bluuebunny/crossref_metadata_2025 huggingface dataset:
Control Over Nursing Practice: A Construct Coming of Age
Authors: Forbes Sarah A. , Bott Marjorie J. , Lee Taunton Roma
Published: September 2018

The purpose of this study was to assess the psychometric properties of the Control Over Nursing Practice Scales using data from registered nurses (N = 1117) employed in four acute care hospitals in the Midwest. Psychometric evaluation included dimensional analysis, reliability estimation, and validity assessment of six dimensions of a 33-item instrument: responsibility and influence of head nurses, staff nurses, and committees; access to ideas; use of personal resources; and research utilization. Factor analysis reproduced six dimensions that explained 61% of the variance. Coefficient alphas ranged from .75 - .89. Correlations between Control Over Nursing Practice with autonomy, group cohesion, job stress, and job satisfaction supported construct validity. Empirical testing of known group differences to obtain new information about the construct revealed that critical care nurses scored higher on research utilization than medical-surgical or obstetrical nurses; baccalaureate-prepared nurses scored higher than associate or diploma nurses on responsibility and influence: committees. Contrary to our hypothesis, there were no differences between part-time and full-time nurses on any of the six dimensions.
The Depressive Cognition Scale: Further Psychometric Evaluation
Authors: Zauszniewski Jaclene A.
Published: September 2018

Depressive cognitions often precede the development of affective and behavioral symptoms of depression. Cognitive factors have been shown to influence the development of depression in older adults and thus identification of depressive cognitions is important for prevention of clinical depression and early intervention. The Depressive Cognition Scale (DCS) assesses cognitions that may precipitate clinical depression, and it has been found to be internally consistent and to demonstrate construct validity with measures of psychosocial development. This psychometric investigation was designed to further examine the construct validity of the DCS through comparison with measures of hypothetically related constructs. An alpha of .78 indicated acceptable internal consistency. Construct validity was demonstrated by significant correlations with measures of depression, resourcefulness, adaptive functioning, and life satisfaction. The study, conducted with 160 healthy elders, provides additional support for the reliability and validity of the DCS and yields promising evidence of its usefulness with elderly persons.
The Index of Self-Regulation: Development and Psychometric Analysis
Authors: Fleury Julie
Published: September 2018

This paper describes the development and initial psychometric evaluation of a measure of individual self-regulation in the maintenance of health behavior change. Items were developed from inductively generated data to index dimensions of self-regulation in behavioral change (Fleury, 1991). Quantification of Index of Self-Regulation (ISR) content validity was supported through the ratings of 10 experts, following criteria established by Imle and Atwood (1988). The instrument was tested in successive steps with 146 individuals who were participating in an outpatient cardiac rehabilitation program for reliability and validity, including internal consistency reliability and three forms of validity assessment (content validity, criterion-related validity, and construct validity). The three subscales of Stimulus Control, Reconditioning, and Behavioral Monitoring demonstrated internal consistency ranging from .73-.76. Total scale alpha was .87. Initial estimates of criterion-related and construct validity were documented with correlations between ISR subscales and theoretically related criterion measures (.20-.47). With refinement the ISR will provide a basis for tailoring and evaluating clinical interventions designed to enhance motivation in the maintenance of health behavior change.
An Abilities Assessment Instrument for Elderly Persons With Cognitive Impairment: Psychometric Properties and Clinical Utility
Authors: Dawson Pam , Wells Donna L. , Reid David , Sidani Souraya
Published: September 2018

In this article the psychometric properties of an Abilities Assessment Instrument (AAI), developed to assess the self-care, social, interactional and interpretive abilities of older people with cognitive impairment (CI) related to dementia, are described. The sample consisted of 112 institutionalized older men with CI and 60 institutionalized older men without CI. The psychometric evaluation of the AAI indicated that: (a) it is reliable in terms of test-retest (Pearson’s r range .93-.99), interrater (Pearson’s r range .95-.99), and internal consistency evaluations (Cronbach’s alpha .90-.98), as well as through confirmatory factor analysis; and (b) that it is valid with respect to content validity (CVI 87.3%), concurrent validity (Pearson’s r correlations ranging from -.67-.80 on the London Psychogeriatric Rating Scale [LPRS], and from -.76-.85 on the Functional Assessment Stages Scale [FAST]), and construct validity with significant differences between subjects with and without CI (t values ranging from 5.13 -9.30). The AAI is a reliable and valid instrument that can be used to provide assessment data.
Development and Validation of the Avoidance of Environmental Tobacco Smoke Scale
Authors: Martinelli Angela M.
Published: September 2018

