Jordon D Bosse | University of Rhode Island (original) (raw)

Papers by Jordon D Bosse

Journal of advanced nursing, Apr 15, 2024

Nursing Clinics of North America, Oct 31, 2023

Conclusions and Implications: Overall, nurse attitudes leaned toward the positive with regard to ... more Conclusions and Implications: Overall, nurse attitudes leaned toward the positive with regard to gay and lesbian pa tients. Factors contributing to positive attitudes toward gay and lesbian patients included: having a friend who is lesbian or gay, being Caucasian (or native to the country being studied), and being in support of non-discrimination acts in the workplace to protect lesbians and gays. Negative attitudes were influenced by strong religious views and number years as a nurse; attitudes toward gay men tended to be more negative than attitudes toward lesbian women. No articles focused on attitudes toward bisexual and transgender patients were identified. Conclusions: Attitudes of nurses in the articles reviewed tended to be positive, but were limited in terms of population and geographical settings. The majority of nurses in these studies were female and worked at major medical centers, thus more research is needed regarding the attitudes of male nurses and nurses in primary care settings toward these vulnerable individuals.

International Journal for Equity in Health, Aug 23, 2023

Background Gender minority (GM; individuals whose gender is not aligned with that traditionally a... more Background Gender minority (GM; individuals whose gender is not aligned with that traditionally associated with the sex that was assigned to them at birth) people have widely reported mistreatment in healthcare settings. Mistreatment is enacted by individuals within society who hold stigmatizing beliefs. However, the relationship between healthcare mistreatment and societal stigma (i.e., the degree to which society disapproves of GM people) is unclear and not measured consistently. Methods We analyzed data from 2,031 GM participants in The Population Research in Identity and Disparities for Equality (PRIDE) Study's 2019 Annual Questionnaire to determine whether societal stigma was associated with participants' past-year reports of mistreatment (defined as denial of healthcare services and/or lower quality care) in medical or mental healthcare settings. We created a proxy measure of societal stigma by incorporating variables validated in existing literature. Participants reported whether they had experienced mistreatment in medical and mental health settings independently. Results Healthcare denial and/or lower quality care during the past year was reported by 18.8% of our sample for medical settings and 12.5% for mental health settings. We found no associations between the societal stigma variables and past-year reports of healthcare denial and/or lower quality care in medical or mental healthcare settings. Conclusions Although a high proportion of GM people reported past-year healthcare mistreatment in both medical and mental health settings, mistreatment had no relationship with societal stigma. Factors other than societal stigma may be more important predictors of healthcare mistreatment, such as healthcare workers' knowledge of and attitudes toward GM people. However, other measures of societal stigma, or different types of mistreatment, may show stronger associations. Identifying key factors that contribute to mistreatment can serve as targets for intervention in communities and healthcare settings.

Background: There are high rates of depression and suicidality in transgender young adults (TGYA)... more Background: There are high rates of depression and suicidality in transgender young adults (TGYA) in response to parental rejection. The impact of sibling rejection on TGYA mental health relationship is not clear. There is also a lack of evidence on the impact of gender identify specific support. Purpose: The purpose of this study was to develop a measure of siblling gender identity-specific social support and to explore the impact of both parent and sibiling acceptance-rejection on depression and suicidality in TGYA. Method: Content experts and members of the transgendered community were included in the development of the sibling gender specific support scale. 470 TGYA between 18 and 25 years were recruited online using paid social media and completed all survey instruments online. Measures included sibling gender identity specific social support, parent and sibling acceptance-rejection, depression, suicidality, friend social support, connectedness to the transgender community, and demographic information. Principal components analysis, multiple regression, and logistic regression were conducted to answer the research questions. Results: Mean participant age was 21.4. The sample was predominantly Caucasian (79.6%) and assigned female at birth (93.6%). Items on the measure of gender identity specific support demonstrated adequate reliability and validity. Factor structure for received support differed based on TGYA and sibling sex assigned at birth constellation. Alarmingly high rates of depression, lifetime, and past year suicidality were reported. Higher perceived rejection from each family member significantly predicted an increase in TGYAs depression, and rejection from family members was cumulative. Having a genderqueer/nonbinary identity and less connection to the transgender community increased depression. Cumulative negative support for gender identity increased risk of depression and lifetime suicidality. Being older was associated with decreased depression and suicidality. Conclusion: TGYA perceptio [...]

