bluuebunny/crossref_metadata_2025 huggingface dataset:
Feeding and Nonfeeding Interactions of Mothers and Prematures
Authors: Holditch-Davis Diane , Miles Margaret Shandor , Belyea Michael
Published: July 2003

The interactions between mothers and premature infants during feeding and nonfeeding periods were explored. Twenty-nine premature infants and their mothers were observed interacting for 1 hour in their homes at 6 months corrected for prematurity. Mothers were more likely to engage in the following behaviors involving close contact during feeding: looking at the infant, holding the infant, having body contact, and rocking their infants. They interacted with their infants 96% of feeding time. During nonfeeding periods, they were more likely to engage in more distal behaviors (e.g., gesturing, touching, and playing with the infant) and spent only 67% of the time interacting with the infant. Infants were more likely to be alert, vocalize, play with objects, express negative affect, and locomote during nonfeeding, and they were more likely to be drowsy or asleep during feeding. Therefore, a complete understanding of interactions between mothers and prematures can only come from examining both feeding and nonfeeding periods.
Personality Traits and Self-Care in Adults Awaiting Renal Transplant
Authors: Horsburgh Martha Elizabeth , Beanlands Heather , Locking-Cusolito Heather , Howe Anne , Watson Diane , Pollock Susan E. , Hilton B. Ann
Published: July 2003

This article reports the pretransplant findings of the first phase of a three-phase, longitudinal study examining relationships among personality traits and self-care abilities and behaviors of Ontario adults pre-and post-renal transplant. A consortium of Ontario nurse researchers representing three of Ontario’s five renal transplant centers conducted this research. All adults on the cadaver transplant lists of 15 Ontario dialysis centers were invited to participate. One hundred ninety-eight adults awaiting renal transplant were enrolled in the study, representing a 70% response rate. A cross-sectional, correlational design was used for the pretransplant phase. Self-report measures with known psychometric properties were used; validity and reliability of the measures were supported by the sample. Data were analyzed using descriptive approaches, correlational analyses, multiple regression, and path analysis. Relationships were supported among selected personality traits, health state and self-care abilities and behaviors. Further research to examine personality traits and health state in relation to adult self-care is warranted.
Cost-Effectiveness Analysis Methods for the REACT Study
Authors: Duren-Winfield Vanessa , Berry Michael J. , Jones Sue A. , Clark Doris H. , Sevick Mary Ann
Published: July 2003

The Reconditioning Exercise and Chronic Obstructive Pulmonary Disease Trial (REACT) is a two-arm randomized clinical trial designed to compare short-term versus long-term exercise intervention in terms of physical function, acute exacerbation of chronic obstructive pulmonary disease, health-related quality of life, and cost-effectiveness. Clinical trials such as REACT are now routinely paired with economic analyses, and nurses can expect to play a growing role in the conduct of these studies. This article describes a model that is useful for structuring economic evaluations of health care interventions, and illustrates a cost-effectiveness analysis that is being conducted in conjunction with the REACT study. An in-depth description of collection methods and procedures is provided, as well as a summary of recruitment and retention experience to date.
A Feminist Critique of Breast Cancer Research among Korean Women
Authors: Im Eun-Ok , Hautman Mary Ann , Keddy Barbara
Published: July 2003

Studies indicate ethnic differences in incidence, mortality, and survival rate of breast cancer. Despite the low incidence rate of breast cancer among the Korean population, Koreans are reported to be less likely to survive breast cancer. In this article, using a feminist perspective, the reasons why Korean women have been reported to be less likely to survive breast cancer are analyzed through a critical review of research among Korean women. A total of 469 studies (145 unpublished master’s theses and doctoral dissertations and 324 articles published in South Korea and in the United States) were reviewed, analyzed, and critiqued in terms of biases present in the research process. Through a feminist critique of the literature, four possible reasons are proposed: androcentric views and assumptions underlying the research, modesty issues imbedded in Korean culture, the victim-blaming tendency of Korean culture, and intense emotions without adequate support.
Mailed Survey Follow-Ups—Are Postcard Reminders More Cost-Effective than Second Questionnaires?
Authors: Becker Heather , Cookston Jeff , Kulberg Vickie
Published: July 2003

Finding cost-effective ways to increase response to mailed surveys is a concern for many nurse researchers. This study compared two follow-up methods: sending a second questionnaire packet versus sending a reminder postcard to those who did not respond to an initial mailing. Although the second questionnaire yielded a higher response than did the postcard, the cost per additional response was approximately 21/2 times higher for the questionnaire than for the postcard when the differential cost of the two mailings is considered.
Balinese Mothers’ Developmental Timetables for Young Children
Authors: Williams Phoebe Dauz , jiningsih Soet , Williams Arthur R.
Published: July 2003