The Avoidance of Environmental Tobacco Smoke (ETS) scale is a self-report measure of the avoidance of ETS by young adults. Initial use of the scale with 30 undergraduate students showed an internal consistency of .84 across 40 items and .90 in a refined 28-item instrument. In a sample of 241 students, a 20-item scale had an internal consistency reliability of .94 and a refined 10-item scale had an internal consistency of .86. In a sample of 95 mothers with a mean age of 36, the 10-item scale had an internal consistency of .81. In three distinct samples, significant known groups’ discrimination was found between smokers and nonsmokers. Psychometric analysis indicates that the scale merits further testing using a more heterogeneous sample from community and clinical populations to ensure its usefulness by clinicians and researchers interested in explaining, predicting, and preventing exposure to ETS.
A Comparison of Newborns’ NBAS Reflex Responses Using Total and Individual Scores
Authors: Pressler Jana L. , Hepworth Joseph T. , Appelbaum Mark I. , Sevcik Rose H. , Hoffman Edward L.
Published: September 2018

The purpose of this study was to compare results found using a total summative score of abnormal reflex responses with the results found using individual reflex scores. The 20 reflexes included as part of the Brazelton Neonatal Behavioral Assessment Scale (NBAS) were assessed on 196 neonates on the 1st and 2nd days postnatally. Differences due to of type of delivery, birth weight, whether their mothers were insulin-dependent diabetics or nondiabetics, and day of testing were assessed by using analysis of variance. The key results were that all effects found using the total reflex score were replicated with individual reflex scores and that individual reflex scores also revealed effects not shown using the total score. It was concluded that the individual reflex scores, rather than the total score, should be used when evaluating newborn reflex performance.
Reliability and Validity Testing of the Self-Efficacy for Functional Activities Scale
Authors: Resnick Barbara
Published: September 2018

Self-efficacy expectations for functional activities were defined operationally by having individuals rate their perceived judgment or confidence in their ability to perform each specific activity of daily living (ADL) (bathing, dressing, transferring, ambulating, and stair climbing) at a given point in time. The Self-Efficacy for Functional Activities (SEFA) scale initially included 27 items focusing on efficacy expectations related to performance of each ADL independently, with adaptive equipment, and with the help of another person. After initial pilaf testing the scale was revised to include 9 items which focused on efficacy expectations related to performance of each ADL independently, or with the help of another person. Two additional studies were done and provided some evidence for the reliability and validity of the SEFA when used with older adults.
Measurement of Staff Empowerment Within Health Service Organizations
Authors: Irvine Diane , Leatt Peggy , Evans Martin G. , Baker Ross G.
Published: September 2018

A measure of empowerment was developed and its psychometric properties evaluated. Employees (n = 52) of two hospitals participated in semistructured interviews and a pilot test of the research instrument. A second study was undertaken with professional, support, and administrative staff (n = 405) of four community hospitals. Psychometric evaluation included factor analysis, reliability estimation, and validity assessment. Subjects responded to questionnaires measuring empowerment, leadership behavior, organizational citizenship behavior and job behaviors related to quality improvement. Factor analysis indicated three dimensions of empowerment: behavioral, verbal, and outcome empowerment. Coefficient alphas ranged from .83 to .87. The three dimensions were positively related to leadership behavior that encouraged self-leadership and negatively related to directive leadership. The three dimensions discriminated between the empowerment level of managers compared to that of nonmanagement staff. Empowerment predicted organizational citizenship behavior and job behaviors related to quality improvement.
Reliability and Validity of the Overeating Tension Scale
Authors: Popkess-Vawter Sue , Gerkovich Mary M. , Wendel Shirley
Published: September 2018

This study presents the development and testing of the Overeating Tension Scale. Overeating tension was defined operationally as the total discrepancy score resulting from differences between subjects’ ratings of actual and desired feelings before overeating. The 32-item Overeating Tension Scale, derived from Apter’ s Reversal Theory, measures reported overall tension and motivation-specific tension. The scale initially included 48 items, six items for each of eight motivational states. After two instrument development studies (N = 373, N = 208), items were refined and reduced to a total of 32, or four for each of eight motivational states. The final version of the instrument was tested in two additional studies (N = 330, N = 130) that provided evidence to support the internal consistency reliability of the Overeating Tension Scale. There was support for construct validity using contrasted groups (overweight and normal weight subjects), convergent validity, and factor analysis.
Development and Psychometric Evaluation of the Caregiver Reciprocity Scale II
Authors: Carruth Ann K. , Holland Catherine , Larsen Laura
Published: September 2018

Caregiver reciprocity is the collective affective and behavioral expression of exchanges given and received between a caregiver and care receiver, and among family members. This psychometric investigation was designed to further examine the reliability and validity of the revised Caregiver Reciprocity Scale II (CRSII). Items were rewritten to reflect valued exchanges and balance among the entire family network, including spouses. An alpha of .83 for Warmth and Regard; .73 for Intrinsic Rewards of Giving; .83 for Love and Affection; and .75 for Balance Within Family Caregiving indicated acceptable internal consistency. The study, conducted with 176 spouse or adult children caregivers, provides additional support for the conceptual model of the four-factor solution. Construct validity was supported by the standardized factor loadings and goodness-of-fit indices obtained from confirmatory factor analysis. The results of the analysis of the measurement model, taken as a whole, demonstrate that the CRS II has adequate psychometric properties. Model parsimony was supported by an AGFI of .87, combined with an adjusted chisquare between 1.0 to 3.0. All but two item loadings were greater than .50. This, combined with the fact that all standardized loadings were twice the standardized errors and t-values were greater than 2.0, contributes to concluding that convergent validity was strong. Discriminant validity, evaluated by variance extracted estimates, and confidence interval (± two standard errors) around the correlation estimate between factors, was adequate. This study provided evidence to support the reliability and validity of the CRS II.
The Elder Image Scale: A Method for Indexing History and Emotion in Family Caregiving
Authors: Phillips Linda R. , Brewer Barbara B. , Torres de Ardon Esperanza
Published: September 2018

