bluuebunny/crossref_metadata_2025 huggingface dataset:
Specific Cognitive Content of Anxiety and Catastrophizing: Looming Vulnerability and the Looming Maladaptive Style
Authors: Riskind John H. , Williams Nathan L.
Published: September 2018

The present study examined the hypothesis, stimulated by the looming vulnerability model of anxiety (Riskind, 1997), that the mental activity of catastrophizing is related to both the general looming maladaptive style and looming vulnerability to potential catastrophes. The looming maladaptive style is a higher-order, more global and abstract characteristic framework that functions as a danger schema to produce cognitive vulnerability to anxiety, whereas looming vulnerability to potential catastrophes is a lower-order sense of looming vulnerability to potential catastrophes in specific situations. In addition, the present study attempted to replicate the findings of Vasey and Borkovec (1992) between catastrophizing, worry, and likelihood, using a self-report version of the structured interview in their study. One hundred thirty-eight undergraduates completed the self-report measure of catastrophizing (LOCO-Q), the looming maladaptive style questionnaire, and several measures of worry. Our results provide strong evidence for the replicability of Vasey and Borkovec’s (1992) findings and provide new evidence for a broader role of looming vulnerability in the cognitive phenomenology of catastrophizing. Specifically, they demonstrate that both looming vulnerability to potential catastrophes and the looming maladaptive style are integrally related to the mental activity of catastrophizing. Further, results suggest the plausibility of a mediated model in which the effects of the general looming maladaptive style are transmitted through specific looming vulnerability to possible catastrophes to produce higher levels of catastrophizing. Additionally, results suggest that the looming maladaptive style is the only variable that significantly predicts gains in catastrophizing over time. The results of this study are consistent with a series of studies that we have conducted in the last several years, demonstrating that the looming maladaptive style functions as a danger schema for threat-related information and produces a cognitive vulnerability to anxiety.
Cognitive Vulnerability to Depression: Theory and Evidence
Authors: Abramson Lyn Y. , Alloy Lauren B. , Hogan Michael E. , Whitehouse Wayne G. , Donovan Patricia , Rose Donna T. , Panzarella Catherine , Raniere David
Published: September 2018

According to the cognitive vulnerability hypothesis of two major cognitive theories of depression, Beck’s (1967; 1987) theory and the hopelessness theory (Abramson, Metalsky, & Alloy, 1989), negative cognitive styles provide vulnerability to depression, particularly hopelessness depression (HD), when people encounter negative life events. The Temple-Wisconsin Cognitive Vulnerability to Depression (CVD) Project is a two-site, prospective longitudinal study designed to test this hypothesis as well as the other etiological hypotheses of Beck’s and the hopelessness theories of depression. We present findings from the CVD Project suggesting that the hypothesized depressogenic cognitive styles do indeed confer vulnerability for clinically significant depressive disorders and suicidality. In addition, we present evidence about the information processing and personality correlates of these styles. Finally, we discuss preliminary findings about the developmental origins of cognitive vulnerability to depression.
Response Modulation Deficits: Implications for the Diagnosis and Treatment of Psychopathy
Authors: Wallace John F. , Vitale Jennifer E. , Newman Joseph P.
Published: September 2018

Laboratory evidence indicates that a specific information-processing deficiency underlies the behavioral manifestations of psychopathy. Specifically, the automatic direction of attention and controlled processing to stimuli or information that are peripheral to ongoing goal-directed behavior or a current response set occurs less readily in psychopathic individuals. We describe how this deficiency constitutes an impairment of the response modulation process, which, in turn, impedes adaptive self-regulatory functioning. This hypothesis is contrasted with the view that antisocial behavior is the essential or core feature of psychopathy, as well as with the position that psychopathy reflects a specific deficit in the processing of affective stimuli. Finally, implications of this hypothesis for the effectiveness of cognitive and behavioral interventions are discussed.
Group CBT Versus Supportive Therapy With Patients Who Have Primary Breast Cancer
Authors: Edelman Sarah , Bell David R. , Kidman Antony D.
Published: September 2018

The psychological effects of two group therapy intervention models with newly diagnosed primary breast cancer patients were evaluated. Sixty women were randomized to attend either 12 sessions of group Cognitive Behavior Therapy (CBT) or a supportive therapy group. Self-report psychological assessments were completed before and after therapy, and at 4 months follow-up. In the period following therapy, patients in both groups showed significant reductions in depression, quality of life and self-esteem relative to their baseline scores. Patients in the CBT group also showed significant improvements in quality of life and self-esteem relative to those in the supportive therapy group. These differences were no longer apparent at the 4-month follow-up. The findings suggest that a group CBT intervention generates greater short-term benefits than a supportive therapy group among primary breast cancer patients. Some limitations of the design are discussed.
Cognitive Therapy in the Treatment of Adults With ADHD: A Systematic Chart Review of 26 Cases
Authors: Wilens Timothy E. , McDermott Stephen P. , Biederman Joseph , Abrantes Ana , Hahesy Amy , Spencer Thomas J.
Published: September 2018

