Kathleen A O'Connell

• PhD
• Professor (Full) at Columbia University

The undergraduate mental health nursing course is an optimal time to address stigma and prejudice, while developing positive student attitudes toward those who live with mental health conditions. A quasi-experimental, pretest-posttest, nonequivalent-group study with a sample of undergraduate nursing students in New York City (N = 126) was conducted...

Introduction: Mental health recovery is a critical concept that needs to be thoroughly understood and supported by nurses. Undergraduate nurse educators have the opportunity to clarify misconceptions and cultivate positive recovery attitudes. Aim: To assess the impact of an undergraduate nursing course on attitudes toward mental health recovery...

Introduction: The undergraduate mental health nursing course may be an optimal time to cultivate students' positive attitudes toward people living with a mental illness. Aim: To determine the impact of an undergraduate mental health nursing course on students' attitudes toward people living with a mental illness, depression, and schizophrenia....

Background: Lower urinary tract symptoms (LUTS) are prevalent across women's life course. Evidence shows toileting behaviors (TBs) and urinary urge cues are related to LUTS. It is unknown when women start using these behaviors and responding to urinary cues. Methods: An online survey was administered to 338 women, 65 years of age and older, to asse...

Introduction and hypothesis: Overactive bladder (OAB) and urinary incontinence (UI) are prevalent in older women. We investigated relations of toileting behaviors and urinary urge cues to OAB and UI in women ≥ 65 years. We tested mediation hypotheses that toileting behaviors lead to higher sensitivity to urinary urge cues (the mediator), which lea...

Review of 145 experimental and quasi-experimental studies of teaching strategies in nursing education revealed that 52 percent were published outside the United States, 80 percent with undergraduate students. Seventy-seven percent assessed learning outcomes, and 80 percent had statistically significant findings. A surge in studies since 2010 showed...

Aims Although physiological factors have a role in nocturia, research suggests that behavioral processes, especially classical conditioning may also play an important role in nocturia and other lower urinary tract symptoms. The study aimed to assess the relationship of stimulus‐associated urges during the day to nocturia in a sample of women aged 1...

Purpose: Nurses who abuse substances are a threat to patients, colleagues, society, and themselves. Research indicates that substance use often begins during undergraduate years. The purpose of this research was to identify rates of past year substance use by student nurses. Method: A quantitative, cross-sectional, correlational design was used...

Background: Nursing school can be an extremely stressful experience. Many nurses with substance misuse issues developed the problem when they were students. The authors, guided by Peplau's interpersonal theory in nursing, examined whether stress and perceived faculty support were related to substance misuse. Method: A quantitative, cross-section...

Aims: Although anecdotal reports of urinary urgency at one's front door are common in overactive bladder syndrome (OAB), little research has been done on how one's front door and other stimuli are related to urinary symptoms. We hypothesized that individuals with OAB would have higher scores on the Urinary Cues Questionnaire, developed for this st...

The aim of this review was to identify etiological environmental factors related to incontinence in children and adults. A variety of etiological environmental factors for the development of incontinence were identifi ed. In children, these encompass stressful life events and trauma, family dysfunction, parental psychopathology, school-related stre...

Background: Near-falls are a frequent, but not commonly studied, occurrence in the elderly Black population and may be related to prospective falls. Objectives: The purpose of this paper is to examine the relationship of near-falls to demographic characteristics, use of assistive devices, gait, and physical activity levels in elderly Blacks. Me...

Aims Nocturia, or waking up at night to void, is a highly prevalent and bothersome lower urinary tract symptom. However, the applied treatment modalities do not improve symptoms in about half of the patients. The aim of this report is to generate new ideas for future nocturia research, with special emphasis on the role of sleep physiology and sleep...

Objective: The present study assessed the relationship between nocturia and cue-induced urinary urges. Methods: Three hundred and six participants (201 females) ranging from 24 to 88 years of age, median age 53 years old participated in an online survey about bladder symptoms and cues related to urinary urge and urgency incontinence. Results: We fo...

This descriptive, survey, cross-sectional study was conducted to investigate the risk factors of depression among four ethnic groups of Asian American adolescents. Convenience sample of 316 adolescents, 16 to 19 years of age (M= 17.53 years, SD = 1.13), living in New York City, were recruited from members and friends of Asian American organizationa...