Although caregiving has been studied extensively, most studies have focused on the activities performed by caregivers, problems encountered and caregivers’ reactions. Less attention has been paid to measuring historical and interpersonal factors that may shape the situation and affect outcomes, but are not necessarily embedded in the role itself. The objective of this article is to report on the development and testing of the Elder Image Scale (EIS) which indexes the personal identity of the elder, the mental image the caregiver has of the elder derived from past associations, present observations, and the reconciliation of the past with present impressions. This scale was based on the Family Caregiving Dynamics Model and the personal image of the elder is predicted to be shaped by certain structural factors and to impact both the perceptions of caregivers and the outcomes of caregiving. This article reports on four separate investigations; six-hundred-and-fifty-six caregivers participated. The EIS is in the semantic differential format. Internal consistency ranged from .92 to .98 over four studies. Stability after two weeks was .93 for both subscales. All correlations with criteria were in the direction predicted and most were significant. Known group comparisons showed all group differences were statistically significant as predicted. The EIS is internally consistent, stable and evidences construct validity. In addition, measuring this concept appears to have great relevance for explaining both perceptions of caregivers and outcomes of caregiving.
Ambulatory Blood Pressure Monitoring: Measurement Implications for Research
Authors: Yucha Carolyn B.
Published: September 2018

Although blood pressure (BP) is a frequently used variable in nursing studies, measurements are likely to be inaccurate for a variety of reasons: incorrect technique, operator error, and environmental factors. Ambulatory BP monitoring (ABPM) reduces measurement error, is relatively easy to use, and yields many more BP parameters than do clinic BP measurements. The cost of equipment for ABPM ranges from $2,500 to $5,000 per monitor and from $2,000 to $3,000 for computer software. A research assistant can easily be trained to follow a standardized procedure. Researchers have used ABPM to study normal BP patterns, complications of hypertension, effects of antihypertensive drugs, and the prognosis of cardiovascular events. This article provides the nurse researcher with an introduction to this technology and an overview of information gained from ambulatory blood pressure monitoring.
Reliability and Validity Testing of the Revised 12-Item Short-Form Health Survey in Older Adults
Authors: Resnick Barbara , Nahm Eun S.
Published: September 2018

The SF-12 Short Form Health Survey was developed to describe mental and physical health status of adults, and to measure the outcomes of health care services. The purpose of this study was to test the reliability and validity of this measure in a sample of 185 older adults living in a continuing care retirement community. The mean age of the participants was 86 + 6.1 and the majority were female (82%), unmarried (82%), Caucasian (99%), and all had at least a high school education. Initial testing of the SF-12 measurement model as proposed by Ware, Kosinski, and Keller (1995) demonstrated that the model did not fit the data (chi-squared/<df = 7.8). The model was revised based on modification indices and the revised model provided evidence of reliability (alpha coefficients of .70, and .89; the majority of the R2 values were greater than .50), and validity as there was improved fit of the model to the data (X2 difference of 123, df difference of 1.0, p < .05). There was also evidence of construct validity, based on hypothesis testing, with a statistically significant correlation between physical health and number of chronic illnesses (r = .33, p < .05) and mental health and chronic illnesses (r = .27, p < .05), and a statistically significant difference in physical health (F = 30.5, p < .05) and mental health (F = 18.5, p < .05) between those who exercise regularly and those who do not. The revised SF-12 is a reliable and valid measure of health status in independent living older adults, and has the potential for use as either a predictor or an outcome measure.
Development of the Perceived Multiple Role Stress Scale (PMRS)
Authors: Gigliotti Eileen
Published: September 2018

Assessment of women’s perception of multiple-role stress arising from occupancy of the maternal and student role is crucial if we are to engage in prevention and intervention strategies. Existing measures do not fully address the components of multiple role stress in this population: emotional role ambiguity, person-role and inter-role conflict. This article describes the development of the Perceived Multiple Role Stress Scale (PMRS) which was derived from Kahn, Wolfe, Quinn and Snoek’s (1964) systems-based role theory. The 8-item, 3-factor PMRS measures multiple role stress in women who are both mothers and students. Review of the PMRS by role stress and women’s roles experts supported content validity. Construct validity was supported in three phases over a five-year period. It is recommended that the three correlated factors be used as one eight-item scale. The internal consistency for the PMRS was .86.
Development of an Exercise Self-Efficacy Questionnaire for Older Mexican American Women
Authors: Laffrey Shirley C. , Asawachaisuwikrom Wannipa
Published: September 2018