Despite the increasing awareness of attention deficit hyperactivity disorder (ADHD) in adults, psychotherapeutic interventions for this group remain unstudied. In this study we evaluated the potential benefit of an adapted form of Beck±s Cognitive Therapy (CT) for adults with ADHD. Consecutive outpatients with DSM-III-R ADHD treated naturalistically with CT were evaluated for response to treatment using multiple variables assessed both prospectively, and by retrospective review of the medical charts. As a result 26 adults with ADHD were identified of whom all had received prior psychotherapy, 96% had lifetime psychiatric comorbidity with ADHD, and 85% were receiving medications in combination with CT. Patients were treated for a mean (±SD) of 11.7 ± 8 months and 36 ± 24 sessions. Treatment was associated with significant improvements in ADHD, anxiety, and depressive symptoms as well as overall global functioning (p’s < .01). Overall, 69% of ADHD adults were considered to be much to very much improved in their ADHD at the end of treatment. The results of this chart review suggest that CT used generally in conjunction with medications appears useful for adults with ADHD. These pilot data further suggest the need for additional controlled investigations.
Developmental Correlates of Psychological Reactance
Authors: Dowd E. Thomas , Pepper Harry F. , Seibel Cynthia
Published: September 2018

These two studies investigated the relationship of psychological reactance to the eight developmental stages according to the theory of Erik Erikson. More reactant individuals were found to be less psychosocially healthy, less positive and more negative in developmental state attitudes, less trusting, more autonomous, possessing a greater sense of identity, and less intimate than less reactant individuals. Verbally reactant individuals were found to be more psychosocially healthy whereas behaviorally reactant individuals were found to be less psychosocially healthy. It appears that reactant individuals have elevated autonomy and identity over trust and intimacy. Reactance appears to derive from the earlier developmental stages more than the later stages.
Use of Cognitive Therapy for Treatment of a Patient Suffering from a Bipolar Affective Disorder
Authors: Chor Philip N. , Mercier Mary A. , Halper Ira S.
Published: September 2018

The authors present the case of a bipolar patient treated with cognitive therapy after she refused treatment with lithium carbonate. Treatment strategies are described, particularly those relating to mania, and possible reasons for their apparent success are discussed.
The Power of Negative Thinking: A New Perspective on “Irrational” Cognitions
Authors: Rich Alexander R. , Dahlheimer David
Published: September 2018

Recent research and clinical observations suggest that the link between negative thinking and emotional and behavioral maladjustment may not be as simple and straightforward as is commonly assumed. Observations suggest that many clients became pessimistic and worried in advance of and during their performance. These negative thoughts or expectancies, however, often have either no effect or a facilitative effect on actual behavior. Although this observation is inconsistent with cognitive-expectancy models of behavior, the phenomenon is consistent with prediction of egotism and self-handicapping models. The present study was designed to test the hypothesis that negative thinking is often used as a strategy for protecting self-esteem and that this strategy often facilitates performance in evaluative situations. High- and low-irrational subjects received either success or failure feedback as they completed a word construction task. As predicted, high-irrational subjects showed increased performance when expectations were negative and decreased performance when expectations were positive. The opposite pattern of results was found for low-irrational subjects. Moreover, the self-esteem of high-irrational subjects was not affected by either success or failure. Results are interpreted as being supportive of an egotism interpretation of negative and irrational thinking. Implications for counseling and psychotherapy are noted.
The Use of Metaphors in Cognitive Therapy
Authors: Gonçalves Oscar F. , Craine Michael H.
Published: September 2018

Recently, cognitive approaches to therapy have been facing an increasingly constructivist orientation, in which persons are viewed as actively constructing their own reality from their deep/tacit/unconscious knowledge representation. This paper begins with the presentation of the main assumptions of the constructive movement in cognitive therapy on the nature and change of cognitive representations. It is asserted that at the deep/tacit/unconscious levels, knowledge is represented in analogical and metaphorical ways. The use of metaphors is suggested as a therapeutic tool to access and change tacit/unconscious levels of cognitive representation. A cognitive adaptation of the multiple-embedded-metaphor strategy is presented and illustrated.
Toward Resolution of Conceptual Issues in the Assessment of Belief Systems in Rational-Emotive Therapy
Authors: Burgess Philip M.
Published: September 2018

