bluuebunny/crossref_metadata_2025 huggingface dataset:
Breast self‐examination and the health belief model: Variations on a theme
Authors: Wyper Mary Alexandra
Published: April 2007

Variables derived from the Health Belief Model (HBM) were studied in relation to breast self‐examination (BSE) performance, which was measured in terms of both frequency and thoroughness. Data were collected from 202 adult women via self‐administered questionnaires. Susceptibility and Seriousness were combined to form a “threat of breast cancer” variable, and two approaches were used to compute “net perceived efficacy of BSE.” However, barriers and susceptibility in their original form explained more variance in BSE practice than did the combined variables. The negative relationship found between perceived barriers and BSE performance (r= –.44) is consistent with previous findings. Implications for research and practice are presented.
Early postpartum transition: Progress in maternal identity and role attainment
Authors: Pridham Karen F. , Lytton Diane , Chang Audrey S. , Rutledge Dorothy
Published: April 2007

Sets of early postpartum transition variables and relationships among them examined in this study were: (a) Maternal attributes (parity, age, education); (b) infant feeding plan (extent of breast‐feeding); (c) birthing conditions (supports and stressors during labor and delivery); (d) birthing experience (how well labor and delivery went, usefulness of postpartum learning resources, adequacy of hospital stay); and (e) transition markers (evaluation of parenting and of infant‐ and self‐care capability). Infant feeding plan was related to supports but not to how well labor and delivery went. Whereas preparation for birthing was positively related to how well labor and delivery went, stressors were negatively related. The direct contribution of preparation for birthing to both parenting evaluation and infant‐ and self‐care capability and of supports and usefulness of postpartum resources to self‐care capability merits clinical attention to these variables. Research concerning types of birthing experience that may contribute to evaluation of parenting is needed.
Factors associated with participation or nonparticipation in a workplace wellness center
Authors: Alexy Betty B.
Published: April 2007

The aim of this project was to compare characteristics and factors that distinguished those individuals (n = 101) who participated in a worksite wellness program from those who did not (n = 100). This project was unique in that the majority of subjects were bluecollar workers. Factor analysis of a 35‐item questionnaire resulted in six factors: perceived benefits of health promotion behaviors, perceived physical barriers of health promotion, perceived self‐efficacy for health promotion behaviors, perceived psychological barriers, situational components relating to convenience of the wellness facility, and the need for social support. Discriminant analysis revealed that self‐efficacy was the most useful factor in distinguishing between the two groups. Participants identified more benefits and fewer barriers to health promotion activities. Nonparticipants were older, less educated, and tended to view their age, their perceived lack of fitness, and perceived poorer health status as deterrents to regular physical activity. Nonparticipants also identified shift work, working overtime, responsibilities at home, and distance from work as important barriers to health promotion activities. Self‐efficacy factors appear to warrant further investigation in future attempts to explain health promotion behaviors in this high risk group.
Multiple drug regimens: Medication compliance among veterans 65 years and older
Authors: Graveley Elaine A. , Oseasohn Celia S.
Published: April 2007

In this study we attempted to develop a profile that could be used prospectively to identify veterans over 64 years of age who might be at risk for medication noncompliance. Male veterans (N = 249) having from one to seven oral daily prescribed medications were studied. Instruments administered to determine their relationship to compliance were the Paired—Associate Test, the Mini Mental State, the Multidimensional Health Locus of Control, and the Standard Depression Scale. Compliance was determined by a pill count made at two home visits. Seventy‐three percent of the subjects were noncompliant. Variables significantly related to noncompliance by bi‐variate analysis were included in the stepwise logistic regression to develop a predictive model of noncompliance. Ethnicity and number of daily prescribed pills were the only significant variables in the final model. The model correctly classified the subjects as compliant/noncompliant in 77% of the cases. Discussions during home interviews revealed a number of common problems.
Effect of teaching decision analysis on student nurses' clinical intervention decision making
Authors: Shamian Judith
Published: April 2007

The purpose of this study was to evaluate the effect of teaching decision analysis on nursing students' ability to prioritize clinical interventions given the probabilities for the decision situation. Sixty‐eight university nursing students were randomly assigned to one of two groups. The 37 nursing students in the experimental group received a 4‐hour didactic and interactive teaching session on decision analysis. The 31 nursing students in the control group also received a 4‐hour interactive session on a nondecision analysis topic. A posttest experimental design was selected to minimize testing bias. Three clinical case studies were developed, tested, and utilized for data collection. Subjects in the experimental group selected clinical decisions that were in accordance with clinical decisions made by experts more often and more consistently than did subjects in the control group (ρ < .0001).
Agressive behavior in cognitively impaired nursing home residents
Authors: Ryden Muriel B. , Bossenmaier Monica , McLachlan Carrie
Published: April 2007