The purpose of this study was to develop a reliable and culturally meaningful exercise self-efficacy questionnaire for older Mexican American women. Items were derived from a 5-item exercise self-efficacy instrument (Laffrey, 2000; Marcus, Selby, Niaura, & Rossi, 1992) and from focus groups with women in the target population. Content validity of the Spanish-language items was supported by three Mexican American professional women and by five Mexican American nurses. A factor analysis of the 11-item questionnaire revealed one major factor. Internal consistency was shown by an alpha reliability coefficient of .86. Item:corrected scale correlation coefficients ranged from .30 to .70. The mean exercise self-efficacy score was significantly higher for 38 regular exercisers than for 37 non-exercisers. The exercise self-efficacy questionnaire can be used in research with older Mexican American women and should be tested with men and with younger men and women to explore its usefulness with these populations.
Psychometric Properties of the California Critical Thinking Tests
Authors: Bondy Kathleen N. , Koenigseder Lauretta A. , Ishee Jimmy H. , Williams Barbara G.
Published: September 2018

The evaluation of critical thinking, as with any other measure, must employ instruments that meet appropriate psychometric standards. Therefore, the purpose of this study was to investigate the psychometricproperties of the two California Critical Thinking Tests. Two samples of undergraduate students enrolled in a southern comprehensive university took the California Critical Thinking Skills Test (TST) and the California Critical Thinking Dispositions Inventory (TDI). A portion of the participants, who were nursing students, were retested on the TST and TDI two weeks after the initial testing. Some participants also completed the Watson-Glaser Critical Thinking Appraisal (WGCTA). In both samples the TST had neither sufficient psychometric properties to assess individual abilities nor sufficient stability reliability. In particular, the analysis subscale of the TST demonstrated exceptional weakness in all administrations. In contrast, the TDI demonstrated very good reliability estimates in all administrations of the test. The data did not conform to the subscale structure during factor analysis. Whereas the TST needs further refinement, the TDI demonstrated sufficient reliability for use in attitudinal research.
Keeping Nursing Human
Authors: Adamski Kathy , White Linda , Dording Wendy , Schroeder Marilyn , Savett Laurence
Published: September 2018

Stories from the experiences of four nurses at United Hospital in St. Paul, Minnesota - their collective years of service total 100 - teach many useful lessons. The power of their individual stories and those of their patients becomes evident in this two-hour conversation, which took place earlier this year. Like most good nurses, they are models for their colleagues and for those just starting their careers. Their insights are fascinating and very, very wise. We hope that they stimulate individual reflection among the readers, discussion with kindred souls and an even greater appreciation of the richness of the nursing profession.

The moderator of the conversation is Laurence Savett, an internist who practiced for 28 years at United and worked with all four of these nurses. He teaches courses for aspiring health professionals at two Minnesota colleges.
Learning Situations in Nursing Education: A Concept Analysis
Authors: Shahsavari Hooman , Zare Zahra , Parsa-Yekta Zohreh , Griffiths Pauline , Vaismoradi Mojtaba
Published: September 2018

Background and purpose:

The nursing student requires opportunities to learn within authentic contexts so as to enable safe and competent practice. One strategy to facilitate such learning is the creation of learning situations. A lack of studies on the learning situation in nursing and other health care fields has resulted in insufficient knowledge of the characteristics of the learning situation, its antecedents, and consequences. Nurse educators need to have comprehensive and practical knowledge of the definition and characteristics of the learning situation so as to enable their students to achieve enhanced learning outcomes. The aim of this study was to clarify the concept of the learning situation as it relates to the education of nurses and improve understanding of its characteristics, antecedents, and consequences.

Methods:

The Bonis method of concept analysis, as derived from the Rodgers’ evolutionary method, provided the framework for analysis. Data collection and analysis were undertaken in two phases: “interdisciplinary” and “intra-disciplinary.” The data source was a search of the literature, encompassing nursing and allied health care professions, published from 1975 to 2016.

Results:

No agreement on the conceptual phenomenon was discovered in the international literature. The concept of a learning situation was used generally in two ways and thus classified into the themes of: “formal/informal learning situation” and “biologic/nonbiologic learning situation.” Antecedents to the creation of a learning situation included personal and environmental factors. The characteristics of a learning situation were described in terms of being complex, dynamic, and offering potential and effective learning opportunities. Consequences of the learning situation included enhancement of the students’ learning, professionalization, and socialization into the professional role.

Implication for Practice:

The nurse educator, when considering the application of the concept of a learning situation in their educational planning, must acknowledge that the application of this concept will include the student’s clinical learning experiences. More studies are required to determine factors influencing the creation of a successful learning situation from the perspectives of nurse educators and nursing students, clinical nurses and patients.
The Effects of Religious and Cultural Beliefs on Muslim Transplant Candidates During the Pretransplant Waiting Period
Authors: Sheikhalipour Zahra , Zamanzadeh Vahid , Borimnejad Leili , Valizadeh Leila , Newton Sarah , Shahbazi Mohammad , Zomorrodi Afshar , Nazari Mojtaba
Published: September 2018

Background:

Awaiting organ transplantation can be stressful, and pretransplant candidates’ religious and cultural beliefs can influence how they adapt to the stress. While little is known about the effect religious and cultural beliefs have on the pretransplant waiting period, virtually nothing is known regarding whether and how Shia Muslim patients’ religious and cultural beliefs facilitate more positive patient outcomes while they await transplantation. Therefore, it is important for nurses and other health care providers to understand transplant candidates’ experiences dealing with the stressors that present themselves during the pretransplant waiting period, especially how their religious and cultural beliefs affect their adaptation to the stressors.