To investigate the extent to which cues are reported to be associated with urinary urgency incontinence and urinary urgency. Descriptive and correlational study comparing 2 groups. An online questionnaire assessing the extent to which 19 environmental, 3 mood, 3 cognitive, 3 stress incontinence, 1 bladder volume cue, and 3 unlikely cues were associ...

Purpose To examine associations between academic performance and moderate-vigorous physical activity, strength training, fruit and vegetable intake, and sleep. Design Cross-sectional observational study. Setting Forty U.S. colleges and universities participating in the Fall 2008 National College Health Assessment-II (NCHA-II) (median response, 27...

PurposeAlthough all certified diabetes educators have been required to have specific clinical training in a health discipline, graduate programs in diabetes education are relatively rare. The purpose of this article is to describe the development of a different approach to educating diabetes educators: an interdisciplinary graduate degree in diabet...

To explore the metamotivational states experienced during first smoking experiences of Asian American adolescents. This survey research investigated the differences among the smokers, resisters, and smoking naives of a convenience sample of 328 Asian Americans, aged 16-19 in New York City (NYC). The study used a demographic questionnaire, Temptatio...

Objectives: The purpose of this study was to gain an insider's perspective regarding the overall experiences of 61 participants who attempted to quit smoking and to determine whether particular factors were associated with lapses. Design: A 14-day longitudinal randomized design. Methods: Participants used palm-top computers and tape-recorders to re...

Purpose: The purpose of this web-based, quantitative, descriptive, correlational study was to identify frequency of use and success of strategies to alleviate sleep problems, to determine whether there is any relationship between use and success (perceived effectiveness) of strategies, on the one hand, and adults' gender, age, income, or education...

This report from members of the Health Behavior Expert Panel of the American Academy of Nursing (AAN) provides an overview of nurse-led scholarship in tobacco control. We reviewed published reviews of nurse-led studies in the field. The synthesis includes theory development, methodological approaches, studies focused on prevention of tobacco use, n...

Urinary urgency and leakage when arriving home are common in overactive bladder syndrome (OAB). This phenomenon, often termed latchkey incontinence, may be an example of a Pavlovian response to a conditioned stimulus. If so, other cues closely associated with urination may serve as conditioned stimuli as well. In this study we investigated the exte...

To assess the frequency with which environmental cues, which might constitute Pavlovian-conditioned stimuli, occur with urgency and leakage symptoms associated with overactive bladder syndrome (OAB). The sample group comprised 17 adults (13 women and 4 men); their median age was 74.71 years. A semistructured interview was conducted with a convenien...

Gardasil is the first vaccine developed to prevent cervical cancer and other diseases caused by certain types of genital human papillomavirus in females, but little is known about parental acceptance of this vaccine. The purpose of this study was to test a model that predicts intention to vaccinate that includes constructs from the health belief mo...

This study investigated whether Pavlovian extinction occurs during smoking cessation by determining whether experience abstaining from smoking in the presence of cigarette cues leads to decreased probability of lapsing and whether this effect is mediated by craving. Secondary analyses were carried out with data sets from two studies with correlatio...

Intrusive thoughts could impair smoking cessation or cause relapse to the extent that the thoughts are stimuli for smoking. This is a secondary analysis of data provided by 61 participants attempting to quit smoking. Participants used a hand-held computer to capture, in real time, the experience of quitting smoking. Intrusive thoughts related to sm...

Theories tell how and why things work; how and why one variable is related to another. Research findings that are theory based can be placed in a framework that advances science further than findings that are unconnected to formal theory. However, much of the research in smoking cessation is atheoretical. This review of nursing research on smoking...

To explore the correlates of smoking status among a sample of Asian American adolescents in New York City (NYC). This descriptive, correlational study compared current smokers and current nonsmokers in terms of age, gender, ethnicity, academic performance, acculturation, depressive symptoms, smoking history, and parental, sibling, and peer smoking....

A resource depletion model of self-control posits that for some period following performance of a task requiring self-control, self-control will be reduced and thus less available for use in a subsequent task. Using 2 substantial data sets collected in real time from individuals who were trying to quit smoking (1,660 and 9,516 temptation episodes c...

The effect of multigenerational legacies of diabetes on health beliefs and behaviors was explored. Diabetic participants (N = 123) with family histories of diabetes responded to survey questions about their own diabetes self-care behavior, illness representation (including consequences and controllability of diabetes), recollection of a family memb...

The purpose of this study was to examine coping strategies used by teens as they attempted to quit smoking. The teens were attending a school-based cessation program titled Quit 2 Win that was offered in four high schools. This study examined situations in which teens were tempted to smoke. The study compares coping strategies teens reported in res...