This article reviews the major developments within the theory of rational-emotive therapy (RET) over the past decade. The absence of adequate validation of the theory’s assumptions is argued to be a function of poorly operationalized irrational belief instruments and the use of inappropriate samples. The present study undertakes the development of a research instrument to assess irrational belief processes. The instrument, the Attitudes and Beliefs Inventory (ABI), was administered to groups of emotionally disturbed and non-disturbed individuals (i.e., anxiety neurotics, agoraphobics, depressive neurotics, and normal controls). Findings from analyses of the simple main effects offer strong and consistent support to the rational-emotive model.
Personal Construct Therapy for the Elderly
Authors: Viney Linda L. , Benjamin Yvonne N. , Preston Carol
Published: September 2018

Personal construct theory has provided a model of psychosocial functioning in the elderly. This model analyzes the changing events construed by the elderly, the content of their constructs, the forms of their construing, and the outcomes of these changes for them. Personal construct theory has also provided a model of psychotherapy, describing the roles of the client and therapist, as well as the therapeutic relationship between them. This model has identified the major therapeutic movements that can occur for elderly clients. The two models and the therapeutic movements are illustrated here in a case study.
Relation of Client Attachment to Therapist First- and Second-Order Assessments
Authors: Lyddon William J. , Satterfield William A.
Published: September 2018

The relation between client working models of attachment and therapist type of change assessments (first- vs. second-order) was examined in a sample of firsttime clients (N=46) seeking services through a university-based outpatient clinic. Results indicated that the problems and goals of clients who exhibited relatively secure working models of attachment were assessed by their therapists as being of a first-order nature, whereas the problems and goals of clients with more insecure working models of the world were assessed as being congruent with second-order conceptualizations. Implications for clinical research and the practice of cognitive psychotherapy are discussed.
Thinking Processes Involved in Irrational Beliefs and Their Disturbed Consequences
Authors: Ellis Albert
Published: September 2018

The rational emotive behavior therapy (REBT) view of irrational beliefs (IBs) is explained, rationality and irrationality are defined in terms of this view, specific thinking processes that are often involved in emotional disturbance are discussed, and concrete ways of actively and forcefully disputing these irrational beliefs are presented.
Self-Control and Enuresis
Authors: Ronen Tammie , Rahav Giora , Wozner Yochanan
Published: September 2018

This paper presents the link between self-control and childhood enuresis, assuming that enuresis is maintained by deficiencies in self-control skills, whether caused by physiological, behavioral, or cognitive components. Acquisition of self-control skills is proposed as helping in eliminating enuresis. Seventy-seven enuretic children (aged 7 to 14) were randomly assigned to three treatment modes (bell and pad, token economy, and cognitive therapy) and to one control group. The self-control skills of children and their parents and the frequency of enuresis were measured before and after treatment. Results showed a negative correlation between self-control and enuresis on the one hand and between the acquisition of self-control skills and recovery from enuresis on the other hand. The results also highlighted the need for a follow-up period to determine the different longer-term effects of treatments.
Factors Associated with a Composite Measure of Financial Behavior among Soldiers
Authors: Carr Nicholas A. , Sages Ronald A. , Fernatt Frederick R. , Nabeshima George G. , Grable John E.
Published: September 2018

Prior research has found a relationship between the health habits of individuals and their financial well-being. Little research has been conducted, however, to explore the nature of the health-wealth connection. The purpose of this study was to explore and test the association of physical health behaviors, namely exercise and diet, and health information search behaviors, and financial wellness. Using data from the 2008 wave of National Longitudinal Survey of Youth (NLSY79), retirement planning activities were used as a proxy for financial wellness, and self-determination theory as a framework for the analysis, this study found that individuals who engage in health information search behaviors, such as reading the contents and nutrition details of food labels, are more likely to engage in financial planning activities.
Individual and Institutional Factors Related to Low-Income Household Saving Behavior
Authors: Heckman Stuart J. , Hanna Sherman D.
Published: September 2018

This research sought to further understanding of factors related to low-income household saving behavior. Saving behavior, defined as whether a household spent less than income, was analyzed by applying institutional theory, which proposes that households' institutional environment has a substantial effect on financial decisions. Two logistic regression models were used to test the effects of variables on saving behavior; the first logit was based on the life cycle hypothesis and the second added noneconomic individual factors (i.e., social networks, financial literacy, and psychological variables) and institutional factors (i.e., access, incentives, and facilitation). Institutional factors, including the number of institutions used, credit access, and having an employer sponsored retirement plan, had significant effects even after controlling for the effect of variables based on the life cycle model, suggesting that promoting institutional access and facilitation—especially through employer-provided plans—may encourage saving behavior among low-income households.
Research Update: Reducing the Rate of Cesarean Birth
Authors: Moore Mary Lou
Published: September 2018

This column examines recent research that illustrates the varying perspectives of cesarean birth and vaginal birth.
Childbirth Education Outcomes: An Integrative Review of the Literature
Authors: Koehn Mary L.
Published: September 2018

