Research in Nursing & Health

Published by Wiley
Online ISSN: 1098-240X
Publications
Article
This article describes the development and psychometric evaluation of the short-form Pulmonary Functional Status Scale (PFSS-11©) derived from the previously validated 35-item PFSS, using data from 179 subjects (120 Chronic Obstructive Pulmonary Disease [COPD]/59 normative, non-COPD). Items were extracted based on item-response distribution and commonality >.60. Factor analysis yielded a three-factor solution, accounting for 65.6% of total variance. Construct validity was supported by PFSS-11© scores for COPD versus norms (p < .001). The PFSS-11© was robustly associated with the PFSS-35 (r = .93), accounting for 88% of variance in the longer version. Internal consistency was satisfactory and significant response to treatment was shown by score changes pre/post-rehabilitation. The PFSS-11© has solid psychometric properties useful in research and clinical practice, similar to the PFSS-35.
 
Article
Images of nurses in pictorial advertisements from all issues of hospital administration journals published in 1930, 1940, and 1950 (N = 598) were examined. Content analysis of the data was based on Goffman's classic 1979 study on gender advertisements. Nurses also were compared with other figures in the advertisements and nursing activities were described. Nurses were predominantly portrayed as female, young, eager to please, and without the appearance of wisdom. In group scenes, nurses were placed as subordinate to physicians and hospital administrators. Nurses in 1940 performed more complex, autonomous activities than in 1930 and 1950. These findings support previous research focused on more recent portrayals of women and nurses in communication media. The overt and subtle subordinate representation of nurses in these advertisements, compared with physicians and administrators, reveals one facet of nursing's heritage as a woman's profession.
 
Article
A content analysis of 191 motion pictures featuring 211 nurses as significant characters was conducted to determine the nature and extent of the motion picture industry's depiction of the nurse as a sex object and to identify changes in that portrayal from 1930 to 1980. Seventy-three percent of the nurse roles characterized nurses as sex objects. The frequency and intensity of stereotypes of nurses as sex objects rose significantly during the 1960s and 1970s (p less than .0001). Exploitation of the nurse as a sex object was more common in the larger nurse roles. However, in films with a strong emphasis on professional nursing in either the story or in character development, sexual stereotyping of nurses was uncommon. It was concluded that the image of the nurse as a professional care giver was incompatible with that of the nurse as sex object, and that the motion picture industry has opted primarily to present the latter image. The extremely negative sexual stereotype of nursing promulgated during the past 20 years is cause for concern. Actions that the nursing profession can employ to counter the unfavorable portrayal of nurses in 1980s motion pictures are suggested.
 
Article
The quality of reported research representing a number of disciplines involved in diabetes patient education was investigated in this study. A rigorous literature search identified 47 studies reported between 1954 and 1986 that met inclusion criteria; 29 were published studies, 18 were unpublished. Quality of the research was measured by Duffy's Research Appraisal Checklist (RAC) and also by coding each study as to the number of threats to internal and external validity present. Overall quality as measured by the RAC ranged from 34 to 95 on a 100-point scale. A statistically significant relationship was found between publication date of the research report and quality, indicating improvement in quality during recent years. Quality of published versus unpublished research reports was not found to differ significantly. Recommendations for improving methodological rigor of future studies include: (a) the use of more rigorous designs, particularly those involving control groups such as randomized clinical trials; (b) reporting of more complete data in research reports; and (c) monitoring of the quality of future studies.
 
Article
Trends in public attitudes toward legal abortion were analyzed for 1972 and 1978. Data were drawn from seven independent probability samples (N = 10,652) of English-speaking persons 18 years of age or older living in noninstitutional arrangements within the continental United States. Attitudes were derived from responses to six items asking whether it should be possible for a pregnant woman to obtain a legal abortion under six different conditions. Guttman Scalogram Analysis revealed two predominant patterns; approval for all six reasons and approval only for the hard reasons (safeguarding the woman's health, preventing birth of a deformed child, or treating rape). Two major shifts were noted in the level of approval; a considerable increase in 1973 for each reason and a sharp decline in 1978 for all but woman's health and rape. These shifts paralleled the introduction of laws pertaining to abortion.
 