The study examined Balinese mothers’ expectations for children’s development and mothers’ child-rearing practices, as influenced by selected variables (child’s gender and ordinal position, mother’s education, and rural or urban residence). Rural (n = 100) and urban (n = 100) mothers responded to structured questionnaires read aloud to them by trained interviewers who recorded responses. All children were between 4 and 6 years. Equal numbers of male and female children were included, and the entire economic and educational ranges of families were represented. MANOVA results showed significant interaction effects of residential location and maternal education on mothers’ expectations of children’s cognitive, F (2, 170) = 4.31, p = .04, and psychosocial development, F (2, 170) = 4.35, p = .01. Significant interaction effects were found for maternal education, residential location, child’s ordinal position, and gender, F (3, 170) = 5.92, p = .001, on maternal child-rearing practices. Two developmental timetables were constructed.
Health as Continuity and Balance in Life
Authors: Emami Azita , Benner Patricia E. , Lipson Juliene G. , Ekman Sirkka-Liisa
Published: July 2003

Research on immigrant health emphasizes that the elderly are more vulnerable than other age groups in many immigrant populations. This study describes the meanings of health, illness, and disease for Iranian elderly immigrants in Sweden and their relationships with life disruptions. Analysis of interviews using an interpretive-phenomenological method illustrates that the participants experience health as continuity and balance in life. Any disruption of this balance creates a sense of illness that is only partially related to the emergence of disease. Participants did not view health and disease as polarized. Rather, disease is just one component among many that may disrupt the experience of health. Health is perceived as a sense of well-being, can be achieved in spite of disease, and can be disrupted even in the absence of disease. This description of the meaning of health, disease, and illness contrasts with the Western biomedical perspective and is similar in its holism to various non-Western medical systems and complementary approaches. This knowledge can foster more culturally sensitive care.
Health Status and Resources of Rural Homeless Women and Children
Authors: Craft-Rosenberg Martha , Powell Sandra Rae , Culp Kennith ,   Iowa Homeless Research Team
Published: July 2003

The purpose of this research is to describe the health status and health resources for homeless women and children in a Midwestern rural community. A group of 31 rural homeless women in a shelter participated in the study by answering questions on the Rural Homeless Interview developed by the investigators. The findings revealed higher than expected rates of illness, accidents, and adverse life events, with the incidence of substance abuse and mental illness being comparable to data from other homeless populations. The data on children were limited by lack of knowledge on the part of their mothers. Some mothers reported that their children were in foster care, had been adopted, or were being cared for by others. The inability to access health and dental care was reported by half of the participants.
A Causal Model of Depression in Early Adolescents
Authors: Yarcheski Adela , Mahon Noreen E.
Published: July 2003

The purpose of this study was to test the extent to which a causal model developed from a theoretical formulation of depression was consistent with data obtained from early adolescents, age 12 to 14. In this cross-sectional correlational design, the final sample consisted of 225 adolescents who responded to a demographic data sheet and instruments measuring depression, self-esteem, state anxiety, and perceived stress in classrooms. The causal model was tested via the LISREL 7 program, using a maximum likelihood structural equation model. The results yielded a chi-square (1, N = 225) = .71, p =.401, indicating a good fit of the model to the data. Perceived stress had the strongest direct, indirect, and total effect on depression in early adolescents. Contrary to expectation, self-esteem did not have a direct effect on depression, and girls did not report higher levels of depression than did boys.
Systemic Oxygen-Free Radical Production in Iron-Loaded Mice
Authors: Bartfay Wally J. , Bartfay Emma
Published: July 2003

Although iron is an essential element for normal cell metabolism, in excess quantities it is highly cytotoxic and lethal. In fact, acute iron poisoning is a leading cause of overdose mortality in young children. Hereditary hemochromatosis, a disorder of iron metabolism, is currently the most prevalent genetic disorder in the world, which results in organ failure and premature mortality. Hence, an enhanced understanding of its pathogenesis is critical for providing safe and effective nursing care to affected individuals and their families. Although the exact mechanism of iron’s toxicity is not known, it was hypothesized that chronic iron loading would result in increased tissue (heart, liver, and spleen) concentrations of iron and increased free radical production in a murine model (n = 20). Our results show that chronic iron loading results in highly significant dose-dependent increases in tissue concentrations of iron and systemic free radical generation (p < 0.001).
The Evolution of Nursing Education in a Postindependence Context—Ghana from 1957 to 1970
Authors: Opare Mary , Mill Judy E.
Published: July 2003

Development of nursing education in Ghana between 1957 and 1970 is characterized by dynamic change and growth. Published manuscripts, personal interviews, and letters were used to analyze evolution of nursing education during this period. Following independence in 1957, developments in nursing education continued to be strongly influenced by external organizations and their designated experts. Policies, such as the local training of nurses and Africanization, provided impetus for nurses to further their education to assume senior positions in nursing education and administration. Emphasis on training nurses to work in a hospital-based curative health system, which had been the legacy of colonialism, gradually shifted to a broad-based education that prepared nurses to work in a variety of settings. Changes in nursing education occurred within an economic climate that presented ongoing impediments, yet the vision of the first generation of Ghanaian nurse leaders facilitated the tremendous progress seen during this period.
Measuring Adherence to a Women’s Walking Program
Authors: Wilbur Joellen , Chandler Peggy , Miller Arlene Michaels , Davis Gail C. , Aaronson Lauren S. , Mayo Kelly
Published: July 2003

