bluuebunny/crossref_metadata_2025 huggingface dataset:
Assessment of discomfort in advanced Alzheimer patients
Authors: Hurley Ann C. , Volicer Beverly J. , Hanrahan Patricia A. , Houde Susan , Volicer Ladislav
Published: April 2007

An objective scale for measuring discomfort in noncommunicative patients with advanced Alzheimer's disease was empirically generated from the perspectives of nursing staff practicing on special care Alzheimer units and was judged to have content validity. On the basis of a pilot test, the discomfort scale was reduced to nine items. Quantifiable scoring procedures and a rater training program were developed. The scale (DS‐DAT) was tested longitudinally for 6 months with 82 subjects at two sites. Psychometric properties, measurement issues, and recommendations for use in practice and research are discussed.
Focus on psychometrics confirmatory factor analysis (CFA) as a method to assess measurement equivalence
Authors: Stommel Manfred , Wang Sping , Given Charles W. , Given Barbara
Published: April 2007

Employing the example of a multidimensional caregiver reaction scale, the use of confirmatory factor analysis techniques to establish measurement equivalence across comparison groups is discussed. The discussion is organized around the key concept of factorial invariance which provides the yardstick for assessing measurement equivalence.
Meta‐analysis of diabetes patient education research: Variations in intervention effects across studies
Authors: Brown Sharon A.
Published: April 2007

Data from a previously reported meta‐analysis of diabetes patient education literature were reanalyzed to determine the influence of study /subject characteristics, such as study quality and age of subjects, on patient outcomes. Patient knowledge and self‐management skills, weight loss, glycosylated hemoglobin levels, and psychological outcomes were analyzed as outcome variables. Seventy‐three relevant published and unpublished studies were located. Patient education appeared to be more effective in younger patients, particularly for the knowledge outcome. For all patients, glycosylated hemoglobin levels improved between 1 and 6 months postintervention, but decreased to 1‐month levels after 6 months. Length of the educational intervention did not appear to influence outcomes. More rigorous, experimental research designs tended to produce more conservative effect size estimates. Implications for diabetes patient education are discussed.
Women's perceptions of cesarean and vaginal delivery: Another look
Authors: Fawcett Jacqueline , Pollio Norma , Tully Ann
Published: April 2007

Perception of the birth experience was examined in a sample of 106 women who had unplanned cesarean deliveries, 113 who had planned cesarean deliveries, and 254 who had vaginal deliveries. Vaginally delivered women had more positive perceptions than their unplanned cesarean counterparts (p < 0.001). There were no differences in perceptions between the unplanned and planned cesarean groups, or between the planned cesarean and vaginal groups. General anesthesia for cesarean delivery was associated with more negative perceptions than regional anesthesia, and regional anesthesia for vaginal delivery was associated with more negative perceptions than no or local anesthesia. Pain intensity and physical distress were negatively correlated with perceptions.
Developing the construct of role integration: A narrative analysis of women clerical workers' daily lives
Authors: Hall Joanne M. , Stevens Patricia E. , Meleis Afaf Ibrahim
Published: April 2007

There is a gap in nurses' knowledge about how women integrate their multiple roles on a daily basis amidst the economic, social, political, and cultural contingencies of their environments. Quantitative results from a triangulated study of work, maternal, and spousal role experiences of 87 women clerical workers from five ethnic/racial groups indicated that role integration was important in predicting health outcomes. This prior work is extended in this article with an in‐depth secondary analysis of the qualitative interview data from the same study to develop a theoretical understanding of the construct of role integration. Using techniques of narrative analysis, a theoretical framework was derived to identify and relate aspects, processes, and patterns of role integration as they are experienced in women's everyday lives. Concepts are identified, defined, and visually represented, propositions are elaborated, and implications for further research and practice are suggested.
Integration of biological and nursing sciences: A 10‐year plan to enhance research and training
Authors: Cowan Marie J. , Heinrich Janet , Lucas Mary , Sigmon Hilary , Hinshaw Ada Sue
Published: April 2007

A proposed multiyear plan of funding mechanisms by the National Center for Nursing Research (NCNR) to increase the use of biological theory and measurements in nursing research has been developed for both research training and research programs. The objectives of the research training programs are (a) to develop a cadre of nurse scientists with solid research training in the biological sciences, (b) to upgrade to state‐of‐the‐art biological research for midcareer nurse scientists, and (c) to ensure adequate highly trained biological‐nurse manpower will be available to accomplish the nation's nursing research agenda. The objectives of the research programs are (a) to stimulate nurse scientists to undertake novel, innovative research using state‐of‐the‐art biological technology, (b) to link the behavioral and biological underpinnings of nursing science in specified areas of biomedical clinical research, and (c) to ensure that, in the coming decade, nursing science and behavioral research will be inextricably interwoven with biological research. The research training programs include: targeted predoctoral‐postdoctoral transitional training, targeted predoctoral or postdoctoral fellowships, training awards for existing institutional training grants in other disciplines, mid‐career awards, the Nurse Scientist award, and institutional training grants for biological nursing. The research programs include: small grants programs, augmentation of existing projects in other Institutes, Requests For Applications (RFA) in biobehavioral nursing, cluster studies, and clinical trials. © 1993 John Wiley & Sons, Inc.
Health consequences of loneliness in adolescents
Authors: Mahon Noreen E. , Yarcheski Adela , Yarcheski Thomas J.
Published: April 2007