Article
Intrauterine growth retardation (IUGR) is an overlooked problem in full-term infants with birth weights greater than 2,500 g. Birth weight less than the 10th percentile underestimates the presence of IUGR. The purpose of this study was to determine the prevalence of IUGR in full-term infants and to identify sociodemographic and maternal characteristics associated with IUGR. The Ohio Department of Health Vital Statistics database was used to obtain data related to sociodemographic and maternal characteristics. The fetal growth ratio (FGR) was used to determine the presence of IUGR. The sample consisted of 1,569 infants with normal ratios and 1,364 infants classified as IUGR. Infants with IUGR were more often male and African American or Asian American. Maternal characteristics associated with IUGR included history of smoking during pregnancy, lower pre-pregnancy weight, lower weight gain during pregnancy, and inadequate prenatal care. IUGR is present in a significant number of full-term infants with birth weights greater than 2,500 g. The long-term effects of IUGR in these infants remain to be determined.
 
Article
Because persons with cognitive impairment often cannot self-report pain, it is imperative to develop instruments that use observable indicators. The purpose of this study was to develop and test the psychometric properties of the Discomfort Behavior Scale (DBS), which is comprised of 17 items from the Minimum Data Set (MDS). MDS data from 29,120 cognitively impaired nursing home residents were used for psychometric testing. Factor analyses of the DBS indicated that it reflects a single discomfort dimension. The items are tau equivalent, allowing unity weighting and simple summation to create scale scores, and the internal consistency was good. The DBS has potential to be useful in studies of efforts to improve pain management in cognitively impaired residents of nursing homes.
 
Article
Informed consumers of the 21st century increasingly will be hesitant to enroll in randomized clinical trials (RCTs) because they will be unwilling to (a) submit to random assignment; (b) complete assessments that are too lengthy, intrusive, or irrelevant; or (c) comply with protocols that do not meet their needs. Research centered on the needs and interests of participants is likely to engender greater participation and commitment than are traditional RCTs. Recommendations for making clinical trials more participant centered include: (a) expanding our conceptualizations of study validity, (b) involving consumers as advisers in the development and execution of clinical trials, and (c) offering participants reasonable alternatives to random assignment.
 
Article
In this prospective, descriptive study, we used a repeated-measures design to explore the 24-hour effects of caregiving and positioning on preterm infants' states and the factors associated with state changes. Thirty preterm infants (gestational age 27.6-36.1 weeks) were observed for 3 days in the neonatal intensive care unit to record six states: quiet sleep (QS), active sleep, transition, active awake, quiet awake, and fussy or crying. The occurrences of QS increased when infants received no caregiving, social interaction, non-nutritive sucking (NNS), and were laterally positioned. However, QS significantly decreased and fussy or crying state increased when infants received routine and intrusive caregiving. These results suggest that caregiving, NNS, and positioning should be appropriately provided to facilitate infants' sleep, and reduce fussiness or crying.
 
Article
The purpose of this ethnic group study was to describe the unique pattern of Korean Americans, as compared with the aggregate of Asian Americans, for: (a) the predisposing, enabling, and need factors for health service utilization, focusing specifically on the role of health insurance coverage; and (b) predictors of health insurance coverage. Using the behavioral model for health service utilization, data were selected from the 1992 National Health Insurance Survey (NHIS, 1994) for Korean Americans (n = 345) and Asian Americans (n = 3,059). Results differed between the Korean American group and the Asian American group. Health insurance coverage was the strongest predictor of Korean American utilization, and need factors lacked significance, suggesting that uninsured Korean Americans have less access regardless of need. For the aggregate Asian American group, need factors tempered the influence of health insurance on utilization. Results of this type of study may be helpful for designing and implementing health care services tailored for specific ethnic at-risk markets.
 