The purpose of this literature review was to identify and describe recent empirical studies of childbirth education outcomes and to identify areas for further study. The search produced 63 studies; only 12 met the inclusion criteria. The literature demonstrated inconclusive evidence regarding the effectiveness of childbirth education. None of the studies used a theoretical framework that proposed multiple factors, as opposed to childbirth education alone, that impact the outcomes. Health-focused versus illness-focused outcomes were also addressed.
Nurses’ Attitudes and Knowledge of Their Roles in Newborn Abandonment
Authors: Cesario Sandra K.
Published: September 2018

The practice of abandoning newborns shortly after birth has always existed. Occurring in primitive and contemporary societies, the motivations for newborn abandonment are varied and dependent upon the social norms of a specific geographic region at a given point in time. Because the desire to abandon an infant has had no support system in American society, such unwanted infants have been abandoned in a manner leading to their deaths. In response, many states have passed safe-haven legislation to save the lives of unwanted newborns. The laws typically specify a mother’s ability to “abandon” her child to a medical service provider. However, judgmental attitudes and a lack of accurate information may impede a health care provider’s ability to carry out a safe-haven law. The study described here examines a sample of nurses in a state with a safe-haven law. The study revealed no significant correlation between a nurse’s knowledge, attitude, and self-perception of preparedness to manage a newborn abandonment event. However, the outcomes highlight the negative attitudes and lack of knowledge many nurses possess regarding newborn abandonment and the women who commit this act. Educational programs for all health care providers and the community are essential to the efficacy of the legislation that currently exists. Continued multidisciplinary strategizing and general awareness are needed to serve as catalysts to build supports for unwanted newborns and their safe assimilation into the community.
Online Birth Plans and Anticipatory Guidance: A Critical Review Using Web Analytics and Crowdsourcing
Authors: Yarrington Christina D. , Radoff Kari , Zera Chloe A.
Published: September 2018

We assessed the content of online birth plans using Web analytics and crowdsourcing to identify the most commonly accessed online birth plans. We analyzed the first 14 websites of 6 different searches across time. We repeated this search using 200 individuals recruited by a commercial crowdsourcing service. We identified the 12 URLs that appeared most frequently from all searches then categorized the content by relevance to stages of labor or newborn care. Twenty-five different URLs with customizable birth plans were identified by clinical and crowdsourced searches, with considerable overlap. Among the most commonly identified birth plans, we found prompts for outdated practices in a minority (18%–37%). The majority of online birth plans can be positive tools for shared decision making.
Beyond Lamaze: Are We Missing the Key to Unlock Women’s Potential?
Authors: Parthasarathy Sangheetha , Doula Paramana
Published: September 2018

In this article, the author shares her birth stories and uses what she has learned to rethink childbirth education and her role as a childbirth educator. There is a bridge from knowledge to action. The thinking part of the brain is like the tip of an iceberg. While the subconscious is what drives many actions, childbirth education classes often talk to the conscious, rational part of our brain. What is the fundamental trick we are missing in childbirth education?
Ask a Lawyer: Applying for Patent Protection
Authors: Philipsen Nayna Campbell
Published: September 2018

A childbirth educator queries Dr. Philipsen about the process of applying for a patent for a labor comfort tool.
Measurement of Mealtime Interactions Among Persons with Dementing Disorders
Authors: Phillips Linda R. , Van Ort Suzanne
Published: September 2018

Difficulty in eating and refusal to eat are common problems for severely demented persons. Feeding can be one of the most frustrating and complex daily tasks performed by caregivers of demented elders in institutional settings. This paper describes the development of a new method for measuring caregiver-elder feeding activities and interactions—the Feeding Traceline Technique (FTLT). The FTLT, which involves both the transcription of videotape recorded data and the coding of data for computer input, is designed to account for all mealtime behaviors of both feeders and elders, to account for the cyclic and repetitive nature of eating and to permit quantification of complex interactions between feeders and institutionalized residents. Data describing the reliability and validity of the method are presented. Issues discussed relate to the units of analysis, the time and energy expenditure of the method in comparison to the yield of information, and the effect of videotaping on measurement.
Assessing the Reliability, Validity, and Sensitivity of Nursing Outcomes Classification in Home Care Settings
Authors: Keenan Gail , Stocker Julia , Barkauskas Violet , Johnson Marion , Maas Meridean , Moorhead Sue , Reed David
Published: September 2018

The purpose of this study is to provide evidence of the validity, inter-rater reliability, and sensitivity of 36 clinically useful of Nursing Outcomes Classification (NOC) results for Home Care (HC) settings. The results of inter-rater reliability, criterion-related validity, and sensitivity evaluations of 36 NOC outcomes were compiled from a 10-site regional evaluation of the NOC. Findings of HC and all sites data were contrasted. More than 90% of the inter-rater reliability scores on the 36 NOC outcome label ratings were within one point, with a substantial number of absolute agreements. All but six of the criterion measures were significantly associated with the corresponding NOC outcomes, and most mean change scores were zero or positive. This was impressive evidence of the adequacy of these measures for reliable and valid use in practice.
Symptom Questionnaire Anxiety and Depression Scales: Reliability and Validity
Authors: Bull Margaret J. , Luo Danni , Maruyama Geoffrey
Published: September 2018

