bluuebunny/crossref_metadata_2025 huggingface dataset:
Will Claims Workers Dislike a Computerized Fraud Detector?
Authors: Smith Robert B.
Published: July 2003

The computerized fraud detector (CFRD) assigns suspicion scores to questionable automobile insurance claims. Evaluators pilot tested this algorithm in three offices, comparing its effects with three matched offices. Observers uncovered that in two target offices and one comparison office, Millennium 2000 (M2K) also was being installed. The study design thus became as follows: Two offices had two interventions, one office had CFRD but not M2K, another office had M2K but not CFRD, and two offices had neither. Hierarchical linear models document that offices with both new computer systems will have the most unfavorable employee attitudes toward computerized fraud detection, followed by offices with only one new system. Employees with jobs of higher rank and employees not receptive to innovation will dislike computerized fraud detection. Implementation of one computer system, CFRD or M2K, may have minor negative fixed effects on employee attitudes, but their effects on the between-office variance are inconsequential.
Testing Privatization of “Long Arm” Service of Process
Authors: Schraufnagel Scot
Published: July 2003

The research addresses questions about the desirability of privatizing a key component of the child support enforcement process, namely, the serving of legal documents or “service of process” for cases in which the noncustodial parent is living in another state. Child support enforcement cases that require this type of “long arm” service of process were randomly assigned to a private vendor and to out-of-state sheriff offices using an experimental research design. The author finds that although there is no difference in the time it took the two groups to process cases, the private vendor was more successful, on average, at performing this function. Furthermore, he finds that the higher success rate of the private vendor is sufficient to produce a substantively important increase in collections in child support enforcement cases. Additional questions about the suitability of privatizing “service of process” and other like services are also discussed.
Evaluating the Effects of Information Technology on Problem-Oriented-Policing
Authors: Nunn Samuel , Quinet Kenna
Published: July 2003

Technologies promise to make our organizations more productive, efficient or effective. But our experience does not always fulfill this promise. Public safety agencies are the target of a barrage of new information technologies offering better performance, many of which are attractive because they can be financed through federal grants. But when evaluations are performed of these technologies, improvements do not always result. This article describes the experiences of a state police agency (SPA) during its use of cellular digital packet data (CDPD) systems to support its problem-oriented policing (POP) project. The CDPD system should have improved the SPA's POP operations; in practice, it was not as clear. Although participants believed the CDPD technology worthwhile, there were only a few minor differences between POP officers that did and did not use it. This evaluation suggests the need for better databases to measure performance as well as more informed federal funding of ways to assess the impact of technologies.
Evaluating Vehicle Inspection/Maintenance Programs Using On-Road Emissions Data
Authors: Dehart-Davis Leisha , Corley Elizabeth , Rodgers Michael O.
Published: July 2003

On-road remote sensing data is an increasingly popular source of evaluation information for vehicle inspection/maintenance (I/M) programs. This article conducts one such remote sensing data evaluation for the Atlanta, Georgia, I/Mprogram. The reference method involves comparing emissions differences in I/Mand non-I/Mfleet vehicles with those predicted by a regulatory computer model. Assuming that on-road emissions differences represent observed effectiveness and model-predicted emissions differences represent effectiveness goals, the Atlanta enhanced I/Mprogram appears to be achieving 83% of its targeted emissions reductions. The method compares favorably with other remote sensing evaluation methods in its ability to be applied over time and its relatively small sample size requirement. The chief limitation to the approach is its reliance on a representative non-I/Mfleet, which may differ in characteristics for which controls are difficult to locate. Such potential confounding factors include discrepancies in maintenance trends, socioeconomic conditions, and vehicle quality.
Data Quality in Evaluation of an Alcohol-Related Harm Prevention Program
Authors: Graham John W. , Roberts Melinda M. , Tatterson James W. , Johnston Sara E.
Published: July 2003

The authors report the reliability and convergent validity in a sample of college students for 27 composite scales and two items covering alcohol use, cigarette smoking, marijuana use, and other drug use; beliefs relating to alcohol use; perceived norms for alcohol-related behavior; harm prevention skills; intentions to take prevention action; harm prevention action taken; risk taken; experienced harm; and other health-related behaviors and person characteristics. Data quality assessment strategies and missing data procedures were illustrated for large, multivariate, longitudinal data sets. Results indicate 23 of the 27 composite scales had at least acceptable reliability, and the remaining 4 composite scales had at least marginally acceptable reliability. At least moderate construct validity was demonstrated for 25 scales.
Grade-Induced Beliefs About Undergraduate Generalist Social Work Practice Competency
Authors: Noble John H. , Stretch John J.
Published: July 2003