Aim:

The purpose of this study was to explore the lived experience of Shia Muslim organ transplant candidates regarding how their religious and cultural beliefs affect their adaptation to the pretransplant waiting period.

Sample:

A purposeful sample of 11 Shia Muslim organ transplant candidates who were on an organ transplant waiting list in Iran (kidney,n= 4; heart,n= 4; liver,n= 3) was recruited.

Method:

A qualitative research design using the hermeneutical phenomenological approach was utilized in this study. In-depth unstructured interviews were conducted by one of the authors (ZS) in different locations across Iran.

Results:

Data analysis led to the development of six themes: “the misty road of organ transplantation,” “to accede to organ transplantation despite religious conflict,” “one step away from death,” “the master key of liberation,” “fear of the unknown,” and “reliance on God.”

Nursing Implications:

The findings of this study will help nurses understand the religious and cultural meaning associated with stressors experienced by Shia Muslim patients awaiting organ transplant. This information can assist nurses to develop plans of care that include patient-specific interventions that take into consideration the patients’ religious and cultural beliefs.

Conclusion:

Shia Muslim patients awaiting organ transplantation experience feelings that are often in conflict with their religious and cultural beliefs. However, the patients’ reliance on God during the pretransplant waiting period facilitated healthier attitudes regarding transplantation.
Beware the Borderline Tightrope
Authors: Root Elizabeth
Published: September 2018

I narrate the story of how I was reduced from a fully employed, capable mother to a person alone and destitute following extensive hospitalization. Interactions with treatment professionals are recounted and analyzed to provide insight into how relationship problems between clients and therapists can shape the vulnerable client into a “borderline personality.” The detrimental consequences of institutionalization, medication, and electroshock therapy are described. Therapeutic posturing more conducive to successful outcomes is recommended as an alternative to that of the traditional medical model.
Latinos and Electroconvulsive Therapy: Implications for Treatment, Research, and Reform in Texas and Beyond
Authors: Major Ken
Published: September 2018

No literature exists concerning the implications of using electroconvulsive therapy (ECT) in the treatment of Latinos. Given the large and increasing Latino population in the United States, the contentious history of ECT, and the possible differences in language and cultural vantage point between the typical ECT provider and Latino client, this paucity of research is worrisome. This article identifies a number of potential problems involved in multiculturally untrained service providers treating Latinos with ECT, including invalid diagnoses, an incomplete knowledge of the strengths and resiliencies of the client, and the use of ECT rather than culturally appropriate interventions. Also discussed are Latino cultural beliefs and practices salient to mental health service providers, some of the recent mandates for multiculturally informed service provision in mental health, ideas for the constructive modification of the diagnostic and treatment protocols currently guiding the use of ECT with Latinos, and needed research relevant to the issues raised.
Contra Pfizer
Authors: Healy David
Published: September 2018

Against a background of longstanding concerns that antidepressants may trigger suicidality, the Food and Drug Administration (FDA) in 2004 convened two committees to review the issues. Prior to the second meeting Pfizer posted an extensive ad hominem attack on me on FDA’s website. There was no opportunity to post a response. This article covers the points made in response and sheds some light on pharmaceutical company handling of debates about adverse events.
Becoming a Mother: Women’s Journeys From Expectation to Experience in Three European Countries
Authors: Luyben Ans G. , Kinn Sue R. , Fleming Valerie E. M.
Published: September 2018

OBJECTIVE:To investigate important aspects of provision of routine antenatal care from women’s points of view in the Netherlands, Scotland, and Switzerland and to construct a conceptual model of care during pregnancy, informed by women.

DESIGN:Grounded theory using semistructured interviews to explore women’s views. The interviews were undertaken in Dutch, English, and German.

FINDINGS:In the main study, one single cross-national model emerged, which had implications for women beyond the antenatal period. “Mothering the mother” emerged as a core category. There were two subcategories: “creating a bond” and “becoming a mother.” The subcategory of “becoming a mother,” which incorporated the stages of “expecting,” “familiarizing,” and “embarking on motherhood,” is reported in this article. Women defined becoming a mother as the aim of provision of maternity care in which they described their journeys from creating expectations in early pregnancy to completing the experience approximately a year after childbirth. Mismatches between expectation and experience at the end of these journeys indicated cross-national differences in the provision of maternity care, particularly regarding the woman–care provider relationships.