The purpose of this study is to demonstrate the use of a self-report exercise log and a heart-rate monitor in the measurement of adherence to the dimensions of an exercise prescription and to propose an alternative way to define adherence to a 24-week home-based women’s walking program, which reflects the dynamic process of behavior change. Adherence was measured with exercise logs, Polar Vantage XL Heart-Rate Monitors, and pre-to postintervention change in VO2 max. Of the dimensions of the exercise prescription, frequency of walks documented by both the heart-rate monitor and the exercise log had a higher correlation than duration and intensity of walking, with change in VO2 max suggesting that frequency was potentially the most predictive adherence measure. Examination of the total number of walks and the number and sequence of weeks without walks over the 24-week intervention revealed dynamic patterns of adherence suggesting variation in the degree of behavioral change.
The Created Environment for Physical Assessment by Case Managers
Authors: Skillen D. Lynn , Anderson Marjorie C. , Knight Cheryl L.
Published: July 2003

Goals of gerontological nursing include maximizing health and confronting functional impairments. The health of older adults is often fragile because of age-related change, complicated by chronic illnesses. Identification of changes in health status permits responsive care and consultation but requires proficiency in physical assessment. In 1995, research was conducted in Alberta, Canada, on registered nurse case managers’ reported use of assessment skills. Nineteen continuing-care facilities in 1 of 17 provincial health regions participated (N = 189). After expert review and pilot testing, questionnaires were distributed to two independent groups: nurse administrators/staff development coordinators and case managers (response rate = 73%). Qualitative data were subjected to descriptive, interpretive, and pattern coding. Reported are factors constraining or facilitating physical assessment in continuing care. Neuman’s concept of the created environment provided a factor-organizing framework. A holistic view of environment and data source triangulation increased confidence in the comprehensiveness and credibility of results.
Spiritual Perception, Attitudes about Spiritual Care, and Spiritual Care Practices among Nurse Practitioners
Authors: Stranahan Susan
Published: July 2003

The purpose of the nonexperimental study was to examine the relationships among spiritual perception, attitudes about spiritual care, and spiritual care practices in nurse practitioners. Attitudes about providing spiritual care and spiritual care practices have been studied among nurse generalists, but little research has been conducted on nurses in advanced practice. All nurse practitioners registered by the state of Indiana were sent Reed’s Spiritual Perspective Scale (SPS) and a modified version of the Nurses’ Spiritual Care Perspectives Scale developed by Taylor, Highfield, and Amenta. Pearson correlation techniques were used to test for significant relationships. Statistically positive relationships were between perception of personal spirituality and 9 of the 12 spiritual care practices. Eight of the 13 items describing attitude toward providing spiritual care were statistically significant with the SPS. Implications of the findings are discussed.
Can Telehealth Technology be Used for the Education of Health Professionals?
Authors: Chang Betty L. , Trelease Robert
Published: July 2003

The purpose of this report is to describe the usefulness and desirability of using telehealth technology in the education of health care professionals. The PC-compatible, Windows-based system allowed for both real-time videoconferencing and store-and-forward (sending information from one site and stored at a distant site for access at a later time) functions. Student responses indicated that they thought they would benefit from this type of technology in their clinical education. They were most positive with respect to increasing access to a wider range of clients they may not otherwise access and least positive for the ability to learn from a televideo interaction when compared with a clinic experience. Similarly, faculty were least interested in using videoconferencing for patient rounds and more interested in using telehealth to enhance classroom presentations.
Sexual Abuse and Sexual Risk Behaviors of Minority Women with Sexually Transmitted Diseases
Authors: Champion Jane Dimmitt , Shain Rochelle N. , Piper Jeanna , Perdue Sondra T.
Published: July 2003

The relationship between sexual abuse and sexually transmitted disease (STD) represents an important and underinvestigated context of domestic violence. This study examined the association between sexual abuse, sexual risk behaviors, and risk for reinfection and HIV among minority women with STD. Mexican American and African American women (n = 617) with active STD entered a randomized study of behavioral intervention to reduce STD recurrence. Each underwent questioning at entry regarding sexual abuse and sexual risk behaviors. Comparisons of these behaviors using chi-square, t tests, and logistic regression were made by history of sexual abuse. Sexually abused women were more likely to have lower incomes, earlier coitus, STD history, currently abusive partners, new sex partners, anal sex, and bleeding with sex, placing them at increased risk for STD reinfection and HIV. Due to this association with sexual risk behavior, assessment for sexual abuse is essential in programs focusing on STD/HIV prevention.
Measuring Nurses’ Self-Concept
Authors: Cowin Leanne
Published: July 2003