Standardized criterion-referenced achievement testing of undergraduate generalist social work knowledge based on correct answers to specific questions is compared to several norm-referenced measures of student learning, including student self-reports and the instructor-imposed cumulative grade point average (GPA). Two hypotheses are tested, namely, (a) norm-referenced measures systematically overstate content knowledge, and (b) student perception or belief about the ascribed meaning of the GPA inflates self-rated attainments. The implications of additional confirming evidence for the hypotheses are explored with a view to limiting the number of social workers with undergraduate degrees who are permitted to enter the field each year overconfident about their knowledge and practice capabilities.
Using Performance Standards to Evaluate Social Programs with Incomplete Outcome Data
Authors: Manski Charles F. , Newman John , Pepper John V.
Published: July 2003

The idea of program evaluation is both simple and appealing. Program outcomes are measured and compared to some minimum performance standard or threshold. In practice, however, evaluation is difficult. Two fundamental problems of outcome measurement must be addressed. The first, which we call the problem of auxiliary outcomes , is that we do not observe outcome of interest. The second, which we call the problem of counterfactual outcomes , is that we do not observe the threshold standard. This article examines how performance standards should be set and applied in the face of these problems in measuring outcomes. The central message is that the proper way to implement standards varies with the prior information an evaluator can credibly bring to bear to compensate for incomplete outcome data. By combining available data with credible assumptions on treatments and outcomes, the performance of a program may be deemed acceptable, unacceptable, or indeterminate.
A Model-Based Evaluation of a Cultural Mediator Outreach Program for HIV+ Ethiopian Immigrants in Israel
Authors: Kaplan Edward H. , Soskolne Varda , Adler Bella , Leventhal Alex , Shtarkshall Ronny A.
Published: July 2003

This article presents a model-based evaluation of a program designed to reduce HIV transmission from HIV-infected Ethiopian immigrants in Israel. Rather than rely on self-reported variables such as condom use, this study’s approach focuses on pregnancy rate reduction, estimated from administrative periodic reporting data, as a measure of unprotected sexual exposure. The models show that among both HIV+ women and the female sex partners of HIV+ men, the ongoing pregnancy rates estimated during the intervention were significantly lower than the estimated baseline pregnancy rates, suggesting reductions in unprotected sexual exposures among those participating in the program.
Local and State School-Based Substance Use Surveys
Authors: Hallfors Denise , Iritani Bonita
Published: July 2003

School-based substance use surveys are an important data source for prevention and evaluation researchers, but access to students has become progressively restricted by schools. Because almost all states and many districts conduct their own regular surveys, archived data are a potential resource for informed policy and practice decisions. In this study, substance use survey data were successfully collected from 69 of 105 targeted school districts located in 12 states. Results indicate the availability and quality of extant data currently limit their usefulness. Recommendations are made regarding how schools could be assisted to improve the value of their substance use surveys.
Resilience, Stress, and Depression among Russian Immigrants to Israel
Authors: Aroian Karen J. , Norris Anne E.
Published: July 2003

This article reports the relationships between resilience, demographic characteristics, immigration demands, and depression in a sample of 450 adult Russian immigrants to Israel. Contrary to theories of how resilience is related to psychological outcomes, no support was found for resilience modifying or mediating the relationship between the demands of immigration and depression. Resilience did, however, increase the risk of not being depressed by about two-fold (p < .0001).
Cultural Verification and Application of the Profile of Mood States (POMS) with Korean Elders
Authors: Shin YunHee , Colling Kathleen Byrne
Published: July 2003

This study assessed the cultural verification of the Profile of Mood States (POMS) for Korean elderly and examined their mood states. After assessment of face validity by a panel of Korean experts, 319 Korean elders, older than 60 years, were recruited from personal contact or senior centers in five Korean cities and completed the questionnaire. Through item analysis, face validity, and factor analysis, the 65-item original POMS was revised and reduced to a three-factor, 34-item instrument specific to Korean elders. Results of descriptive analysis showed that Korean older people perceived relatively good mood states. Lower mood states were significantly correlated with female gender, advanced age, unemployment, less education, lower economic status, being widowed or divorced, and with their children as the main source of income. In conclusion, the revised POMS for Korean elders has been shown to be a reliable and valid measure of mood states.
Web Conference Scheduling for Research Projects
Authors: Nies Mary A. , Artibee Kay , Baird Maria , Hein Laura , Schmidt Angela
Published: July 2003

Scheduling and tracking of participants for research projects is an important yet time consuming process. Our research team has developed an approach that is innovative and timesaving for scheduling appointments. We use Web conferencing, which can be done on site or from remote locations by all members of our staff. The purpose of this article is to present an overview of Web conferencing, explain the process of scheduling appointments on Web conferencing, and discuss the advantages of Web conferencing for nursing research projects.
Refugee Experiences and Southeast Asian Women’s Mental Health
Authors: Davis Ruth E. , Kennedy Michael G. , Austin Wendy
Published: July 2003