Current Sexual Health Reports, Dec 1, 2019

Purpose of Review The purpose of this review is to update what is known about sexual orientation ... more Purpose of Review The purpose of this review is to update what is known about sexual orientation and gender identity development, including factors that facilitate positive development, and healthcare experiences of sexual and gender minority youth (SGMY) in relation to their identity. Recent Findings Models of identity development have been proposed that draw on the experiences of young people and their families rather than adult models of identity development. Family support can both help and hinder identity development, and healthcare providers are in a unique position to intervene. However, SGMY and their families experience significant barriers to accessing appropriate and affirming healthcare. Summary Key improvements in provider knowledge, healthcare systems, quality of care, and support for SGMY and their families are needed. Keywords Sexual and gender minority. Identity development. Healthcare experiences. Gender-affirming treatment This article is part of the Topical Collection on Female Sexual Dysfunction and Disorders

Journal of Nursing Scholarship, May 26, 2023

IntroductionTransgender and nonbinary young adults (TNB YA) report high rates of depression and m... more IntroductionTransgender and nonbinary young adults (TNB YA) report high rates of depression and more suicidality than their cisgender counterparts. Parental rejection is a known predictor of worse mental health among TNB YA; however, less is known about TNB YA experiences of sibling acceptance‐rejection. The purpose of this study was to determine how TNB YA perception of sibling and parental acceptance‐rejection are related to TNB YA depression and suicidality.DesignCross‐sectional.MethodsTNB YA (ages 18–25) who had disclosed their gender identity to an adult sibling were recruited to take part in an online study and completed measures of sibling and parent acceptance‐rejection, depression, as well as lifetime and past year suicidality. Stepwise regressions were conducted to evaluate associations between acceptance‐rejection and TNB YA depression and suicidality.ResultsThe sample consisted of 286 TNB YA (Mage = 21.5, SD = 2.2) who were predominantly White (80.6%) and assigned female sex at birth (92.7%). Each family member's acceptance‐rejection was associated with increased TNB YA depression scores when considered independently and combined. Independently, high rejection from each family member was associated with greater odds of reporting most suicidality outcomes. When all family members were considered together, only high rejection from a male parent was associated with four times greater odds of reporting lifetime suicidality. High rejection from both parents was associated with greater odds of reporting past year suicide attempt (OR: 3.26 female parent; 2.75 male parent).ConclusionRejection from family members is associated with worse depression and suicidality, and rejection from male parents may be particularly damaging. Sibling acceptance uniquely contributes to TNB YA's depression symptoms alone and in the context of parental support.

Annals of Internal Medicine, Oct 23, 2018

Burnout Contagion TO THE EDITOR: In Lapedis's poignant description of the suicide of a classmate ... more Burnout Contagion TO THE EDITOR: In Lapedis's poignant description of the suicide of a classmate shortly after receiving her U.S. Medical Licensing Examination Step 1 score, she wrote: "We know the statistics.. .. Rates of burnout, depression, and suicide are significantly higher in medical students, residents, and physicians than in an age-matched population" (1). In a recent Grand Rounds presentation on burnout, depression, and suicide at one of our institutions, an anonymous poll found that approximately 70% of the audience-comprising faculty, residents, and medical students-agreed with that statement. In reality, however, the statistics do not completely support that statement. Rates of burnout, depression, and suicidal ideation are reportedly higher in medical students than in an agematched population (2). But actual suicides are lower in medical students and residents than in their age-matched peers (3, 4). Middle-aged physicians (40s and early 50s) have rates similar to the general population. It is only after physicians enter their late 50s and beyond when actual suicide rates exceed those of the general population. The deleterious effects of prolonged stress and work hours have led to widespread awareness and positive changes in policies regarding the work environment (5). We wonder, however, if the nationwide notoriety and spread of potential misinformation contribute to the enhanced anxiety of young trainees early in their professional education. After our own institutional workshops to heighten awareness of burnout and depression, we have heard more than one medical student and resident say, "I didn't realize I was burned out until I heard this presentation." "Suicide contagion" is a term used to describe cluster outbreaks of suicide and is thought to be related to the widespread reporting and sensationalizing or detailed descriptions of the methods of suicide (5). We propose a similar term-"burnout contagion"-related not just to the heightened awareness of the topic but in part to the dissemination of misinformation that suicide rates are higher in medical students and residents. The causal relationship between burnout and suicide remains unclear. Our intent is not to minimize the death of any single medical student or resident as acceptable, nor to detract from the movement to increase wellness and resiliency among all physicians. Perhaps, however, we should emphasize that despite an increase in reported anxiety and burnout, the fact that actual suicide rates are lower among medical students and residents may reflect a positive effect of resiliency and a supportive environment during their training years.

