bluuebunny/crossref_metadata_2025 huggingface dataset:
The Effects of a Cognitive Experiential Therapy Utilizing Hypnosis, Cognitive Restructuring, and Developmental Staging on Psychological Factors Associated with Duodenal Ulcer Disease: A Multivariate Experimental Study
Authors: Tosi Donald J. , Judah Steven M. , Murphy Michael A.
Published: September 2018

This study evaluated the effects of a Cognitive Experiential Therapy (CET)—in the pastreferred to as Rational Stage Directed Hypnotherapy (RSDH)—Cognitive Restructuring (CR), Hypnosis Only (HO), and a no-treatment control condition on the duodenal ulcer syndrome. CET or RSDH is a systematic, stage-directed therapy that employs hypnosis and the cognitive restructuring of self-defeating cognitive, emotional, physiological, and behavioral tendencies. Seven criterion variables were assessed using two standardized instruments and ques-tionnaire data. The standardized instruments included the Millon Behavioral Health Inventory (MBHI) and the Common Beliefs Survey ID (CBS III).

Twenty-five volunteer duodenal ulcer patients served as subjects for the study. The research design, a 4 X 3 factorial design with repeated measures, consisted of four treatment levels (Control, CR, HO, and RSDH) and three time periods (pretest, posttest, and follow-up) over which the subjects were observed. MANOVA on residualized change scores revealed a significant treatment effect. Univariate effects were observed on the MBHI personality coping styles, CBS III evaluation and locus of control scales, and gastrointestinal disturbance. GET appeared to have an ameliorative effect on psychological factors associated with duodenal ulcer.
Explanations for Positive and Negative Events Among Heavy and Moderate College Drinkers
Authors: Corcoran Kevin J. , Thielbahr Paige E.
Published: September 2018

This study examined the relationship between explanatory style for positive and negative events in heavy- and moderate-drinking college students. Results indicate no difference between the two drinking groups in explanations for negative events; however, hearvier-drinking subjects did tend to have more global and stable explanations for positive events. In addition, those subjects attached more importance to positive events. Results are discussed in terms of the utility of such a style in avoiding depressed mood. Also discussed is the potential for changing such a belief pattern and the possible implications for the use of the Attributional Style Questionnaire with populations other than those who are depressed.
Teaching Personal Problem Solving to Adults
Authors: Brammer Lawrence
Published: September 2018

Solving personal problems is a basic life skill. The goal is to achieve problem-solving competence in applying a variety of models, three of which are trial and error/reinforcement, linear/rational, and intuitive/creative. The focus in this article is on the intuitive creative model that deals with novel problematic situations. Conditions of readiness for solving problems with any model are accurate problem awareness and appraisal of the problem, an attitude of meeting a challenge, self-efficacy or confidence in one’s ability to solve problems, and an appropriate problem-solving set. While much research has been devoted to studying children and college youth in laboratory situations doing essentially thinking types of tasks, little research has been done with middle-aged and older adults. More research is needed on how adults learn problem-solving skills, and how they might develop greater problem-solving competence.
Problem-Solving Training for Effective Stress Management and Prevention
Authors: D’Zurilla Thomas J.
Published: September 2018

According to recent theoretical and research developments in the area of stress and coping, social problem solving (i.e., real-life problem solving) appears to be an important general coping strategy that can have a significant effect on a person’s ability to reduce, control, and prevent the experience of stress in everyday living. Although an increasing number of studies have been providing support for this viewpoint, current stress-management programs still provide little or no training in general problem-solving principles. A new stress-management program is described that focuses on training in the application of a general problem-solving coping strategy. The results of three recent outcome studies are reported which, taken together, strongly suggest that problem-solving training is a viable and promising approach to stress management which increases positive psychological resources (problem-solving ability, self-esteem, life satisfaction), while reducing stress and its negative effects (psychological symptomatology, health problems).
Non-Cognitive Panics: The Missing Catastrophic Link
Authors: Dyck Murray J.
Published: September 2018

Recent research by Rachman, Levitt and Lopatka (1987) suggests that not all panic attacks are mediated by catastrophic misinterpretations of physiological sensations. The present case report illustrates how catastrophic misinterpretations may be present in such “non-cognitive” panics, even when they are not immediately reported as present. Misinterpretations may be at the end of a chain of automatic thoughts and/or may strike the patient as so ludicrous as to be not worthy of mention.
Narrative Activity as Perspective Taking: The Role of Emotionals, Negations, and Voice in the Construction of the Story Realm
Authors: Bamberg Michael
Published: September 2018

This article develops the argument that narratives are organized along two orienting axes, one of horizontally sequencing the events, the other of vertically and hierarchically relating events to each other. The use of particular linguistic devices (references to emotions, references to negative states, and active/passive alternations) is explained in terms of their particular indexing functions regarding the relationship between these two axes. The suggested type of discourse analysis elaborates on the form-function relationship relevant to reconstruct the textual and interpersonal context bearing on all interpretation or listening processes—especially the therapeutic setting.
Egocentrism and the Cognitive Psychotherapy of Personality Disorders
Authors: Liotti Giovanni
Published: September 2018

