Journal of Nursing Scholarship (J NURS SCHOLARSHIP)

Publications in this journal

• Article: Interaction of duration of homelessness and gender on adolescent sexual health indicators.

  Lynn Rew, Matthew Grady, Tiffany A Whittaker, Katherine Bowman
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  ABSTRACT: The purpose of this analysis was to determine the effects of duration of homelessness and gender on personal and social resources, cognitive-perceptual factors, and sexual health behaviors among homeless youth. Cross-sectional analysis of data collected at baseline from 461 homeless adolescents who participated in a sexual health intervention study was done. Data were collected via laptop computers from homeless adolescents (mean age=19.52+1.91 years) in both comparison and intervention groups before the initiation of the intervention. Significant interaction effects were found for personal and social resources F (4, 426)=2.83, p<.05. Male participants who had been homeless<6 months had significantly higher scores on social connectedness than did male participants who were homeless>1 year. Univariate analysis of variance (ANOVA) indicated that both boys and girls who had been homeless>1 year had greater AIDS knowledge, F (1, 441)=7.91, p<.01, reported significantly more sexual risk-taking behaviors, F (1, 396)=9.93, p<.05, and engaged in fewer safe-sex behaviors, F (1, 396)=12.05, p<.05, than did those who had been homeless<6 months. Univariate ANOVA indicated that female participants had significantly lower levels of perceived health status, F (1, 429)=12.08, p<.01, significantly greater sexual self-care behaviors, F (1, 396)=16.29, p<.01, and significantly higher levels of assertive communication F (1, 396)=4.03, p<.05 than did male participants, regardless of duration of homelessness. The duration of homelessness and gender has both direct and interaction effects on cognitive-perceptual and behavioral outcomes associated with sexual health. Nurses and other healthcare providers working with homeless youth recognize the need to develop brief interventions that address health-risk behaviors. Findings from this study indicate that gender-specific interventions should be provided to youth soon after they become homeless.
  Journal of Nursing Scholarship 02/2008; 40(2):109-15.
• Source

  Available from: nih.gov

  Article: Letters to the editor.

  Nancy Ann Faller
  Journal of Nursing Scholarship 02/2008; 40(1):3.
• Article: Household composition and fatal unintentional injuries related to child maltreatment.

  Patricia G Schnitzer, Bernard G Ewigman
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  ABSTRACT: To determine if household composition is an independent risk factor for fatal unintentional injuries related to child maltreatment. A population-based, case-control study using data from the Missouri Child Fatality Review Program for 1992-1999. Children under age five who died during the 8-year study period were eligible for study. Cases were defined as children who died of an unintentional injury that occurred when a parent or other adult caregiver: (a) was not present, (b) was present but not capable of protecting the child, (c) placed the child in an unsafe sleep environment, or (d) failed to use legally mandated safety devices. Controls were randomly selected from children who died of natural causes. Household composition was classified based on relationship of the adults living in the household to the deceased child. The five household composition categories were households with: (a) two biologic parents and no other adults, (b) one biologic parent and no other adults, (c) one or two biologic parents and another adult relative, (d) stepparents or foster parents, and (e) one or two biologic parents and another unrelated adult. Logistic regression analyses were conducted and odds ratios estimating the risk of maltreatment-related unintentional death associated with each household category compared to the reference households: those with two biologic parents and no other adults. Three hundred eighty children met the case definition. Children residing within households with adults unrelated to them had nearly six times the risk of dying of maltreatment-related unintentional injury (adjusted odds ratio [aOR] 5.9; 95% confidence interval [95% CI] 1.9-17.6). Children residing with step or foster parents and those living with other, related adults were also at increased risk of maltreatment death (aOR 2.6, 95% CI 1.0-6.5; and aOR 2.1, 95% CI 1.0-4.5, respectively). Risk was not elevated for children in households with a single biologic parent and no other adults in residence. Young children residing in households with unrelated adults, step-parents, or foster parents are at increased risk of fatal unintentional injury related to maltreatment. Nurses can use the findings of this study to facilitate injury prevention by identifying families at risk for fatal unintentional injuries and providing these families with targeted education or referral.
  Journal of Nursing Scholarship 02/2008; 40(1):91-7.
• Article: Nurses' perceptions of research utilization in a corporate health care system.