The purpose of this study was to test a causal model developed from a theoretical formulation of the health consequences of loneliness in adolescents. The sample consisted of 325 adolescents, ages 12 to 21. Data were obtained in classroom settings on the variables of age, gender, and loneliness on one testing date; and on the variables of introspectiveness, symptom patterns, and perceived health status on another testing date 1 week later. The causal model was tested via the LISREL 7 program. By all indicators used in this study, there was a very good fit of the overidentified model with the data, the causal relationships predicted in the model were correctly specified, and modification of the model was not indicated. The results indicated that loneliness contributed to introspectiveness, that both loneliness and introspectiveness contributed to the reporting of symptom patterns, and that all of the aforementioned variables contributed directly and/or indirectly to a less positive perception of health status among adolescents. A vast majority of the direct and indirect effects of age and gender predicted on other variables in the model were supported. © 1993 John Wiley & Sons, Inc.
Predictors of partner relationships during pregnancy and infancy
Authors: Mercer Ramona T. , Ferketich Sandra L. , Dejoseph Jeanne F.
Published: April 2007

The partner relationship of 153 women hospitalized for a high‐risk pregnancy, 75 of their partners, 218 women who experienced a low‐risk pregnancy and 147 of their partners was studied to determine risk‐status or gender differences at pregnancy, the postpartal hospitalization, 1, 4, and 8 months following birth. A theoretical causal model predicting partner relationships was tested, followed by model respecification to derive the best explanatory model for each group. No differences were observed between low‐ and high‐risk mothers' partner relationship; however, high‐risk fathers scored lower than low‐risk fathers. Partner relationships for all groups were significantly higher during pregnancy and at birth than at 4 and 8 months after birth. Respecified models explained from 26% to 63% of the variance in partner relationship during pregnancy, and from 31% to 52% at 8 months after birth. © 1993 John Wiley & Sons, Inc.
Cerebral palsy: Evaluation of a model of risk
Authors: Polivka Barbara J. , Nickel Jennie T. , Wilkins J. R.
Published: April 2007

The purpose of this study was to assess a model of risk for cerebral palsy (CP) in preschool children. The research was structured as a retrospective case‐control study in which cases (n ‐ 112) were children with CP while controls (n = 153) were either friend referrals or populationbased. Data were collected via structured telephone interviews. While significant associations with CP were found on univariate analyses for a number of variables, only four variables–birth weight/gestational age, 5‐min APGAR, medication for miscarriage, and urinary tract infection during pregnancy–were found predictive in multivariate analysis. These variables accounted for 36% of the log‐likelihood explained by the model. © 1993 John Wiley & Sons, Inc.
The relationship between physical health and psychological well‐being in elderly women: A developmental perspective
Authors: Heidrich Susan M.
Published: April 2007

Little is known about the physical health and psychological well‐being of very old women, although they are one of the fastest growing segments of the population. The relationships among physical health, psychological well‐being, and age were investigated using a developmental perspective and a multidimensional approach to the assessment of psychological wellbeing. Two hundred and forty‐three elderly women completed multiple self‐report measures of physical health status and psychological well‐being. Multiple regression analyses indicated that older age was related to lower levels of purpose in life, personal growth, and positive relationships. Poor health, regardless of age, was associated with more depression and anxiety and lower levels of positive relationships and autonomy. Implications for the nursing care of elderly women are discussed. © 1993 John Wiley & Sons, Inc.
Relationships among selected antecedent variables and coping effectiveness in postmyocardial infarction patients
Authors: Bennett Susan J.
Published: April 2007

Selected theoretical relationships from Lazarus' (1966) model of stress were tested in a convenience sample of 81 postmyocardial infarction clients. Two hypothesized causal models were analyzed. Results from regression analyses indicated 63% of the variance in coping effectiveness was explained by marital status, length of time since hospitalization, perceived availability of social support, uncertainty, degree of threat, coping strategies, and emotions. A revised model that fit the data was proposed. Findings indicated that emotions were an outcome of threat, not coping; threat did not directly affect coping strategies; and coping strategies did not directly influence coping effectiveness. © 1993 John Wiley & Sons, Inc.
Guidelines for using psychometric consultants in nursing studies
Authors: Davis Linda Lindsey , Grant Joan S.
Published: April 2007