The concept of cognitive egocentrism provides useful guidelines for the cognitive psychotherapy of personality disorders. The patient’s imaginary audience-and “personal fable” (aspects of egocentrism that are normally overcome in late adolescence, according to developmental psychologists, and that unhealthily permeate the thinking of adult personality disorders) may be effectively selected as targets for the therapist’s assessment and intervention. This paper illustrates the hypothesis that therapy should involve criticism of the imaginary audience first, and that this should be followed by exercises of interpersonal perspective-taking. These first steps allow for deliberate, responsible self-disclosure in interpersonal relationships that the patient may wish to develop in the direction of growing degrees of intimacy. The experience of healthy relationships seems necessary in order to relinquish the personal fable.
R.A.D.A.R.: A Five-Session Approach for Referrals of Employee Assistance Programs
Authors: Morris G. Barry
Published: September 2018

This paper outlines a five-session approach based on rational-emotive therapy for clients referred through an Employee Assistance Program. Fundamental to the approach are the four operations of the human condition—sensing, feeling, thinking, behaving—and the concept of preferential or specialized therapy. Each session is described in terms of the four processes, the procedures involved, and the desired outcomes. A case study is included in order to demonstrate the methods employed. The assumptions and limitations of the approach are also examined.
A Cognitive Perspective on Organizational Change
Authors: Knaus William
Published: September 2018

The cognitive revolution has added many powerful conceptual, emotive and behavioral change strategies to the armamentarium of counselors, educators and business consultants. This article describes rational procedures that have grown out of this revolution. To illustrate, I present a rational organizational change model, a rational organizational audit, common organizational myths and a case example that shows how organizations can benefit from a rational method for selecting and developing key people.1
The Application of RET to Improve Supervisory and Managerial Response to Subordinate Survey Feedback
Authors: Miller Alfred R.
Published: September 2018

In 1981, 11,500 Federal Aviation Administration (FAA) air traffic controllers throughout the United States walked off their jobs. Since government employees are prohibited by law from striking, the controllers were ordered back to work or they would be subject to dismissal. When the return-to-work deadline expired, approximately 11,000 air traffic controllers were fired. After two years of unsuccessful attempts to improve supervisory and managerial effectiveness following the strike, the FAA incorporated rational-emotive therapy (RET) concepts into a subordinate survey feedback program for supervisors and managers. This article describes the RET techniques that were used to improve supervisory and managerial response to survey feedback in the FAA.
The Ancient Origins of Cognitive Therapy: The Reemergence of Stoicism
Authors: Montgomery Robert W.
Published: September 2018

In this article, I will discuss some of the similarities between modern cognitive therapy and the Stoic philosophies of ancient Rome. Although a one-to-one correspondence is not asserted, a number of fundamental similarities between the two schools of thought are drawn upon in making a comparison between stoicism and modern cognitive therapy. This comparison provided a historical perspective on the evolution of the philosophical foundations and assumptions of cognitive therapy. The Stoic concepts (including those of Epictetus, Marcus Aurelius, Seneca, and Chrysippus) of emotion and those of leading cognitive therapists (primarily Beck and Ellis) were compared. The fundamental Stoic belief that the emotions arise from an interaction between reason and the world was shown to anticipate both Beck and Ellis
The Given Element in Experience: An Important Therapeutic Consideration
Authors: Marcus Ned N.
Published: September 2018

Conflation of the “given” or raw data with the interpretation or thoughts about the given may be an inescapable aspect of becoming aware of anything. Nonetheless, in the interest of correcting dysfunctional thinking and achieving a mentally healthier outlook it is imperative that the clinician differentiate the two. “The given,” unlike interpretations or thoughts, cannot, by definition, be modified; i.e., “a fact is a fact”... Delineation of the “given” in terms of its immutabilty for the patient, rather than in respect to how real it seems to the therapist, constitutes an empathic first step facilitating optimal completion of the therapeutic transaction. Specific difficulties in carrying out this initial therapeutic task, which sometimes demand a certain suspension of disbelief on the therapist’s part, are inescapably associated with characteristic types of psychopathology. However, strategies can be designed to overcome resistances as they arise.
The Challenge of Change: Reflections on Constructivist Psychotherapy
Authors: Neimeyer Greg J.
Published: September 2018

Both the preservation and alteration of meaning structures are central to being human. Constructivist psychotherapies respect this essential tension between retaining and relinquishing personal patterns of meaning, and have devised methods of exploring alternative perspectives without first abandoning existing ones. This paper examines some of those methods as exemplars of three central features of constructivist therapy: the primacy of personal experience, the importance of novel enactments, and the role of languaging in developing new patterns of personal meaning.
Should I Relax or Change My Thoughts? A Preliminary Examination of Cognitive Therapy, Relaxation Training, and their Combination with Overanxious Children
Authors: Eisen Andrew R. , Silverman Wendy K.
Published: September 2018