Aggressive behavior was documented in a sample of 124 residents on units for the cognitively impaired in four nursing homes over a period of 7 days using the Ryden Aggression Scale. Some form of aggression was found in 86.3% of the residents, with no differences among facility, gender or diagnostic group. Neither mental status nor physical dependency was associated with aggression. The 68.5% who received psychotropic drugs had significantly higher aggression scores. Most incidents of aggression involved response to invasion of personal space and occurred during the day shift.
Correlates of diurnal sleep patterns in infants of adolescent and adult single mothers
Authors: Becker Patricia T. , Chang Audrey , Kameshima Shinya , Bloch Marianne
Published: April 2007

Sleep behavior has been related to both child and environmental factors, but the relative importance of these factors is not yet clear. This study was an examination of the relation of diurnal sleep patterns to perinatal risk, infant temperament, home environment, parenting stress, emotional support, and social class. Twenty‐three adolescent and 23 single adult mothers and infants were assessed in the home at 4 and 12 months. Percent sleep during the night was most strongly related to parenting stress and variability of night sleep to emotional support. Emotional support mediated effects of stress at 4 months. Results support the value of clinical assessment of sleep behavior.
Interaction between high‐risk infants and their mothers: The NCAST as an assessment tool
Authors: Farel Anita M. , Freeman Victoria A. , Keenan Nora L. , Huber Cathee J.
Published: April 2007

Using the NCAST Feeding, Teaching, and HOME Scales, we tested 37 high‐risk infants matched with 37 healthy infants on gender, race, and socioeconomic status. All infants were 8 months old. A one‐to‐one matched case‐control design was used to determine whether increased risk of impaired mother—infant interaction was associated with case status. Conditional logistic regression was used to control for possible confounding and to evaluate interaction. Of the 37 high‐risk infant—mother dyads, 25 had a low score on one or more scales while only 10 of the control dyads had a low score on one or more of the three scales. The Feeding scale was the only assessment in which the association found in the univariate analysis persisted after adjusting for other variables. Because of its low cost and high efficiency, the NCAST battery appears to be valuable for directing more specialized intervention services in a high‐risk infant population.
The concept of grief: A foundation for nursing research and practice
Authors: Cowles Kathleen V. , Rodgers Beth L.
Published: April 2007

In spite of the significance of grief as a human response, research to expand knowledge of this phenomenon has been impeded by the existence of a conceptual problem. In this study, a comprehensive and systematic review of both current and classic literature concerning grief was conducted within the disciplines of nursing and medicine. Findings contributed to the definition of grief as a pervasive, highly individualized, dynamic process that often is discussed normatively within professional disciplines. This definition provides not only a synthesis of knowledge concerning grief but a reconceptualization that can promote efforts to clarify this important concept for nursing.
Video analysis of playground injury‐risk situations
Authors: Coppens Nina M. , Gentry Lois Krehel
Published: April 2007

An observational study was conducted to examine injury‐risk situations as they occurred during playground recess periods. A process analysis approach was used to describe antecedent conditions, response, consequence, and reaction depicted in the video scenes. Results indicate that boys were more involved than girls, playground equipment was frequently used improperly, aggressive behaviors were sometimes a factor, situations occurred more frequently with nonteacher than teacher monitors, and children infrequently took action to stop the situations. Other children were more likely to react to the target child than the monitor. Direction is provided for child and monitor safety promotion programs.
Operationalizing the theory of planned behavior
Authors: Young Heather M. , Lierman Letha , Powell‐Cope Gail , Kasprzyk Danuta , Benoliel Jeanne Q.
Published: April 2007

The Theory of Planned Behavior (TPB) is an expectancy‐value theory that provided a framework for the study of behavioral and normative beliefs affecting health behaviors. The purpose of this article is to describe operationalization of the TPB. The process of instrument development is explicated, with examples from two studies of BSE behavior in older women. Potential threats to reliability are discussed.
Development and evaluation of the osteoporosis health belief scale
Authors: Kim Katherine K. , Horan Mary L. , Gendler Phyllis , Patel Minu K.
Published: April 2007

The Osteoporosis Health Belief Scale was developed to measure health beliefs related to osteoporosis. It is a 35‐item self‐report questionnaire based on the Health Belief Model which is specifically designed to assess beliefs related to exercise behaviors and calcium intake of elderly subjects. The instrument consists of seven subscales: Seriousness, Susceptibility, Health Motivation, Calcium Benefits, Calcium Barriers, Exercise Benefits, and Exercise Barriers. The instrument was tested on a sample of 150 elderly individuals. The psychometric properties of the scales are discussed along with recommendations for its use in research and practice.
Discovering older women's experience of urinary incontinence
Authors: Dowd Therese Trudel
Published: April 2007