Many instruments have been developed with college students and used primarily with students or younger adults. Thus, researchers face challenges in selecting measures of psychological state that are valid and reliable for use with elders. This article describes a measure of psychological state, the Symptom Questionnaire; provides information about its reliability and validity; and details the steps used to evaluate reliability and validity of its anxiety and depression scales for elders hospitalized for an acute episode of a chronic condition. The findings suggest that a short version of the Symptom Questionnaire, consisting of the depression and anxiety scales, is valid and reliable for elders. The findings also revealed small differences between the means of data collected using the short version and those obtained using the full instrument.
Development and Testing of a Measure of Depressive Cognitions in Older Adults
Authors: Zauszniewski Jaclene A.
Published: September 2018

Assessment of cognitive processes that predispose or contribute to clinical depression in elders is important for planning interventions that facilitate positive cognitive appraisal and effective coping strategies. Instruments evaluating severity of depression exist; however, none measure specific depressive cognitions. This paper describes the development and pilot testing of the Depressive Cognitions Scale (DCS) for older adults. Derived from Erikson’s Psychosocial Theory, the 8 items comprising the scale were selected by clinical experts from a pool of 24 items. Each item reflects a depressive cognition that may arise from less than successful resolution of one of Erikson’s developmental phases. Psychometric testing of the DCS was conducted with 60 functionally independent, community dwelling older adults (age 65+). An alpha of .78 indicated acceptable internal consistency. Construct validity was demonstrated by significant correlation with measures of psychosocial development. Further psychometric study of the DCS is recommended.
Patient Satisfaction With Nursing Care: Concept Clarification
Authors: Eriksen Lillian R.
Published: September 2018

Concept clarity is essential for instrument development and validity of research findings. The process of concept clarification can help rectify some of the issues in the measurement of patient satisfaction. This study presents a strategy, for concept clarification, for the purpose of refinement of an existing instrument for measuring patient satisfaction with nursing care in the hospital setting. The results of the exercise yielded a definition of patient satisfaction with nursing care, including a new framework, and provided guidance for rewording two items, elimination of some items related to knowledge and skill of nurses, as well as generating new items not previously included in the original instrument.
Development and Psychometric Evaluation of the Reciprocal Empowerment Scale
Authors: Klakovich Marilyn
Published: September 2018

This article reports on the development and evaluation of the Reciprocal Empowerment Scale (RES) which was designed to measure empowerment in the context of the leader-follower relationship in organizational settings. The instrument was developed through a process of retroductive triangulation of theoretical and empirical empowerment literature and results of a qualitative study. Deletion of items not considered valid by a panel of expert judges brought the content validity index to .97. An internal consistency reliability coefficient alpha of .95 was achieved for the RES. Subscale coefficients of .82 to .95 were obtained. Convergent and divergent validity and freedom from social desirability response bias were supported. Principal component extraction with oblique rotation resulted in a three-factor solution: reciprocity, synergy, and ownership. With further testing, the RES should prove useful for nursing administration research and practice.
Measurement Characteristics of the Levels of Institutionalization Scales: Examining Reliability and Validity
Authors: Barab Sasha A. , Redman Barbara K. , Froman Robin D.
Published: September 2018

The Level of Institutionalization (Loin) scales were developed to assess the extent to which a health promotion program has become integrated into a health care organization. The instrument was designed specifically to measure the amount of routinization and niche saturation of four subsystems (production, maintenance, supportive, and managerial) believed to make up an organization. In this study, the Loin scales were completed for diabetes programs in 102 general hospitals and 30 home health agencies in Maryland and Pennsylvania. Reliability estimates across the four subsystems for routines (α = .61) and for niche saturation (α = .44) were substandard. Average correlation among the four subsystems for routines was .67, and among the four subsystems for niche saturation was .38, indicating moderate to large amounts of shared variance among subsystems and challenging claims of discriminant validity. Given these large correlations and a poor fit when testing the eight-factor model, higher-order confirmatory factor analyses were carried out. Results supported the existence of two second-order factors. When collapsed into two factors, the reliabilities were adequate (routines α= .90; niche saturation α = .80). Criterion-related validity also was found between length of program existence and the routine factor.
Development of a Scale to Measure Information Needs in Cancer Care
Authors: Degner Lesley F. , Davison B. Joyce , Sloan Jeff A. , Mueller Bryan
Published: September 2018