This investigation examined the efficacy of cognitive therapy, relaxation training, and their combination with 4 children (6-15 years of age) diagnosed with DSM-III-R overanxious disorder using a multiple baseline design across subjects. Each intervention contained an exposure component equalized across treatments. All children improved on child and parent pre-post self-report measures as well as parent and independent clinician’s ratings. Treatment gains were maintained at six month follow-up. While all three treatments were associated with diminished anxiety, evidence suggested that interventions were most effective when “matched” to a child’s problematic response class (i.e. cognitive symptoms, somatic symptoms or both). Implications for treatment of childhood anxiety disorders are discussed.
Paradoxical Intention as a Proposed Alternative in the Treatment of Panic Disorder
Authors: Dattilio Frank M.
Published: September 2018

The use of paradoxical intention is suggested as a viable alternative to symptom induction and other traditional methods in the treatment of panic disorder. A case example is provided to illustrate the technique. A discussion section highlights the circumstances under which this technique may serve as a viable alternative in the treatment of panic attacks.
Cognitive-Behavioral Treatment of Excessive Interpersonal Dependency: A Four-Stage Psychotherapy Model
Authors: Overholser James C. , Fine Mark A.
Published: September 2018

This article describes a four-stage model for the cognitive-behavioral treatment of excessive interpersonal dependency. Stage 1 involves active guidance on the part of the therapist to help the client make small but immediate behavioral changes. Stage 2 attempts to enhance the client’s self-esteem through the use of cognitive techniques. Stage 3 builds upon the strengthened self-image to promote client autonomy through the use of problem-solving training, the Socratic method, and self-control strategies. Stage 4 uses relapse prevention strategies to reduce the likelihood that the ck’ent will behave in an excessively dependent manner in the future. In each stage, desirable outcomes that must be achieved before progressing to the next stage are described. Also, strategies are discussed for managing various impediments to client progress.
Applications of Cognitive Therapy With Survivors of Head Injury
Authors: Whitehouse Ann Maliniak
Published: September 2018

There is little formally documented application of cognitive therapy with survivors of head injury. Nevertheless, techniques familiar to cognitive therapy have proven useful in the rehabilitation of this clientele. This article outlines the special psychotherapeutic needs of this population, proposes a framework for individual cognitive therapy to facilitate postinjury adjustment, and outlines a group cognitive therapy model for addressing anger and impulse control difficulties.
Storytelling and Cognitive Therapy with Children
Authors: Friedberg Robert D.
Published: September 2018

Storytelling is a developmentally sensitive tool to elicit children’s thoughts, identify their distortions, and help them to more accurately make sense of their world. Integration of storytelling into a cognitive approach to child psychotherapy is encouraged due to cognitive therapy’s conceptual richness and flexibility. Cognitive case conceptualization augments the application of the storytelling techniques. Advantages of the storytelling approach such as familiarity to children, relationship enhancement, meaningfulness, and flexibility are delineated. Clinical examples are described and special considerations are outlined.
Cognitive-Behavioral Hypnotherapy for Anxiety Disorders
Authors: Golden William L.
Published: September 2018

The similarities and differences between cognitive behavioral hypnotherapy (CBH) and cognitive-behavior therapy (CBT) as treatments for anxiety disorders are discussed. CBH interventions such as relaxation procedures, cognitive restructuring, desensitization, flooding, self-hypnosis, and hypnotic regression are described. Case examples are presented to illustrate the application of each technique.
Cognitive Hypnotherapy With Depression
Authors: Alladin Assen
Published: September 2018

A cognitive dissociative model of nonendogenous unipolar depression (CDMD) is described. The model offers a framework for extending Beck’s cognitive theory of depression and it provides the grounding for combining cognitive and hypnotic techniques in the management of depression. An integrated approach to treatment, referred to as cognitive hypnotherapy, based on the model is described in detail.
Cognitive Hypnotherapeutic Interventions in the Treatment of Multiple Personality Disorder
Authors: Fine Catherine G.
Published: September 2018

The uses of cognitive hypnotherapy will be considered in the treatment of Multiple Personality Disorder (MPD), an autohypnotic disorder (Bliss, 1984). Review of the phenomenology and the etiology of MPD will precede exploration of the goals and structure of MPD cognitive therapy. The role of hypnosis and the nature of the various cognitive hypnotherapeutic interventions will be explored through the pre-integration phase of treatment.
Panic Control Treatment of Panic Disorder With Agoraphobia and Comorbid Major Depression: A Private Practice Case
Authors: Warren Ricks
Published: September 2018