Consultation for measurement issues is an increasingly common expectation for many studies, yet there are few published guidelines on the use of psychometric consultants. The role of the psychometrician as research consultant is discussed and questions commonly asked of these measurement experts are identified. Consultation when selecting, revising, and developing data collection instruments is explored. © 1993 John Wiley & Sons, Inc.
Effects of a procedural/belief intervention on breast self‐examination performance
Authors: Champion Victoria , Scott Catherine
Published: April 2007

The purpose of this study was to test the effect of a theoretically based nurse‐delivered intervention on BSE behavior. A 2 × 2 prospective, randomized, factorial design yielded four groups: control, belief intervention, procedural intervention, and procedural/belief intervention. A total of 301 women were randomly selected from a target population. One year following intervention, significant differences in self‐reported proficiency, observer‐rated proficiency, and sensitivity (lump detection) were found between the Procedural and Control Group and the Procedural/Belief and Control Group. Significant increases were found on observer‐rated proficiency and sensitivity for the Procedural/Belief Group when compared to the Belief Group. In addition, a significant increase was found in the Procedural/Belief Group on nodule detection, when compared to the Procedural Group alone. © 1993 John Wiley & Sons, Inc.
Effect of warm and cold applications on the resolution of IV infiltrations
Authors: Hastings‐Tolsma Marie T. , Yucha Carolyn B. , Tompkins Joy , Robson Linda , Szeverenyi Nikolaus
Published: April 2007

Differences in pain intensity, surface area measurements of induration and erythema, and interstitial fluid volume when warm versus cold applications were randomly made to an intentional intravenous infiltrate of 5 mL of a designated solution were examined. Three solutions were used: 0.5 saline (154 mOsm), normal saline (308 mOsm), and 3% saline (1027 mOsm). Differences in volume were determined by magnetic resonance imaging (MRI) at three intervals postinfiltration. The sample was 18 healthy adults between 20 and 45 years. There was no difference in remaining infiltrate when 0.5 saline or normal saline were used, but a significant (p < 0.001) difference was found with 3% saline. For all solutions there was a significant (p < 0.001) difference in the volume of infiltrate remaining when warmth was applied and this effect held across MRI readings and solutions. Pain intensity did not differ by treatment but a significant (p < 0.005) difference was found by solution, with 3% saline producing the greatest difference. Erythema was absent with all solutions. Surface induration was affected by solution and decreased over time (p = 0.001). There was no effect of warmth or cold on surface area induration. © 1993 John Wiley & Sons, Inc.
Themes of loss and dying in caring for a family member with AIDS
Authors: Brown Marie Annette , Powell‐Cope Gail
Published: April 2007

The study purpose was to provide an in‐depth description of experiences associated with loss and dying among AIDS family caregivers. Grounded theory provided the methodological framework for data collection and analysis. In‐depth interviews were conducted with 53 family caregivers of persons with AIDS and included individuals from family of origin and family of choice. Living with loss and dying was identified as a major substantive category and was further explicated in two subcategories: facing loss and transformed time. Common strategies of caregivers included taking one day at a time, living fully in the present, and actualizing future dreams. © 1993 John Wiley & Sons, Inc.
Variables related to caregiver behaviors with cognitively impaired elders in institutional settings
Authors: Burgener Sandy C. , Shimer Rosemary
Published: April 2007

The purpose of this study was to identify variables that might influence the behaviors of institutional caregivers when they interact with institutionalized, cognitively impaired elders. Independent variables included type of care situation, type of institution and nursing unit, and selected characteristics of both the caregiver and elder. The care situation was found to have a significant effect on caregiver behaviors. Caregiver characteristics of knowledge of dementia, experience in working with demented elders, and total years of education were significantly related to several caregiver behaviors. Elder characteristics of years of education, number of diagnoses, time on the nursing unit, age, self‐care ability, and extent of dementia were related to several caregiver behaviors. Caregiver behaviors did not vary by the elder's gender. © 1993 John Wiley & Sons, Inc.
Insufficient milk supply among black and white breast‐feeding mothers
Authors: Hill Pamela D. , Aldag Jean C.
Published: April 2007

The purpose of this study was to investigate whether ethnicity is associated with insufficient milk supply (IMS) among breast‐feeding mothers. A major reason reported by mothers for early termination or introduction of formula and/or solids is insufficient milk. A retrospective survey was conducted among 42 black and 148 white breast‐feeding mothers participating in the WIC program in a midwestern state. The results suggested that: (1) the incidence of IMS was similar for black and white mothers; (2) controlling for education, black mothers initiated breast‐feeding later and stopped sooner; IMS mothers fed less frequently and for shorter periods; and (3) controlling for education, there were no ethnic differences in the determinants or indicators of IMS. © 1993 John Wiley & Sons, Inc.
Caregiving tasks as predictors of mental health of wife caregivers of men with chronic obstructive pulmonary disease
Authors: Cossette Sylvie , Lévesque Louise
Published: April 2007