Little is known of nurses’ self-concept in light of their professional identity or as working adults. This article explores the development and rigorous testing of a new self-concept instrument designed specifically for nurses. The new measure is based on the self-concept measurement theory of Shavelson, Hubner, and Stanton. An expert panel was used to critique and aid refinement of the measure. The dimensions of nurses’ self-concept were measured in six scales: General Nursing, Care, Staff Relations, Communication, Knowledge, and Leadership. Two groups participated in this study: Group 1 consisted of nursing students prior to graduation (n = 506) and Group 2 consisted of randomly selected, experienced, working nurses (n = 528). A series of exploratory and confirmatory factor analyses were conducted to test the fit of a priori models. The results indicate that all scales possess good construct validity and a satisfactory fit with the data.
Using Collaborative Research to Facilitate Student Learning
Authors: Thompson Cathy J. , McNeill Jeanette A. , Sherwood Gwen D. , Starck Patricia L.
Published: July 2003

Developing research partnerships between academia and the service sector is an innovative way to meet the demand for high-quality, cost-effective, and clinically oriented research. Undergraduate student participation in clinical research is an educational strategy to facilitate positive mindsets toward research. This article outlines the methodological steps in recruiting and training undergraduate students for clinical research teams to benefit nurse educators, nurse researchers, students, and institutional partners. Student volunteers collected data for a study examining patient satisfaction with pain management practices. The research proposal was used to demonstrate principles of the research process and to familiarize the students with the study. A detailed study protocol guided the entire team through the project. Student sensitivity to pain assessment and management was enhanced. Learning the research process and the students’ appreciation for the rigors of research were reinforced using this experiential model. Student evaluation of the research experience is presented.
Testing a Predictive Model of What Makes a Critical Thinker
Authors: Rapps Jane , Riegel Barbara , Glaser Dale
Published: July 2003

The goal of nursing education is to help individuals become self-determining, independent thinkers. Cognitive development may be the outcome that best characterizes such a thinker. The purpose of this study was to test a model of cognitive development in which four independent variables—knowledge base, critical thinking skills, critical thinking dispositions, and experience—were used to predict cognitive development. Data were analyzed from 232 practicing registered nurses. Three hierarchical levels of cognitive development were examined: dualism, relativism, and commitment. Critical thinking skill was a significant contributor only to the dualistic level of cognitive development. Critical thinking dispositions contributed to all three levels of cognitive development. Experience contributed only to the commitment level. The results of this study suggest that the development of a critical thinker may require time and experience. These findings can be used to examine current policy regarding the criteria used to evaluate nursing education.
Focused Life Stories of Women with Cardiac Pacemakers
Authors: Beery Theresa A. , Sommers Marilyn Sawyer , Hall Joanne , King Kathryn M.
Published: July 2003

Biotechnical devices such as cardiac pacemakers are implanted into people to manage a range of disorders, yet comparatively little is known about the emotional impact of this experience. Women may have a unique response to implanted devices due to cultural messages about the masculinity of technology. In this qualitative study using Hall’s focused life stories design, 11 women from teenagers to elders with permanent cardiac pacemakers were asked to describe their experiences using semistructured interviews. The themes that emerged are relinquishing care, owning the device, experiencing fears and/or resistance, imaging the body, normalizing, positioning as caretaker, finding resilience, and sensing omnipotence. Understanding what it means for women to live with an implanted biotechnical device may facilitate planning interventions to support their psychological and physiological health. Effective pacemaker function may depend, in part, on recipients’ successful emotional attachment to the device.
Mexican-Origin Mothers’ Experiences Using Children’s Health Care Services
Authors: Clark Lauren
Published: July 2003

A focused ethnographic study in an urban Latino community in the western United States describes Mexican-origin mothers’ experiences obtaining and using health services for their children. Repeated interviews with mothers, participant observation, and children’s medical records composed the data sources. Qualitative findings suggest access to health care begins in the household, where women negotiate a working diagnosis for the children’s illness with family members and coalesce support for health care seeking. Immigrant mothers described more barriers to children’s health care than more acculturated mothers. Quantitative analyses of medical records supported this finding, with children of the least acculturated mothers demonstrating fewer well-child visits, increased emergent visits, and lower levels of immunization completeness. The results suggest health care providers can better meet the needs of Latino families with children by offering better explanations about children’s diagnoses and treatment plans and demonstrating personalismo, or a friendly, kind, and social approach to care.
Acculturation, Socioeconomic Vulnerability, and Quality of Life in Spanish-Speaking and Bilingual Latino HIV-Infected Men and Women
Authors: van Servellen Gwen , Chang Betty , Lombardi Emilia
Published: July 2003