CONCLUSION:The findings from this study suggest that an essential aim of the maternity services was to support women in the process of becoming a mother, in the context of their own social world. Supportive conditions include woman–care provider partnerships, involvement of women’s individual social worlds in care provision, and continuity of the care providing process. These conditions should be taken into account, while designing effective models of maternity care.
General Practitioner Involvement in Remote and Rural Maternity Care: Too Big a Challenge?
Authors: Caldow Jan , Hundley Vanora , Teijlingen Edwin van , Reid John , Kiger Alice , Tucker Janet , Ireland Jilly , Harris Fiona , Farmer Jane , Bryers Helen
Published: September 2018

BACKGROUND:In the United Kingdom, general practitioner (GP) involvement in maternity care has declined significantly over the past decade. This is particularly so in remote and rural areas where midwives have stepped up and taken over units to ensure that women in these areas continue to have a service. A recent report by the King’s Fund argues for a greater role for the GP in maternity care provision; however, this raises questions about whether GPs have the skills and training to provide such care.

AIM:To explore the views of GPs on the skills and training required to deliver safe and appropriate local intrapartum services in remote and rural settings.

METHODS: Mixed-method study consisting of qualitative interviews with a purposive sample of GPs in six remote and rural sites. To triangulate the interview findings and identify features that might have been missed in the interviews, a questionnaire was developed using initial key themes identified.

FINDINGS:Maternity care accounted for less than 10% of most remote and rural GPs’ workload, yet interviewees reported that their role required them to be competent in a wide range of procedures. This was seen as a major barrier to recruitment and retention in rural areas. Although self-reported competence and confidence was high, several GPs felt de-skilled and felt that they were fighting a losing battle to maintain skills. GPs regarded isolation, need for comprehensive expertise, limited resources, and transportation difficulties as factors affecting the decline in their contribution to remote and rural maternity care.

CONCLUSION:Although rural GPs and midwives might traditionally have been in competition, providing a woman-centered service in remote areas may be easier to achieve through collaborative working. However, if GPs are to play a greater role, then they will need to be prepared to make a strategic commitment to the maintenance of remote and rural maternity care. This will require innovative methods of training, special consideration of educational needs, and incentives for practitioners to settle in rural areas, but it may already be too late for GPs to have a substantial input into maternity care.
Expanding Postpartum Hemorrhage Prevention to the Community in Resource-Poor Contexts: Critical Considerations and Next Steps
Authors: Spangler Sydney A. , Koski Alissa , Armbruster Deborah , Stanton Cynthia
Published: September 2018

Increasing the proportion of pregnant women with medically skilled care at childbirth is widely regarded as the best strategy for reducing maternal mortality and morbidity in resource-poor contexts. For many countries, however, local conditions necessitate continuing discussion concerning the role of targeted, community-based interventions in efforts to tackle this problem. One such intervention gaining momentum is community-based use of uterotonic drugs to prevent postpartum hemorrhage (PPH). But how this intervention fits within the larger maternal health agenda still needs addressing, as do questions regarding whether, where, and how to proceed. This article presents a usable framework for context-based decision making around PPH prevention, evaluating why and under what circumstances it might make sense to implement uterotonic drugs at the community level. Using Demographic and Health Surveys (DHS) data along with current evidence, we identify four critical considerations for policymakers to take into account: (a) where births are happening, (b) which women are delivering in what settings, (c) capacity of health care systems, and (d) criteria for selecting specific uterotonic drugs. Incorporating these considerations, we propose a checklist to aid policymakers in determining what strategy realistically suits the needs of their particular country contexts. Although a large and rigorous body of evidence supports PPH prevention methods, research gaps remain. Even with sufficient evidence, however, a global consensus may not be reached because of the ongoing debates over community- versus facility-based interventions. Despite these issues, it is still possible to arrive at policy decisions on community-based use of uterotonic drugs by taking a careful, context-based approach. In many settings, implementation of this intervention can be pursued in conjunction with improvements to facility-based care. As a complement to skilled attendance, expanding PPH prevention to the community can be part of a national push to target the reduction of PPH as an achievable goal.
Competence and Competency: Core Concepts for International Midwifery Practice
Authors: Fullerton Judith T. , Ghérissi Atf , Johnson Peter G. , Thompson Joyce B.
Published: September 2018

The global health community has implemented several initiatives over the past in the interest of accelerating country-by-country progress toward the Millennium Development Goal of improving maternal health. Skilled attendance at every birth has been recognized as an essential component of approaches for reducing maternal and perinatal morbidity and mortality.