Grounded theory was used to acquire an understanding of older women's experience of urinary incontinence (Ul). Women explained that accidents or other problems related to the UI were threats to their self‐esteem. These threats provided strong incentives to develop an effective continence care system which would help to protect their self‐esteem. If they were successful in developing an effective system, it was possible that they could accept the UI and lead “normal” lives. Examination of the data using the constant comparative method revealed the self‐care system that the women in this study produced to manage the UI, but not how they developed or sustained it. Further investigation into how women with UI develop and sustain continence care routines is needed, so that nurses can provide better assessments and nursing care.
A model of parenting stress
Authors: Younger Janet B.
Published: April 2007

A preliminary theoretical model of parenting stress was tested. The additive effects of a series of stresses, namely, stressful pregnancy, stress of labor and delivery, and the stress of parenting were examined in a causal model of parenting stress. Factors theoretically expected to be protective in stressful circumstances, like, personality strength, prior experience, age, education, and social support, were predicted to be negatively related to stress. Data from 101 mothers whose infants were 6 weeks old were analyzed using path analysis. The data fit the model and explained 41% of the variance in parenting stress. The empirical model showed significant paths from prior experience and social support to the stress of pregnancy. The mother's education was the only significant variable in the pathway to labor and delivery stress and it was positively related to stress. Paths to parenting stress existed from personality and from pregnancy stress, but not from labor and delivery stress or any of the other variables.
Remarriage and health
Authors: Ganong Lawrence H. , Coleman Marilyn
Published: April 2007

One hundred and five adult females and 100 adult males from the mid‐Missouri area participated in a study to compare the health complaints of remarried women and men and to determine correlates of these health complaints. A structured interview format was used to gather information, and each subject completed the Dyadic Adjustment Scale (DAS) and the Inventory of Family Feelings (IFF). No major health differences between women and men were found, although women experienced more changes in health complaints following remarriage than men did. Overall, the health of both men and women was affected most by their feelings toward one another and by having decision‐making power within the family. For men, more decision‐making power in the family and high marital satisfaction were associated with better health. For women, health was associated with positive feelings toward their spouse and less decision‐making power. In addition, a woman's health was better with fewer children in the family and when all the children in the household were hers.
The patient intensity for nursing index: A validity assessment
Authors: Prescott Patricia A. , Ryan Judith W. , Soeken Karen L. , Castorr Alexandria H. , Thompson Kathleen O. , Phillips Carole Y.
Published: April 2007

The psychometric assessment of a new measure of nursing intensity, The Patient Intensity for Nursing Index (PINI) is reported. Four dimensions of nursing intensity are measured by the PINI: (a) severity of illness, (b) dependency, (c) complexity of care, and (d) time. There are 10 items rated on a 5‐point ordinal scale. A purposively drawn sample of 6,445 patients was obtained from five hospitals, with 487 registered nurses (RNs) providing daily patient ratings from 29 medical—surgical and intensive care units.

Substantial interrater reliability was demonstrated. Validity testing included confirmatory factor analysis, hypothesis‐testing, contrasted groups, and an observational study of time. The factor structure confirmed specified components of severity, dependency, and complexity, with time loading on all three factors. PINI scores were significantly related to medical severity of illness, length of hospital stay, disposition at discharge, number of secondary medical diagnoses and specialty consults, and scores on three different hospital classification systems used for staffing. PINI scores were significantly different for high‐and low‐intensity DRGs. Observed time spent delivering nursing care to specific patients was significantly correlated with nurse estimates of time.
Utilizing research assistants and maintaining research integrity
Authors: Gift Audrey G. , Creasia Joan , Parker Barbara
Published: April 2007

The appropriate use and supervision of research assistants is essential to the success of a research study and the avoidance of academic misconduct. The focus of this article is to provide guidelines for the new principal investigator regarding hiring, contracting, orienting, monitoring, and evaluating research assistants. Particular attention is given to techniques that will avoid academic misconduct resulting from research assistants being uniformed or unsupervised.
Computer‐assisted reinforcement of instruction: Effects on adherence in adult atopic asthmatics
Authors: Huss Karen , Salerno Maria , Huss Richard W.
Published: April 2007

A randomized comparison group pretest–posttest experimental design was used to determine computer‐assisted instruction effects on adherence to implementing house dust mite avoidance measures in adult atopic asthmatics. Fifty‐two subjects were randomly assigned to comparison and experimental groups. The comparison group received traditional instruction in avoidance measures while the experimental group received traditional instruction supplemented by identical information provided by computer‐assisted reinforcement of instruction. Adherence was measured by subjects' self‐ratings and investigators' observations. Data were collected during two home visits 12 weeks apart. The computer group had significantly (p < 0.05) greater adherence scores than the comparison group. The results indicate that computer‐assisted reinforcement of instruction is an effective method of increasing self‐care behaviors about allergen avoidance activities.
Relationship of resources to emotional distress, somatic complaints, and high‐risk behaviors in drug recovery and homeless minority women
Authors: Nyamathi Adeline M.
Published: April 2007