Little is known about the health-related QOL (HRQOL) of low-income, Latino men and women living with HIV. Monolingual Spanish-speaking Latino individuals may be at greater risk than bilingual men and women for poor HRQOL due to problems associated with language and cultural barriers. This study examined the health status and HRQOL of these two groups of clinic patients. The monolingual group had significantly lower levels of acculturation but did not differ from the bilingual group on any dimension of health status. This group also reported more disruptions on several dimensions of HRQOL. In a multivariate context, health status variables (as a block) accounted for the greatest proportion of variance in all three measures of HRQOL. The results did not support the hypothesis that acculturation mediates the impact of health status on HRQOL. More studies are needed to examine the impact of acculturation and socioeconomic vulnerability on health outcomes.
Help-Seeking and Social Support in Japanese Sojourners
Authors: Arnault Denise Saint
Published: July 2003

Research shows that social support is essential for healthy psychological functioning. Help seeking and social support are social processes shaped by cultural understandings about how need should be expressed, to whom, and in what circumstances. This study used grounded theory methodology to examine how cultural factors regulate help seeking and social support in a sample of 25 Japanese sojourners’ wives living in America. Culturally based social edicts such as mutual responsibility and in-group solidarity were found to promote help seeking and social support. In contrast, culturally specific factors such as enryo ( polite deference), hierarchy, and the cultural rules governing reciprocity inhibited these behaviors. From these data, a cultural model of social exchange, allowing for cultural diversity, is proposed. This model can increase the effectiveness of nursing interventions aimed at community-based health promotion.
Resident Dog in the Alzheimer’s Special Care Unit
Authors: McCabe Barbara W. , Baun Mara M. , Speich Denise , Agrawal Sangeeta
Published: July 2003

Behavioral disturbances are a common feature of Alzheimer’s disease (AD). Prior studies have demonstrated a significant reduction in agitation behaviors during short-term exposure to a dog on an Alzheimer’s special care unit (SCU) for persons with AD. The purpose of this study was to determine the effect over time of a resident dog on problem behaviors of persons with AD in an SCU. A within-participants repeated-measures design was used for this study. The Nursing Home Behavior Problem Scale was used to document behaviors (on days and evenings) 1 week before and 4 weeks after placement of the dog. Participants on the dayshift exhibited significantly fewer problem behaviors across the 4 weeks of the study (F[ 1, 80] = 7.69, p < .05). No significant change in behaviors occurred on the evening shift. The findings support the long-term therapeutic effects of dogs for persons residing in Alzheimer’s SCUs.
Animal-Assisted Therapy and Nutrition in Alzheimer’s Disease
Authors: Edwards Nancy E. , Beck Alan M.
Published: July 2003

This study examined the influence of animal-assisted therapy, specifically fish aquariums, on nutritional intake in individuals with Alzheimer’s disease (AD). Sixty-two individuals with AD who lived in specialized units were studied. Baseline nutritional data were obtained followed by a 2-week treatment period when the aquariums were introduced. The treatment data were collected daily for 2 weeks then weekly for 6 weeks. Nutritional intake increased significantly (21.1%; p < .001) when the aquariums were introduced and continued to increase during the 6-week weekly follow-up. Weight increased significantly(1.65 lbs; p < .001) over the 16-week period. In addition, participants required less nutritional supplementation, resulting in health care cost savings.
Acceptance, Cognitions, and Resourcefulness in Women with Diabetes
Authors: Zauszniewski Jaclene A. , McDonald Patricia E. , Krafcik Karen , Chung ChaeWeon , Dobratz Marjorie C. , Downe-Wamboldt Barbara
Published: July 2003

The coexistence of diabetes and depression occurs frequently among young and middle-age women. Unless one is resourceful, simultaneous management of the symptoms of both conditions is especially challenging. Skills constituting resourcefulness are learned throughout life and are important for the optimal performance of daily activities. Little is known about specific factors that influence resourcefulness. In this study, contextual factors (diabetic and depressive symptoms) and cognitive factors (positive cognitions and acceptance of diabetes) were examined as antecedents of learned resourcefulness in 82 women with type 2 diabetes. Regression analyses showed that depressive symptoms and positive cognitions were significant antecedents of learned resourcefulness: Positive cognitions mediated the effects of depressive symptoms on learned resourcefulness. The findings suggest the need for interventions that focus on development of positive cognitions to better promote resourcefulness in women with type 2 diabetes who are at risk for depression.
Korean Women’s Breast Cancer Experience
Authors: Im Eun-Ok , Lee Eun Ok , Park Young Sook , Salazar Mary K.
Published: July 2003