Article
This prospective, descriptive study used a repeated-measures design to explore preterm infants' biobehavioral responses to 24-hour neonatal caregiving and positioning, and the factors associated with changes in their biobehavioral responses. Thirty preterm infants (gestational age 27.6-36.1 weeks) were observed for 3 days to record biobehavioral responses. Infants' disorganized behaviors increased as caregiving intrusiveness and supine positioning increased. Social interactions did not lead to increases in infants' disorganized behaviors, but to increased regulatory behaviors. Non-nutritive sucking (NNS), and prone positioning reduced occurrences of infant disorganized behaviors. Routine caregiving increased instability of oxygen saturation, but lateral and prone positioning improved physiological stability. Clinicians can appropriately provide NNS, positioning, and social interactions to promote biobehavioral stability. © 2012 Wiley Periodicals, Inc. Res Nurs Health.
 
Article
The purposes of this study were to: (a) identify which determinants of physical activity among African American and Caucasian women predict adherence to a 24-week home-based walking program; and (b) explore differences between African American and Caucasian women. Participants were 153 working women who were sedentary at leisure. The program included an exercise prescription, instructions, and support. Background determinants included demographics, previous exercise experience, and social role influences. Intrapersonal determinants (self-efficacy, self-determinism) were measured at baseline and 24 weeks. Adherence was measured with heart rate monitors and logs. Adherence was significantly higher in Caucasians, those with less previous exercise experience, and those with higher self-efficacy. Findings suggest that adherence to a walking program is influenced by multiple factors including background and intrapersonal determinants of physical activity.
 
Article
Skeletal muscle wasting is a prominent feature of cancer cachexia and involves decreased muscle protein synthesis and increased activity of the ubiquitin-proteasome pathway of protein degradation. We report that both indomethacin and ibuprofen improved body weight and weight of the gastrocnemius muscle in tumor-bearing mice. Ibuprofen increased the soluble protein content of the muscle without affecting muscle levels of phosphorylated p70 S6 kinase, a ribosomal kinase involved in protein synthesis. Paradoxically, indomethacin increased levels of ubiquitin-conjugated proteins. Further study is needed to understand the mechanism of action by which indomethacin and ibuprofen preserve body weight and muscle mass in the tumor-bearing mice. The data suggest that ibuprofen may have beneficial effects in the treatment of cancer cachexia.
 
Article
Cancer cachexia is a syndrome of weight loss, muscle wasting, fatigue, and anorexia that occurs in patients with advanced or recurrent solid tumor disease. Tumor necrosis factor-alpha (TNFalpha) and prostaglandin E2 (PGE2) have been implicated in the biology of cachexia and serve as possible targets for treatment of this condition. Conjugated linoleic acid (CLA) is a polyunsaturated fatty acid that alters the synthesis of PGE2 and reduces the negative effects of TNF on body weight of healthy mice. We hypothesized that a diet supplemented with .5% CLA might reduce muscle wasting in mice bearing the colon-26 adenocarcinoma, an animal model of cancer cachexia. CLA preserved gastrocnemius muscle mass and reduced TNF receptors in muscle of tumor-bearing mice. These data suggest that CLA may preserve muscle mass by reducing the catabolic effects of TNF on skeletal muscle.
 
Article
A correlational study was conducted to identify attitudinal variables specified by the Health Belief Model that were related to intent, frequency, and proficiency of breast self-examination. The probability sample consisted of 380 women age 35 and over who were contacted via random digit dialing. Data were collected during in-home interviews. Results supported the combined ability of susceptibility, seriousness, barriers, health motivation, and control to predict intent to practice breast self-examination (R = .61, p. less than or equal to .001). In addition, frequency and total proficiency for breast self-examination were predicted by health motivations, susceptibility, and barriers using discriminant analysis. Results lend support to use of the Health Belief Model variables in predicting women's intention and actual behavior of breast self-examination.
 
Article
The Self-Care of Heart Failure Index Version 6.2 (SCHFI v.6.2) is widely used, but its psychometric profile is still questioned. In a sample of 659 heart failure patients from Italy, we performed confirmatory factor analysis (CFA) to test the original construct of the SCHFI v.6.2 scales (Self-Care Maintenance, Self-Care Management, and Self-Care Confidence), with limited success. We then used exploratory factor analysis to determine the presence of separate scale dimensions, followed by CFA in a separate sub-sample. Construct validity of individual scales showed excellent fit indices: CFI = .92, RMSEA = .05 for the Self-Care Maintenance Scale; CFI = .95, RMSEA = .07 for the Self-Care Management Scale; CFI = .99, RMSEA = .02 for the Self-Care Confidence scale. Contrasting groups validity, internal consistency, and test-retest reliability were supported as well. This evidence provides a new understanding of the structure of the SCHFI v.6.2 and supports its use in clinical practice and research. © 2013 Wiley Periodicals, Inc. Res Nurs Health 36: 500-511, 2013.
 