  Donna Jo McCloskey
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  ABSTRACT: To explore selected characteristics of nurses based upon educational level (masters, baccalaureate, associate degree/diploma), years of experience, and hospital position (management, advanced practice, staff nurse) that might affect perceived availability of research resources, attitude towards research, support, and research use in practice. A descriptive nonexperimental mailed survey design was used for this study. Nurses in five hospitals within a corporate hospital system were surveyed using the Research Utilization Questionnaire (RUQ). The RUQ was used to measure nurses' perceptions of research utilization in the four dimensions of perceived use of research, attitude toward research, availability of research resources, and perceived support for research activities. ANOVA was used to analyze the data. Statistically significant differences (p<.001) were found in the perceived use of research, attitude toward research, availability of research resources, and perceived support for research activities based on educational level and organizational position. No significant differences were found in the perception of nurses based on years of experience. The results of this study have implications for staff nurses, administrators, advanced practice nurses, and educators working in hospital systems. The different perceptions based upon educational level and hospital position can be integrated and used at all levels of nursing practice to promote research utilization and evidence-based practice initiatives within the organizational structure. The results of this study have nursing implications within administration and for nursing practice. The different perceptions that were found based upon educational level and hospital position can be positively integrated and used by administrators and by nurses all levels of nursing practice to promote research utilization and evidence based practice initiatives within the organizational structure.
  Journal of Nursing Scholarship 02/2008; 40(1):39-45.
• Article: Job satisfaction and acculturation among Filipino registered nurses.

  Emerson E Ea, Mary Quinn Griffin, Nora L'Eplattenier, Joyce J Fitzpatrick
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  ABSTRACT: To determine the (a) levels of acculturation and job satisfaction, (b) relationship between acculturation and job satisfaction, and (c) effects of select sociodemographic variables in predicting job satisfaction among Filipino RNs educated in the Philippines who are working in the US. Descriptive correlational. A convenience sample of Filipino RNs (N=96) present during the PNAA Eastern Regional Conference in Baltimore, MD was conducted. A survey was conducted using A Short Acculturation Scale for Filipino Americans (ASASFA) to measure acculturation, Part B of the Index of Work Satisfaction Scale (IWS) to assess job satisfaction, and a participant demographic questionnaire. Data were analyzed using A Pearson correlation coefficient and multiple regression analysis. Participants had a moderate level of job satisfaction that was positively correlated to a level of acculturation that was closer to American than to Filipino culture. Furthermore, age, length of U.S. residency, and acculturation significantly predicted perception of job satisfaction among this group of Filipino RNs. Job satisfaction among Filipino nurses is related to acculturation and select sociodemographic variables. Further research to determine how best to improve acculturation may lead to improved retention rates of Filipino nurses in countries to which they have migrated.
  Journal of Nursing Scholarship 02/2008; 40(1):46-51.
• Article: The experiences of Western expatriate nursing educators teaching in Eastern Asia.

  Carolyn S Melby, Joan E Dodgson, Marie Tarrant
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  ABSTRACT: To describe the lived experience of English-speaking Western nurse educators teaching in East Asian countries. The study design was an application of existential phenomenological approach to qualitative data collection and analysis. Eight expatriate nurse educators who had taught more than 2 years in an East Asian country were interviewed about their experiences between January 2004 and November 2005. Narrative data were analyzed using a phenomenological approach aimed at distilling the experience of the educators. Each member of the research team analyzed the data, then through group discussions a consensus was reached, paying close attention to developing clear understandings of language nuances and maintaining the participants' voices. Four themes emerged from the data: (a) differing expectations, (b) the cost of the expatriate experience, (c) bridging pedagogies, and (d) adapting and finding purpose. The tacit meanings of cultural differences affecting participants' experiences are presented. The ways that a collectivist-oriented culture may affect nurse educators coming from a Western individualist worldview needs to continue to be researched to develop better mutual understandings that will lead to culturally collaborative models of nursing practice, education and research. Nurses providing direct care and nurse educators who work with people from cultures other than their own will find the discussion of cross-cultural misunderstandings useful.
  Journal of Nursing Scholarship 02/2008; 40(2):176-83.
• Article: Maternal worries, home safety behaviors, and perceived difficulties.