In a sample of 581 homeless or drug‐abusing minority women, the relationship of self‐esteem, sense of coherence, and support availability to emotional distress, somatic complaints, and high‐risk behavior were investigated. Findings revealed that women who were high in self‐esteem and stronger in sense of coherence reported significantly less emotional distress, and significantly fewer high‐risk behaviors. In addition, women who were high in any of the three resources reported lower somatic complaints. Regression analyses revealed that coherence, self‐esteem and support availability jointly accounted for 49% of the variance in emotional distress, 10% of the variance in high‐risk activities, and 26% of the variance in somatic complaints. Implications for empowering women at risk for HIV infection are discussed.
Content analysis of reminiscences of elderly women
Authors: Kovach Christine R.
Published: April 2007

The content of reminiscences of 21 cognitively intact elderly women registered in an adult daycare program was examined. Content analysis of transcripts from a semistructured interview was used to discover categories of reminiscence meaning. The interpretations made about past experiences were grouped under two categories: (a) validating reminiscences that involved confirming or verifying that one had lived a fruitful life; and (b) lamenting reminiscences that involved negative interpretations of past events. Validating themes were: positive self‐appraisals, choices, social connections, joys, and past to present comparisons. Lamenting themes were: regrets, difficulties, and lacking choice.
A descriptive analysis of experienced nurses' clinical reasoning during a planning task
Authors: Grobe Susan J. , Drew Judith A. , Fonteyn Marsha E.
Published: April 2007

A Think Aloud (TA) method was employed to collect verbal data from seven clinical nurses as they reviewed a written case study and formulated a plan of care. Protocol Analysis (PA) of the verbal data resulted in a visual representation of each subject's plan of care and provided information regarding the clinical data that subjects used to plan care. The results demonstrated that frequently problems and interventions were inextricably linked and considered in unison rather than during separate steps of a planning process. This finding has implications relative to the current practice within both nursing education and nursing service of focusing on problems and interventions separately when planning care.
Focus on psychometrics. The multitrait–multimethod approach to construct validity
Authors: Ferketich Sandra L. , Figueredo Aurelio J. , Knapp Thomas R.
Published: April 2007

The multitrait–multimethod matrix approach as proposed by Campbell and Fiske (1959) was an important contribution to our understanding of the nature of validation procedures. There are, however, problems encountered when using the Campbell and Fiske (1959) approach. The purpose of this article is to discuss the method and selected problems, and to propose an alternate approach to address those problems.
Two explanations of nurse practitioner interactions and participatory decision making with physicians
Authors: Lamb Gerri S.
Published: April 2007

The purpose of this study was to test a theoretical model that integrated two explanations of nurse practitioner interaction and participatory decision making with physicians. The two explanations were derived from technology theory and social exchange theory. Nurse practitioners (N = 38) responded to a four‐scale magnitude estimation instrument measuring each of four concepts in the model: complexity, expected benefit‐cost ratio of interaction, interaction, and participatory decision making. Predictions derived from both theories were supported. Nurse practitioner decisions about interaction with physicians were influenced by the dynamics of social exchange with physicians, as well as the technological requirements of primary care. The findings offer nurse practitioners new strategies for managing professional exchanges on behalf of their patients.
Effects of a skin refrigerant/anesthetic and age on the pain responses of infants receiving immunizations
Authors: Maikler Virginia Egbert
Published: April 2007

Although pain management is an important nursing responsibility, few interventions for minimizing distress of infants during painful procedures have been studied. Sixty infants, 2 through 6 months of age, were studied during a routine DPT immunization in order to examine (a) the effectiveness of cooling the skin in reducing distress behaviors and (b) the relationship between age and distress behavior. Infants were randomly assigned to experimental or control groups. Prior to the injection, the sites were sprayed for 2 to 3 s with either a skin refrigerant/anesthetic or compressed air. Behaviors were video‐ and audio‐taped during and 60 s post injection, and coded for (a) facial expression, (b) cry, and (c) body movements. MANOVA revealed fewer distress behaviors following refrigerant spray and more complex, varied behavioral responses for older infants. The findings provide further evidence that infants perceive pain and that nursing interventions for pain reduction should be tested and extended to the very young.
Clinical predictors of intravenous site symptoms
Authors: Dibble Suzanne L. , Bostrom‐Ezrati Janet , Rizzuto Carmella
Published: April 2007

The purpose of this prospective multi‐site study was to determine the frequency of intravenous (IV) site symptoms and to develop a preliminary model of the factors implicated in the number of these symptoms. In a sample of 514 patients from four institutions, IV site symptoms including pain, redness, swelling, induration, and/or a venous cord were present in 205 (39.9%) of the patients. The IV catheters were in place an average of 48.7 hr. There were no significant differences in symptoms by hospital site. Using multiple regression techniques, a seven‐factor model explained 18% of the variance in number of IV site symptoms. Further research is required to explore other potential causes for the numbers of IV site symptoms.
The effects of cognitive distortion and depression on disability in rheumatoid arthritis
Authors: Clough Dorothy Hendel
Published: April 2007