The present case explored the applicability and effectiveness of panic control treatment (PCT) administered in a private practice setting by a recently PCT-certified cognitive-behavior therapist. The issue of exportability, i.e., whether treatments developed at clinical research centers and found effective when conducted by the experts who developed them are equally effective when administered in other clinical settings, was specifically addressed. In addition, the impact of comorbid major depression on the PCT treatment of panic disorder with agoraphobia was also assessed. Results indicated that, after 21 sessions of PCT, panic attacks were eliminated, worry about panic decreased from severe to mild levels, and client ratings of global phobia changed from markedly disturbing/disabling to slightly disturbing/not disabling. In addition, comorbid depression was reduced from severe to minimal, while worry and trait anxiety were reduced to within the normal range. The process of therapy is discussed, and speculations regarding the contribution of specific interventions to successful outcome are offered.
Decomposition Analyses of Racial/Ethnic Differences in High Return Investment Ownership After the Great Recession
Authors: Shin Su Hyun , Hanna Sherman D.
Published: September 2018

We investigated racial/ethnic differences in high return investment ownership using the 2010 Survey of Consumer Finances (SCF). Logistic regression analysis shows that even after controlling for income, risk tolerance, education, and other factors, Black and Hispanic households are less likely to hold high return investments than White households, but Asian/Other households are not different from White households. Based on results from decomposition methods, if the households with Black and with Hispanic respondents have the same characteristics and risk tolerance as White households, the racial/ethnic gap in high return investment ownership would be narrowed, but still exists. The Fairlie decomposition method might be more reasonable to use for decomposition analyses than the Blinder-Oaxaca method.
Homeownership and Financial Strain Following the Collapse of the Housing Market: A Comparative Study on Loan Delinquencies Between Black and White Households
Authors: Bieker Richard F. , Yuh Yoonkyung
Published: September 2018

The objectives of this study were to evaluate the extent to which homeownership contributed to household financial strain as measured by loan delinquency after the onset of the recent housing market crash, and to examine if the impact of homeownership on household financial strain differed for Black and White households. Using data from the 2010 Survey of Consumer Finances, we found that, after controlling for other factors, a household's housing preferences had a potential effect on the likelihood of experiencing financial strain following the collapse of residential housing prices. In addition, Black homeowners were more likely to have experienced financial strain following the housing collapse than were White homeowners, regardless of the time period in which the home was purchased. The implications of the findings for public policy, personal financial planning and education, and further research are presented.
Mortgage Holding and Financial Satisfaction in Retirement
Authors: Seay Martin , Asebedo Sarah , Thompson Cametra , Stueve Cherie , Russi Ricardo
Published: September 2018

The purpose of this study was to evaluate the relationship between holding mortgage debt into retirement and financial satisfaction. Using data from the 2012 National Financial Capability Survey, this study explored the association between holding a mortgage in retirement and financial satisfaction through the use of a two-block hierarchical regression model. The first model of socio-demographics, financial constraints, and financial characteristics revealed a negative relationship between mortgage holders and financial satisfaction. The second model added measures of financial capability and financial beliefs, which revealed strong relationships between comfort with debt, knowledge about mortgages, subjective financial knowledge, and risk tolerance with financial satisfaction. After the addition of financial capability and belief measures, no relationship was found between holding a mortgage and financial satisfaction. Results suggest practitioners should explore their clients' beliefs about debt, as opposed to just the objective costs and benefits, when evaluating whether to hold a mortgage in retirement.
Letter from the Editor: Can Visions of Natural Birds Dance in Our Heads?
Authors: Humenick Sharron S.
Published: September 2018

Through the observations of a childbirth educator of women who are planning epidurals, these women’s vision of birth can be contrasted with a vision of the inner-strength-promoting experience that birth can be.
Letter from the Editor: Normal Birth as the Standard Versus Cesarean as a “Deserved” Choice
Authors: Humenick Sharron S.
Published: September 2018

In this column, childbirth educators are urged to provide pregnant women with informed choices, not just deserved choices, of giving birth.
Integrating Marriage Education into Perinatal Education
Authors: Hawkins Alan J. , Gillil Tamara , Christiaens Glenda , Carroll Jason S.
Published: September 2018

Couples making the transition to parenthood experience challenges that can threaten the quality and stability of their relationships and the health of family members. Currently, the educational infrastructure to support the delivery of couple-relationship education during the transition to parenthood is limited. Because new-parent couples interact with the health care system at many points during this transition time, an opportunity exists for strengthening couple relationships within the system to improve the well-being of adults and children. In this article, we propose a productive collaboration between marriage/couple educators and health care systems to integrate couple-relationship education into the standard of perinatal care.
Postpartum Depression, Marital Dysfunction, and Infant Outcome: A Longitudinal Study
Authors: Roux Gayle , Anderson Cheryl , Roan Chris
Published: September 2018