Article
In a quasi-experimental study, decision support software was installed in three hospitals to study the ability to scale (spread) its use from one hospital on paper to three hospitals as software, and to examine the effect on 30- and 60-day readmissions. The Discharge Decision Support System (D2S2) software analyzes data collected by nurses on admission with a proprietary risk assessment tool, identifies patients in need of post-acute care, and alerts discharge planners. On six intervention units, with a concurrent comparison group of 76 units, we examined the implementation experience and compared readmission outcomes before and after implementation. The software implementation finished one month ahead of schedule, and the software performed reliably. High-risk patients admitted in the experimental phase after implementation of D2S2 decision support had significantly fewer 30-day readmissions (a decrease from 22.2% to 9.4%). When high- and low-risk patients were analyzed together, D2S2 achieved a 33% relative reduction in 30-day readmissions (13.1 to 8.8%) and sustained a 37% relative reduction at 60 days. The software, available commercially through RightCare Solutions, was adopted by the health system and remains in use after 22 months. The D2S2 risk assessment tool can be installed easily in existing EHR systems. Future research will focus on how the tool influences discharge decision-making and how its accuracy can be improved in specific settings. © 2015 Wiley Periodicals, Inc. © 2015 Wiley Periodicals, Inc.
 
Article
In this study we attempted to develop a profile that could be used prospectively to identify veterans over 64 years of age who might be at risk for medication noncompliance. Male veterans (N = 249) having from one to seven oral daily prescribed medications were studied. Instruments administered to determine their relationship to compliance were the Paired-Associate Test, the Mini Mental State, the Multidimensional Health Locus of Control, and the Standard Depression Scale. Compliance was determined by a pill count made at two home visits. Seventy-three percent of the subjects were noncompliant. Variables significantly related to noncompliance by bi-variate analysis were included in the stepwise logistic regression to develop a predictive model of noncompliance. Ethnicity and number of daily prescribed pills were the only significant variables in the final model. The model correctly classified the subjects as compliant/noncompliant in 77% of the cases. Discussions during home interviews revealed a number of common problems.
 
Article
The purpose of this study was to examine effects of sleep deprivation on cellular and biochemical markers of wound healing. Expanded polytetrafluoroethylene tubing inserted in subcutaneous tissue created miniature wounds in the dorsal skin of 12 rats. Seven days later, 6 rats were deprived of sleep by the platform method for 72 hr; control rats remained on usual sleep/wake routines. Numbers of macrophages, granulocytes, fibroblasts, and extent of connective tissue present and total amounts of protein, DNA, and hydroxyproline in the implants were not different between sleep-deprived and control rats. There is no evidence from this study that sleep deprivation impairs cellular and biochemical indicators of tissue repair.
 
Article
The purpose of the present study was to assess the prevalence of pressure ulcers and the use of Dutch guidelines for the prevention and treatment of pressure ulcers. A survey of 16,344 patients in 89 health care institutions on 1 day showed a mean prevalence of pressure ulcers of 23.1%. It was found that Dutch guidelines on some aspects of prevention and treatment of pressure ulcers were not being followed. Only 53% of the patients who should have been positioned on a support surface were positioned on such a device. Fewer than one-third of the patients who should have been repositioned, should have received nutritional support, or should have been educated received these interventions, and only 33.6% of all pressure ulcers were dressed as recommended. More attention to the dissemination and implementation of the guidelines is needed to reduce this high prevalence of pressure ulcers.
 
