as an ever-present manager of care for the hospitalized child and family, 2. parents' difficult, fearful, stressful, and unknowing experiences in the presence of a language barrier, and 3. expected nursing care that was kind, respectful, compassionate, and attentive. Conclusions: Lack of knowledge creates hardships for parents who desire to be involved, informed caregivers. Communication in Spanish language is integral to parents' understanding and expected nursing care. SSP-LEP may have negative feelings; yet describe a positive care experience. Practice implications: Culturally congruent care should incorporate language services for information sharing that facilitates parent participation and decision-making; be kind, respectful, compassionate, and attentive; and promote maternal role maintenance.

Loneliness is linked to many physiological and psychological issues and disproportionately affects older adults. Interpersonal goals (compassion and self-image) are essential to interpersonal relationships; however, how they relate to loneliness in older adults is unknown. We investigated the impact of interpersonal goals on loneliness using the Ecosystem–Egosystem Theory of Social Motivation. This study, adopting a descriptive cross-sectional correlational design, used data from the 2016 Health and Retirement Study. Participants (n = 3212) included people aged >65 years (mean age: 75; female: 60.1%). We performed exploratory factor analysis with principal axis factoring and varimax rotation to examine the suitability of compassionate and self-image goals as separate factors. The complex samples general linear model was used to assess the relationship between loneliness and interpersonal goals. Interpersonal goals were significantly negatively associated with loneliness. Respondents with higher compassion and self-image goals reported lower loneliness levels. Our results contribute to understanding how interpersonal goals relate to loneliness in older adults. These initial findings warrant further investigation.