bluuebunny/crossref_metadata_2025_split huggingface dataset:
Native American Graduate Nursing Students' Learning Experiences
Authors: Dickerson Suzanne Steffan , Neary Mary Anne , Hyche‐Johnson Marilyn 
Published: April 2004

Purpose: To identify learning experiences of Native American graduate nursing students in a university‐based nurse practitioner program.Design: The phenomenological approach of Heideggerian hermeneutics.Method: A purposive sample of 11 Native American graduate students in a nurse practitioner program were given the choice of participating in a focus group or completing an individual interview to elicit common meanings and shared experiences.Findings: Four themes and two constitutive patterns: (a) Native American students' worldviews reflected unwritten knowledge that served as a background of common understanding, (b) academic environment as a rigid environment with only one way to learn and constant evaluation, (c) faculty‐student relationship barriers to establishing a supportive learning environment, and (d) strategies to survive, including a commitment to succeed, conforming to unwritten rules, helping each other, and ultimately changing themselves. Constitutive patterns were: (a) value conflicts when students' values conflicted with academic behavioral values, and (b) on the fringe, when students felt isolation from the main student body, and open to attack (evaluation). Students struggled to be successful in their commitment to complete the degree, but often questioned the applicability of the program in their cultural setting.Conclusions: A more flexible supportive environment is needed to support students' goals to attain degrees, as well as to encourage dialogue on differing cultural values. Faculty who teach culturally diverse students may need to examine rigid behavioral standards that mandate an assertive practitioner persona and may be a barrier to attainment of goals.
An Instrument to Measure Professional Nursing Values
Authors: Weis Darlene , Schank Mary Jane 
Published: April 2004

Purpose: To describe the Nursing Professional Values Scale (NPVS), its development, reliability and validity, and its derivation from the Code of Ethics of the American Nurses Association.Design: The NPVS was tested on 599 subjects, including baccalaureate and masters' students and practicing nurses. The students were enrolled in one of 25 programs selected at random from all NLN accredited programs in the United States. Practicing nurses were randomly selected from a State Board of Nursing list.Method: A 44‐item, norm‐referenced instrument with a Likert‐scale format was tested. The responses of participants to this instrument were subjected to principal axis factor analysis with varimax rotation.Findings: Eight factors were identified, accounting for 58% of the total variance. The two major factors were Caregiving and Activism.Conclusions: Initial results showed a high level of reliability and validity for the NPVS. The NPVS is a useful instrument for measuring professional nursing values and enhancing professional socialization.
Documentation of Health Risks and Health Promotion Counseling by Emergency Department Nurse Practitioners and Physicians
Authors: Sheahan Sharon L. 
Published: April 2004

Purpose: The purpose of this study was to examine medical record documentation of health risk factors and health promotion discharge counseling by nurse practitioners and physicians practicing in an emergency department in the U.S. midwest.Methods: In this two‐group comparative study researchers examined random‐stratified medical records 305 nonacute ambulatory patients for selected health risk factors, including smoking, alcohol use, elevated blood pressure, obesity, and dental caries.Results: Fifty‐nine percent of this sample of relatively young adults (mean age = 33) had one or more health‐risk factors. According to medical record documentation, only 22% of these adults, with nonacute problems, received health promotion counseling. Multivariate analyses indicated that nurse practitioners were slightly more likely to provide smoking cessation counseling than were physicians.Conclusions: Many opportunities for identification of health risks and follow‐up counseling, as recommended in Healthy People 2000 and by the U.S. Preventive Services Task Force, were not documented. To meet the new goals of Healthy People 2010, health care providers in all settings should identify health risk factors and document health promotion counseling during every patient encounter.
American Nursing Scholars Abroad, 1985–1995
Authors: Lash Ayhan Aytekin , Lusk Brigid , Nelson Madelyn A. 
Published: April 2004

Purpose: To explore the international activities of American nursing scholars from 1985 to 1995, as indicated by their international teaching, scholarship, and consultation.Methods: All faculty (N = 2,254) teaching in nursing doctoral programs in the United States were surveyed using an investigator‐designed questionnaire. The professional characteristics of American nursing scholars who worked abroad and the dates, nature, and types of international activities they undertook were ascertained. From a total of 928 usable returns, 247 described international activity.Findings: Data indicated a three‐fold increase in international activity from 1985 to 1995 in the three major areas investigated. Universities in Western Europe and Asia were the most frequent recipients of nursing scholarly activity. The scholars or representatives of the host institutions made approximately half the initial contacts. The international hosts or U.S. universities were the predominant providers of funding. Nurses most likely to participate in international scholarly activity were senior faculty who were full professors in doctoralgranting institutions, published in international journals, presented educational topics, and were recognized by peers through membership in honorary organizations.Conclusions: A substantial increase in international nursing scholarship occurred during the decade studied, particularly related to teaching.
The Shifting Perspectives Model of Chronic Illness
Authors: Paterson Barbara L. 
Published: April 2004