The type, number, and amount of disturbance generated by caregiving tasks as well as the adequacy of informal social support were examined as predictors of the mental health of 89 wife caregivers of men with chronic obstructive pulmonary disease (COPD). The number of supervision tasks performed was predictive of all the mental health outcomes except one. When disturbance level was examined, giving emotional support in difficult situations was the task category that predicted five of the eight outcomes. Support variables accounted for small amounts of variance of most outcomes. However, caregivers who received respite support when they needed it were actually three times more likely to take psychotropic drugs than those not receiving support. © 1993 John Wiley & Sons, Inc.
The confidence of latina mothers in the care of their low birth weight infants
Authors: Zahr Lina Kurdahi
Published: April 2007

The growing numbers of Latina mothers with low birth weight (LBW) infants in U. S. hospitals prompted an investigation of maternal confidence and caretaking ability in this group. A sample of 54 Mexican‐born, Latina mothers with LBW infants was compared with a group of 25 who had full‐term infants. Unexpectedly, there was no significant difference in the perceived maternal confidence of the two groups. Behaviors indicative of sensitivity and competence in caretaking, assessed in mothers with LBW infants, did not correlate with maternal confidence. Factors correlated with maternal confidence and caretaking behavior were the mother's age, education, and parity, as well as the infant's birthweight, weight at discharge, and medical complications. Weight at discharge correlated with caretaking behaviors. The strongest predictor of maternal confidence was parity, followed by infant health (fewer medical complications). These factors together accounted for 25% of the variance in confidence, suggesting that other factors that contribute to maternal confidence of Latina mothers need to be identified. © 1993 John Wiley & Sons, Inc.
Factors influencing home care nursing problems and nursing care
Authors: Helberg June L.
Published: April 2007

This study was conducted to determine the contributions of sociodemographic factors, medical conditions, and nursing dependency to nursing problems identified and nursing care provided to patients during a home care nursing visit. Patient interviews, direct observation of nursing care, record abstraction, and nurses' reports were used to obtain data from 438 patients receiving nursing visits from a certified home health agency. Nursing dependency was the strongest predictor of the nursing problems of and nursing care provided to home care patients. Measures of nursing dependency should be incorporated in models to determine the extent of nursing problems and nursing care provided in the home and in models of home care nursing reimbursement. © 1993 John Wiley & Sons, Inc.
Maternal–fetal attachment: Influence of mother–daughter and husband–wife relationships
Authors: Zachariah Rachel
Published: April 2007

Intergenerational attachment relationships between the pregnant woman and her mother, her husband, and her fetus were examined. Self‐completed instruments were used to measure the attachment variables for a convenience sample of 115 middle‐class mothers who attended urban prenatal classes. Results supported the hypothesis that mother–daughter and husband–wife attachment were correlated positively. Contrary to study predictions, maternal–fetal attachment scores were not related to mother–daughter and husband–wife attachment scores. Maternal–fetal attachment was related to length of gestation. Results provide only partial support for the intergenerational model of attachment relationships.
Psychometric properties of the driving practices questionnaire: Assessment of risky driving
Authors: Kidd Pamela , Huddleston Sandra
Published: April 2007

A national public health goal is to reduce injuries and deaths from motor vehicle crashes (MVC). The development and psychometric evaluation of the 10‐item Driving Practices Questionnaire (DPQ) to measure risky driving is described. Based on responses from 297 drivers divided into safe, unsafe, and injured groups, the DPQ was evaluated using item and factor analysis, and reliability and validity measures. Principal axis factor analysis isolated one factor with 42.3% of the variance explained. The alpha coefficient for the scale was .87 and test–retest correlation was .94. High DPQ scorers were three times more likely to have prior traffic violations. The identification of driver subtypes will assist the testing of injury prevention interventions.
Retaining army nurses: A longitudinal model
Authors: Kocher Kathryn M. , Thomas George W.
Published: April 2007

A longitudinal sample of active duty Army nurses working in a broad range of nursing specialties and settings was analyzed for retention behavior. A turnover model of actual retention behavior, estimated using logistic regression, included external market, personal/demographic, and work‐related variables as explanatory factors. Satisfaction with work and military life, satisfaction with location/assignment stability, race–ethnic group, and family status had significant effects on the retention of Army junior nurse‐officers.
Focus on psychometrics use of health records in research: Reliability and validity issues
Authors: Aaronson Lauren S. , Burman Mary E.
Published: April 2007

Data extracted from health records are commonly used in studies to address a variety of questions raised by health researchers. However, concern about the reliability and validity of such data generally is limited to an assessment of interrater reliability. Less attention has been paid to the reliability of the health record itself, and to the validity of both the health record and the data extracted from it. This article reviews the distinctions and overlaps among these types of reliability and validity and the factors that influence the validity and reliability of research data obtained from health records. Recommendations to investigators who use health record data in their research projects are offered.
Living with mental illness: Effects of professional support and personal control on caregiver burden
Authors: Reinhard Susan C.
Published: April 2007