The question explored in this study was: What is the effect of cognitive distortion and depression on disability in arthritis patients when stage of disease is controlled? Patients (N = 165) completed the Sickness Impact Profile, two Cognitive Error Questionnaires, and the Symptom Questionnaire, and were staged for severity of disease. Findings indicated a significant effect of distortion on disability in rheumatoid arthritis patients; however, this effect varied by stage. Distortion and depression best explained total disability in Stage II (R2 = 0.60 using general distortion; R2 = 0.58 using arthritis distortion). Future nursing interventions designed to decrease or prevent distortion might reduce disability as well as depression.
An empirical test of rogers' original and revised theory of correlates in adolescents
Authors: Yarcheski Adela , Mahon Noreen E.
Published: April 2007

The purpose of this study was to examine Rogers' original and revised theory of correlates in adolescents. The correlates were measured by Perceived Field Motion, Human Field Rhythms, Creativity, Sentience, Fast Tempo, and Waking Periods. The original theory was tested with data obtained from samples of early (n = 116), middle (n = 116), and late (n = 116) adolescents. The revised theory was tested in a fourth selectively combined sample of adolescents, aged 12 to 21 (n = 89). Data were collected in classroom settings. Although the findings did not support either theory, they did indicate that: (1) four of the six correlates studied performed as correlates when examined in three discrete phases of adolescence, as determined by chronological age, (2) the means of the individual correlates increased slightly in frequency levels developmentally, and (3) the correlates emerged at different frequency levels when examined in adolescents, aged 12 to 21.
Focus on Psychometrics. Coefficient alpha: Conceptualizations and anomalies
Authors: Knapp Thomas R.
Published: April 2007

In this article distinctions are made among some of the different conceptualizations of, and formulas for, Cronbach's coefficient alpha as it is applied to dichotomous or nondi‐chotomous, standardized or unstandardized, and weighted or unweighted data. Issues regarding the statistical significance of alpha and the occasionally encountered anomalies of artificially high alpha and negative values of alpha are given particular attention.
Illness and Treatment Appraisal Processes of Healthy and Hemophilic Boys
Authors: Spitzer Ada
Published: April 2007

The purposes of this study was to describe patterns characterizing appraisal processes of chronically ill and healthy school‐age boys regarding illness and treatment situations. The specific aims were to describe () the domains representing the process of appraisal, () the relationships among the domains, and (c) the patterns of appraisal based on the interplay among the various domains. The sample included 18 healthy boys and 18 hemophilic boys. The two groups were matched on the basis of child's age and family socioeconomic level. A qualitative methodology was used to understand the ways in which boys appraise illness and treatment‐related stimuli. Findings showed that appraisal processes of school age boys were comprised of four interacting domains: delineation of the context, fears related to the stimuli, the emotional response to the stimuli, and the final decision. The characteristics of these domains and the relationships among them resulted in two patterns of appraisal: amplification and minimization.
Cognitive Performance on Piagetian Tasks by Alzheimer's Disease Patients
Authors: Thornbury Julia Mcgregor
Published: April 2007

The purpose of this study was to examine cognitive abilities in Alzheimer's disease (AD) patients using Piaget's child developmental theory. Thirty elderly AD patients and 30 elderly control subjects were given two traditional Piagetian measures, the Infant Psychological Development Scale and the Concrete Operations Test. Half of the AD subjects (15) were in Piaget's sensorimotor or preoperational stages, while the remaining half of the AD subjects and all elderly control subjects were in Piaget's concrete operational stage, x2 [1, N = 60] = 17.42, p <0.001. If subsequent studies confirm that AD patients' cognitive characteristics are similar to Piaget's theoretical model, nursing care might be individualized based on mental competence, thus minimizing the commonly observed caregiver overestimation and underestimation of the AD patient's ability to understand and cooperate.
Effects of personal control over hospital noise on sleep
Authors: Topf Margaret
Published: April 2007