Purpose: To present the Shifting Perspectives Model of Chronic Illness, which was derived from a metasynthesis of 292 qualitative research studies.Design: The model was derived from a metasynthesis of qualitative research about the reported experiences of adults with a chronic illness. The 292 primary research studies included a variety of interpretive research methods and were conducted by researchers from numerous countries and disciplines.Methods: Metastudy, a metasynthesis method developed by the author in collaboration with six other researchers consisted of three analytic components (meta‐data‐analysis, metamethod, and metatheory), followed by a synthesis component in which new knowledge about the phenomenon was generated from the findings.Findings: Many of the assumptions that underlie previous models, such as a single, linear trajectory of living with a chronic disease, were challenged. The Shifting Perspectives Model indicated that living with chronic illness was an ongoing and continually shifting process in which an illness‐in‐the‐foreground or wellness‐in‐the‐foreground perspective has specific functions in the person's world.Conclusions: The Shifting Perspectives Model helps users provide an explanation of chronically ill persons' variations in their attention to symptoms over time, sometimes in ways that seem ill‐advised or even harmful to their health. The model also indicates direction to health professionals about supporting people with chronic illness.
Purpose in Life and Depressive Symptoms in Persons Living with HIV Disease
Authors: Lyon Debra E. , Younger Janet B. 
Published: April 2004

Purpose: To examine relationships among purpose in life, HIV disease severity, demographic variables, and depressive symptoms in people living with HIV disease (PLWHIV). The hypothesis tested was that purpose in life is a stronger predictor of depressive symptoms than is HIV disease severity.Design: Descriptive, correlational study using a convenience sample of 123 PLWHIV recruited from an urban infectious disease clinic in a university teaching hospital in the Southeast United States.Methods: A self‐administered questionnaire, including a sociodemographic tool, the Center for Epidemiologic Studies Depression Scale (CES‐D), and the Purpose in Life Scale (PIL), was used to collect data. Concurrent severity of HIV disease measures included HIV RNA viral load, CD4+ T‐lymphocyte count, and the Revised HIV Medical Symptom Scale. Analytical methods included descriptive and inferential statistics and hierarchical regression analysis.Findings: Depressive symptoms were greater and purpose in life was lower than in normative samples. Purpose in life was a stronger predictor of depressive symptoms than was HIV disease severity.Conclusions: Purpose in life was more important than were laboratory markers of disease progression for predicting depressive co‐morbidity. Results from this study indicate the need for routine assessment of depressive symptoms in PLWHIV. Purpose in life should be explored as a potential buffer for depressive symptoms.
Ability of Blind People to Detect Obstacles in Unfamiliar Environments
Authors: Kells Karolyn 
Published: April 2004

Purpose: To describe obstacle detection, sometimes called face vision, and blind peoples' lived experiences.Design: This Husserlian phenomenologic inquiry included a convenience sample of eight blind participants who possessed the ability to detect obstacles in unfamiliar environments.Methods: Face‐to‐face conversations were audiotaped in a setting of the participant's choice.Findings: Three themes were identified: “a sense that something is there,”“sensing,” and “space.” These three entwined themes were recognized in the unity‐of‐meaning or uniting theme: sensing presence as open or closed space.Conclusions: The findings of this study indicate many questions for nurses. Given the synergistic recognition of obstacles that the participants described, secondary analysis of the data is indicated, for example regarding pattern recognition and human environmental field integrality.
Youth Access to Tobacco in Two Communities
Authors: Teall Alice M. , Graham Margaret Clark 
Published: April 2004

Purpose: To describe the availability of tobacco to youth in two urban communities, as a basis for designing a community‐based intervention program.Design: Two Midwestern U.S. urban communities were the setting for unannounced tobacco compliance checks. The population of retailers for this study included all convenience stores, grocery stores, pharmacies, and discount stores licensed by the state to sell tobacco products in the two communities. Establishments where entry is restricted to adults were not included. The total population of retailers was used as the sample, and two purchases were attempted at each retail outlet.Methods: Cigarette purchases by female teens and the location of cigarettes in stores were documented. Compliance‐check procedures were planned with needed protections for retailers and youth.Findings: Adolescent tobacco purchase rates were near the federal recommendations for the two urban communities. Retailer use of self‐service displays was higher than expected. Availability of the designated brand for self‐service was significantly associated with the purchase rate of tobacco by underage youth.Conclusions: Self‐service displays provide increased availability of tobacco to teens. Teen smoking and youth access to tobacco could be limited by legislation and policies to restrict retailer use of self‐service displays.
Adjustment to Chronic Illness Among HIV‐Infected Women
Authors: Bova Carol 
Published: April 2004