  Sherry Garrett Hendrickson
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  ABSTRACT: The aim of the study was to explore the worries, safety behaviors, and perceived difficulties in keeping children safe at home in a purposive sample of low-income, predominantly non-English speaking mothers as a foundation for later nursing interventions. This study was a qualitative, descriptive design with content analysis to identify maternal concerns, behaviors, and perceptions of home safety as part of a larger study. Eighty-two mothers, 64% of whom were monolingual Spanish-speakers, responded in writing to three semistructured interview questions. When mothers were unable to read and write the researcher wrote the responses, then read the content aloud for verification. A standardized probe for each question was posed to obtain richer responses. Data management included use of the software program NUD*IST and coding analyses following the Miles and Huberman guidelines (1994). Interpretations were translated into English for this report. The major worries were falling, health, kidnapping, and being hit by a car. The leading maternal behaviors were coded as being physically, verbally, and environmentally preventive. Mothers said that it was their role to provide safety, and that this role could be wearisome, such that constant supervision was difficult. Low-income mothers described their worries for their 1 to 4 year-old children, explored their behaviors for preventing injury, and discussed what made keeping children from harm difficult. Understanding how mothers keep children safe, the barriers to home safety, and effective safety behaviors are important to the health of children. The clinical relevance of this study includes building trust as clinicians plan assessment, intervention and evaluation of home safety to encourage dialog about concerns, safety behaviors, and barriers to keeping children from injury.
  Journal of Nursing Scholarship 02/2008; 40(2):137-43.
• Article: Relative contribution of intrapersonal and partner factors to contraceptive behavior among Taiwanese female adolescents.

  Ruey-Hsia Wang, Chii-Jun Chiou
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  ABSTRACT: To explore the relative contribution of intrapersonal factors (demographic data, sexual history, and self-efficacy for contraception) and partner factors (perceptions of support from sexual partners for contraception, and relationship power) to contraceptive behaviors among sexually active female adolescents in Taiwan. A cross-sectional design. Female adolescents who have had a steady male sexual partner in the past 3 months (N=375) were recruited as participants. Questionnaires including demographic data, sexual history, contraceptive behavior, self-efficacy for contraception, perceptions of support from sexual partner for contraception, and perceptions of relationship power were submitted anonymously for this study. Participants who had their first sexual experience at less than 14 years of age and were from one-parent families had the least comprehensive contraceptive behavior than did other participants. Number of steady sexual partners was significantly negatively correlated with contraceptive behavior. Self-efficacy, perceptions of support from sexual partner for contraception, and relationship power all were positively correlated with contraceptive behavior. The important explanatory variables of contraceptive behavior were self-efficacy, age of first sexual intercourse, intervals between sexual intercourse, and perceptions of support from sexual partner for contraception. These accounted for 39.1% of variance in contraceptive behavior. Intrapersonal factors (self-efficacy, age of first sexual intercourse, and intervals between sexual intercourse) were more important than were partner factors (perceptions of support from sexual partners for contraception and relationship power) in influencing contraceptive behavior among sexually active female adolescents in Taiwan. Intervention to increase contraceptive behavior among female adolescents should be focused more on intrapersonal factors than on partner factors.
  Journal of Nursing Scholarship 02/2008; 40(2):131-6.
• Article: Expanding the comfort of postmastectomy patients using the Papilla Gown.