This longitudinal study explores the relationship of postpartum depression (PPD) and marital dysfunction on infant outcomes from birth to 2 1/2 years of age among middle-class, postpartum women. Participants were recruited during the prenatal period. Twelve mothers completed the study throughout a 2 1/2-year period. Questionnaires, semistructured interviews, and observations were used to collect data. Content analysis of the interviews (Morse & Field, 1995) was conducted and thematic patterns were identified. Clinical PPD and marital dysfunction (defined as little or no support or closeness, or verbal, emotional or physical abuse) characterized nearly one in three mothers. Four themes describing the women’s postpartum progression were identified: stress, isolation, resentment, and eventual adjustment by creating a new normal. No major developmental delays or behavioral problems were found among the infants. Eight of the 12 mothers who were initially identified as breastfeeding nursed their infants for 6–18 months. Regardless of financial and educational advantages, mothers in the study experienced depression and marital dysfunction. These findings support other studies that confirm the lack of association of PPD with social class or marital status. Childbirth educators and other health care professionals are encouraged to continue providing expectant families with anticipatory education and community resources in order to increase awareness of mental health and marital risks during the postpartum transition.
Deb’s Page: Potty Training
Authors: Gauldin Deb
Published: September 2018

In this column, a childbirth educator takes a humorous look at bladder control.
Guest Editorial: Old Childbirth Educators Never Die … They Just Labor Away
Authors: Tumblin Ann
Published: September 2018

Teaching childbirth education classes year after year can become monotonous or stale for some educators. Consequently, their students may also become bored. Rejuvinating one’s professional self takes effort; however, the results are a renewed sense of purpose and a more exhilarating atmosphere in class.
Nutrition and HIV-Positive Pregnancy
Authors: Montgomery Kristen S.
Published: September 2018

When an HIV-positive woman becomes pregnant, additional nutritional considerations are warranted. Compared to routine prenatal nutritional assessment and intervention, pregnant HIV-positive women have increased needs to promote a healthy outcome. This column contains information on HIV and pregnancy, nutrition and infection, and nutrition for HIV-positive pregnancy. This content can be integrated into childbirth education settings to improve care to women who are HIV-positive.
Exploring Women’s Preferences for Labor Epidural Analgesia
Authors: Stark Mary Ann
Published: September 2018

The purpose of this study was to explore demographic factors related to women’s prenatal preferences for using an epidural during labor. Women recruited from prenatal classes provided data for this descriptive correlational study. Women with the most education, income, and parity indicated greatest preference for epidural analgesia. Thus, these women may be comfortable with the technology and most likely to be willing to pay for epidurals and to select care providers who provide epidural anesthesia. In this sample, prenatal preference for an epidural was not predictive of actual use, although it has been shown to be predictive in previous research.
Abandoned-Baby Laws
Authors: Philipsen Nayna Campbell
Published: September 2018

In this column, the author examines the current status of abandoned-baby laws in the United States and how it can impact the work of childbirth educators.
Just the Facts, Ma’am
Authors: Gauldin Deb
Published: September 2018

In this column, the author humorously relates how a childbirth educator transporting medical antiques caused a stir in airport security.
The Impact of SARS on Childbirth Education
Authors: Midmer Deana
Published: September 2018

The SARS (Severe Acute Respiratory Syndrome) crisis in Toronto in the spring of 2003 had major consequences for prenatal learners. Classes in hospitals were cancelled; many couples were left without any prenatal education. This paper outlines the decision-making process of one programme that was determined to keep classes open. The impact of SARS on hospital procedures is also described. Childbirth educators are encouraged to prepare for future public health emergencies. Strategies to prepare for conducting childbirth education classes during times of crisis are outlined.
Recent Research Questions the Values of Routine Intervention
Authors: Moore Mary Lou
Published: September 2018

Under appropriate circumstances, intervention in labor and birth can be valuable, even lifesaving. But interventions can also become routine procedures. This paper reviews three recent studies in which the focus of research is common interventions: electronic fetal monitoring and epidural anesthesia. A fourth study reviewed here examines the effect of previous vaginal birth and fetal weight on the success of vaginal birth after cesarean.
Web Resources that Address Psychiatric Disorders in Pregnancy
Authors: Montgomery Mary Lou
Published: September 2018

Psychiatric disorders occur at every life stage, including pregnancy. This resource column highlights several Web resources that may be useful to childbirth educators and other health care providers who may care for pregnant woman experiencing one of these conditions.
The Mother of All Inventions
Authors: Gauldin Deb
Published: September 2018

Crusty childbirth educator humorously reflects upon the conveniences of modern-day parenting.
A Reclamation of Childbirth
Authors: Behrmann Barbara L.
Published: September 2018

In the first of a two-part article, the author recounts the childbirth experiences of her mother and grandmother, as well as her own, providing a view of three distinct eras and revealing profound changes in how American culture manages and understands birth.
When Parents Ask…about Preterm Birth, Breastfeeding Success, Breast Cancer, or Waterbirth
Authors: Moore Mary Lou
Published: September 2018