The purpose of this study is to develop a means to assess recollections of a family member's diabetes self-care behavior and to assess the relationships to a participant's own self-care behavior. Assessing recollections of a family member's self-care behavior may provide insight into what patients learn from family members with diabetes. Volunteers...

To determine whether types of coping strategies have differential effects on preventing lapses and lowering urge levels and to investigate mechanisms by which coping strategies prevent lapses during smoking cessation. Sixty-one respondents performed ecological momentary assessment using palm-top computers and tape recorders to report their coping s...

The effects of behavioral strategies and cognitive strategies, individually or in combination, on the likelihood of lapsing during smoking cessation were examined by random effects regression analyses of 1,499 temptations reported by 61 smokers during the first 2 weeks of cessation. Compared to using no strategies, using either type exclusively or...

In the United States cigarette smoking accounts for 11 % of deaths of women. Approximately one of every four women smoke. Among pregnant women, 20–50% smoke, although prevalence rates vary depending upon income, age, and educational level. Spontaneous quit rates are highest among pregnant smokers. interventions have been used to assist pregnant wom...

This article proposes a framework for understanding multigenerational legacies of diabetes, which will assist with designing educational interventions for individuals with a known family history of type 2 diabetes. Diabetes is a chronic illness that has an associated hereditary predisposition. Family members at risk in subsequent generations may be...

There is strong evidence for the beneficial health effects associated with smoking cessation during pregnancy. Although many pregnant women spontaneously quit smoking during pregnancy, postpartum relapse is high. Evidence suggests that pregnant women do not use smoking cessation strategies as identified by the 40-item Processes of Change Scale as f...

Reversal theory constructs of playful and rebellious states are compared with negative affect as predictors of temptations and lapses and as predictors of three important correlates of resisting temptations to smoke: Cigarette availability, urge level, and coping during temptations. A total of 61 participants entered data in palmtop computers and t...

Although 67% of adolescent smokers say they want to quit, only 7% are able to do so. The purpose of this study was to use metamotivational states as described in reversal theory to predict whether adolescents who are trying to quit smoking will lapse (smoke a cigarette) or will resist smoking in highly tempting situations. Reversal theory holds tha...

There is a wealth of opportunities for nurses to facilitate smoking cessation with their patients. Nurses have shown to have a modest but positive effect on cessation rates when they deliver brief or intensive counseling. Because nurses work in a multitude of clinical settings, they can impact both prevention and treatment of nicotine addiction ass...

The authors tested a model hypothesizing the predictors and the effects of anticipatory strategy use on the 1st day of smoking cessation using data from 63 participants in an ecological momentary assessment study of smoking cessation. Remaining abstinent on the 1st day of cessation was not associated with mean level of urges to smoke during temptin...

Reversal theory posits that individuals reverse between being telic (serious-minded) and paratelic (playful). Validating a measure of this construct required a novel approach, because the states are posited to be mutually exclusive and orthogonal to both arousal levels and affect. Vignettes depicting telic and paratelic states experienced in low, m...

Whereas prior research has indicated that negative affect states contribute to lapses during cessation attempts, studies using retrospective interviews have shown that the reversal theory states of playfulness and rebelliousness also increase the likelihood of lapsing. Using ecological momentary assessment techniques, the relationship of playfulnes...

Although it is widely believed that drug cravings are responsible for drug use and relapse, S. T. Tiffany (1990) has proposed a cognitive model in which drug use is triggered not by craving but by the cuing of automatized action plans. The purpose of this study was to examine the lapse episodes from an ecological momentary assessment (EMA) study of...

Coping is important for success at smoking cessation, yet little is known about the natural history of coping with urges to smoke during a cessation attempt. In this study, Ecological Momentary Assessment (EMA) methods were used to gather real-time quantitative and qualitative data. For 3 consecutive days during their first 10 days of smoking cessa...

Coping is important for success at smoking cessation, yet little is known about the natural history of coping with urges to smoke during a cessation attempt. In this study, Ecological Momentary Assessment (EMA) methods were used to gather real-time quantitative and qualitative data. For 3 consecutive days during their first 10 days of smoking cessa...

Smoking has well-known effects on heart rate and muscle activity. The influence of individual difference factors such as gender and personality characteristics, however, are not as well-known. This study examined the effects of smoking on heart rate and muscle activity and tested for differential changes due to gender and personality characteristic...