Purpose: To identify factors that influence adjustment to chronic illness among HIV‐infected women, using the cognitive appraisal model of stress and coping.Design: Cross‐sectional descriptive survey of 101 HIV‐infected women living in the Northeastern United States, from December 1996 to December 1997.Methods: During face‐to‐face interviews, the Meaning of Illness Questionnaire, Duke UNC Functional Social Support Questionnaire, HIV Symptom Experience Inventory and Medical Outcomes Study (MOS) Short Form Survey were used to measure appraisal of illness, social support, HIV symptom severity and adjustment to chronic illness. Hierarchical linear regression, path analysis, and procedures to test for mediation were performed.Findings: The model variables explained 70% of the variance in adjustment to chronic illness. Symptom experience accounted for the greatest percentage of variance in adjustment (28%). Two of the three predicted relationships were supported as hypothesized: adjustment to chronic illness was directly influenced by appraisal of illness and by HIV‐symptom experience. Social support was not found to have a direct effect on adjustment. Instead, appraisal of illness mediated the effect of social support on adjustment and symptom experience. HIV illness stage was not a significant predictor of adjustment.Conclusions: The cognitive appraisal model of stress and coping was useful for building knowledge on adjustment to chronic illness among HIV infected women. Interventions aimed at reframing negative appraisals have the potential to affect adjustment.
Emotional Disorders in Young Offenders
Authors: Shelton Deborah 
Published: April 2004

Problem: To estimate rates of emotional disorder in the Maryland Juvenile Justice system as a guide for planning and policy efforts.Methods: In this cross‐sectional study, psychopathology and level of functioning in a random sample of 312 committed and detained youth (60 females, 252 males) were assessed. Youth diagnostically classified met criteria for mental disorder using the Diagnostic Interview Schedule for Children (DISC) combined with a cut‐off score (60 or below) on the Child Global Assessment Scale (CGAS), as established by the National Institute of Mental Health (NIMH).Findings: Fifty‐three percent were classified with diagnosable mental disorders on the DISC, but were above the cut‐off scores on the CGAS. Forty‐six percent met criteria for diagnosis and low functioning. Twenty‐six percent of youth indicated need for immediate mental health services. Fourteen percent with serious mental disorders and substantial functional impairment were in need of a highly restrictive environment as determined by the severity of their offenses.Conclusions: The number of youth in the Maryland Juvenile Justice System in need of mental health services indicates a need to examine treatment options that meet the requirements for security and treatment. The complexity of problems found in this sample indicates the need for collaborative efforts between mental health and juvenile justice personnel in planning for the immediate and future needs of these youth.
The Development and Psychometric Evaluation of the Ethical Issues Scale
Authors: Fry Sara T. , Duffy Mary E. 
Published: April 2004

Purpose: To describe the Ethical Issues Scale (EIS), its conceptual development and psychometric evaluation, and its uses in determining how frequently nurses experience ethical issues in practice.Design: The EIS was validated with a sample (N=2,090) of New England registered nurses (RNs) currently in practice. The sample was randomly split into two approximately equal samples. The calibration sample was used to derive the underlying components; the validation sample was used to confirm the component structure.Methods: Psychometric analysis of the 35‐item EIS included: (a) item analysis, (b) confirmatory principal components analysis (PCA), and (c) internal consistency reliability using Cronbach's alpha.Results: Three components (end‐of‐life‐treatment issues, patient care issues, and human rights issues) were demonstrated, confirming the original conceptually‐derived structure. The calibration sample accounted for 42.4% of initially extracted common variance; the validation sample accounted for 41.5% of initially extracted common variance.Conclusions: The three EIS subscales had satisfactory internal consistency reliability and factorial validity for use as independent scales in future studies.
Acknowledging Unexplained Fatigue of Tired Women
Authors: Dzurec Laura Cox , Hoover Phyllis M. , Fields Jonathan 
Published: April 2004