Families of mentally ill persons often report feeling burdened, helpless, and ignored by mental health professionals. The purpose of this study was to examine relationships among professional support, caregivers' personal sense of control, and burden. Ninety‐four caregivers rated support received in 11 areas, perceptions of control, and objective and subjective burdens. General well‐being measures included a depression scale (CES–D) and self‐reported physical health. Controlling for the relative's disruptive behaviors and selected caregiver characteristics, hierarchical multiple regression analyses demonstrated that professional support selectively reduced burden. Practical advice on managing disruptive behaviors reduced objective burden (adjusted R2 = .16, p < .001; R2 increment = .04, p < .05), in part by enhancing personal control.
Alternate oucher form testing: Gender, ethnicity, and age variations
Authors: Jordan‐Marsh Maryalice , Yoder Laurie , Hall Deon , Watson Robin
Published: April 2007

This study was part of a project to improve pain assessment and management for a multiethnic group of children. Based on its visual appeal for the clinical team, the Oucher was selected for trial. A reduced size and shortened screening technique were introduced. Children (N = 79) aged 3 to 12 years were randomly assigned to use the original or a reduced‐size Oucher first. Scale scores were highly correlated regardless of size or presentation order. There were no differences attributable to age, gender, or ethnicity (Black, White, Hispanic). There is preliminary support for using the more convenient size and screening process.
Validity and reliability testing of the prenatal psychosocial profile
Authors: Curry Mary Ann , Campbell Ruth Ann , Christian Megan
Published: April 2007

Two studies of low‐income pregnant women (N = 179) were done to examine the validity and reliability of the Prenatal Psychosocial Profile (PPP). The PPP, a composite of the Rosenberg Self‐Esteem Scale, the Support Behaviors Inventory, and a newly developed measure of stress, is a brief, comprehensive clinical assessment of psychosocial risk during pregnancy. Construct validity of the stress scale was supported by theoretically predicted negative correlations with self‐esteem, partner support, and support from others (N = 91). Convergent validity of the stress scale was demonstrated by a correlation of .71 with the Difficult Life Circumstances Scale. Adequate levels of internal consistency were found. Interrelationships between the four sub‐scales were consistent with the underlying conceptualization, and there was beginning evidence of the factorial independence of the subscales.
Psychometric properties of two instruments to measure quality decision making
Authors: Hollen Patricia J.
Published: April 2007

The results of testing two instruments for consequential decision making are reported: a screening instrument, the Decision Making Quality Scale (DMQS), which assesses the degree to which a person adheres to seven quality criteria of decision making; and a diagnostic measure, the Decision Making Quality Inventory (DMQI), which assesses an individual's dominant decision‐making style through six sequential stages of the process. The instruments are conceptually linked through the same theoretical framework, the Janis and Mann (1977) conflict model of decision making, as well as operationally linked as counterpart instruments. Feasibility of the instruments was demonstrated with low readability indexes, reasonable administration times, and respondent acceptability by six samples (N = 766). Content validity was supported by panels of experts in decision theory. Reliability coefficients were consistently high (>.70) for all samples. Support for construct validity was obtained using the contrasted groups approach and relationship testing. The instruments are ready for research and clinical use with healthy adolescents and their parents, as well as with adolescents and young adults who have experienced a chronic illness such as cancer and with their parents.
Epilepsy self‐management: Partial replication and extension
Authors: Dilorio Colleen , Faherty Barbara
Published: April 2007

The purpose of this study was to determine the association between selected social cognitive variables and self‐management behaviors among a sample of adults with epilepsy. The study, based on Social Cognitive Theory, was a partial replication and extension of a previous study that explored the role of self‐efficacy and social support in epilepsy self‐management. The variables examined in the present study were self‐efficacy, social support, regimen‐specific support, self‐esteem, and self‐management. Data collected from 80 adults attending an epilepsy clinic were analyzed using correlation and regression procedures. Statistically significant relationships were found between self‐efficacy and self‐management and between regimen‐specific support and self‐management. Regression analyses revealed that self‐efficacy and regimen‐specific support made significant contributions to the variance in self‐management, whereas social support and self‐esteem did not.
Early outcomes after hip fracture among women discharged home and to nursing homes
Authors: Williams Margaret A. , Oberst Marilyn T. , Bjorklund Barry C.
Published: April 2007

In a prospective design, early outcomes after hip fracture were compared in three groups of formerly community‐living women: those discharged home from the hospital (n = 58), those discharged to a nursing home (NH) and staying there ≤ 1 month (n = 23), and those staying > 1 month (n = 39). Data were collected on mobility and mood states prior to hospital discharge and at 2,8, and 14 weeks. Overall recovery ratings were obtained at the latter three times; readiness for discharge from hospital and nursing home also was examined. The short‐stay group did as well in regaining mobility as the home‐discharge group and both rated their overall recovery similarly. Affective mood distress was associated with discharge destination site. The short‐stay NH group had a greater proportionate lack of designated caregivers than either of the other two groups. Research is needed to identify features of nursing homes as well as characteristics of patients that contribute to positive outcomes in the large number of hip fracture patients currently discharged to these institutions.
A comparative analysis of coping behaviors in persons with multiple sclerosis or a spinal cord injury
Authors: Wineman N. Margaret , Durand Ellen J. , Steiner Richard P.
Published: April 2007