The wars in Southeast Asia displaced thousands of families from Cambodia, Laos, and Vietnam. The upheavals led to a number of waves of immigration to the United States. Current research supports hypotheses of post-traumatic stress disorder diagnoses in refugees from the wars in Vietnam but omits pertinent cultural factors. This phenomenological study of 19 women from Southeast Asia examines the meanings of their refugee experiences. Open-ended interviews with these women reveal themes of survival, despair, and isolation. Health care providers may notice cultural bereavement as opposed to post-traumatic stress disorder, reflecting a psychological resilience not extensively explored previously. Developing empathetic interactions and including important ethnic identity factors in caring for refugee women appear essential in providing appropriate health care.
A Typology of Residential Fire Survivors’ Multidimensional Needs
Authors: Keane Anne , Brennan Ann Marie Walsh , Pickett Mary , Stern Phyllis Noerager , Ryan-Wenger Nancy A. , Lindgren Carolyn L.
Published: July 2003

This article presents an analysis of the tangible, psychological, and general needs of adults and their children reported by residential fire survivors approximately 14 weeks postfire. Three hundred and seven survivors, who identified that they needed help for themselves or their children, differed from 133 survivors who did not request help. Those needing help were more likely to be women with children younger than age 18 living in their household, have low-income status, less education, and to have already received services from church groups. The classification of self-identified needs of fire survivors included the need for specific tangible and social service assistance, psychological and spiritual support, and nonspecific assistance. This classification contributes to our understanding of the relationship between needs and loss, grief, and changes in family and life situations postfire.
Self-Disclosure of HPV Infection to Sexual Partners
Authors: Keller Mary L. , von Sadovszky Victoria , Pankratz Barbara , Hermsen Joan , Sowell Richard L. , Demi Alice S.
Published: July 2003

Disclosure decisions of persons with genital HPV infection were examined. The research questions focused on relationships among knowledge of transmission, beliefs about the obligation to disclose knowledge of HPV infection to sexual partners, factors that influence the disclosure decision, and evaluations of the decision. Participants were 92 persons diagnosed with HPV 6 months prior to data collection. Sixty-three women and 29 men whose average age was 23.1 years constituted the sample. A subset of 48 persons provided detailed information about their reasons for disclosing or not disclosing knowledge of HPV and subsequent evaluation of their behavior. Knowledge of HPV transmission was adequate; however, there was no relationship between transmission knowledge and disclosure beliefs. Participants tended to disclose the presence of HPV to partners at point of diagnosis, but not to new partners 6 months later. Both disclosers and nondisclosers felt positively about their decision. Possible changes in clinical interventions for persons with HPV infection are discussed.
The Meaning of Hope in Healthy, Nonreligious Swedes
Authors: Benzein Eva G. , Saveman Britt-Inger , Norberg Astrid
Published: July 2003

This study aims to illuminate the meaning of the lived experience of hope as narrated by healthy Swedish adults, who considered themselves as nonreligious. Twenty-four interviewees were asked to narrate their experience of hope. A phenomenological-hermeneutical analysis was performed and the meaning of the lived experience of hope was interpreted as an internal process (i.e., hope related to being), which is linked to the experience of meaning and the awareness of one’s possibilities in life. This awareness releases energy and activates thoughts and feelings, enabling the person to make good and meaningful choices. The process generates a sense of independence, freedom, and inner peace. Hope related to being is a prerequisite for an external process (i.e., setting goals). Setting goals comprises action and the expectation of a positive outcome. Hope related to doing nurtures hope related to being. The findings also revealed that hope related to doing is reconstructed throughout the life process.
Do Pressure Relief Cushions Really Relieve Pressure?
Authors: Defloor Tom , Grypdonck Maria H. F.
Published: July 2003

In a laboratory setting, interface pressures of 29 cushions and a sheepskin were measured on 20 healthy volunteers. Each participant was seated in an upright posture with their back against the back of the chair, hands resting on the lap, knees bent at an angle of 90 degrees, and feet resting on the floor. Only 13 cushions had any pressure-reducing effect. Gel cushions and sheepskins appear to have no pressure-reducing effect. The category of foam includes both cushions that reduce interface pressure very well and cushions that increase interface pressure. The lowest interface pressures were measured on air cushions and on some foam cushions.
Social and Professional Influences of the Technology of Electronic Fetal Monitoring on Obstetrical Nursing
Authors: Hoerst Barbara J. , Fairman Julie
Published: July 2003

Electronic fetal monitoring (EFM) is one example of a biomedical technology that rapidly diffused from an experimental innovation into a standard medical practice. First developed in the 1950s, EFM became commercially available in the early 1970s and quickly transformed intrapartum obstetrical practice. Assessments and interventions, which practitioners had previously based primarily on laboring women’s subjective reports of bodily sensations, were now being based on quantifiable objective data from uterine activity and fetal heart rate transducers. Despite concerns of over-medicalization of the natural event of birth, iatrogenesis related to the increased incidence of operative deliveries, and escalating costs, EFM became widely accepted as routine and necessary by both practitioners and patients. By presenting the confident expectations and cautious reservations of various practitioners and patients to EFM, this article explores the rapid diffusion of EFM within the social context of the 1970s. A special focus is given to the perspective of intrapartum obstetrical nurses, because they have been the primary users of this perinatal technology since its introduction.
Nursing Advocacy during a Military Operation
Authors: Foley Barbara Jo , Minick Ptlene , Kee Carolyn
Published: July 2003