Article
The Alcohol and Alcohol Problems Perception Questionnaire (AAPPQ) is a multi-dimensional measure of clinicians' attitudes toward working with patients with alcohol problems. In the past 35 years, five- and six-subscale versions and a short version of the AAPPQ have been published. While the reliability of the AAPPQ subscales has remained acceptable, the factor structure has not been verified using confirmatory techniques. In the current study, we split a sample of 299 baccalaureate nursing students to use exploratory (EFA) and confirmatory factor analyses (CFA). When compared to the original six-factor solution and an imposed six-factor structure in CFA, the EFA seven-factor solution with three original items (19, 20, and 25) removed had the best model fit. © 2013 Wiley Periodicals, Inc. Res Nurs Health 9999: XX-XX, 2013.
 
Article
The results of thermal applications to the abdomens of unrestrained, unanesthetized dogs are reported. A silicone rubber envelope through which water circulated at 0 degrees, 10 degrees, 20 degrees, 30 degrees, 40 degrees, or 50 degrees C was applied. Skin surface, subcutaneous, intraperitoneal, intestinal, and colonic temperatures were measured after 90 minutes. Pad applications at 0 degrees, 10 degrees, 20 degrees, and 30 degrees C significantly lowered skin surface and subcutaneous temperatures, while pad applications at 40 degrees and 50 degrees C significantly increased subcutaneous and skin surface temperatures. None of the pad applications had a significant effect on intraperitoneal, intestinal, or colonic temperatures. The findings indicate that a wide range of thermal applications to the abdominal skin of the dog do not alter deep abdominal temperatures.
 
Article
Although early discharge is common place, little is known about its impact after abdominal aortic aneurysm (AAA) surgery. We sought to prospectively describe patient outcomes and caregiving experience after early discharge following elective AAA repair using a standard or endovascular grafting system (EGS) procedure. Fifty-one patients (Standard, n=25; EGS, n=26) completed questionnaires on symptoms and health-related quality of life (HRQoL) while hospitalized and 1, 4, and 8 weeks after discharge. Data were also obtained from caregivers. HRQoL decreased at Week 1 in both groups but returned to near baseline by Week 8. Standard AAA patients experienced more symptoms and activity limitations, but these were concentrated in Week 1. Most caregivers were positive about caregiving and required no additional resources. Findings suggest that most patients who undergo early discharge following elective AAA surgery experience few problems. Those problems that occur concentrate in the week following discharge, suggesting the need for closer monitoring at this time.
 
Article
Aberrant eating behavior among 14 elderly, non-demented and 10 demented patients with Parkinson's disease was studied by means of video-recordings. The findings revealed problems in handling food on the plate, transporting food into the mouth, manipulating food in the mouth, and swallowing. Interpretations were performed based on impairments of autonomic processes, perception, cognition, emotion, and motor performance that occur in the disease.
 
Article
There have been suggestions in the literature that the care of people with dementia must be focused on abilities as opposed to disabilities. However, this approach has not been carefully defined in terms of what constitutes remaining abilities. This article provides a description of the abilities in people with dementia, which is based on a descriptive analysis of data derived from a larger study regarding the psychometric evaluation of an abilities assessment instrument. The sample comprised 112 male veterans with dementia who were living in a long-term care facility. Their mean age was 75 years. Data were collected in the areas of self-care, social, interactional, and interpretive abilities. Abilities were retained in all four areas. Furthermore, abilities were differently affected and varied considerably across subjects, which is consistent with evidence pertaining to cognitive changes in dementia. Our results provide support for an individualized, abilities-focused approach to the care of people with dementia.
 
Article
The purpose of this experimental study was to compare the effects of skill training, a traditional stimulation approach, and regular care (control group) on the ability to perform the basic activities of daily living of nursing home residents with dementia. Sixty-three subjects were randomly selected and randomly assigned to the three groups. Ability to perform the basic activities of daily living (ADLs) and progress toward meeting individually set ADL-related goals were measured. Significant differences were found in two of the three measures used. In general, the greatest improvement was found in the skill training group, modest improvement in the simulation group, and decline in the control group.
 