Coping behaviors in individuals with multiple sclerosis (MS) or a spinal cord injury (SCI) were compared. Data were collected on 433 subjects with MS and 257 with SCI. Coping and illness uncertainty were measured by the Ways of Coping Checklist (revised) and the Mishel Uncertainty in Illness Scale. Results of the multivariate analysis of covariance indicated that there was no significant difference between the groups for the use of emotion‐focused coping (EFC) or problem‐focused coping (PFC). However, there was a significant difference in coping depending on illness uncertainty and the appraisal of life with a disability. Subjects used more EFC at high uncertainty and more PFC at no uncertainty compared to the other levels. When situations were appraised as dangerous, EFC was used more often, and when situations were appraised as an opportunity, PFC was used. The construct of vulnerability emerged as an important antecedent variable. When vulnerability was not included in the analysis, a spurious difference in EFC was found between the groups. Multiple regression results indicated that, for both groups, the choice of coping strategies had no significant effect in explaining emotional well‐being while controlling for selected sociodemographic and disability‐related variables.
A longitudinal model of maternal self‐efficacy, depression, and difficult temperament during toddlerhood
Authors: Gross Deborah , Conrad Barbara , Fogg Louis , Wothke Werner
Published: April 2007

The purpose of this study was to test a model of maternal self‐efficacy during toddlerhood using a longitudinal sequential design. Participants were 126 mothers of 1‐year olds (Cohort 1) and 126 mothers of 2‐year olds (Cohort 2) who completed questionnaires measuring maternal self‐efficacy, depression, and perceived difficult toddler temperament three times over 1 year. Data were analyzed using structural equation modeling and maximum likelihood estimation. Findings support a model whereby (a) the more depressed the mother feels, the more likely she is to rate her toddler's temperament as difficult, (b) the more difficult the child's temperament is perceived to be, the lower the mother's estimates of her parenting self‐efficacy, (c) the lower the mother's self‐efficacy, the greater her depression, and (d) the more depressed the mother feels at one point in time, the more likely she is to remain depressed 6 months later. Implications of the findings are discussed as they relate to self‐efficacy theory and nursing intervention with parents of difficult toddlers.
Protective strategies of lesbian clients in health care environments
Authors: Stevens Patricia E.
Published: April 2007

In this triangulated, feminist narrative study, a multiethnic, socioeconomically diverse sample of 45 lesbians recounted their actions in health care in a total of 332 health care stories. Findings of a multistaged narrative analysis suggest that lesbians experience compounded vulnerability in health care environments. A repertoire of protective strategies intended to meet needs for safety characterized their actions in health care, including: rallying support, screening providers, seeking mirrors of one's experience, maintaining vigilance, controlling information, bringing a witness, challenging mistreatment, and escaping danger. Implications for theory and practice are drawn from these results.
Focus on psychometrics. A controversy in scaling of subjective states: Magnitude estimation versus category rating methods
Authors: Wills Celia E. , Moore Colleen F.
Published: April 2007

Measurement issues surrounding the quantification of subjective states such as sensations and attitudes have received increasing attention in nursing in recent years. It has sometimes been argued that magnitude estimation (ME) procedures are superior to category rating (CR) methods for scaling of subjective states which require judgments of intensity or strength of perception. A critique of the two scaling methods is presented. In contrast to arguments first proposed by Stevens and others for the superiority of ME procedures and the ability to attain “direct” ratio level measurement with ME scaling, there is evidence to suggest that ME procedures do not in fact produce ratio level scales. The “characteristic” exponents associated with ME scaling are not necessarily intrinsic to particular subjective states. CR scales neither necessarily constrain nor lack the requisite sensitivity needed to produce valid responses. It is concluded that ME is not necessarily superior to the commonly used CR method for scaling of subjective states in nursing research. Implications of the controversy for selection of scaling methods for nursing research are discussed. Greater attention to the ordinal or rank‐order properties of data is encouraged. A small set of data is used to illustrate the importance of rank order properties in scaling subjective states in nursing.
The impact of posthospital home care on patients with cancer
Authors: McCorkle Ruth , Jepson Christopher , Malone Dolores , Buhler‐Wilkerson Karen , Lusk Edward , Braitman Leonard , Daly John
Published: April 2007