Advocacy is an essential component of the registered nurse’s professional role, yet experts provide no consistent definition of advocacy. The purpose of this study was to explore the experiences of military nurses as they engage in advocating practices and to describe their shared practices and common meanings. Heideggerian hermeneutic phenomenology, provided the framework and method for this study. Twenty-four U.S. Army nurses were individually interviewed and the researcher kept interview observational notes. The constant comparative method of analysis was used. The stories of these nurses revealed one constitutive pattern—safeguarding—and four related themes. The themes were advocating as protecting, advocating as attending the whole person, advocating as being the patient’s voice, and advocating as preserving personhood. One conclusion was that military nurses must be prepared for the important safe-guarding role. They must be coached in how to deal with other members of the health team on the patient’s behalf.
Informed Consent and the Limits of Confidentiality
Authors: Haggerty Lois A. , Hawkins Joellen
Published: July 2003

Investigators encounter many legal and ethical issues when they conduct research on partner abuse. Balancing abused women’s rights to privacy with legally mandated reporting requirements involves considerable thought and planning. Failure to protect participants may result in escalation of abuse as well as loss of children to protective services. Various perspectives on maintaining participant privacy while conforming to legal mandates to report child abuse, homicidality, and suicidality are discussed. The role of confidentiality certificates in providing legal immunity for researchers and the method of obtaining the certificates are presented. In addition, the authors describe the strategies for participant protection that are implemented in a federally funded study of abuse, women’s self-care, and pregnancy outcomes. The decision to clearly and specifically inform abused women of the limits of confidentiality allows participants to make informed decisions about disclosures, but may result in diminished recruitment.
Hardships and Personal Strategies of Vietnam War Nurses
Authors: Scannell-Desch Elizabeth A. , Anderson Marion
Published: July 2003

This study describes hardships faced in Vietnam and personal strategies used to deal with these hardships as defined by 24 female military nurses who served during the war. Purposive sampling was used, and data were generated using four core questions and in-depth interviews. The research methodology was phenomenology, incorporating data analysis procedures of Colaizzi, Lincoln and Guba, and Van Manen. Eight hardship and nine personal strategy themes were identified. This study found that caring for young, severely injured, and disfigured soldiers was a significant hardship and that nurses struggled with the moral dilemmas inherent in mass casualty situations, triage policies, and the practice of returning recovered soldiers to combat. Most nurses relied on personally proven and familiar strategies to reduce or buffer the effects of emotional hardships, whereas some discovered and used new strategies.
Severe Visual Impairment in Older Women
Authors: Moore Linda Weaver , Constantino Rose E. , Allen Marion
Published: July 2003

The purpose of this qualitative, phenomenological study was to uncover the meaning of severe visual impairment to older women diagnosed with macular degeneration, a leading cause of blindness in older adults. The research question for the study was, What is the lived experience of severe visual impairment in older women diagnosed with macular degeneration? Participants were eight women, aged 63 to 85 years, who had been diagnosed with macular degeneration and who had severe visual deficits. Data were gathered through audiotaped interviews. Interview recordings were transcribed and later analyzed using a modified Giorgi methodology. The meaning of severe visual impairment emerged as “persisting toward unfolding ways of being in the world sparked by personal discoveries amidst enveloping losses while embracing a realistic awareness with steadfast positivism.” Findings from this study were congruent with the theory of Human Becoming. Study findings highlight factors that may place older women with severe visual deficits at risk for lower levels of well-being.
Integrating Clinical Quality Improvement Strategies with Nursing Research
Authors: King Kathryn M. , Teo Koon K.
Published: July 2003

Bridging the research-practice gap has been a focus of concern for nursing and other health care disciplines. The challenge in linking research and practice is for practitioners to use consistently the best available evidence in their clinical practice and for researchers to engage in clinically relevant research that provides practitioners with the evidence to do so. The authors of this article advocate that blending Clinical Quality Improvement (CQI) strategies with research methodology is a means of bridging the research-practice gap. The process of blending CQI strategies and nursing research is described in this article.
Translation and Validation of Caregiving Satisfaction Scale into Korean
Authors: Son Gwi-Ryung , Zauszniewski Jaclene A. , Wykle May L. , Picot Sandra J. Fulton
Published: July 2003