  Ho Soon Michelle Cho, Jae Un Paek, Gail Davis, Tara Fedric
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  ABSTRACT: To determine whether the Papilla Gown designed specifically to meet the needs of postmastectomy patients with a closed drainage system in place is more comfortable than is a typical hospital gown. The closed wound drainage system used for breast cancer patients immediately following mastectomy requires external drainage tubes that connect to a pouch. The pins that are usually used to attach the drains to a patient's gown create problems. The Papilla Gown (Papilla is the Latin term for breast) was designed with safety pouches for supporting the drains. A convenience sample of 13 postmastectomy patients participated in this preliminary study of the gown's use. Participants were taught how to properly wear the typical hospital gown and Papilla Gown before surgery. Patients were discharged with the gowns and two questionnaires that were to be returned approximately 1 week following surgery. Thirteen of the 38 (34%) who agreed to participate submitted usable forms. The Wilcoxon signed-ranks test was used for comparing the comfort scores of the Papilla with the hospital gown. Participants reported significantly higher scores (p<.003) for the Papilla Gown on all of Comfort Questionnaire's 10 items, except one (p=.337) related to fear of pulling out the drainage tubes. Specifically, patients felt more comfortable about their appearance in the gowns, their ability to move, and the support of the drainage tubes. The newly designed Papilla Gown shows promise for meeting the purpose of increasing the comfort of postmastectomy patients with closed drainage systems. The Papilla Gown was designed to address the comfort, mobility, and body image issues that patients face during the first week following a mastectomy, when they are dealing with such issues as the cancer diagnosis, loss of a breast, and managing drainage tubes. Preliminary results show that nurses can improve patient satisfaction by providing clothing that is comfortable, attractive, and supports the drainage system in place during this critical time.
  Journal of Nursing Scholarship 02/2008; 40(1):26-31.
• Article: Couple decision making and use of cultural scripts in Malawi.

  Ellen Mbweza, Kathleen F Norr, Beverly McElmurry
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  ABSTRACT: To examine the decision-making processes of husband and wife dyads in matrilineal and patrilineal marriage traditions of Malawi in the areas of money, food, pregnancy, contraception, and sexual relations. Qualitative grounded theory using simultaneous interviews of 60 husbands and wives (30 couples). Data were analyzed according to the guidelines of simultaneous data collection and analysis. The analysis resulted in development of core categories and categories of decision-making process. Data matrixes were used to identify similarities and differences within couples and across cases. Most couples reported using a mix of final decision-making approaches: husband-dominated, wife-dominated, and shared. Gender based and nongender based cultural scripts provided rationales for their approaches to decision making. Gender based cultural scripts (husband-dominant and wife-dominant) were used to justify decision-making approaches. Non-gender based cultural scripts (communicating openly, maintaining harmony, and children's welfare) supported shared decision making. Gender based cultural scripts were used in decision making more often among couples from the district with a patrilineal marriage tradition and where the husband had less than secondary school education and was not formally employed. Nongender based cultural scripts to encourage shared decision making can be used in designing culturally tailored reproductive health interventions for couples. Nurses who work with women and families should be aware of the variations that occur in actual couple decision-making approaches. Shared decision making can be used to encourage the involvement of men in reproductive health programs.
  Journal of Nursing Scholarship 02/2008; 40(1):12-9.
• Source

  Available from: umich.edu

  Article: Evaluating home health care nursing outcomes with OASIS and NOC.

  Julia Stocker Schneider, Violet Barkauskas, Gail Keenan
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  ABSTRACT: To determine the sensitivity and responsiveness of the Outcome and Assessment Information Set (OASIS) and the Nursing Outcomes Classification (NOC) to the effects of home healthcare nursing interventions. A quasi-experimental before-after study was conducted using a sample of 106 home healthcare participants referred to one of seven participating Midwest home healthcare agencies for treatment of a cardiac condition. Patient outcomes data were collected at home healthcare admission and discharge using OASIS and NOC. Nursing intervention data were collected at each visit using the Nursing Interventions Classification (NIC). Intervention intensity was calculated by totaling the number of NIC interventions provided over the episode of care. Neither OASIS nor NOC were sensitive to the effects of home healthcare nursing as measured by intervention intensity. The OASIS was not responsive to clinically discernable changes in patient outcomes; while the NOC was responsive to patient status change in the outcome categories including activities of daily living, cardiopulmonary status, coping, and illness management behavior. Outcome measures that are more condition-specific and discipline-specific are more responsive to the effects of home healthcare nursing. Further research is needed to identify and refine outcome measures that are sensitive and responsive to the effects of nursing care in home health and other nursing settings. Clinical Relevance: The use of outcome measures that are more sensitive and responsive to nursing are more effective in guiding nursing practice.
  Journal of Nursing Scholarship 02/2008; 40(1):76-82.
• Source

  Available from: umich.edu

  Article: Global nurse migration today.