Symptom distress, mental health status, enforced social dependency and health perceptions were measured in two groups of cancer patients, one receiving home care services (n = 49) and the other receiving no such services (n = 11). Data were obtained at hospital discharge and 3 months later. Patients receiving home care demonstrated statistically significant improvement on mental health and social dependency; patients not receiving home care did not improve on any variable. After controlling for baseline scores, the home care group had significantly higher mental health status at the second interview than the no home care group.
Gender, relationships, and crack cocaine: A content analysis
Authors: Henderson Dorothy J. , Boyd Carol , Mieczkowski Thomas
Published: April 2007

Past research has indicated gender differences among narcotic users that have implications for the prevention and treatment of substance abuse; however, little is known about these differences among crack cocaine users. The purpose of this secondary analysis was to compare the relational context of male and female crack cocaine use. Data from open‐ended, structured interviews with 46 predominantly African–American women (n = 23) and men (n = 23) were compared using manifest content analysis. Women were more likely to begin, use and/or maintain their use of crack in the context of more intimate opposite sex relationships, while men were more likely to begin their use with male friends and associates and to maintain drug use with income from jobs and selling drugs. Overall, relationships (both sexual and familial) were a more prominent aspect of crack use for women while entrepreneurship was more salient for men. These findings suggest the need for gender‐sensitive prevention and treatment strategies.
Depressive symptomatology and smoking among persons with diabetes
Authors: Haire‐Joshu Debra , Heady Susan , Thomas Leela , Schechtman Kenneth , Fisher Edwin B.
Published: April 2007

The purpose of this study was to determine whether (a) symptoms of depression are more prevalent and severe among diabetic smokers than diabetic nonsmokers, (b) smoking is related to depressive symptomatology among diabetic patients, and (c) there is a positive relationship between number of cigarettes smoked and severity of depressive symptoms. Diabetic non‐smokers (n = 103) and diabetic smokers (n = 83) were surveyed regarding symptoms of depression as measured by the Beck Depression Inventory (BDI). Depressive symptomatology was more prevalent and severe among smokers than nonsmokers. Smoking was significantly associated with depressive symptomatology. Among smokers, the number of cigarettes smoked per day was independently associated with cognitive symptoms of depression.
Mode of acquiring aids and nurses' intention to provide care
Authors: Cole Frank L. , Slocumb Elaine M.
Published: April 2007

The intention of 322 staff nurses to provide care to male patients who acquired AIDS either through sexual activity with males, sexual activity with females, sharing needles, or a blood transfusion was examined. For each mode of acquiring AIDS, respondents indicated their intent to perform 11 care‐giving behaviors, whether they were comfortable performing the behaviors, and if they felt in danger by performing the behaviors. No statistically significant differences related to mode of acquiring AIDS were found in nurses' intention to provide care. Comfort was the only significant predictor of intent to provide care.
Focus on qualitative methods. Notes on Transcription
Authors: Sandelowski Margarete
Published: April 2007

The ontology of the transcript is both realist and constructed. There is a theory and ethic implicit in the transcription process. Transcripts are accurate and useful to the extent that the researcher understands their constructed reality, the need to be selective concerning what about the interview event must be preserved, the potential uses for transcripts that will influence the selection process, and the need for a consistent notation system.
The interaction effects of gender within the health promotion model
Authors: Ratner Pamela A. , Bottorff Joan L. , Johnson Joy L. , Hayduk Leslie A.
Published: April 2007

A male‐female stacked version of Pender's Health Promotion Model (HPM) was used to evaluate whether the causal mechanisms underlying health promotion behaviors are the same for men and women. Indicators of the conceptual variables in the HPM were obtained from the National Survey of Personal Health Practices and Consequences, 1979–1980–a telephone sample survey of 3,025 noninstitutionalized adults. All coefficients to be estimated were initially constrained to be equal for men and women, except for six direct effects originating from marital status. The estimates obtained via the LISREL VI program indicated that the stacked model did not fit the data and that additional gender interactions were required between gender and other concepts within the HPM. Based on model diagnostics and with the relaxation of some equality constraints, a modified stacked model was constructed that fit the data. The explanatory power of the model was poor, calling into question the validity of the HPM. Theorists and researchers of health promotion should not assume that the causal mechanisms underlying health promotion behaviors in men and women are identical, but must forge ahead with an exploration and clarification of possible differences.
Cancer stressors and protective factors: Predictors of stress experienced during treatment for childhood cancer
Authors: Hockenberry‐Eaton Marilyn , Kemp Virginia , Dilorio Colleen
Published: April 2007

Perceptions of cancer stressors and protective factors as predictors of stress experienced during treatment for childhood cancer were assessed in this study. Cancer stressors were the type of treatment received during two clinic visits and the child's perception of the cancer experience. Protective factors were self‐perception, coping strategies, perceived social support, and family environment. The child's responses to stressors were assessed by epinephrine, norepinephrine, and cortisol levels of urine, and measures of state anxiety. Forty‐four children between 6 1/2 and 13 1/2 years of age receiving treatment for cancer were evaluated during two clinic visits. Epinephrine was elevated for children during both clinic visits, while norepinephrine and cortisol remained normal. Stepwise multiple regression analyses revealed that the family environment and global self‐worth were the best predictors of epinephrine levels, while social support from friends predicted norepinephrine levels. The family environment and social support from teachers predicted state anxiety.
The effect of psychological stress on neutrophil superoxide release
Authors: Kang Duck‐Hee , McCarthy Donna O.
Published: April 2007