43rd Biennial Convention (07 November - 11 November 2015), Mar 21, 2016

Journal of Clinical Nursing, Nov 23, 2016

To explore the variations of sexual orientation and gender identity as well as the intersections ... more To explore the variations of sexual orientation and gender identity as well as the intersections of those identities in a sample of lesbian, gay, bisexual, transgender, queer, and questioning youth. Identity development is a key task of adolescence. Among the multiple identities that young people navigate are sexual orientation and gender identity. Challenges with solidifying and integrating aspects of one&amp;#39;s identity can contribute to poor physical and mental health outcomes. Design Cross-sectional descriptive survey. A convenience sample was recruited via collaborations with community organizations and Internet groups who provide information and services for LGBTQ youth under the age of 25. Of the 175 respondents, one third of the sample reported a gender identity that was not congruent with their sex assigned at birth. Those assigned female sex at birth reported non-congruent gender identities as well as fluid and non-binary identities such as genderqueer and agender more frequently than respondents assigned male at birth. Individuals with non-congruent gender identities were more likely to identify with a sexual orientation other than lesbian, gay, or bisexual than individuals with gender identities congruent with their sex assigned at birth. Adolescent sexual orientation and gender identity is complex and nuanced. Nurse scientists and clinical nurses can contribute to understanding of these identities, their meaning to the young person, and the unique health implications by regularly inquiring about sexual orientation and gender identity in their practice. This article is protected by copyright. All rights reserved.

Sigma Theta Tau International's 26th International Nursing Research Congress, Jul 25, 2015

Journal of Nursing Education, Dec 1, 2021

Background: Nursing students may have risk factors for trauma reactivation through learning activ... more Background: Nursing students may have risk factors for trauma reactivation through learning activities conducted as part of their education and training. Trauma-informed education practices (TIEP) could help reduce this risk. Method: Course policies, content, procedures, and support structures consistent with the tenets of TIEP were implemented in undergraduate mental health courses with traditional third-year nursing students at two universities. Results: Students responded positively to the implementation of TIEP. Most (92%) qualitative feedback students provided in formal evaluations was directly related to at least one principle of TIEP, most commonly “promoting social, emotional, and academic safety.” Some students (39.3%) interpreted TIEP as demonstrations of “genuine” caring for the students as individuals and their own mental health. Conclusion: Integrating TIEP into an undergraduate nursing mental health course is feasible and beneficial and allows faculty to role model skills and values central to nursing practice. [ J Nurs Educ . 2021;60(12):707–711.]

Journal of Adolescent Research, Sep 20, 2022

To explore specific responses that sexual and gender diverse young adults (SGD YA) perceive to be... more To explore specific responses that sexual and gender diverse young adults (SGD YA) perceive to be supportive and unsupportive of sexual orientation and gender identity by caregivers and other adults following identity disclosure. SGD YA ( N = 101), ages 18 to 25 years ( M = 21.2) were predominantly White (83.1%), non-Hispanic (89.1%), assigned female at birth (82.2%). The majority (97.8%) were sexually diverse (e.g., queer, pansexual, lesbian, gay, asexual, bisexual) and half (50%) were gender diverse (e.g. transgender, agender, genderqueer, nonbinary). Participants completed an online survey. This analysis is focused on participants’ responses to open-ended questions regarding responses they perceived to be supportive and unsupportive of their SGD identity/identities. Content analysis of participants’ open-ended survey responses was conducted using a combination of inductive and deductive coding. Six themes emerged for both supportive responses (communication, actions, acceptance, open-mindedness, unconditional love, and advocacy) and unsupportive responses (distancing, hostility, minimizing, controlling, blaming, and bumbling). For some themes, different sub-themes emerged based on identity. Parents/caregivers as well as other adults in the lives of SGD YA can implement specific responses to demonstrate support for sexual orientation and gender identity with the potential to improve the mental health of SGD YA.