Article
This study compared the predictive abilities of the STOP-Bang and Epworth Sleepiness Scale (ESS) for screening sleep clinic patients for obstructive sleep apnea (OSA) and sleep-disordered breathing (SDB). Forty-seven new adult patients without previous diagnoses of OSA or SDB were administered the STOP-Bang and ESS and were assigned to OSA or SDB risk groups based on their scores. STOP-Bang responses were scored with two Body Mass Index cut points of 35 and 30 kg/m(2) (SB35 and SB30). The tools' predictive abilities were determined by comparing patients' predicted OSA and SDB risks to their polysomnographic results. The SB30 correctly identified more patients with OSA and SDB than the ESS alone. The ESS had the highest specificity for OSA and SDB. © 2012 Wiley Periodicals, Inc. Res Nurs Health.
 
Article
The effects of alternatively framed messages and dispositional optimism on follow-up for abnormal Papanicolaou tests were studied. Participants (N = 116) had a mean age of 24; 94% were black, 67% had a high school education, and 82% received public assistance. A message about losses without follow-up or gains with follow-up was randomly given. Optimism was measured with the Life Orientation Test and attendance was defined as coming or not coming within 6 weeks of contact. Logistic regressions of attendance on framing and optimism did not reveal significant relationships. Exploratory analyses revealed that personal and familial history of disease were related to attendance. Explanations for the findings and implications for research are delineated.
 
Article
We identified factors associated with elevated parental perceptions of child vulnerability (PPCV) 12 months after newborn screening (NBS) of 136 children: healthy, normal results (H, n = 37), cystic fibrosis carriers (CF-C, n = 40), congenital hypothyroidism (CH, n = 36), and cystic fibrosis (CF, n = 23). Controlling for infant and parent characteristics, mixed logit structural equation modeling showed direct paths to elevated PPCV included parent female sex, CF diagnosis, and high documented illness frequency. PPCV was positively associated with maternal parenting stress. Infants with CF and CF carriers had significantly more documented illness frequency than H group infants. The CH group did not differ significantly from the H group and had no paths to PPCV. Unexpectedly high documented illness frequency among infants who are CF carriers warrants further investigation.
 
Article
We investigated whether fatigue can be used to screen nursing populations for risk of sickness absence. Data were available from a prospective cohort study of 2,059 Norwegian nurses working in hospital care, psychiatric care, and nursing home/home care settings. Physical and mental fatigue were measured at baseline with Chalder's Fatigue Questionnaire (FQ). Self-rated sickness absence at 1-year follow-up was considered high if nurses reported >30 sick days in the past year. Physical fatigue accurately predicted high sickness absence and adequately discriminated between high- and low-risk nurses in nursing home/home care settings. Mental fatigue was not predictive in any setting. The FQ is suitable for screening specific nursing populations for the risk of high sickness absence. © 2013 Wiley Periodicals, Inc. Res Nurs Health.
 
Article
We developed and pilot-tested a comprehensive HIV prevention/sexual risk reduction intervention with 54 sexually abstinent girls and estimated the effect of the intervention on three antecedents of sexual risk behavior: information, motivation, and behavioral skills. Girls ages 14-18 were randomized into either (a) an AbsPlus intervention or (b) a structurally equivalent control group. Assessments were obtained at baseline and 3 months follow-up using audio computer assisted self-interview. The intervention resulted in a large effect for information (d = 1.11); small to large effects for the motivational measures (d = .34-.88), and a moderate effect for a measure of behavioral skills (d = .67). The results indicate that antecedents of sexual risk behavior change were improved by a gender-specific theoretically guided intervention.
 
Article
A non-experimental longitudinal prospective study was conducted to examine the relationships between patient-centered nursing interventions (PCNIs), system characteristics, patient characteristics, and desired health outcomes (DHOs) for 173 hematology-oncology patients. Forty-nine nurse participants provided system characteristics data. Confirmatory factor analyses yielded parsimonious scales to operationalize the variables. In the path model, one PCNI-individualization-was positively related to three subsequent DHOs: authentic self-representation, optimism, and sense of well-being. Two additional PCNIs-responsiveness and proficiency-were positively related to subsequent trust in nurses. PCNIs did not vary with patient race, ethnicity, age, gender, or educational level. Patient-centeredness of care for cancer patients may be enhanced by quality improvement activities that measure and monitor these PCNIs and resultant outcomes.
 