  Barbara L Brush
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  ABSTRACT: To examine emerging trends in global nurse migration and those effects on nurse workforce planning and development efforts in select donor and recipient countries. This integrative literature review is an analysis of current literature (journal articles, media, and press releases) and data from various sources (PUMS, NSSRN, CGFNS, Nurse & Midwifery Council) to explicate new trends in nurse migration. Rapid changes in nurse migration are significantly challenging nurse workforce management efforts in both donor and recipient nations. As the market demand for nurses around the globe escalates, the changes and consequences associated with nurse migration are increasingly in need of policy solutions that indicate the needs and motivations of all stakeholders.
  Journal of Nursing Scholarship 02/2008; 40(1):20-5.
• Article: Searching for the intervention in intervention research reports.

  Vicki S Conn, Pamela S Cooper, Todd M Ruppar, Cynthia L Russell
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  ABSTRACT: Precisely described interventions in nursing research reports are essential as a foundation for nursing practice and to facilitate future research. The purpose of this project was to characterize the intervention descriptions in nursing intervention research reports. Quantitative content analysis was used to analyze intervention descriptions in reports published in English-language general nursing journals during 2005. Normative analysis was used to examine reports for details related to intervention content and delivery. Physical unit analysis was used to compare relative amounts of article space devoted to intervention description vs. other methodological details. Results were tabulated for 141 research articles published in 27 journals. Analysis indicated incomplete reporting of intervention details in many articles. Dose and dosing frequency were rarely completely defined. Delivery setting and interventionist were frequently not indicated, and the professional credentials of nurse interventionists were often unclear. While descriptions of interventions involving substances or devices were typically detailed, the specifics of psychological, educational, behavioral, and systems-level interventions were often lacking. Intervention descriptions averaged 7.27% of total article space, whereas nonintervention methodological descriptions averaged 20.74% of space. Of studies examined, only 38 (27.0%) reported enough detail to potentially replicate the study or translate the intervention into practice. Intervention descriptions in general nursing journals lack sufficient detail to provide the evidence basis for practice.
  Journal of Nursing Scholarship 02/2008; 40(1):52-9.
• Article: Predictors of home healthcare nurse retention.

  Carol Hall Ellenbecker, Frank W Porell, Linda Samia, James J Byleckie, Michael Milburn
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  ABSTRACT: To examine the level of job satisfaction and test a theoretical model of the direct and indirect effects of job satisfaction, and individual nurse and agency characteristics, on intent to stay and retention for home healthcare nurses. A descriptive correlation study of home healthcare nurses in six New England states. Home healthcare nurse job satisfaction self-report data was collected with the HHNJS survey questionnaire & Retention Survey Questionnaire. Based on a structural equation model, job tenure and job satisfaction were the strongest predictors of nurse retention. Understanding the variables associated with home healthcare nurse retention can help agencies retain nurses in a time of severe nurse shortages and increased patient demand. Predicted nursing shortages and increasing demand have made the retention of experienced, qualified nursing staff essential to assure access to high-quality home healthcare services in the future.
  Journal of Nursing Scholarship 02/2008; 40(2):151-60.
• Article: The expatriate experience: teaching nursing across eastern and Western cultures.

  Fang Yu
  Journal of Nursing Scholarship 02/2008; 40(2):184-6.
• Article: Creating cross-disciplinary research alliances to advance nursing science.