The purpose of this study was to establish the equivalence and to examine the psychometric properties of a Korean translation of the Caregiving Satisfaction Scale (CSS). A convenience sample of 44 bilingual Koreans was selected. The Cronbach’s alpha for the English and Korean versions were .87 and .90, respectively. There was significant mean difference between items 3 and 12 of the English items and their Korean translations. Pearson’s Correlations demonstrated that 13 of the 15 CSS items had significant correlations (r = .35 ~ .75, p < .05) between two versions. The correlation between total scores of both versions was .86 (p < .001). Overall, none of the items would be regarded as having unacceptable numeric properties. According to the fine process for translation, back-translation, and bilingual field test, the Korean version of the CSS appears to have concrete construct validity and reliability for use in measuring caregiver satisfaction in the Korean population.
Job Uncertainty and Health Status for Nurses During Restructuring of Health Care in Alberta
Authors: Maurier Wendy L. , Northcott Herbert C.
Published: July 2003

The Alberta health care system experienced dramatic changes after provincial funding cuts to health care from 1993 to 1996. As a result, stressors for nurses increased. The question of whether job uncertainty, working conditions, cognitive appraisal, and coping strategies influence the health of registered nurses in a context of health care restructuring was examined. Lazarus and Folkman’s Transactional Model of Stress was used as the conceptual framework. A total of 271 registered nurses employed in a large, urban, acute-care teaching hospital responded to a self-administered survey questionnaire. Using multiple regression analysis, depression and self-reported physical health were analyzed. The data suggest that the threat of being placed on recall, having a coworker bumped or laid off, and perceived job security were adversely related to physical health. High primary appraisal of threat was associated with high levels of depression and poor physical health. In addition, the findings suggest that various coping strategies had both buffering and exacerbating effects on physical health and depression.
Prayer and Health Outcomes in Church Lay Leaders
Authors: Meisenhelder Janice Bell , Chandler Emily N.
Published: July 2003

This study examined the relationship of frequency of prayer on health outcomes in a national sample of 1,014 church lay leaders. The survey included questions on the frequency of prayer and the Medical Outcomes Study, Short Form 36 Health Survey, measuring eight categories of functional health. The results indicated a high level of functioning overall. Age was strongly related to most aspects of health in this sample. Frequent prayer was associated with poor physical functioning and poor ability to carry out role activities, but these relationships were not significant when the effect of age and gender was controlled. Frequent prayer was also significantly associated with high mental health scores, regardless of age or gender. This study supports the growing body of data suggesting a positive relationship between frequency of spiritual practices and mental health, even in a homogenous sample of active church members.
The Effect of a High-Fat Diet and Exercise on the Expression of Genetic Obesity
Authors: Metzger Bonnie L. , Jarosz Patricia A. , Noureddine Samar
Published: July 2003

In the United States, there are 300,000 obesity-related premature deaths each year. Furthermore, no current obesity treatment program results in consistent weight reductions. Obesity is thought to be caused by complex genetic-environmental interactions. We studied the effect of two environmental factors, high-fat diet and non-weight-bearing exercise, on obesity expression. Young adult, female, genetically obese (fa/fa) rats (n = 52) and their lean (Fa/fa) littermates (n = 24) were studied using an experimental 2× 2× 2 factorial design (diet type, genetics, and exercise). Repeated measures ANOVA and secondarily stepwise regressions were used to analyze the data. The authors discovered that the effect of appetite on obesity expression is more limited than expected, and there may be critical stages when obesity expression is amenable to environmental modification.
Posttransplant Improvement in Heart Rate Variability Correlates with Improved Quality of Life
Authors: Hathaway Donna K. , Wicks Mona N. , Cashion Ann K. , Cowan Patricia A. , Milstead E. Jean , Gaber A. Osama
Published: July 2003

A prospective evaluation of 37 kidney and 20 kidney-pancreas transplant recipients was conducted to assess the relationship between pre-to posttransplant changes in heart rate variability (HRV) and quality of life (QoL). Assessments of 24-hour interbeat variability (pNN50 and rMSSD, SDNN, SDANN) and power spectral analysis of total, low (sympathetic), and high (parasympathetic) frequency components of HRV were performed. The Sickness Impact Profile was used to assess three dimensions of QoL (physical, psychosocial, and total functioning) prior to and at 6 months following transplantation. Changes in vagally mediated time domain measures of HRV were related to changes in physical and total functioning. Stronger correlations occurred between biobehavioral measures in kidney-pancreas recipients, with the strongest relationships occurring between changes in HRV frequency domain measures and changes in physical functioning. Findings indicate that changes in HRV and QoL are related, suggesting that interventions that enhance transplant recipients’ HRV may also enhance their QoL.
Factors Associated with Vagal Tone Responses in Preterm Infants
Authors: Harrison Lynda Law , Williams Anita Kay , Leeper James , Stem John T. , Wang Lei , Medves Jennifer
Published: July 2003