Critical Care Unit (CCU) sound levels, subjective stress due to noise, and sleep were studied in 105 female volunteers in a simulated hospital environment. Subjects were randomly assigned to instruction in personal control over noise via the availability of a sound conditioner, no instruction in personal control over noise, or quiet conditions. Subjects in the two noise conditions heard audiotape‐recorded CCU nighttime sounds while attempting to sleep overnight in the laboratory. The intervention did not facilitate better sleep as measured by polysomnograph equipment and self‐report. However, the results provided strong support for a causal relationship between CCU sounds and poorer sleep. When compared to the quiet condition, subjects in the noise conditions had poorer sleep efficiency; more difficulty falling and staying asleep; more difficulty progressing from one stage of sleep to the next; more intrasleep awakenings; spent less time in Rapid Eye Movement sleep; and poorer sleep via self‐report (all ps < 0.03). As predicted, scores for subjective stress due to CCU sounds yielded significant relationships with 9 of 16 measures of sleep (all ps <0.01). Hierarchical multiple regressions showed that 13% (p <0.001) and close to 6% (p <0.05) of the variance in sleep efficiency was accounted for by CCU sound levels and noise‐induced subjective stress, respectively. Thirty‐eight percent (p <0.001) of the variance in Rapid Eye Movement sleep was accounted for by CCU sound levels.
Tailoring nursing care to the individual client: Empirical challenge of a theoretical concept
Authors: Brown Sarah Jo
Published: April 2007

Tailoring of client‐nurse interaction to the client's individuality is a central concept in Cox's interaction Model of Client Health behavior, and represents a specification of the term individualization of cafe (Cox, 1982). In this study, the empirical adequacy of Cox's definition of tailoring was challenged by comparing the content of naturally occurring encounters between an expert nurse and clients to content predicted by the definition. Analyses of the content of the encounters revealed that: client individuality was featured; client individuality and clinical assessment‐management were considered in association with one another; and a majority of interventions were fitted to the individual client. The findings were interpreted as supportive of the empirical existence of tailoring as specified by Cox, and provided the bases for suggested refinements of the theoretical model.
“Nursing as a way of thinking”—heideggerian hermeneutical analysis of the lived experience of the returning RN
Authors: Rather Marsha L.
Published: April 2007

Although RNs are returning for baccalaureate education in large numbers, little research has been conducted on their lived experience to identify what they deem significant about their schooling experiences. For this phenomenological study, returning RNs from three baccalaureate nursing programs (N = 15) participated in extended, nonstructured, audio‐recorded interviews. Resulting verbatim transcripts were analyzed hermeneutically by a team of researchers using Heideggerian phenomenology as the philosophical background to identify common meanings, relational themes across texts, and finally, constitutive patterns expressing relationships between themes. The major finding of the research was the constitutive pattern “Nursing as a Way of Thinking.”
Beyond campbell and fiske: Assessment of convergent and discriminant validity
Authors: Lowe Nancy K. , Ryan‐Wenger Nancy M.
Published: April 2007

While it is not an innovation in the more established social sciences, the multitrait multimethod (MTMM) technique (Campbell & Fiske, 1959) and additional, more powerful statistical methods of interpreting a MTMM matrix of correlations, have not been used extensively in nursing to asses construct validity of new instruments. This article reviews the Campbell and Fiske method for the assessment of convergent and discriminant validity, reviews the application of the method in the nursing literature, and describes the limitations of the original method. In addition, the procedures, strengths, and limitations of the analysis of variance and confirmatory factor analytic approaches to the quantification of Campbell and Fiske's criteria are described.
Psychophysiologic and behavioral effects of tactile stimulation on infants with congenital heart disease
Authors: Weiss Sandra J.
Published: April 2007

A within‐subjects, counterbalanced, repeated measures design was employed to determine the effects of gender and six different types of verbal and tactile stimuli on the arousal of 24 infants hospitalized for congenital heart disease during their first 6 months of life. Infants were systematically assigned to different sequences of the various stimuli. Measures of arousal included heart rate, blood pressure, respiration, and activity level. Results indicated that the use of touch conducive to neural excitation (i. e., intense, vigorous, extensive touching of highly innervated body areas) produced higher heart rates (p < 0.01) and systolic blood pressure (p < 0.002) as well as greater activity (p < 0.01) than did other types of tactile stimulation or soothing verbal stimulation. Girls appeared more physiologically responsive to touch than boys and a subset of infants showed evidence of distress during more arousing stimulation.
Evaluation of hypertension screening in the hutterite population
Authors: Brunt J. Howard , Love Edgar J.
Published: April 2007

The purpose of this study was to examine the impact of a hypertension screening program on Hutterites from Alberta, Canada who were found to have a diastolic blood pressure > 90 mm Hg. At approximately 16 months postscreening, 200 subjects completed a selfadministered questionnaire requesting information about physician follow‐up and pharmacologic and nonpharmacologic therapy. Seventy‐four percent of the subjects reported that they had their blood pressure measured at least twice since screening. A third of the respondents reported changes in pharmacologic management. Subjects reported weight loss (36%), and salt and alcohol reduction (64% and 48%, respectively) as nonpharmacologic methods for lowering blood pressure. In terms of physician follow‐up and pharmacologic and nonpharmacologic modification, the screening program was effective.
Quality of Life after Liver Transplant
Authors: Hicks Frank D. , Larson Janet L. , Ferrans Carol Estwing
Published: April 2007