America's overweight problem is universally recognized and escalating, despite billions of dollars spent to combat it. For the past century, a unidimensional paradigm was predominantly used to correct the overweight problem by reducing calories through dieting. As a result of the profound failure of traditional diet programs, a phenomenon known as...

Research has indicated that using coping strategies is significantly related to resisting smoking during highly tempting situations. However, little is known about the nature of coping during smoking cessation. The purpose of this study was to identify coping strategies used within the first 10 days of smoking cessation by having participants descr...

This qualitative study describes the experience of individuals who were attempting to quit smoking. Ten respondents participated in the semistructured interactive interviews. Five themes emerged from the data analysis: the intensity of the struggle, the personification of the cigarette, planning to quit, replacement of an old habit with a new habit...

Concepts from reversal theory, a general theory of motivation, emotion and action, have recently been shown to be relevant to smoking behavior and smoking cessation. One relevant concept is that of telic and paratelic dominance. Individuals who are paratelic-dominant are playful, spontaneous, and prefer high arousal seeking. Those who are telic-dom...

Philosophical explanations of the phenomenon of akrasia have been used in this article to characterize some of the difficulties involved in successful behavior change. The theory of psychological reversals provides a framework for understanding various types of akratic behavior. In addition, empirical research on the temptations of persons trying t...

The purpose of this study was to investigate the contribution of reversal theory constructs (i.e., metamotivational states) to understanding the outcome of tempting situations that occur in the first 6 weeks of smoking cessation. Cessation program participants (n = 68) were interviewed about tempting situations in which they either smoked or mainta...

Reversal theory, a general theory of motivation, emotion and action, has recently been shown to predict lapses in smoking cessation. Individuals are less likely to lapse if they are in the telic (serious-minded, arousal avoidant, goal-oriented) state than when they are in the paratelic (playful, arousal seeking, spontaneous) state. The literature i...

Relapse is the most frequent outcome of smoking cessation attempts. This study tests the usefulness of the mastery and sympathy concepts of Apter's reversal theory to explain whether subjects lapse or abstain during highly tempting situations. Descriptions of the highly tempting situations of 57 individuals who were attempting to quit smoking were...

Smoking continues to be a habit that is extremely difficult to change despite increasing social pressure to do so. Models that look for consistency within individuals do not adequately account for the high rate of relapse following smoking cessation. Reversal theory provides an excellent framework for understanding the situations in which ex-smoker...

Reversal theory, a new theory of motivation, emotion and personality, has been shown to have important implications for health behavior. Valid, reliable instruments for the measurement of reversal theory concepts are needed to promote further research in this area. None of the previous self-report methods for measuring the telic (serious-minded) an...

Careful, comprehensive, and empirical observations provide the building blocks of the sciences, whereas theory and mechanisms provide the "cement" to hold the blocks together and serve as blueprints to direct future building. This article resulted from several days of discussion regarding theories that may underlie the relation between cigarette sm...

This article resulted from several days of discussion regarding theories that may underlie the relation between cigarette smoking and body weight and the relation between smoking cessation and body weight. The working group composed of social and biological scientists who addressed this assignment considered what is already known within the smoking...

Previous investigations of smoking relapse crises have found limited within-subject consistency. Several investigators have suggested that greater consistency might be observed if situations were described phenomenologically. Reversal theory provides one phenomenological framework. Two relapse crises from each of 49 ex-smokers were compared, using...

1. The theory of psychological reversals holds that individuals are inherently inconsistent and that they reverse between metamotivational states. Four pair states have been identified: telic/paratelic; negativistic/conformist; mastery/sympathy; autocentric/allocentric. 2. Individuals interpret motivational variables in different ways depending on...

Examined the frequency of use and the perceived usefulness over time of various coping strategies in the attempt to overcome the urge to smoke. Both interview and questionnaire measures were used with 182 Ss who abstained for at least 3 mo after attending community-based smoking cessation programs. The most frequently used strategies were deep brea...

Reversal theory provides a new approach to understanding ex-smokers' behavior during highly tempting situations. Hypotheses derived from the theory were tested in 2 studies of the highly tempting situations of ex-smokers drawn from community smoking cessation programs. Study 1 consisted of interviews with 55 Ss (25 men and 30 women, mean age 37 yea...