Developing approaches to improve the use of scarce health care resources is of increasing importance in cancer care. Being able to target the provision of information to the primary needs of consumers ensures more productive use of expensive teaching time by health care professionals. Researchers and clinicians have used a variety of measurement techniques to assess the information needs of individuals with cancer at various points in their illness trajectory. The two most common types of scaling techniques used by researchers to measure information needs have been summative and differential. The advantages and disadvantages of using these types of measurements are evaluated. This article describes the development and pilot testing of a measure of the information needs in cancer patients that uses one type of differential scaling technique, Thurstone scaling. This measure was subsequently converted into a patient-friendly computerized program capable of helping consumers identify their information priorities before their medical visits. Individualized teaching may be guided by this new measurement technique in the future.
The Children’s Cognitive Triad Inventory: Reliability, Validity, and Congruence With Beck’s Cognitive Triad Theory of Depression
Authors: Zauszniewski Jaclene A. , Panitrat Rungnapa , Youngblut JoAnne M.
Published: September 2018

Depression, once thought rare in children, is now more widely recognized and believed to arise from negative views of self, world, and future, according to Beck’s cognitive theory of depression. The Cognitive Triad Inventory for children measures the three negative views, and although reported as psychometrically adequate, this study extended previous analyses with confirmatory factor analysis in a sample of 122 school-aged children. Internal consistency was .82 (total scale) but ranged from .54 to .76 for subscales reflecting the views of self, world, and future. Confirmatory factor analysis revealed factors reflecting three aspects of the self rather than the three negative views. The findings suggest that Beck’s theory about the negative cognitive triad may be less suitable for children than adults.
An Instrument to Measure the Attentional Demands of Community-Dwelling Elders
Authors: Jansen Debra A. , Keller Mary L.
Published: September 2018

The capacity to direct attention (CDA) is a pivotal facet of cognitive functioning that allows people to focus on trains of thought, complex tasks, and the daily business of life. According to a theoretical framework of directed attentional fatigue (DAF) and restoration, excessive demand for attention depletes CDA, a condition called DAF. Attentional demands are factors such as feelings of loss and worries that require intense or prolonged use of CDA and thus can lead to DAF. The purposes of this study were to determine reliability and validity for an instrument to measure attentional demands, the Attentional Demands Survey (ADS). The ADS was administered to 197 (142 females, 50 males) community-dwelling elderly (ages 65-98 years, M = 77). A factor analysis revealed 4 factors/subscales consistent with theorized domains. Internal consistency for each subscale ranged from .87 to .90 and test-retest reliability was .91. The ADS can be used to explore the relationships among attentional demands, CDA, and interventions to support and restore attentional functioning for elders.
Development of the Misener Nurse Practitioner Job Satisfaction Scale
Authors: Misener Terry R. , Cox DeAnna L.
Published: September 2018

The purpose of this study was to construct a reliable and valid instrument to measure job satisfaction among nurse practitioners (NP). The methodological approach consisted of a literature review and modification of an extant instrument (Mueller/McCloskey, 1990) to reflect primary care, followed by augmentation and validation of the items suggested by nurse practitioner faculty members and Master’s prepared nurse practitioners. A 77-item scale was developed and mailed to 413 NPs recognized by the state boards of nursing in two states. Usable returns were received from 342 (83%) NPs. Items were reviewed for validity prior to field-testing the instrument. The 77 items were subjected to exploratory factor analysis to support construct explication using the maximum likelihood method of extraction and a promax rotation. An eigenvalue cutoff of 1.0 and item-to-factor loadings of at least .35 were criteria that guided item retention. Thirty-three items were deleted. The resultant six factors were named: (a) intra-practice partnership/collegiality; (b) challenge/ autonomy; (c) professional, social, and community interaction; (d) professional growth; (e) time; and (f) benefits. The six factors (subscales) produced internal consistency reliability estimates of .94, .89, .84, .86, .83, and .79, respectively. The 44 retained items were used to create the final version of the Misener Nurse Practitioner Job Satisfaction Scale (MNPJSS), with a possible maximum score of 264 using a 6-point Likert-type scale.
Psychometric Properties of the “Modified Transplant Symptom Occurrence and Symptom Distress Scale”
Authors: Moons Philip , De Geest Sabina , Versteven Kristel , Abraham Ivo , Vlaminck Hans , Moens Guido , Waer Marc
Published: September 2018

The aim of this study was to assess key aspects of the reliability and validity of the “Modified Transplant Symptom Occurrence and Distress Scale,” an instrument measuring symptom experience associated with side effects of triple drug therapy in transplant patients. This cross-sectional, comparative study included 108 renal transplant recipients (61% men; 39% women) with a median age of 47 years and a median posttransplant status of 5.5 years. Renal transplant patients were matched by age and gender with 108 healthy control persons not taking immunosuppressive drugs. Content validity, construct validity and discriminant validity of the instrument were substantiated. Internal consistency reliability was not useful to assess in this instrument, as the conditions for calculating Cronbach’s alpha were not satisfied. These findings document the validity of the “Modified Transplant Symptom Occurrence and Symptom Distress Scale” as an instrument to measure symptom experience with immunosuppressive drugs.
Evidence of Case Management Effect on Traumatic-Brain-Injured Adults in Rehabilitation
Authors: Patterson Patricia K. , Maynard Hugo , Chesnut Randall M. , Carney Nancy , Mann N. Clay , Helfand Mark
Published: September 2018