The purpose of this study was to compare the quality of life and health related variables in two groups of liver transplant patients, one at 2 years or less after transplant and the other at more than 2 years after transplant. Both groups reported a high overall quality of life and an above average health status. Long‐term transplant patients reported significantly more health‐related functional impairment and a tendency toward higher levels of depressed and anxious moods. The high quality of life suggested that patients were coping effectively with the realities of life, despite health‐related functional impairment.
The effects of noise stress on leukocyte function in rats
Authors: McCarthy Donna O. , Ouimet Mary E. , Daun Jane M.
Published: April 2007

It has been reported that exposure to increased noise levels impairs wound healing in surgical patients and in rats. The purpose of the present study was to determine if exposure to noise stress would alter the biological function of neutrophils, macrophages, and lymphocytes, leukocytes that are involved in wound healing. Rats were exposed to 80 db of “rock” music for 24 hr, during which time the control animals were maintained in their usual environment. Leukocyte subpopulations were obtained and stimulated in vitro. Neutrophils and macrophages from noise‐exposed animals secreted significantly less superoxide anion and interleukin‐1 than cells from control animals. Lymphocyte function was not altered following noise stress. We conclude that short‐term exposure of rats to noise stress alters some of the biological functions of leukocytes.
The effect of clients' family structure on nursing students' cognitive schemas and verbal behavior
Authors: Ganong Lawrence H. , Coleman Marilyn
Published: April 2007

The primary purpose of this study was to investigate if nursing students stereotype clients on the basis of family status. In addition, the influence of information about the client's family status on students' predictions about the client's behavior, information sought from the client, recalled information, and verbal responses directed toward the client were examined. The participants were 83 nursing students from a large Midwestern university. They were randomly assigned to one of two groups. Brief written information about a female adult client with a vaginal discharge was provided and, after listening to an audiotaped interview between a nurse and the client, students completed a battery of questionnaires. They also responded verbally to questions asked by the audiotaped client. All information given to both groups was identical except for the client's family status. Results indicated that the client who was a married mother was perceived somewhat more positively than the unmarried mother client. Participants' perceptions were only somewhat consistent with cultural stereotypes about these family statuses. Information sought and information remembered about the client were greater when she was an unmarried mother. There were no differences in predictions of patients' behaviors and verbal responses.
The consent process and children
Authors: Broome Marion E. , Stieglitz Kimberly A.
Published: April 2007

Traditionally, recommendations and procedures for obtaining consent and assent from children to participate in research have varied somewhat from institution to institution. At least some of this inconsistency can be attributed to a lack of consensus on what consent means when applied to individuals less than 18 years of age. Developmental theories provide some rationale for reconsidering the arbitrary age limit of 18 years for informed consent. In this article, the concepts of consent and assent are discussed relative to developmental characteristics of children and adolescents and implications for consent and assent procedures are discussed.
Focus on psychometrics the kappa statistic for establishing interrater reliability in the secondary analysis of qualitative clinical data
Authors: Brennan Patricia Flatley , Hays Bevely J.
Published: April 2007

Analysis of extant clinical records is receiving increased emphasis in nursing investigations. Appropriate use of this approach to patient research requires careful attention to data management, including assessment of reliability. Percent agreement, phi, and Kappa all serve as estimates of interrater reliability in the analysis of data. Kappa has particular merit as a measure of interrater reliability; it also has some peculiar problems in implementation and interpretation. The nature and computation of Kappa and its application in analysis of clinical data are discussed.
Psychosocial outcome six months after heart transplant surgery: A preliminary report
Authors: Bohachick Patricia , Anton Bonnie B. , Wooldridge Powhatan J. , Kormos Robert L. , Armitage John M. , Hardesty Robert L. , Griffith Bartley P.
Published: April 2007

With improvement in survival of patients treated with heart transplant, evaluation of recovery with respect to psychosocial function has become an important issue. In this study, psychosocial functioning of 44 heart transplant recipients pretransplant was compared to their functioning 6 months posttransplant. Before transplantation, patients experienced considerable psychosocial distress attributable to illness. At 6 months after transplantation, the majority of patients showed significant improvement in emotional, domestic, sexual, social, and vocational functioning. However, 25% of patients showed deterioration in psychosocial adjustment and 11% showed an increase in mood disturbance. Further effort is indicated to improve psychosocial outcome of heart transplantation.
Attentional fatigue following breast cancer surgery
Authors: Cimprich Bernadine
Published: April 2007