Article
Although violence against women is recognized as a major public health problem, few interventions have been developed to reduce abuse. In this study, 132 pregnant women received three counseling sessions that were designed to reduce further abuse. A comparison group of 67 abused women were offered wallet-sized cards listing community resources for abuse. Women in both groups were followed at 6 months and 12 months post-delivery. Using repeated measures MANCOVA with entry scores as a covariate, we found significantly less violence reported by women in the intervention group than by women in the comparison group.
 
Article
Close spacing of children may be a significant risk factor for subsequent abuse in some families. Twin births are an extreme example of close spacing. Therefore, the authors hypothesized that twin births may predispose to an increased incidence of child abuse. Thirty-eight families with twins were compared with 97 single birth families and matched for birthdate, maternal age, race, and socioeconomic status. Families with twins experienced a significantly higher incidence of child abuse and neglect than did those with single births (p less than .003). A written questionnaire designed to study mothers' feelings and perceptions of support systems showed a significant difference only in greater difficulty in feeding twins as compared with single infants (p less than .001). Mothers of abused children were more likely not to answer the questionnaire at all (p less than .005). Neither mothers of single births nor those of twins felt that health professionals provided adequate education or support following the birth of their infants.
 
Article
The purposes of this study were to identify factors associated with nurses' intention to report suspected child abuse in Taiwan, and to determine the empirical adequacy of the extended theory of planned behavior (TPB) to explain nurses' intention to report child abuse. A stratified quota sampling technique was used to select registered nurses in emergency rooms, psychiatric units, and pediatric units in Taiwan. A total of 1,362 questionnaires from 1,617 nurses were used for the analyses. Structural equation modeling demonstrated that nurses' attitudes toward reporting child abuse, perceived behavioral control, subjective norms, and knowledge of the child abuse and reporting law explained 85% to 91% of the variance in nurses' intention to report child abuse for the less severe and severe child abuse cases in vignettes, respectively. The findings support the use of the extended TPB in identifying factors associated with nurses' intention to report child abuse in Taiwan.
 
Article
Mexican American and African American women (N = 617) with a sexually transmitted disease (STD) underwent a targeted physical exam and questioning regarding sexual abuse, current genitourinary symptomatology, and pelvic inflammatory disease (PID) risk behaviors to determine the relationship between sexual abuse and risk for PID. Sexually abused women (n = 194) reported higher PID risk behaviors, including earlier coitus, more sex partners, higher STD recurrence, and a tendency toward delayed health-seeking behavior. They also reported more severe genitourinary symptomatology, confirmed by physical exam, and presumptive diagnoses of PID. These characteristics identify sexually abused women at high risk for PID. Because of its considerable impact on risk for PID, assessment for sexual abuse is essential in clinical management of women with STD and for diagnosis of PID.
 
Article
The Social Stress Model of Substance Abuse builds upon and integrates knowledge from numerous psychosocial theories and models. According to this model, the likelihood of an individual engaging in drug abuse is a function of the stress level and the extent to which it is offset by stress modifiers such as social networks, social competence, and resources. This article synthesizes current empirical evidence for this model. Thirty-five primary research studies are described, with special attention to the four psychosocial constructs inherent in the model: stress, social networks, social competence, and resources. Consistencies and inconsistencies in the findings, a critique of key methodological issues, and suggestions for future research are provided.
 
Article
The development of a scale to measure an abused woman's self-efficacy is described. The Self-Efficacy Scale for Abused Women (SESAW) originally was a 27-item 100-mm visual analog scale. It underwent face and content validity testing and was administered to a community sample of abused women (N = 50). The SESAW was tested for internal consistency, test-retest reliability, and construct validity. Cronbach's alphas were.95 and.96 at times 1 and 2, respectively. The bivariate correlation between the SESAW at times 1 and 2 was r =.85, p <.01. Construct validity was established by a moderate bivariate correlation with the criterion as measured by the Self-Efficacy Scale-general/global subscale (r =.64, p <.01 at time 1, and r =.78, p <.01 at time 2). The SESAW was streamlined to 19 items. The SESAW is an acceptable measure of situation-specific self-efficacy in community-based abused women.
 