The purpose of this study was to evaluate the evidence for effectiveness of case management during recovery from traumatic brain injury (TBI) in adults. After an overview of TBI incidence, prevalence, and problems, and a brief explanation of case management, the study methods are described, the findings are discussed and recommendations are made for future research. Medline, HealthSTAR, CINAHL, PsychINFO, and the Cochrane Library databases were searched and 83 articles met the criteria for review. The strongest studies (n = 3) were critically appraised and their design features and data were placed in two evidence tables. Due to methodological limitations, there was neither clear evidence of effectiveness nor of ineffectiveness. For future research, we recommend controlled research designs, standardization of measures, adequate statistical analysis and specification of health outcomes of importance to persons with TBI and their families.
Enhancing the Case Manager’s Role Through Early Identification of At-Risk Members
Authors: Dammann Meredith , Patel Shushma
Published: September 2018

This article describes a methodology to improve early identification and stratification of at-risk patients with comorbidities that could result in catastrophic illness. Data from the HMO line of business identified diabetic members. Total frequency and total cost for 19 comorbid diseases were calculated on data from the diabetic members who were classified as having high severity and comorbidity rankings. Members were further segmented into quadrants based on frequency and cost for referral to case management and/or educational programs. A total of 1312 HMO diabetic members were classified as high severity. Quadrant 4 diabetic members consumed greater than $10,000 in heath care expenses and had 6 or more collapsed DECs. Similar types of comorbid diseases were found in both quadrants 2 and 4. Quadrant 2 diabetic members were identified as “in danger” members with the potential to incur total costs greater than $10,000.
The Financial Burdens of the Balanced Budget Act of 1997
Authors: Bloss Joseph P.
Published: September 2018

The Balanced Budget Act of 1997 (BBA) was signed into law on August 5, 1997 as Public Law No. 105-33. This single act introduced a revolutionary phase for the health care industry in the United States. It marked the beginning of momentous change to the overall health care coverage provided through the Medicare program. These changes, contained in the Balanced Budget Act, were intended to reduce substantially Medicare reimbursement, primarily to postacute care providers, including Certified Home Health Agencies. As a matter of fact, the Federal Register of August 5, 1999 states that “the intent of Section 4602 of the BBA is to control the soaring expenditures of the Medicare home health benefit that have been driven largely by increased utilization rather than price per visit.”
An Insider’s Perspective of Managed Mental Health Care
Authors: Anderson Christopher E.
Published: September 2018

Managed mental health care has been examined from different perspectives in scholarly literature. It has been examined from the provider’s perspective through scholarly writing. Executives of managed care companies have also provided their input in this arena. One group of professionals involved in managed care has not contributed to the literature. That is, the case managers employed by the managed mental health care companies themselves. Issues in managed mental health care are discussed from the perspective of the case managers employed by the managed care companies. This group can view managed mental health care from different standpoints. Thus, case managers can provide unique insights into managed mental health care.
Community Care Management: Advanced Practice Nurses as Care Managers
Authors: Waszynski Christine M. , Murakami Wendy , Lewis Mary
Published: September 2018

A group of advanced practice nurses partnered with a major insurer in the design and implementation of a care coordination model for high-risk older adults. This article will discuss the process of such an undertaking, highlighting the successes and barriers encountered. The key elements of this program included early identification and regular reassessment of each member’s acuity level; fostering close partnerships between individual or teams of APRNs and groups of physicians; and uninterrupted clinical management of high-risk members across the health care continuum.

This model was designed to achieve the following outcomes: to support the physician management of high-risk, chronic individuals; to increase or maintain the health of members; and to reduce health care costs. Outcome studies have demonstrated a substantial net savings by decreasing acute care admissions by 54%, reducing hospital days by 42%, and trimming primary care physicians’ and specialists’ visit costs by 37%. There was a 33% reduction in the overall costs of health care for members enrolled in this program. Physicians and members both rated their satisfaction with the APRN-based model of care as very high.
Computer-Assisted Tracking of a Case Management Program for the Homeless
Authors: Heft-LaPorte Heidi , Frankel Arthur J.
Published: September 2018