Attentional fatigue usually follows intense use of mental effort and is manifested as a decreased capacity to concentrate, that is, to direct attention. The purpose of this study was to examine the capacity to direct attention in persons with cancer during the initial phase of illness. The sample consisted of 32 women without cognitive or affective disorders who underwent surgery for localized (Stage I or II) breast cancer. Subjects manifested attentional deficits of varying intensity on a battery of tests of directed attention on the day before discharge from the hospital, which was a mean of 3 days following mastectomy or breast conservation surgery. Unexpectedly, the two surgical groups did not differ significantly in attentional capacity and functioning. Attentional test scores were not significantly correlated with narcotic pain medication interval, mood state, or self‐ratings of attentional functioning. However, as number of days postsurgery increased, attentional performance decreased. The theoretical basis for further examination of attentional fatigue in people with cancer or other life‐threatening illnesses is discussed.
Parental and family well‐being in families of children with down syndrome: A comparative study
Authors: Van Riper Marcia , Ryff Carol , Pridham Karen
Published: April 2007

The purpose of this study was to examine the effects of a child with Down syndrome on the individual functioning of both parents, marital functioning, and family functioning. Thirtyfour families of children with Down syndrome were compared to 41 families with nondisabled children. Mothers and fathers in both groups completed a series of self‐report measures. No significant differences were obtained between the two groups of families on any of the measures of individual, marital, or family functioning. The results of this study support a competence model in which parents may respond to the challenges associated with parenting a child with Down syndrome with resilience and adaptive functioning.
The stress response of mothers and fathers of preterm infants
Authors: Miles Margaret Shandor , Funk Sandra G. , Kasper Mary Ann
Published: April 2007

Differences in neonatal intensive care unit (NICU) environmental stress, uncertainty, and anxiety of 23 mothers and fathers (couples) whose premature infants were hospitalized in an NICU were explored. Alterations in the parental role were found to be stressful for both mothers and fathers, with mothers reporting significantly greater stress in this area than did fathers. Stress and uncertainty decreased significantly over time. Mothers and fathers did not differ in level of anxiety. Findings suggest that both mothers and fathers are distressed by the admission of a premature to an NICU; however, mothers may be more distressed by certain aspects of the experience.
The organizational environments and services of VNAs and hospital‐based home health care agencies
Authors: Burman Mary E.
Published: April 2007

Visiting Nurse Associations (VNAs) and hospital‐based home health care agencies (HBHHAs) were used to explore the impact of organizational environments on agency services. Disproportionate stratified random sampling, based on type and region of agency, was used to select the agencies. Seventy‐three percent (120 HBHHAs and 156 VNAs) responded to the mail survey. Differences were found in the environments of the two types of agencies in funding and referral sources, amount of competition, accreditation by external bodies, and involvement in professional organizations. In terms of services, HBHHAs provided more types of high‐tech services and were more likely to use external arrangements to provide services than VNAs. The organizational environment did have an impact on agency services. Medicare funding and referral sources, as environmental factors, had an impact on agency services.
Patient perceptions of quality of life after coronary artery surgery: Was it worth it?
Authors: King Kathleen B. , Porter Laura A. , Norsen Lisa H. , Reis Harry T.
Published: April 2007

Quality of life and perceptions of the consequences of surgery were examined in 155 individuals having coronary bypass surgery. One year after surgery, subjects believing surgery was worth it because of functional improvement (n = 64) had more positive scores on subjective indicators of life satisfaction and mood than those believing surgery was worth it because it saved them from death (n = 62) or those who were not sure surgery was worth it (n = 23). Differences in perceptions of quality of life between the two groups who believed surgery was worth it are discussed in terms of focus of attention. Individuals who perceive improved functional ability may focus on concrete outcomes of surgery, whereas those who interpret the benefit of surgery in light of the alternative of death may focus their attention on affective aspects of recovery. Findings emphasize the need for using a multidimensional approach to studying quality of life.
Self‐report of indifference and anxiety among persons with right hemisphere stroke
Authors: Williams Anne M.
Published: April 2007

A sample of persons with a single ischemic cerebral stroke was used to elucidate and quantify the indifference associated with right hemisphere stroke. Seven persons with right hemisphere stroke were compared with 10 persons with left hemisphere stroke on two aspects of indifference (social indifference and lack of anxiety). Persons with right hemisphere stroke reported themselves as being substantially less anxious (p = 0.025) and somewhat more socially indifferent (p = 0.081) than did those with left hemisphere stroke. Lack of appropriate anxiety may contribute to the clinical descriptions of indifference, failure to make expected recovery, and difficulty in relationships with others.
An emerging paradigm for the investigation of spirituality in nursing
Authors: Reed Pamela G.
Published: April 2007

A paradigm is presented as a perspective for the investigation of spirituality in nursing. Elements in the paradigm include assumptions about the self‐transcendent nature of human beings as derived from the developmental‐contextual worldview, a description of spirituality in terms of various forms of connectedness integral to human development and health, and assumptions about the empirical and multidimensional nature of spirituality. Extant sources of conceptual, empirical, and clinical knowledge are utilized to support the ideas put forth in the emerging paradigm. It is concluded that the study of spirituality from the perspective of the paradigm would entail examination of the multiple expressions of connectedness intrapersonally, interpersonally, and transpersonally as related to human health and well‐being.