In this column, the author reviews research on four separate topics: the prevention of preterm birth, the effect of epidurals on breastfeeding success, the possible protective effect of lactation on breast cancer, and laboring in water. In two separate studies—a multisite study in the United States and a second study from Brazil—natural progesterone was shown to significantly reduce the incidence of preterm birth in women at high risk. A third study conducted in the United Kingdom examined the effect of clindamycin on preventing infection that can lead to preterm birth. A group of studies related to lactation found that early breastfeeding was more successful in women who did not have epidural anesthesia. In a Korean study, the lifetime duration of breastfeeding was associated with a significant reduction in breast cancer. Concerning waterbirth, Swiss researchers found that, when a woman labored in water, she regulated both water temperature and bathing duration to ensure that her body temperature and that of the fetus remained within a normal physiological range.
The Gestational Diabetes Group Program
Authors: Nasso Jacqueline , McCloskey Cynthia , Nordquist Sally , Franzese Christine , Queenan Ruth Anne
Published: September 2018

The purpose of the Gestational Diabetes Group Program (GDGP) was to provide patients with diabetes self-management education that occurs in a supportive, prenatal group care setting. The Centering Pregnancy Interdisciplinary Model of Empowerment and the Chronic Care Model guided the program. The pilot project took place at an urban clinic that cares for a diverse, underserved population. The GDGP, a series of four prenatal group sessions after the diagnosis of gestational diabetes and one postpartum group, used an interprofessional/interdisciplinary approach to care with the groups cofacilitated by certified nurse-midwives, certified diabetes nurse-educators, and other community partners. The program was able to show statistically significant changes in knowledge and empowerment, optimal pregnancy outcomes, and high patient satisfaction.
Advocating Reimbursement for Family-Centered Childbirth Education in the 21st Century
Authors: Capik Lynne Koehler
Published: September 2018

There are several positive socio-economic trends with implications for health care reimbursement of childbirth education. Despite the documented benefits and improved outcomes associated with receiving childbirth education, this service has not been regarded by most insurance plans as a reimbursable service for the childbearing family. Perinatal educators must become politically active in analyzing policy and issues of resource allocation. Perinatal educators must support policy and legislative efforts that guarantee access to and reimbursement for childbirth education.
Questions From Our Readers: Helping Women Decide to Breastfeed: Beyond the Breast Is Best
Authors: Lothian Judith A.
Published: September 2018

This article describes preparing women for the choice of breastfeeding within the context of preparation for childbirth classes. The challenges presented by society to and the joys and the naturalness of breastfeeding are interwoven within the course of the article.
Defining Women’s Preferences for Support During Labor: A Review of the Literature
Authors: Watkins Theresa M.
Published: September 2018

Determining women’s preferences for their care in labor is a reasonable basis for care giving activities. A review of the literature was undertaken to determine what has been written about implementing preferences in support during labor. Seven research studies dealing with the topic were analyzed. The results indicated that although the studies are limited in number, the resulting information is worthwhile. Most actual care as currently administered was not found to be based on women’s preferences. The implications for future research are delineated.
Testing the Nursing Outcomes Classification in Three Clinical Units in a Community Hospital
Authors: Moorhead Sue , Johnson Marion , Maas Meridean , Reed David
Published: September 2018

The testing of the Nursing Outcomes Classification (NOC) was the focus of a 4-year study to evaluate the use of the outcomes and measurement scales developed by the Iowa Outcomes Project, a research team at the University of Iowa. Three units in a Midwest community hospital collected data as part of the larger (ten) clinical site study to test the reliability, validity, and sensitivity of the NOC. This article focuses on the results of sensitivity testing obtained in a birth center, behavioral health center, and an oncology unit in a midwestern community hospital. Methods used in this study focused on change scores from initial assessment to post-treatment status for the outcomes studied in each unit. Average baseline ratings, average follow-up ratings, average change scores, and range of change are reported. Thirty-five outcomes are reported for the behavioral health unit, 21 outcomes are reported for the Birth Center, and 8 outcomes for the Oncology Unit. The overall average baseline for the behavioral health unit was 1.89 with an average follow-up rating of 3.22. For the Birth Center, the average baseline rating was 3.23 with an average follow-up score of 3.88. For the Oncology Unit, the average baseline score was 3.01 with an average follow-up rating of 3.12. The results of this study suggest that the NOC outcomes are able to identify change in some outcome ratings through time and in a direction expected for the populations studied in these three specialty units.
Establishing Competency in the Use of North American Nursing Diagnosis Association, Nursing Outcomes Classification, and Nursing Interventions Classification Terminology
Authors: Keenan Gail , Falan Sharie , Heath Crystal , Treder Marcy
Published: September 2018

The purpose of this study was to evaluate a 16-hour intervention designed to build clinician competency in the use of North American Nursing Diagnosis Association (NANDA), Nursing Outcome Classification (NOC), and Nursing Interventions Classification (NIC) (hereinafter: N3) among nurses with limited N3 knowledge. Each of 19 pairs of nurses independently selected N3 terms and rated the outcomes applicable to an actual patient for a specified time. A pair-through discussion then created a single consensus patient profile of the applicable terms. Before discussion, pairs agreed on 46% of the NANDA diagnoses, 30% of the NOC outcomes, and 20% of the NIC interventions selected. Eighty-nine percent of NOC label pair ratings were within 1 point. Building competency in N3 requires consistent use in written and oral communication with peers across time. Inter-rater reliabilities (IRRs) for NOC label ratings support previous findings.
A Questionnaire to Measure Mother-to-Infant Attachment
Authors: Müller Mary E.
Published: September 2018