Stress has long been suggested to exacerbate symptom expression in people with chronic inflammatory disorders. The release of oxidative metabolites from activated PMN plays a significant role in the pathophysiology of inflammation. Thus, we examined the effects of psychological stress on release of superoxide anions from PMN of rats with or without an inflammation induced by injection of shellfish glycogen (SFG). Psychological stress was found to significantly increase PMN superoxide release in both healthy and SFG‐injected animals. Total amounts of superoxide release were similar between the two groups, suggesting that PMN from animals with a mild inflammatory condition were not more susceptible to the effects of stress than PMN from healthy animals. However, this study should be repeated using an animal model of chronic inflammation, such as airway hyperactivity or rheumatoid arthritis.
The relation of cortisol reactivity and anxiety to perinatal outcome in primiparous adolescents
Authors: McCool William F. , Dorn Lorah D. , Susman Elizabeth J.
Published: April 2007

The relation of cortisol reactivity and self‐report anxiety to perinatal outcomes was examined in a sample of 38 primiparous adolescents. Maternal cortisol and anxiety levels obtained in the first half of pregnancy and in mid‐third trimester were found to be related to the gestational age of newborns, with higher levels of cortisol and/or anxiety predicting greater chance of pre‐ or postmature birth. However, when measured over time, a greater increase in cortisol levels was more predictive of positive perinatal outcomes, such as no meconium in labor. These findings suggest that certain levels of maternal reactivity/anxiety are necessary for positive perinatal outcomes.
Care‐seeking behavior with breast cancer symptoms in caucasian and african‐american women
Authors: Lauver Diane
Published: April 2007

Based on a theory of care seeking, the influences of psychosocial variables (anxiety, utility beliefs, norm, and habit) and facilitators (e.g., an identified practitioner) on care‐seeking behavior with a breast cancer symptom were examined. Also, the influences of variables not identified by the theory (e.g., optimism and race) on care‐seeking behavior were examined. Participants were Caucasian (n = 64) and African‐American women (n = 71) with breast symptoms. Care seeking was measured by the days between symptom detection and contact with the health system. Habit was associated with promptness, utility beliefs were associated with delay, and anxiety interacted with having an identified practitioner to explain care seeking. Optimism and having a friend with a breast symptom also were associated with promptness. Race had neither direct nor interactive effects on care seeking.
The relationship of emotional and tangible support to psychological well‐being among older women with heart failure
Authors: Friedman Maureen M. , King Kathleen B.
Published: April 2007

The purpose of this study was to determine the relationship between social support, symptom severity, and psychological well‐being in older women with heart failure. In‐home interviews were conducted with 80 older women following a hospital admission for heart failure. Subjects were asked their perceptions of emotional and tangible support received, symptom severity, and psychological well‐being. Greater emotional support was related to greater positive affect and satisfaction with life. Greater tangible support was related to less negative affect. Neither emotional nor tangible support buffered symptom severity. The results indicate that emotional and tangible support may each affect different aspects of psychological well‐being in older women with heart failure.
Predictive validity of the braden scale for pressure sore risk in a nursing home population
Authors: Braden Barbara J. , Bergstrom Nancy
Published: April 2007

The predictive validity of the Braden Scale and the timing of assessment for optimal prediction of pressure sore development (PS) were studied in a nursing home population. Subjects (N = 102) over age 19, free of PS and admitted within the previous 72 hr, were randomly selected from consecutive admissions to a skilled nursing facility. Subjects were assessed for risk and skin condition every 48 to 72 hr for 4 weeks. Twenty‐eight subjects (27.5%) developed a PS. A cut score of 18 used at the observation prior to the first recorded PS maximized prediction, producing a sensitivity of 79%, a specificity of 74%, a 54% predictive value of a positive test, 90% predictive value of a negative test, and 75% correct classification rate.
Light, social zeitgebers, and the sleep–wake cycle in the entrainment of human circadian rhythms
Authors: Elmore Shawn K. , Betrus Patricia A. , Burr Robert
Published: April 2007

The availability of sufficient zeitgebers is essential for entrainment of circadian rhythms. Bright light is an important human zeitgeber. However, social cues acting through the sleep–wake cycle may also be important in the entrainment of human rhythms. Current research suggests that humans receive inadequate and sporadic exposure to bright light. Social cues, although less powerful, may be an important form of entrainment for contemporary humans, and also serve to augment the effects of available bright light. Both light and social zeitgebers should be investigated for their roles in the genesis, prevention, and treatment of alterations in health.