Addiction Science & Clinical Practice, Sep 9, 2022

Background: People with opioid use disorder (OUD) face barriers to entering and remaining in life... more Background: People with opioid use disorder (OUD) face barriers to entering and remaining in life-saving treatment (e.g., stigma, detrimental interactions with health care, and privacy concerns). Telehealth and related technology can reduce barriers to entering and staying in care. Patient feedback is critical to the development of these newer treatment approaches to ensure they are usable and do not inadvertently recreate treatment barriers. Purpose: Evaluate the perceived usability of existing and planned features of a mobile application (app) that facilitates delivery of OUD treatment via telehealth. Methods: People with current or prior experience with OUD treatment were eligible for the study. Participants (n = 31; 55% women) provided feedback on an interactive prototype demonstration via individual qualitative interviews and completed a quantitative survey on the app's perceived usability. Descriptive statistics summarized the usability survey. We analyzed qualitative interview transcripts to elicit common themes. Results: Participants were primarily white (77%) with a mean age of 42.2 years (range 22-69). Participants rated the six major features of the current app as helpful (median response 5 out of 5) and appreciated the flexibility of conducting a visit from a place of their choosing. Participants regarded the five proposed components of the app, such as daily affirmations and medication treatment-related reminders (e.g., pick up medication at pharmacy, medication schedule), as useful features with medians 5 out of 5, and reported they would recommend the app to others for OUD care. Participant qualitative interviews provided additional information on perceived usability of existing and proposed app features. Conclusion: Our study suggests that an appealing, easy-to-use app-with tools and features that effectively support care-could circumvent existing barriers and foster sustained recovery.

Research in Nursing & Health, Jun 29, 2022

Nursing Outlook, Sep 1, 2018

The Journals of Gerontology: Series A

Background Despite known disparities in health status among older sexual and gender minority adul... more Background Despite known disparities in health status among older sexual and gender minority adults (OSGM), the prevalence of frailty is unknown. The aim of this study was to develop and validate a deficit-accumulation frailty index (AoU-FI) for the All of Us database to describe and compare frailty between OSGM and non-OSGM participants. Methods Developed using a standardized approach, the AoU-FI consists of 33 deficits from baseline survey responses of adults aged 50+. OSGM were self-reported as “not straight” or as having discordant gender and sex assigned at birth. Descriptive statistics characterized the AoU-FI. Regression was used to assess the association between frailty, age, and gender. Validation of the AoU-FI used Cox proportional hazard models to test the association between frailty categories (robust <0.15, 0.15 ≤ pre-frail ≤ 0.25, frail >0.25) and mortality. Results There were 9 110 OSGM and 67 420 non-OSGM with sufficient data to calculate AoU-FI; 41% OSGM versu...

Journal of Nursing Scholarship

Background: Prior systematic reviews have compared the relative effectiveness of buprenorphine (B... more Background: Prior systematic reviews have compared the relative effectiveness of buprenorphine (BUP), methadone (MET) and other medications and treatments for opioid use disorder (OUD). The results suggest BUP is highly effective for reducing illicit opioid use and retaining people in treatment. The current review extends these prior reviews by synthesizing research, which compares BUP and buprenorphine and naloxone (BUP/NX) to several treatments in addition to MET on several primary and secondary outcomes. Method: Literature searches were conducted using nine databases. Articles were limited to quantitative reports of studies conducted with adult human subjects in an outpatient, non-residential treatment settings in the United States, in peer-reviewed journals between January 1, 2001 and May 31, 2017, and written in English. Search strategies returned 1,981 articles, an additional eight articles were added through hand searching. Ninety-nine articles met inclusion criteria. After r...