The purpose of this study was to explore cultural meanings of breast cancer among Korean women in South Korea. A descriptive longitudinal study using methodological triangulation was conducted, and only qualitative findings are presented in this article. Ten Korean women who were newly diagnosed with a plan of surgery and subsequent chemotherapy, who did have severe fatigue at the time of recruitment, were recruited through Seoul National University Hospital. Data were collected using in-depth, 2-hour interviews and analyzed using thematic analysis. The themes emerged through the analysis process included: (a) “I did wrong,” (b) “I cannot ask male physicians,” (c) “I don’t want to show the operation site to my husband,” and (d) “I do household tasks by myself.” The overriding theme was marginalization of the women within the context of their patriarchal culture. The findings suggest that culture is an important context circumscribing women’s health/illness experience.
A Comparison of Imputation Techniques for Handling Missing Data
Authors: Musil Carol M. , Warner Camille B. , Yobas Piyanee Klainin , Jones Susan L.
Published: July 2003

Researchers are commonly faced with the problem of missing data. This article presents theoretical and empirical information for the selection and application of approaches for handling missing data on a single variable. An actual data set of 492 cases with no missing values was used to create a simulated yet realistic data set with missing at random (MAR) data. The authors compare and contrast five approaches (listwise deletion, mean substitution, simple regression, regression with an error term, and the expectation maximization [EM] algorithm) for dealing with missing data, and compare the effects of each method on descriptive statistics and correlation coefficients for the imputed data (n = 96) and the entire sample (n = 492) when imputed data are included. All methods had limitations, although our findings suggest that mean substitution was the least effective and that regression with an error term and the EM algorithm produced estimates closest to those of the original variables.
Are Egalitarian Relationships a Desirable Ideal in Nursing?
Authors: Thorne Sally E. , Henderson Dorothy J.
Published: July 2003

Recent discourse in nursing’s various theoretical enterprises has been dominated by a passionate concern for the moral principle of equality. Although philosophical claims about equality shape current thinking in nursing education, research, and practice theory, this author contends that the dialogue has eclipsed an egalitarian view of justice and created the conditions under which only narrow, individualistic, and prima facie interpretations of equality can be sustained. Current interpretations of equality are linked to systematic patterns in theoretical reasoning and its application to various nursing contexts. Many nurse theorists have uncritically adopted equality as an incontestable and overarching truth, such that its limitations are overlooked and competing positions not afforded serious consideration; extreme and dichotomous positions proliferate within nursing scholarship. Deconstruction of the dominant discourse around equality raises questions about the way justice and truth are understood within nursing’s theoretical, educational, and research scholarship.
Can Justice Coexist with the Supremacy of Personal Values in Nursing Practice?
Authors: Liaschenko Joan
Published: July 2003

This article explores a relationship between justice and personal values, typically understood as illustrative of universalist and particularist accounts of morality, and therefore, as oppositional. The possibility of the coexistence of personal values and justice depends on the conceptualization of justice and the nature of the personal values. In contrast to traditional conceptions, the author presents an alternative and feminist view of justice in which the universalist and particularist accounts of morality need not conflict. The author argues that personal values that work in such a way so as to include previously marginalized others in the group of those who have access to the goods of social life are the personal values that are compatible with justice. In conclusion, the author focuses on the implications for the care/justice debate, the necessity of political participation, and the importance of educating for justice.
Is Practical Nursing Experience Necessary in Administration, Education, and Research?
Authors: Storch Janet L.
Published: July 2003

Because nursing is a practice discipline involving a relationship between nurse and client based on moral commitments of nurse to client, it is critically important that nurse administrators, educators, and researchers have experienced that relationship in practice. Nurse administrators need that basis to found a vision of nursing required to lead and guide. Nurse educators need to have experienced nursing practice to engage nursing students in praxis, that act of reflection and action. Nurse researchers need to have practiced nursing to identify critical areas of focus in nursing practice and to give meaning to the interpretation of findings. The author urges greater convergence and clarity in identifying the nonnegotiables of nursing’s art and science, including the importance of nursing practice as foundational to nursing work.
Organ and Tissue Weight Presentation in Rat Populations
Authors: Schedler Pamela A. , Westfall Una E.
Published: July 2003

Multiple ways of reporting organ weights are sources of confusion in literature. This study was designed to determine if there is a linear relationship between body weights and selected organ and tissue weights in groups of rats after different liquid feeding options. A randomized 2× 2× 2 factorial, randomized block design was used with 40 postpubescent male rats with two levels of feeding schedules, kilocalorie levels, and fiber contents. In addition to a skeletal muscle, 13 abdominal and thoracic organs or tissues were weighed. Pearson product-moment correlation coefficients and regression analyses were completed to determine the relationship between these weights and the final body weights. Findings support the need to use different approaches in order to accurately report various organ and tissue weights.
Discovering a Dialectic of Care
Authors: Mohr Wanda K.
Published: July 2003