Purpose: To investigate indicators of fatigue, including depression, sense of powerlessness, and body aches, and to examine differences between symptomatic and asymptomatic women.Design: Descriptive, comparative analysis.Methods: Investigators evaluated fatigue, depression, sense of powerlessness, and body aches for two groups of women in a small, rural community. Participants in one group (n=20) reported subjective experiences of fatigue and the other group (n=20) did not. No participant had a recognizable disease or physiologic alteration that would account for her fatigue. Symptoms in groups were compared using t tests with Bonferroni adjustment.Results: Although the asymptomatic group members were younger, the groups did not differ in ethnicity, mean weight, number of medications taken, or normality of laboratory values. Women who reported feeling fatigued also had significantly higher scores on the depression and fatigue subscales of the fatigue instrument and significantly lower scores on the power instrument. For participants reporting fatigue, fatigue correlated with depression and depression negatively correlated with sense of power. Data did not indicate how fatigue and depression, or depression and sense of power, are interrelated.Conclusions: Findings provide support for the importance of acknowledging fatigued women's often readily dismissed complaints not only of fatigue, but of depression and sense of powerlessness, and for conducting further research regarding these complaints in women with no objective indicators of fatigue.
A Patient‐Derived Perspective of Health‐Related Quality of Life With Peripheral Arterial Disease
Authors: Treat‐Jacobson Diane , Halverson Sheri L. , Ratchford Andria , Regensteiner Judith G. , Lindquist Ruth , Hirsch Alan T. 
Published: April 2004

Purpose: To evaluate the effects of peripheral artery disease (PAD) on health‐related quality of life (HRQoL) from the patient's perspective to establish a foundation for systematic PAD‐specific HRQoL assessment in this population.Design: Grounded theory methodology.Methods: Open‐ended, tape‐recorded interviews were conducted with 38 patients (24 men, 14 women) 44 to 83 years old (mean 65) from two US medical centers to report patient experience of PAD and its perceived effects on HRQoL. Tapes were transcribed and analyzed to identify themes and conceptual domains pertinent to the experience of PAD in this population.Results: Seven major themes were identified: (a) delay in diagnosis and frustration with management of disease; (b) pain; (c) limitation in physical functioning; (d) limitation in social and role functioning; (e) compromise of self; (f) uncertainty and fear; and (g) adaptation to the effects of the disease and demonstration of resiliency.Conclusions: These findings indicate important psychosocial and emotional consequences of PAD that existing HRQoL questionnaires do not indicate. More complete data might lead to greater understanding of the effects of PAD, serving as the foundation for a more sensitive instrument to assess HRQoL as a basis for more effective interventions.
Patients' Attitudes Toward Advance Directives
Authors: Douglas Rebecca , Brown Hazel N. 
Published: April 2004

Purpose: To explore hospitalized patients' attitudes toward advance directives, their reasons for completing or not completing advance directive forms, and demographic differences between patients who did and did not complete advance directive forms.Design and Method: The convenience sample comprised 30 hospitalized patients in North Carolina. Participants were interviewed using an adapted advance directive attitude survey (ADAS), and were asked five general questions about advance directives. Validity and reliability were established on the adapted tool.Findings: The overwhelming majority of participants had received information on advance directives and they were moderately positive about them. The majority who had completed advance directives were Caucasian, female, over age 65, had less than a high school education, and perceived their health as poor. Most believed that an advance directive would ensure they received the treatment they desired at the end of life.Conclusions: Patients' attitudes alone did not determine who will and will not complete advance directives. Most participants who completed advance directives had specific reasons for doing so. Nurses have responsibility for discussing advance directives with patients, families, and physicians to ensure adequate education about the completion of advance directives.
Health Promotion and Participatory Action Research with South Asian Women
Authors: Choudhry U.K. , Jandu S. , Mahal J. , Singh R. , Sohi‐Pabla H. , Mutta B. 
Published: April 2004

Purpose: To examine South Asian immigrant women's health promotion issues and to facilitate the creation of emancipatory knowledge and self‐understanding regarding health‐promoting practices; to promote health education and mobilization for culturally relevant action.Method: The study was based on critical social theory; the research model was participatory action research (PAR). Two groups of South Asian women (women from India and of Indian origin) who had immigrated to Canada participated in the project. The qualitative data were generated through focus groups. Reflexive and dialectical critique were used as methods of analyzing qualitative data. The data were interpreted through reiterative process, and dominant themes were identified.Findings: Three themes that were extracted from the data were: (a) the importance of maintaining culture and tradition, (b) placing family needs before self, and (c) surviving by being strong. An issue for action was the risk of intergenerational conflicts leading to alienation of family members. Over a period of 3 years, the following action plans were carried out: (a) workshops for parents and children, (b) sharing of project findings with the community, and (c) a presentation at an annual public health conference.Conclusions and Implications: The project activities empowered participants to create and share knowledge, which was then applied toward action for change. Health and health promotion were viewed as functions of the women's relationships to the world around them.