Computer scan sheet technology was used to evaluate process and outcome variables in a case management shelter program for the homeless. Clients spent up to four months in this program, working on a number of goal areas, including housing, employment, drugs and alcohol, mental and physical health, and literacy. Using Tele-Form, a computer program that allows scan sheets to be designed on screen, case manager recording forms were developed that allowed interventions to be documented on a daily basis, while psychosocial goal areas were documented on scan sheets at intake and termination. Data from these scan sheets were fed into SPSS, a statistical program for the social sciences. Using the case management tracking guidelines developed by Frankel and LaPorte, 1998, the results of this study showed that scan sheet technology was an effective, efficient, and extremely cost-effective way to track case management. The analysis of the data and subsequent discussion suggested ways about how to make case management evaluation more uniform across the country.
A Study of Case Managers’ Decision-Making Processes
Authors: Crook Wendy P. , Vinton Linda
Published: September 2018

Decision-making processes were explored in a study of 122 case managers from community-based aging network agencies. Of interest was how often case managers employed a consumer-driven model whereby elders’ input is always considered during the assessment and decision-making processes. Approximately 80% always used clients as a source of information during assessment but less than a majority always used client recommendations in decision making. The case managers indicated that safety was more frequently a guiding principle used in decision making than the least restrictive alternative, disruption to lifestyle, and freedom. When clients disagreed with the case managers’ decisions, attempting to convince the client was the strategy the greatest proportion of respondents employed. Case manager characteristics (gender and degree) were not found to be associated with consumer-oriented methods of assessment or decision making. The authors concluded that the respondents tended to use a consumer-oriented approach when assessing clients but moved away from the consumer-driven model when making decisions with regard to clients. Safety, rather than freedom, was the prevailing guiding principle.
The Home Health Aide: Scarce Resource in a Competitive Marketplace
Authors: Dawson Steven L. , Surpin Rick
Published: September 2018

Direct-care staff—home health aides and personal care attendants—are the very point where home care “touches the client.” Yet our system of care delivery has never been designed for the needs of the direct-care worker. Today we are paying the price: Across the country, our industry is experiencing the highest rates of direct-care vacancies and turnover in its history. The very future of our industry now rests on our ability to attract workers within an increasingly competitive labor market. In order to survive, let alone provide high-quality care, the home care industry must restructure paraprofessional employment.
Control Beliefs of the Frail Elderly: Assessing Differences Between Homebound and Nursing Home Residents
Authors: Grain Madeleine
Published: September 2018

Previous age-related sense of control studies have largely focused on active, community-dwelling aged individuals and have excluded elderly persons who are frail. This study compares sense of control and life satisfaction as determined through rating scale administration between two frail, dependent samples: nursing home residents and homebound elderly. Differences in control scores were statistically significant for those who were homebound expressing higher perceived personal control than nursing home residents (p < .001). Sense of control has no correlation with either life satisfaction or length of stay in the nursing home cohort.
The Use of the Minimum Data Set: Home Care in a Case Management Project in Hong Kong
Authors: Chi-tat Leung Antony , Pun Liu Chi , Lee Tsui Lee , Yee Li Sau , Wing-yan Tang Gloria , Cn Yau Daniel , Chi Iris , Wing-sun Chow Nelson
Published: September 2018

130 hospital-discharged elderly patients received our comprehensive assessment by using a Chinese Minimum Data Set-Home Care (MDS-HC). Our case manager developed and implemented care plans with reference to the computer-generated Clients Assessment Protocols. Results showed that the MDS-HC was sensitive to identify elderly persons’ holistic needs, and helpful in formulating all-inclusive care plans.
Case Management in Australia: Application of Moxley’s Scenarios
Authors: Harvey Judy , Gursansky Di , Kennedy Rosemary
Published: September 2018

In 1989 David Moxley produced a text for generic case management in the human services. He has revisited his initial work and argues that the case management concept has taken on diverse meaning as it has been applied more widely and for very different agendas. It may have emerged in community care, but is now being utilised as a tool of restructuring in all arenas of service provision. Moxley now suggests five distinct scenarios for the future of case management: community support and the organisation of support systems for people with disabilities; management of the economic costs of human services; the management of undesirables; the management of clinical pathways; recipient management services. His commentary is based on his U.S. experience. This article will examine the relevance of his predictions to the Australian context.
Group Dynamic Assessment: Reliability and Validity of a Cognitive Assessment Procedure With Adolescents with Developmental Disabilities
Authors: Jepsen Ruthanne H. , Lidz Carol S.
Published: September 2018

In this study the authors investigated the reliability and validity of a group dynamic assessment procedure applied with adolescents with significant cognitive delays and multiple handicapping conditions. The authors addressed the question of how responsive these students are to group mediated intervention using an instrument that measures cognitive processes. The test used was a modification of selected subtests from the Das/Naglieri Cognitive Assessment System (CAS). From the results they documented test-retest reliability and concurrent validity with classroom achievement. The performance of 26 adolescents who participated in a group dynamic assessment procedure was compared to the performance of 22 adolescents who did not participate in the procedure. The group participating in the dynamic assessment procedures showed significant gains in posttest scores. Gains were maintained six months following the intervention.