The purpose of this study was to examine factors related to vagal tone (VNA) among preterm infants receiving a 10-minute gentle human touch (GHT) intervention three times daily for 10 days. VNA was measured continuously for 10 minutes before, during, and after each 10-minute GHT intervention. Findings indicated that there was a significant relationship between VNA and gestational age, although there were no relationships between VNA and measures of motor activity or behavioral distress. There was no difference in pattern of response to GHT or level of morbidity, average daily weight gain, or behavioral organization among infants with low, moderate, and high baseline VNA levels. There was no difference in VNA comparing infants in the GHT and control groups or during baseline, touch, and posttouch phases for infants in the GHT group. There is a need for further research to examine the usefulness of VNA as a measure of stress vulnerability among preterm infants.
Basic Need Status and Health-Promoting Self-Care Behavior in Adults
Authors: Acton Gayle J. , Malathum Porntip
Published: July 2003

Health-promoting self-care behavior emphasizing positive lifestyle practices may improve the health and quality of life of adults. One variable that may influence health-related decisions is the status of basic needs as described by Maslow. The purpose of this study was to investigate the relationships among basic need satisfaction, health-promoting self-care behavior, and selected demographic variables in a sample of community-dwelling adults. A convenience sample of 84 community-dwelling adults was recruited to complete the Basic Need Satisfaction Inventory, the Health-Promoting Lifestyle Profile II, and demographic information. Results of the study indicated that self-actualization, physical, and love/belonging need satisfaction accounted for 64% of the variance in health-promoting self-care behavior. The findings of this study are consistent with Maslow’s theory of human motivation and suggest that persons who are more fulfilled and content with themselves and their lives, have physical need satisfaction, and have positive connections with others may be able to make better decisions regarding positive health-promoting self-care behaviors.
Needs of Chinese Families of Critically Ill Patients
Authors: Leung Kai-kwong , Chien Wai-Tong , Mackenzie Ann E.
Published: July 2003

Critical illness and subsequent hospitalization are stressful for patients and their family members. The purpose of this descriptive study was to identify the family members’ perceptions of their immediate needs within 48 to 96 hours following admission of a relative to a critical care unit in Hong Kong and to compare their perceptions with the critical care nurses’ perceptions of the family needs. A convenience sample of 37 Chinese family members and 45 registered nurses completed a self-report Chinese version of the Critical Care Family Need Inventory. The 10 most important and 10 least important family needs were identified by family members and by nurses and the results were compared. Conclusions were drawn about the implications for nurses in planning and implementing quality family-centered care for critically ill patients.
“Thinking Aloud”: Data Collection in the Natural Setting
Authors: Aitken Leanne M. , Mardegan Karen J.
Published: July 2003

Knowledge of how nurses make decisions is a desirable outcome of research. However, there currently exists an inadequacy in the techniques used to examine such decision making. In this article, the authors describe the techniques used in two studies incorporating “thinking aloud” to successfully examine the decision making of expert critical care practitioners in the natural setting. Both techniques of thinking aloud were found to provide useful information regarding decision making in the natural setting. No ethical implications were experienced in conducting these studies in the natural setting. In conclusion, the use of thinking aloud in the natural setting is an effective means of data collection.
Bearing Illness and Injury
Authors: Dewar Anne L. , Lee Elizabeth A.
Published: July 2003

This qualitative study examined how individuals with catastrophic illness and injury managed their personal and social world. The 28 males and females had endured their chronic conditions from 3 to 25 years prior to the study. Participants were individually interviewed. Responses were analyzed using grounded theory methods. Individuals with catastrophic illness and injury experienced three phases in bearing their situation: finding out, facing reality, and managing reality. Individuals did not progress through stages as has been argued by stage theorists. Rather, the phases flowed together and were reexperienced continuously. Individuals employed three strategies—protecting, modifying, and boosting—in all of the phases to help them endure their circumstances.
Evaluation of a Home Health Patient Classification Instrument
Authors: Anderson Kathryn L. , Rokosky Joanne S.
Published: July 2003

The purpose of this study was to assess reliability and validity of the Revised Easley-Storfjell Patient Classification Instrument (R-ESPCI). Content validity was assessed by expert home health nurses. Interrater reliability was assessed by staff nurse ratings of patients on home visits (N = 34) and by chart review by the investigators (N = 30). Concurrent validity was also assessed. Percentage agreement for staff nurses was 36% (kappa = -.15) and 52% (kappa = .04) in two phases and for investigators 90% (kappa = .63) and 50% (kappa = .02) in two phases. Minimal support for concurrent validity was found. Content validity was established, but revised reimbursement policy eliminated less acutely ill patients, narrowing the acuity range. More discrete rating criteria or scoring changes may be needed, followed by further assessment of the R-ESPCI. Agency stability and adequate resources for staff training are required for additional testing of the instrument.
Chinese Students’ Concept of Mental Health
Authors: Wang Wei , Miao Xiaochun
Published: July 2003