Reversal theory provides a new approach to understanding ex-smokers’ behavior during highly tempting situations. Hypotheses derived from the theory were tested in 2 studies of the highly tempting situations of ex-smokers drawn from community smoking cessation programs. Study 1 consisted of interviews with 55 Ss (25 men and 30 women, mean age 37 yea...

The relationships of blood glucose levels to symptoms and symptom beliefs were examined in this study of persons (N = 51) with Type II diabetes. Analyses revealed that 88% of the subjects had at least one symptom that was substantially correlated with blood glucose levels. However, subjects' symptom beliefs (symptoms subjects believe are the best i...

The changes in salivary thiocyanate (SCN) following smoking cessation were determined for 70 people recruited from community-based smoking cessation programs. Data collected over 3 months following cessation showed a half value of 5 days for abstainers, a strong linear relationship between SCN level and number of days since quitting, and considerab...

This study examined linkages between negative affect smoking and relapse. A sample of 669 smokers treated in smoking cessation clinics completed the Horn Motives for Smoking Scale at baseline and were followed at 3 and 12 months posttreatment. Negative affect (NA) smoking scores were unrelated to initial cessation or to maintenance at 3 months. Neg...

why do human beings so often behave in ways that do not appear to aid their survival and that, on occasion, appear to work against their survival discuss some of the research on smoking from a reversal theory perspective in order to illustrate the usefulness of reversal theory for explaining smoking cessation and relapse approaches to understan...

A model for self-regulation of diabetes was tested which proposed that individuals monitor their disease status by comparing their current state with their standard of well-being. When a discrepancy is experienced and associated with a change in blood glucose, action is taken to relieve the symptom and thereby regulate blood glucose. Two variables...

This study investigated the effects of salivary stimulation on thiocyanate (SCN) levels. A device for collecting parotid saliva that allowed for the measurement of flow rate was used in stimulated and nonstimulated conditions with six subjects. Results indicated that SCN levels exhibited considerable within-subject variability and were inversely re...

This study examined linkages between negative affect smoking and relapse. A sample of 669 smokers treated in smoking cessation clinics completed the Horn Motives for Smoking Scale at baseline and were followed at 3 and 12 months posttreatment. Negative affect (NA) smoking scores were unrelated to initial cessation or to maintenance at 3 months. Neg...

In nursing, the term 'education in the psychosocial and behavioral factors that influence health and illness' is preferred to the term 'behavioral medicine training'. Despite the differences in terminology, the psychosocial and behavioral factors in health and illness hold a prominent place in the education and research of nurse scholars. Currently...

A classification scheme developed by Marlatt and Gordon (1980) was used to categorize the highly tempting situations of 596 participants in smoking cessation programs. When the distributions of relapsers, temporary lapsers (those who smoked and then resumed abstinence), and abstainers were compared, chi-square analyses revealed significant differen...

A classification scheme developed by Marlatt and Gordon (1980) was used to categorize the highly tempting situations of 596 participants in smoking cessation programs. When the distributions of relapsers, temporary lapsers (those who smoked and then resumed abstinence), and abstainers were compared, chi-square analyses revealed significant differen...

Salivary samples from three placement sites and under stimulated and unstimulated flow-rate conditions were collected from 36 participants (18 smokers, 18 nonsmokers) on each of 3 days. These samples were used to determine the best collection methodology for discriminating smokers from nonsmokers, the reliability of salivary thiocyanate (SCN) over...

Salivary samples from 3 placement sites under stimulated and unstimulated flow-rate conditions were collected from 18 smokers and 18 nonsmokers on each of 3 days. Salivary thiocyanate levels were significantly higher in smokers than in nonsmokers, in parotid site collections than either sublingual or mixed collections, and in unstimulated collectio...

A model of self-regulation that explains the health behavior of type II diabetic patients was tested by examining the use of symptoms as indicators of perceived blood glucose levels in 38 outpatients. Results of the study supported the self-regulation model by demonstrating that patients use symptoms to monitor blood glucose levels and to guide dia...

Presents a review of the literature on thiocyanate (SCN) to illustrate the methodological issues involved in using biochemical indices of behavior. Issues related to the sensitivity, specificity, predictive value, and reportedly long half-life of SCN are discussed in relation to other biochemical indices of smoking, which include expired air CO, bl...

Presents a review of the literature on thiocyanate (SCN) to illustrate the methodological issues involved in using biochemical indices of behavior. Issues related to the sensitivity, specificity, predictive value, and reportedly long half-life of SCN are discussed in relation to other biochemical indices of smoking, which include expired air CO, bl...