Using data from a recent study on the outcomes of child psychiatric hospitalization, the author presents a critique of the intervention-outcome movement that dominates the health care agenda. Employing an exploratory descriptive study design and Denzin’s interpretive interactionism method, she presents data that illustrate how interventions can become distorted by contextual factors, conflicting ideologies, agendas, and failure to thoughtfully consider patient needs. She posits that research agendas are heavily tilted toward outcomes research that often discount the nature of structure and process. The marketplace emphasis of health care may result in environments in which a structure and process of caring is replaced by a focus of profits over patients. The value of focusing on interventions and outcomes in research without addressing broader ecosystem variables that influence practice is questioned in view of in-depth data that emerge from practice settings.
Culturally Sensitive Research Methods of Surveying Rural/Frontier Residents
Authors: Shreffler M. Jean
Published: July 2003

This article describes adaptations to conventional survey research methods based on knowledge of and respect for characteristics and qualities of rural communities and rural culture. These culturally sensitive methods may have contributed to a high response rate in a population-based study of frontier residents conducted in one western state in the United States. Through these methods, residents’interest in the study was heightened and the study’s visibility was increased. Adaptations were also necessary to compensate for shortcomings in the available sample frame for the rural population of interest. References on survey research by mail provide standards for generally accepted procedures but offer few guidelines for tailoring these approaches for varying cultures. Approaches based on the local culture of the persons to be surveyed can increase response rates as well as demonstrate respect for the culture of intended study participants.
Parents Call for Concerned and Collaborative Care
Authors: Stubblefield Carol , Murray Ruth L.
Published: July 2003

Parents’perceptions and expectations of health care providers within the context of the pediatric lung transplant experience were investigated using a phenomenological approach. Fifteen parents of 12 children were interviewed. Two theme clusters, concerned care and collaborative care, were formulated. Themes that reflected parents’perceptions of concerned care included: being treated as an individual, seeing familiar faces, feeling that their children really mattered, and conversely, experiencing a feeling of abandonment. Parents’ perceptions of collaborative care included: being part of the team, and conversely, feeling caught in the middle. The theme cluster, concerned care, reflected the value parents place on continuity of care. Humanistic nursing theory provided the link between study results and nursing practice.
Utilization and Satisfaction with Prenatal Care Services
Authors: Ivanov L. Louise , Flynn Beverly C.
Published: July 2003

This study was conducted in St. Petersburg, Russia, under the auspices of the World Health Organization, Healthy Cities Project, and the St. Petersburg Healthy City Project. The purpose of this study was to investigate and predict use of prenatal care services (utilization) and satisfaction with the services. A high maternal mortality rate and low attendance at prenatal clinics brought this health care issue to the forefront of the St. Petersburg Healthy City Project agenda. Aday and Andersen’s conceptual model was used to investigate use of and satisfaction with prenatal care services. Several characteristics of pregnant women were found to influence early use of prenatal care services and women’s level of satisfaction. Need had no influence in explaining when women started prenatal care or satisfaction with the services. Lastly, there was no relationship between early use of prenatal care services and women’s level of satisfaction with the services.
Two-Year Follow-Up of AIDS Education Programs for Impoverished Women
Authors: Nyamathi Adeline M. , Kington Raynard S. , Flaskerud Jacquelyn , Lewis Charles , Leake Barbara , Gelberg Lillian
Published: July 2003

The long-term effects of two culturally competent AIDS education programs with different content on the risk behavior and AIDS-related knowledge of 410 homeless African American women 2 years after program completion were examined. Participants were members of a larger cohort of impoverished African American and Latina women recruited in Los Angeles from 1989 to 1991. Of a subsample of 527 African American women selected randomly for a 2-year follow-up interview, 410 (78%) were located and agreed to participate. Women participating in both AIDS education programs reported reduced HIV risk behaviors and demonstrated greatly improved AIDS knowledge at 2-year follow-up (p < .001). Women in a specialized program were less likely than those in a traditional program to report noninjection drug use at 2 years. Women in the traditional program had significantly better AIDS knowledge at follow-up (p < .001). These findings suggest that educational programs can produce sustained benefits among impoverished women.
Family Involvement in the Nursing Home
Authors: Friedemann Marie-Luise , Montgomery Rhonda J. , Rice Clementine , Farrell Linda
Published: July 2003

The focus of this study was the influence of pre established family behavior patterns, family orientation of nursing home policies, and practices and caregiver and elder characteristics on the family members’expectations for involvement in the nursing home and the actual involvement 6 months later. The conceptual model was based on findings of Montgomery’s nursing home study and open systems principles applicable to families. Data were collected through telephone interviews with 216 family members of residents in 24 nursing homes in southern Michigan. Regression analyses revealed that measures of pre established patterns of family behavior accounted for 19% to 31% of variance in measures of expected family involvement. Expected family involvement, resident activities of daily learning (ADL), and caregiver relationship accounted for 11% to 23% of variance in measures of actual family involvement. Opportunity for family leadership in resident care had a mild effect of moderating the amount of family direct care and learning activities in the nursing home.
Male Caregivers’ Use of Formal Support
Authors: Coe Maureen , Neufeld Anne
Published: July 2003