This study explored Chinese students’ concept of mental health through a questionnaire completed by 999 students from six primary schools, six high schools, and three universities in Shanghai. The results confirmed the expectation that Chinese students’ mental health concept would be multifaceted and would reflect psychological, physical, and sociocultural factors. An exploratory factor analysis on 12 mental health items with a subsample extracted a three-factor model, which was cross-validated by confirmatory factor analysis with a different subsample. These three factors were labeled as Affective Strength, Adaptive Strength, and Personal Strength. No gender differences were found. The grade differences supported the notion that Chinese students’ concept of mental health seems to be more consistent with the developmental paradigm of health. The senior years in primary school could be the turning point at which children start to conceptualize health as a holistic experience by recognizing the importance of mental health.
Cardiovascular Disease Risk Factors in Korean American Elderly
Authors: Kim Miyong T. , Juon Hee Soon , Hill Martha N. , Post Wendy , Kim Kim B.
Published: July 2003

An in-depth cardiovascular risk factor assessment was carried out in a sample of 205 Korean American elderly in Maryland, consisting of 75 males and 130 females aged 60 to 89 years (mean age = 69.9± 6.5 years). Six risk factors were assessed in each participant: high blood pressure, current smoking, high blood cholesterol, overweight, sedentary lifestyle, and diabetes. The findings of this cross-sectional study suggested that high blood pressure was the leading cardiovascular disease risk factor among Korean American elderly (71%), followed by high blood cholesterol (53%), overweight (43%), sedentary life style (24%), diabetes (18%), and smoking (7%). Two thirds of the sample had multiple cardiovascular disease risk factors. The pattern of prevalence and risk factors that was observed was consistent with the distribution of multiple risk factors in that the combination of high blood pressure, high blood cholesterol, and overweight was most common in Korean American elderly (62%). These findings indicate that culturally relevant and salient strategies are needed to reduce multiple risk factors in this population.
Impact of Cognitive Impairment on Wandering Behavior
Authors: Algase Donna L. , Beattie Elizabeth R. A. , Therrien Barbara
Published: July 2003

The purpose of this study was to explore cognitive impairment as a predictor of wandering rhythm and pattern in a sample of 25 demented residents from two long-term care settings. Parameters of rhythm indicating cycle frequency and structure were examined for wandering patterns (random, lapping, and pacing) and for nonwandering (direct) ambulation. All measures of cognitive impairment (Mini-Mental State Exam, Mattis Dementia Rating Scale, and a neuropsychologist’s clinical rating) were significant predictors of parameters signifying frequency of wandering for random and lapping patterns but not for the pacing pattern. In addition, for nonwandering ambulation, cognitive impairment predicted some parameters of cycle structure (mean locomoting and nonlocomoting phase durations) but not those denoting frequency of ambulation. Results indicate that cognitive impairment plays an important role in determining the frequency of wandering cycles, but other factors may better explain parameters that characterize its cycle structure.
A Descriptive Study of Function in Acute Motor Stroke
Authors: Hinkle Janice L.
Published: July 2003

The functional independence measure (FIM™) instrument was introduced in 1987 and has proven to be a useful tool for measuring disability in different patient populations. The FIM™ instrument data collected during inpatient rehabilitation for stroke is very informative, as it is voluminous, comprehensive, and has a uniform reporting mechanism. In contrast to inpatient rehabilitation, there is a paucity of FIM™ instrument data on acute stroke patients. The purpose of this study was to describe functional level of 100 patients within the first 24 hours of acute care admission. The mean total FIM™ instrument score was 94.05 (SD ± 19.31, range = 38-120), the mean motor domain subscore was 61 (SD ± 17.8, range 23-85), and cognitive was 33.4 (SD ± 3.3, range 15-35). Significant group differences were identified for age, gender, and disposition for total and/or domain subscores. Significant differences in age, gender, employment, and disposition were found for clinical subscales. This study fills a gap in current knowledge, that of baseline total FIM™ instrument scores, domain subscores, and six clinical subscales on one particular group of stroke patients, those with a primary motor stroke.
Outcomes of Depression in Early Adolescents
Authors: Mahon Noreen E. , Yarcheski Adela
Published: July 2003

The purpose of this study was to examine the relationship between depressed mood and depressive symptomatology and the influence of both variables on perceived social support, interpersonal conflict, general well-being, and perceived health status in 144 early adolescents. The subjects responded to instruments measuring the study variables in classroom settings. Two bivariate regression structural equation models were examined using the LISREL 7 computer software program. In the health model, depressed mood had a direct positive effect on depressive symptoms and a direct negative effect on well-being and on perceived health status. Depressive symptoms had a direct negative effect on well-being and on perceived health status. In the interpersonal model, depressed mood had a direct positive effect on depressive symptoms and on conflict and a direct negative effect on social support. Depressive symptoms had a direct positive effect on conflict and a direct negative effect on social support.
Common Patterns of Person-Environment Interaction in Persons with Rheumatoid Arthritis
Authors: Brauer Donna J.
Published: July 2003