Midwives have been acknowledged as a preferred cadre of skilled birth attendant. The International Confederation of Midwives (ICM) speaks for the global community of fully qualified (professional) midwives. The ICM document entitledEssential Competencies for Basic Midwifery Practiceis a core policy statement that defines the domains and scope of practice for those individuals who meet the international definition of midwife. This article explores the meaning of competence and competency as core concepts for the midwifery profession. An understanding of the meaning of these terms can help midwives speaking individually at the clinical practice level and midwifery associations speaking at the policy level to articulate more clearly the distinction of fully qualified midwives within the skilled birth attendant and sexual and reproductive health workforce. Competence and competency are fundamental to the domains of midwifery education, legislation, and regulation, and to the deployment and retention of professional midwives.
Policy and Systems Issues Limiting the Participation of Historically Black Colleges and Universities in the Federal Disability Research Agenda
Authors: Corey L. Moore , Jean E. Johnson , Edward O. Manyibe , Andre L. Washington , Nkechi E. Uchegbu , Kenyotta Eugene Cross , Bridget Hollis-Staten , Tyra Turner-Whittaker , Yolanda Edwards
Published: September 2018

This study reports on an investigation of barriers that prevent Historically Black Colleges and Universities (HBCUs) from fully participating in the federal disability and rehabilitation research and development (R&D) agenda. The Delphi technique was used to examine panelists' perceptions on the importance of contextual R&D barriers ensuing from policy/systems issues across 13 different categories. The findings provide information about what Federal research entities (e.g., National Institute on Disability and Rehabilitation Research) and HBCU administrators can do to more effectively address the Section 21 Legislative Mandate of the 1992 Rehabilitation Act Amendments and stimulate competitive R&D participation across the HBCU community.
Predictors of Outcomes for African Americans in a Rehabilitation State Agency: Implications for National Policy and Practice
Authors: Fabricio E. Balcazar , Ashmeet K. Oberoi , Yolanda Suarez-Balcazar , Francisco Alvarado
Published: September 2018

A review of vocational rehabilitation (VR) data from a Midwestern state was conducted to identify predictors of rehabilitation outcomes for African American consumers. The database included 37,404 African Americans who were referred or self-referred over a period of five years. Logistic regression analysis indicated that except for age and disability type, none of the other demographic variables were significant predictors of vocational rehabilitation for the individuals in the sample. However, as the amount of money spent on a case increased, the probability of gaining employment increased. Recommendations for VR practice with minority consumers are suggested.
Opportunities in the Affordable Care Act to Advance Long-Term Services and Supports: The Role of Rehabilitation Counseling
Authors: Joe Caldwell , Reginald J. Alston
Published: September 2018

The Affordable Care Act includes many new provisions for long-term services and supports (LTSS). Among these are several new options, improvements, and incentives within Medicaid to balance service systems and expand access to home and community-based services. In addition, the Affordable Care Act authorizes the establishment of a new voluntary national long-term care insurance program, the Community Living Assistance Services and Supports (CLASS) Program. This article discusses some of the major provisions and implementation. It also examines how the major principles of rehabilitation counseling are central to advancing LTSS policy and how rehabilitation counselors can play a key role in ensuring quality LTSS services for persons with disabilities.
Assistive Technology in Rehabilitation: Improving Impact Through Policy
Authors: Joseph W. Madaus , Jennifer S. Kowitt , Adam R. Lalor
Published: September 2018

The Higher Education Opportunity Act of 2008 (HEOA) contains several important provisions that make postsecondary education more accessible and affordable for young adults with disabilities. This is particularly true for students with intellectual disabilities, as the law created new comprehensive transition and postsecondary programs and provided access to federal student aid to this population for the first time. This article presents a brief summary of the original Higher Education Act of 1965, as well as a detailed summary of the HEOA. Portions of the legislation specific to students with disabilities are highlighted, and specific implications for rehabilitation counselors and pre-service students are presented.
Inter-University Collaboration for Online Teaching Innovation: An Emerging Model
Authors: Andrea Perkins Nerlich , James L. Soldner , Michael J. Millington
Published: September 2018

Distance education is constantly evolving and improving. To stay current, effective online instructors must utilize the most innovative, evidence-based teaching methods available to promote student learning and satisfaction in their courses. One emerging teaching method, referred to as blended online learning (BOL), involves collaborative education across multiple university settings. In this article, we describe an inter-university educational collaboration designed to connect students from various academic institutions using the BOL teaching method. The article begins with an overview of the theoretical framework that informs the BOL method, followed by an overview of the method and its key components. Benefits of this collaborative learning effort to students, educators, universities, and the profession are also provided. The article culminates with implications for using the BOL method with rehabilitation educators, including collaborative teaching tips for working in educator and student teams.
Beyond Instruction; Beyond a Website: Distance Learning, Disability Inclusiveness and Changing Workplace Practices
Authors: Hannah Rudstam , Wendy Strobel Gower
Published: September 2018

Often, the aim of distance learning (DL) is to enhance individual learning, not to change workplace practices. Changing organizational policies, practices and behaviors related to disability calls for a different DL approach that engages users and contextualizes knowledge. In the disability arena, there is a need for programming that brings about disability inclusive workplace practices by reaching more deeply within workplace cultures. Mid-level managers are key arbiters of disability inclusiveness and workplace practices, yet they are difficult to reach. We have designed and piloted a Just-in-Time (JIT) approach to reach managers that includes two phases: Phase I engages a core group within the organization, and Phase II focuses on a JIT toolkit.
Sistem Informasi Elektronik Kuliah Kerja Nyata (E-KKN) Berbasis Web Service pada Lembaga Penelitian dan Pengabdian Masyarakat (LP2M) Universitas Islam Negeri Raden Fatah Palembang
Authors: Anwar Saipul
Published: September 2018