The purpose of this study was to explore male caregivers’perceptions of formal support. The men were caregivers of adults with cognitive impairment. The study involved secondary analysis of interview data on perceptions of support that had not been previously analyzed from the perspective of formal support. Techniques of data analysis used in grounded theory were applied to 62 guided interactive interviews conducted with 24 male caregivers during a period of 18 months. The men experienced a process of making concessions for care in the following four sequential stages: resisting, giving in, opening the door, and making the match. Personal barriers deterred the caregivers from seeking help, and once the caregivers engaged formal help the influence of characteristics of the health care system and individual staff members had both enabling and disabling effects. For caregivers whose use of formal support involved admitting their relative to a long-term care facility, the phase of making the match was followed by redesigning their caregiver role.
Cross-Cultural Study of Beliefs about Smoking among Teenaged Females
Authors: Hanson Mary Jane S. , Laffrey Shirley Cloutier
Published: July 2003

This study was designed to identify beliefs associated with smoking behavior in three different ethnic groups of teenaged females. The Neuman Systems Model provided the conceptual framework, and the Theory of Planned Behavior provided the basis for the development of the research instrument. Participants included 141 African American, 146 Puerto Rican, and 143 non-Hispanic White females, ages 13 to 19. Logistic regression analyses identified beliefs that were significantly related to smoking behavior in each ethnic group. Beliefs related to attitudes about smoking and perceived social pressure regarding smoking differed among the three ethnic groups. The findings suggest that specific beliefs distinguish between smokers and nonsmokers and that some beliefs differ by ethnicity.
Perceptions about Substance Use among Male Adolescents in Juvenile Detention
Authors: Anderson Nancy Lois Ruth
Published: July 2003

Although adolescents in juvenile detention represent a vulnerable population who are exposed to situations that foster risk-taking behaviors, few studies have been conducted with detained adolescents to determine their perceptions regarding substance use. Ethnographic interviews and observations were conducted with 20 male adolescents who resided in a large metropolitan area juvenile detention facility, to discover their substance use beliefs and the decisions they make to continue or discontinue substance use or abuse. The participants described how they initiated substance use and said that they had rarely made active decisions about substance use until they were detained. They explained the decisions they made, while they were in detention, to stop or cut down their substance use after release. They talked about the problems they anticipated when they returned home and how they hoped to balance their resolutions with their reputations and obligations. Time-out in juvenile detention may offer nurses the opportunity to capitalize on the potential readiness of detained adolescents to make resolution decisions regarding risky behaviors. Findings from a similar study conducted with 20 detained adolescent women were reported elsewhere.
Research Methodology Issues Related to Interviewing the Mechanically Ventilated Patient
Authors: Higgins Patricia A. , Daly Barbara J.
Published: July 2003

Difficulties conducting research in vulnerable or frail patient populations limit the data-based information on which to base practice in these populations. Although there are many challenges in this type of research, they are not insurmountable, and, in an effort to encourage others interested in studying vulnerable patient populations, we discuss the methodological process used to prospectively study one vulnerable group. Interviews about perceptions of weaning, fatigue, mood, and sleep/rest states were conducted with 20 patients who were chronically critically ill and required long-term mechanical ventilation. Illness severity and communication difficulties were primary considerations in the design, development, and implementation of the study. Ethical considerations, informed consent, sample representation, and data collection issues are discussed.
Evaluation Research and Quality Assurance
Authors: Pesta George , Respress Trinetia , Major Aline K. , Arazan Christine , Coxe Terry
Published: July 2003

This article describes the Juvenile Justice Educational Enhancement Program’s implementation of an evaluation research–driven quality assurance process for Florida’s juvenile justice educational programs. The article reviews the prior literature on promising juvenile justice educational practices and describes the educational quality assurance standards and annual modifications that draw from these promising practices. Included is description of the associated quality assurance, technical assistance, and corrective action processes that are used in the effort to ensure quality and accountable juvenile justice education. Quality assurance is argued to be a fundamental and necessary component to both the Juvenile Justice Educational Enhancement Program’s evaluation research and accountability functions.
Is Clinical Relevance Sometimes Lost in Summative Scores?
Authors: Hinds Pamela S. , Schum Lisa , Srivastava Deo Kumar
Published: July 2003

It is possible to have a reliable and valid measure of a clinical phenomenon but to score the measure in a way that inaccurately represents the clinical meaning of the measured phenomenon. The purpose of this article is to demonstrate the risk to research and clinical assessments caused by a discrepancy in the clinical meaning of scores obtained by total scale scoring and those obtained by individual item scoring. The clinical phenomenon that is used in this demonstration is symptom distress as measured by the Symptom Distress Scale (SDS). In this example, the discrepancy in meaning between total scale scores and the individual item scores of the SDS has potential clinical implications as more than 30% of participating adolescent patients at each of four time points spanning a 6-month time period would have been inaccurately assessed when the assessment was based on the total scale score.