The Maternal Attachment Inventory (MAI) was developed and tested to provide a practical measure of maternal affectionate attachment. MAI items were identified from the literature, and their construct validity was assessed by experts who numerically rated them for relevance. The MAI, two other indicators of maternal attachment, and a measure of maternal adjustment were completed by 196 women approximately 1 month after the birth of their infants. Two subgroups of women completed the research instruments when their infants were 4 (Group A) or 8 (Group B) months old. The MAI demonstrated evidence of validity through significant correlations with other indicators of maternal attachment (the How I Feel About the Baby Now Scale and the Maternal Separation Anxiety Scale) at all time points and a correlation with maternal adjustment as measured by the Maternal Attitudes and Maternal Adjustment Scale. The MAI also demonstrated evidence of acceptable internal consistency reliability at all three time points.
A Physiologic Method for Monitoring Premature Infants
Authors: Ludington-Hoe Susan , Kasper Christine E.
Published: September 2018

Instrumentation capable of handling 12 continuous hours of nine-channel real-time physiologic data sampled at 10Hz was needed to test within and between subject variability and preterm infant responses to skin-to-skin contact with the mother. A review of basic electrical components, electrical principles related to physiologic monitoring, and electrophysiology concepts generic to physiologic monitoring is presented. The development, specifications and applications of a new instrument to monitor premature infant cardiorespiratory adaptations are discussed.
Development and Psychometric Evaluation of an Instrument to Measure Staff Nurses’ Perception of Uncertainty in the Hospital Environment
Authors: Salyer Jeanne
Published: September 2018

Perceived environmental uncertainty is an individual response to stimuli in the internal and/or external environment. The measurement of uncertainty in the health care environment is important in order to characterize the impact of this phenomenon on nursing practice. This study describes the development, pilot testing, and initial psychometric evaluation of the Perceived Environmental Uncertainty in Hospitals Scale (PEU-H) in a sample of 95 hospital staff registered nurses. Principal components analysis of the PEU-H was conducted and indicated that the factor structure represented one factor that explained 37.3% of the variance. Internal consistency reliability using Cronbach’s alpha was .83, which is acceptable for a scale in the early stages of development.
Translation and Reassessment of the Adolescent Self-Perception Profile for a Rural, Mexican-American Population
Authors: Dimmitt Jane H.
Published: September 2018

Research has identified problems with self-concept in abused adolescents, and past studies have been conducted primarily with urban populations. Rural and minority adolescents also constitute subgroups at risk for abuse. This study was conducted to reassess reliability and validity of the Adolescent Self-Perception Profile (ASPP), for investigation of relationships between self concept and abuse in rural communities and to develop and perform initial psychometric evaluation of a Spanish language version of the ASPP as a tool to enable investigation of rural Mexican-American adolescents. ASPP development is projected for data base formation of theoretically based interventions and outcome measurement for self-concept. This study provides preliminary validation of the ASPP for these purposes.
Adequacy of Two Organizing Principles for the Classification of Lay Caregiving Decisions
Authors: England Margaret , Kiley Marylou
Published: September 2018

The specific aims of this study were to examine two organizing principles for caregiver planning and the consistency with which four nurses independently classified 1,096 caregiving decisions into one of 12 categories of a taxonomic structure. The typology for classification consisted of a coordinate for goal structure made up of three categories and a coordinate for human need orientation made up of four categories. The 3-by-4 classification schema was used to develop a coding manual of theoretical and operational definitions for 12 mutually exclusive cell categories of caregiver planning. The criterion for consistency of the nurses’ classification judgments was the assignment of a caregiving decision to a cell category identical to the a priori assignment of the principal investigator. The findings from the study provide initial support for content validity of the organizing principles for caregiver planning and interrater reliability of the nurses’ judgments when controlling for the effect of chance agreements. The nurses “correctly” classified 63.75% of the targeted caregiving decisions and did not “incorrectly” classify 83.74% of the decisions. The respective coefficient kappas for agreements made on the basis of goal structure and human need orientation were .72 and .65.
Development, Reliability, and Validity Testing of the Ethical Behavior Test: A Measure for Nurses’ Ethical Behavior
Authors: Dierckx de Casterlé Bernadette , Grypdonck Mieke , Vuylsteke-Wauters Magda
Published: September 2018