This study’s purpose was to identify and describe common patterns of person-environment interaction in persons with rheumatoid arthritis. Newman’s propositions about pattern provided the theoretical foundation, and a combination of quantitative and qualitative techniques were used to recognize pattern. Sixty-six adults diagnosed with rheumatoid arthritis completed questionnaires that assessed characteristic ways of functioning. Iterative cluster analysis of the data identified five distinct groups of individuals with similar response profiles. Content analysis of each group’s characteristics produced a core theme representing the nature of the common pattern. The finding of multiple, distinct common patterns of person-environment interaction within the population of persons with RA is consistent with findings in other populations. Further study of the common patterns, in relation to health outcomes, has potential for increasing knowledge about the sources of different health experiences among persons with the same chronic illness.
Perceptions of Role Functions of Psychiatric Nurse Specialists
Authors: Chien Wai-Tong , Ip Wan-Yim
Published: July 2003

Specialized and advanced psychiatric nursing practice is an innovative concept in the health care service in Hong Kong. A clear definition of the role and practice of psychiatric clinical nurse specialists (CNS) is important for the development of expert psychiatric nursing practice but is still in a formative stage. A qualitative exploratory study was conducted to identify the psychiatric CNS’s perceptions of their role and to compare their perceptions with those of their clinical psychiatric nurse colleagues. The main themes emerging from interviews, observations, and personal diary data were compared and condensed. Eight CNSs and 24 clinical nurse colleagues from acute care and community psychiatric nursing units voluntarily participated in the study. A four-component framework, including clinical practice, organization, education, and professional role, was adopted from nursing literature and used for categorization. The findings showed similarities of role perceptions in the clinical practice, organization, and education components between the CNSs and their nursing colleagues. Differences in role perceptions, concerns about inadequate knowledge and autonomy, and limitations in professional role are discussed.
Spirituality and Spiritual Care Provided by Parish Nurses
Authors: Tuck Inez , Wallace Debra , Pullen Lisa
Published: July 2003

The high level of religious participation in the United States provides a venue for parish nursing, a holistic nursing specialty that emphasizes the relationship between spirituality and health. This descriptive study measured two aspects of spirituality (spiritual perspective and spiritual well-being) in a national sample of parish nurses and described variables related to their practice. Furthermore, it qualitatively examined the provision of spiritual care to clients in this parish nurse sample. Parish nurses scored high in spiritual perspective and spiritual well-being and reported an emphasis on health promotion and education in their activities. Three views of spiritual interventions (ideal, general, and specific) were reported. Types of spiritual interventions typically fell into one of four categories: religious, interactional, relational, and professional.
The Interaction of Age and Cognitive Representations in Predicting Blood Pressure
Authors: Scisney-Matlock Margaret , Watkins Ken W. , Colling Kathleen Byrne
Published: July 2003

The purpose of this study was to investigate the interaction of age and cognitive representations of hypertension in predicting blood pressure. A model of illness self-regulation was used as the theoretical framework for the study. Secondary analysis of data collected from 224 hypertensive adult outpatients was conducted to assess five constructs of illness. ANOVA results indicated that older adults reported fewer hypertension-related symptoms than younger-and middle-aged adults, and that younger adults reported fewer health behaviors to control hypertension than did middle-aged and older adults. Results of hierarchical multiple regression models indicated that after adjusting for effects of demographic factors, no single cognitive representation construct was a significant predictor of blood pressure. The interactions of age and three cognitive representation constructs were, however, significant predictors of blood pressure. For younger adults, increases in the perceived Consequences, Control, and Timeline for hypertension were predictive of decreases in hypertension, although for older adults increased perceptions of control were associated with increased blood pressure.
Social Cognitive Factors Predicting the Health of Elders
Authors: Zauszniewski Jaclene A. , Chung ChaeWeon , Krafcik Karen
Published: July 2003

The social cognitive model of health is primarily concerned with influences on a person’s decisions to perform health behaviors. In this study, the relationships among social cognitive factors reflecting enabling skills (learned resourcefulness), internal motivation for health (health self-determinism), and help responses (coping responses) and a measure of physical and psychosocial health were examined in 137 chronically ill elders. Gender, race, and number of chronic conditions were predictors of learned resourcefulness. Learned resourcefulness was associated with the use of informal help, whereas health self-determinism was related to self-help and formal help. None of the help responses were significant predictors of health. Model testing revealed that greater resourcefulness or skill in coping with stressful situations was the most important predictor of health. Strategies are recommended to help elders achieve optimal health.
A Metaphor for HIV-Positive Mexican and Puerto Rican Women
Authors: del Rosario Valdez Maria
Published: July 2003

Human Immunodeficiency Virus (HIV) represents an overwhelming disruption for Hispanic women. This Grounded Theory (GT) (Glaser & Strauss, 1967) study sought to explore how culture guided health practices and to identify health and folkcare activities used by HIV+ Hispanic women. La Protectora (The Protectress), a theoretical framework, emerged to describe the process by which cultural beliefs guided Hispanic women’s health practices and how they dealt with life after their affirmation of HIV status. Five main categories emerged to describe the process. Knowledge about how culture influences HIV+ Hispanic women obtain and/or make decisions about health care will contribute to a foundation for theory development and subsequent theory testing.