Article
The analysis of covariance (ANCOVA) is a powerful analytic tool, but there continue to be abuses of the method. We review assumptions and illustrate legitimate uses of ANCOVA, and summarize statistical packages' approach to the method. Finally, we consider how ANCOVA is used in contemporary nursing research.
 
Article
The development and psychometric study of a measure of middle schoolers' perceptions of self-efficacy for physical, emotional, and academic behaviors appropriate to their age and developmental tasks are described. The validation of the Middle School Self-Efficacy Questionnaire (MISSE) included the adaptation of existing items and the generation of new ones. Items were subjected to judges' review by two expert panels and were tested with a large, geographically diverse sample of youngsters aged 11-14. Statistical analyses included factor analysis, internal consistency estimations, t tests, and analyses of variance for hypothesis testing related to construct validity. Results showed support for the expected factors and provided evidence of the validity of the MISSE.
 
Article
Indicators of the environment of doctoral programs in nursing were examined in relationship to productivity. Student and faculty perceptions of the academic program environment were correlated with outcome measures of productivity for both faculty and alumni. Twenty-five of the 29 eligible doctoral programs in nursing participated in the study; results are based on the responses of 326 faculty, 659 students, and 296 alumni. Environmental and productivity indicators were primarily measured by the Graduate Program Self-Assessment (GPSA) instruments developed by Educational Testing Service (ETS) for studying dimensions of quality in doctoral education. Significant relationships were found between faculty perceptions of the environment's scholarly excellence, available resources, and student commitment and motivation and faculty productivity. Students consistently viewed the environment more positively when greater percentages of the faculty were at the associate, rather than the assistant, professor level. There was minimal relationship between faculty and student perceptions of the environment and alumni productivity.
 
Article
Relationships of student and academic variables with nursing licensure examination scores were examined. During the years 1978-1984, 164 graduates of an integrated baccalaureate program took the old State Board examination and 159 took the new examination. Among the pre-admission variables, gradepoint average and student age were most useful in predicting exam scores. Nursing lecture courses were better predictors of success than clinical courses. Students who received A-grades in lecture courses scored relatively higher and B-students scored lower on the new licensure examination compared to the old examinations. Compared with their classmates, students entering the program as LPNs did markedly better on the new licensure examination than they did on the old examinations.
 
Multiple Regressions of Demographic Characteristics on Academic Performance (N ¼ 273)
Article
Students who speak English as a second language (ESL) face considerable challenges in English language universities, but little is known about the relationship between English-language acculturation and academic performance. A prospective, correlational design was used to validate the English Language Acculturation Scale (ELAS), a measure of the linguistic aspect of acculturation, and to determine the relationship between English-language acculturation and academic achievement among 273 first-year nursing students. Exploratory factor analyses demonstrated that the ELAS was a valid and reliable measure (alpha = .89). When ELAS scores were examined in relation to students' grades, students with the lowest ELAS scores also had the lowest mean subject grades, highlighting the need to place greater emphasis on identifying English-language acculturation among ESL students.
 
Article
The objective of this study was to examine the relationships of undergraduate academic and admission test performance with graduate academic performance. Results could aid in selecting health service administration students in the future. The sample included 139 students (40 women and 99 men) entering seven health services administration programs during the fall of 1975 and graduating during the spring and summer of 1977. Participating programs were located in the Midwest, Northeast, South, and West Coast. Independent variables included undergraduate academic performance and admission test scores, while the dependent variable was graduate academic performance. Correlation analyses revealed that: (a) the verbal and quantitative subtest scores of the GRE were related to most aspects of graduate academic performance for men but only to selected aspects for women, (b) performance on the MAT was related to women's graduate academic performance in quantitative courses, and (c) men's and women's composite undergraduate grade point average was not related to composite graduate grade point average. These findings suggest that some of the standardized tests presently employed as admission screening devices should be used judiciously.
 
Top-cited authors
Carol Estwing Ferrans
  • University of Illinois at Chicago
Sharron L Docherty
  • Duke University Medical Center
Carolyn Emden
  • University of Tasmania
Deborah a Gross
  • Johns Hopkins University
Hyejin Kim
  • Chung-Ang University