  Susan J Loeb, Janice Penrod, Ann Kolanowski, Judith E Hupcey, Kim Kopenhaver Haidet, Donna M Fick, Dee McGonigle, Fang Yu
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  ABSTRACT: To demonstrate the utility of a developmental approach to building and sustaining cross-disciplinary research alliances. Cross-disciplinary collaborations offer great promise for advancing an evolving program of research. Funding agencies' commitment to interdisciplinary work further heightens these collaborations. Nurse researchers, however, are not necessarily equipped with the knowledge and skills needed to strategically and successfully build and maintain cross-disciplinary collaborations. Successful strategies for forging, extending, and sustaining alliances are organized using a developmental approach and illustrated by exemplars. The initial phase of forging alliances is focused on creating a limited network to support relatively clear-cut research goals. The cohesive cross-disciplinary team is subsequently extended beyond the initial team to strategically address broader research goals. As the team matures, emphasis shifts toward sustaining the team through shared leadership that more actively focuses on the development of the field than the development of individual programs of research. The advancement of nursing science requires nurse researchers to rethink the developmental phases of building appropriate research teams. Strategic approaches for forging, extending, and sustaining cross-disciplinary alliances position nurse researchers as leaders in innovative cross-disciplinary research. The development of cross-disciplinary teams supports translational research and, by extension, the science that undergirds practice. Research that reflects cross-disciplinary perspectives is particularly well suited to addressing the complex health issues encountered by patients, families, and communities.
  Journal of Nursing Scholarship 02/2008; 40(2):195-201.
• Article: Testing a bioecological model to examine social support in postpartum adolescents.

  M Cynthia Logsdon, Craig Ziegler, Paige Hertweck, Melissa Pinto-Foltz
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  ABSTRACT: The purpose was twofold and included examining a bioecological model as a framework to describe social support in postpartum adolescents. The second purpose was to determine the relationship between a comprehensive view of the context of social support and symptoms of depression. Cross-sectional design with convenience sampling (n=85) of adolescents at 4-6 weeks postpartum, recruited from two community hospitals. Approval was received from the university's IRB (institutional review board), each recruitment site, the adolescent mothers, and their parents or guardians. Data were collected by a research assistant during home visits using a battery of self-report instruments to measure macro, meso, and microsystems of social support. Demographics, exposure to community violence (macrosystem), social support, social network (mesosystem), and perceived stress, mastery, and self-esteem (microsystem) were predictor variables. Depressive symptoms were measured by using the Center for Epidemiologic Studies of Depression (CES-D) Scale. Variables from each system were significant predictors of depressive symptoms but perceived stress was the strongest predictor. Many postpartum adolescents reported that they had been victims of violence. Significant symptoms of depression were identified in 37% of the postpartum adolescents. Context is important to consider in comparing international studies of social support. Researchers and clinicians should investigate variables associated with the low incidence of treatment for depressive symptoms in postpartum adolescents. Feelings of high self-esteem and mastery should be fostered in nursing interventions with postpartum adolescents and routine screening for symptoms of depression should be considered in relevant healthcare settings.
  Journal of Nursing Scholarship 02/2008; 40(2):116-23.
• Article: Sing of significance.

  Susan Gennaro
  Journal of Nursing Scholarship 02/2008; 40(2):99-100.
• Article: Health beliefs and mammography rates of Turkish women living in rural areas.

  Ilknur Aydin Avci, Hatice Kurt
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  ABSTRACT: Breast cancer is the most frequently occurring cancer among women globally as well as in Turkey and mammography is known to be an effective screening tool for this disease. This study was undertaken to characterize health beliefs and practices related to mammography of women in Turkey and also to survey mammography rates. Cross-sectional. The study was performed between September 2006 and January 2007 in Samsun, Turkey. Of 503 women, aged 35 years or older and registered at a local Health Center, 387 (76.94%) agreed to participate in this study. A self-administered descriptive questionnaire and the Champion Revised Health Belief Model Scale for breast cancer screening (CHBMS) were used as data collection instruments. Analysis included descriptive statistics, Chi-square, and independent t test. Logistic regression analysis was conducted to identify the extent to which individual variables significantly predicted mammography use. Study participants did not undergo mammography at optimal rates (23.5%), but perceived benefits were higher than were perceived barriers to the procedure after education about mammography. Consequently women reported they were likely to adopt the practice of regular mammography in the future. Mammography rates were low in this rural area in Turkey, but may improve after education about the procedure. Mammography is an important tool in the early diagnosis of breast cancer. Many women still do not understand the benefit of mammograms and further education may help increase rates of early screening.
  Journal of Nursing Scholarship 02/2008; 40(2):170-5.