Tridharma Universitas Islam Negeri (UIN) Raden Fatah dilaksanakan oleh Lembaga Penelitian dan Pengabdian Masyarakat (LP2M). Salah satu tugasnya mengadakan kegiatan Kuliah Kerja Nyata (KKN) bagi mahasiswa yang telah memenuhi persyaratan perkuliahan. KKN dilaksanakan untuk membentuk jiwa sosial di lingkungan masyarakat Sumatera Selatan. Sistem ini mengintegrasikan database server PUSTIPD UIN Raden Fatah dalam proses pengambilan data mahasiswa yang akan dihubungkan dalam sistem E-KKN menggunakan teknologi web service dengan notasi JSON (JavaScript Object Notation).Sistem E-KKN dibangun untuk mempermudah proses pendaftaran Mahasiswa, penentuan Dosen Pembimbing Lapangan (DPL), desa dan kelompok mahasiswa antar fakultas serta proses validasi data KKN. Sistem ini dapat memberikan fungsi pembatas, mendeteksi total Satuan Kredit Semester (SKS) yang telah ditempuh mahasiswa yang terdapat dalam Sistem Informasi Akademik UIN Raden Fatah. Metode pengembangan sistem menggunakan RAD (Rapid Aplication Development) terdiri dari Pemodelan Bisnis, Pemodelan Data, Pemodelan Proses, Kontruksi dan Pengujian. Hasil akhir dari sistem ini dapat melihat informasi persentase jumlah pendaftaran KKN dalam bentuk grafik visual berdasarkan jenis kelamin, prodi dan fakultas serta dapat melihat data KKN di tahun sebelumnya.
Makna Kebahagiaan pada Lansia Muslim yang Tinggal di Panti Tresna Werdha Teratai Palembang
Authors: Impisari Iin Nasri
Published: September 2018

Penelitian ini berjudul “Makna Kebahagiaan pada Lansia Muslim yang Tinggal di Panti Tresna Werdha Teratai Palembang. Tujuan penelitian ini adalah untuk memahami makna kebahagiaan manurut lansia yang tinggal di Panti Werdha. Jenis penelitian yang digunakan adalah penelitian kualitatif. Penulis menggunakan metode fenomenologi, metode fenomenologi itu sendiri merupakan analisis deskriptif dan instrospektif tentang kedalaman dari semua bentuk kesadaran dan pengalaman langsung yang meliputi indrawi, konseptual, moral, estetis dan religius. Penelitian ini dilaksanakan dipanti Sosial Tresna Werdha Teratai Palembang. Berdasarkan analisis data hasil penelitian yang telah dilakukan mengenai Makna Kebahagiaan pada Lansia Muslim yang Tinggal di Panti Tresna Werdha Teratai Palembang, maka dapat di simpulkan bahwa semua subjek merasa bahagia tinggal di panti dan semua subjek memaknai kebahagiaan sebagai perasaan senang. Mereka merasa bahagia/senang karena semua kebutuhan hidupnya terpenuhi dan terjamin, subjek mempunyai banyak teman dan subjek juga tidak perlu memikirkan biaya hidup, seperti membayar sewa tempat tinggal dan membayar keperluan lainnya.
Ajaran Taoisme dan Mistisisme Islam (Studi Komparatif)
Authors: Rudin Toha
Published: September 2018

Dalam pembahasan ini menunjukkan bahwa: Ajaran Taoisme adalah ajaran yang lebih menekankan pada perbaikan akhlak umat manusia yang sudah rusak, kemudian untuk dapat menjadi manusia yang bijaksana dengan tujuan terakhir yaitu untuk mendapatkan kebahagian yang kekal dengan cara menyatu dengan Tao (Tuhan). Mistisisme Islam juga bertujuan untuk pembinaan aspek moral untuk mewujudkan kestabilan jiwa yang berkesinambungan, penguasaan dan pengendalian hawa nafsu sehingga manusia istiqomah dalam pendirianya. Dalam hal ini yang paling ditekankan adalah membina akhlak, baik akhlak kepada sesama mansia dan lebih lagi kepada Allah. Perbedaan antara Ajaran Taoisme dan Mistisisme Islam yaitu: Mistisisme Islam bersumber dari al-Qur’an dan Hadis Nabi Saw, sedangkan ajaran Taoisme bersumber dari kitab Tao Te Ching yang merupakan ajaran Lao Tze yang berisi filsafat, hikmah dan jalan hidup. Adapun persamaan antara Ajaran Taoisme dan Mistisisme Islam yaitu: Sama-sama bertujuan untuk pembinaan aspek moral yang bertujuan mewujudkan kestabilan jiwa yang berkesinambungan, penguasaan dan pengendalian hawa nafsu sehingga manusia istiqomah dalam pendirianya. Dalam hal ini yang paling ditekankan adalah pembinaan akhlak, baik akhlak kepada sesama manusia, terlebih lagi akhlak kepada Allah Swt.