The need for reliable and valid measures for ethical behavior of nurses has encouraged the authors to develop a new instrument to measure students’ ethical behavior in daily nursing dilemmas. Characteristic of the instrument presented is the inclusion of two fundamental components of ethical behavior: (1) ethical reasoning (and the resulting decision), and (2) the actual implementation of the ethical decision. As for many instruments, Kohlberg’s theory of moral development has been used as the conceptual framework. However, Kohlberg’s abstract justice orientation was refined by a care perspective and representative nursing dilemmas were used to make the instrument conceptually more appropriate for measuring nurses’ ethical behavior. The analysis of the psychometric properties of the instrument has provided several relevant indications for the reliability and validity of the ethical reasoning and implementation scores. The revealed inconsistencies in the Ethical Behavior Test could be satisfactorily interpreted in terms of Kohlberg’s theory and related empirical research findings, supporting the reliability of the ethical behavior scores. The content validity rests upon the careful development of the instrument resulting in an optimal mix of dilemmas, arguments and care situations to reveal nurses’ ethical behavior and in a substantial degree of correspondence between the concept and operationalization. The congruency between the patterns of ethical behavior and Kohlberg’s theoretical insights about ethical reasoning and practice support the construct validity of the instrument.
Organizational Culture In Hospitals: Issues in Measurement
Authors: Seago Jean Ann
Published: September 2018

It is still not clear that organizational culture in hospitals is linked to patient or provider outcomes. However, measurement of organizational culture in nursing units within hospitals and for entire hospitals is common. Two instruments frequently used to measure hospital culture or work group culture within hospitals are the Organizational Culture Inventory (OCI) (Cooke & Lafferty, 1987) and the Nursing Unit Cultural Assessment Tool (NUCAT-2) (Coeling & Simms, 1993a). The purpose of this paper is to review selected empirical studies of organizational and work group culture in hospitals and critique these two measurement instruments. The paper discusses the issues of unit of analysis/aggregation bias and sample size when using these two instruments. It was concluded that OCI has been widely used in many types of organizations and has substantial data supporting the reliability and validity. However, the instrument does not always capture variation in nursing units. The NUCAT- 2 has less reliability and validity data but researchers have reported wide variation among units. Individual items can be selected for use from the NUCAT-2 and it is less expensive to use than the OCI.
Reliability and Validity of the Functional Performance Inventory in Patients With Moderate to Severe Chronic Obstructive Pulmonary Disease
Authors: Larson Janet L. , Kapella Mary C. , Wirtz Scott , Covey Margaret K. , Berry Jean
Published: September 2018

The Functional Performance inventory (FPI) is a new instrument designed to measure functional status in terms of activities that people perform on a daily basis. Psychometric characteristics were examined by a survey of 45 men and 27 women with chronic obstructive pulmonary disease (COPD). Internal consistency reliability was high and no ceiling and floor effects were observed for the Total FPI. Concurrent validity was demonstrated by correlations with the Total Sickness Impact Profile (r = -.59). Construct validity was supported by correlations with the Medical Outcomes Study Short Form-36, Physical Functioning (r = .69), the Physical Activity Scale for the Elderly (r = .62) and American Thoracic Society-Division of Lung Disease Breathlessness scale (r = - .62). The Total FPI is a reliable and valid measure of functional performance in persons with COPD.
Methodologic Issues in the Measurement of Oxytocin in Human Neonates
Authors: White-Traut Rosemary , Powlesland Jean , Gelhar Deborah , Chatterton Robert , Morris Mariana
Published: September 2018

Oxytocin’s (OT) role in the onset and maintenance of labor and in the letdown reflex is well known. OT also has been recognized as a neurotransmitter having functions in the central nervous system, including an influence on behavior (e.g., initiation of maternal behavior). This research was conducted to (1) evaluate whether human tactile contact in the human newborn would increase urine OT levels and alter infant behavioral state, and (2) determine the reliability of measuring OT in human infant urine. Although the data did not support the hypotheses, it was noted that OT levels, significantly decreased in infants who cried during the study period and that there was no correlation between infant’s chronologic age and OT levels. The findings illustrate several methodologic and measurement problems in the study of OT in human infants and that urine sampling in the neonate is not the most reliable method to evaluate change in OT levels. Some general issues concerning research with human infants also are discussed. Further research is recommended to document baseline levels of OT in neonates and to explore the use of salivary OT to measure short-term responses to interventions.
Development and Psychometric Evaluation of the Demands of Immigration Scale
Authors: Aroian Karen J. , Norris Anne E. , Tran Thanh V. , Schappler-Morris Nancy
Published: September 2018

The Demands of Immigration Scale (DI) measures demands associated with immigration, including loss, novelty, occupational adjustment, language accommodation, discrimination, and not feeling at home in the resettlement country. The DI scale was evaluated in a sample of 1,647 immigrants from the former Soviet Union who had resided in the United States from a few months to 20 years. Confirmatory factor analysis supported the proposed factor model. The DI subscales were internally consistent and had good test-retest reliability. Support for concurrent validity was demonstrated by correlations in the expected direction between the DI total and subscale scores and measures of depression and somatization. Support for discriminant validity was demonstrated by mean group differences in some or all of the DI dimensions according to age and years in the United States.