Western Journal of Nursing Research RSS feed -- OnlineFirst Articles

Processes Inherent in Mammography-Screening Decisions of Rarely or Never-Screened Women

Purtzer, M. A. — Sat, 14 Nov 2009 19:29:20 PST

Breast cancer is a significant cause of mortality and morbidity. A strong association exists between survival and early detection through regular mammography. Impoverished women underuse this life-saving screening, resulting in a disproportionate cancer burden. The study purpose is to discover the process of rarely or never-screened women’s mammography-screening decisions. The sample consists of five rural, low-income, uninsured, and rarely or never-screened women. Grounded theory methodology is used to generate a new theoretical explanation of mammography-screening decision making. Findings include the central conceptual categories, intuitive dominance and intuitive certainty, which contribute toward an intuitive decision-making default. This intuitive thinking style weaves throughout two interrelated categories: (a) scarce, supportive, relational resources for learning and (b) dichotomous health care-seeking behaviors. Implications focus on a nontraditional client assessment whereby nurses can facilitate relational-based knowledge construction. Recommendations for future research include examination of the process of integrating intuition with reasoned thought for more fully informed decisions.

The Invisible Family: A Qualitative Study of Suicide Survivors in Taiwan

Tzeng, W.-C., Su, P.-Y., Chiang, H.-H., Kuan, P.-Y., Lee, J.-F. — Sat, 14 Nov 2009 19:29:23 PST

The purpose of this interpretive phenomenological study is to describe the commonality of the lived experience of suicide survivors and how it influences their family relationships in Taiwan from a sociocultural perspective. Thirteen suicide survivors have participated in this study. Study results reveal that some survivors blame themselves, some blame others, and some are blamed by their family as part of their need to find a reason for the death. Consequently, family members ignore each other and treat each other as if they are invisible. These Chinese suicide survivors, unlike Western survivors, maintain their strained family connections because of strong cultural influences. Therefore, health professionals should acknowledge the experiences of living with an invisible family when supporting Chinese suicide survivors.

Translating the Pittsburgh Sleep Quality Index Into Arabic

Suleiman, K. H., Yates, B. C., Berger, A. M., Pozehl, B., Meza, J. — Sat, 14 Nov 2009 19:29:19 PST

This descriptive correlational study describes the translation process and the psychometric testing of the Pittsburgh Sleep Quality Index (PSQI). The PSQI has been successfully translated into Arabic and back-translated into English by 10 Arabic bilingual translators. Then the PSQI is tested in a sample of 35 healthy Arabic bilinguals. The internal consistency reliability for the Global PSQI demonstrates borderline acceptability (Cronbach’s alpha = .65). The reliability is further supported by moderate to high correlations between five PSQI components and the global PSQI score (r = .53 to .82, p < .01). Convergent validity is supported by the global PSQI correlating strongly with the Insomnia Severity Index (r = .76) and moderately with the related construct of the Medical Outcome Study Short Form–36 vitality subscale (r = –.33). Further testing of the PSQI is needed in a larger Arabic population, both clinical and healthy populations, living in their native countries.

Effect of n-3 Oral Supplements on the n-6/n-3 Ratio in Young Adults

McDaniel, J. C., Ahijevych, K., Belury, M. — Sat, 14 Nov 2009 19:29:22 PST

Epidemiological studies show that n-6/n-3 polyunsaturated fatty acid (PUFA) ratios have risen dramatically in Western diets and are associated with numerous chronic inflammation-related diseases. More balanced ratios are linked to less inflammation. This study examines the effects of adding oral supplements containing n-3 eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA) to diets of healthy young adults on plasma n-6/n-3 ratios. Thirty volunteers are randomly assigned to one of two groups: experimental group, EPA (1.6 g/day) and DHA (1.2 g/day); and the control group, mineral oil (2.4 ml/day). Plasma fatty acids, nutrients from foods, and anthropometric measures are evaluated at baseline and at the Week 4 endpoint. The mean (±SD) n-6/n-3 ratio for the experimental group is significantly lower (6.3 ± 1.6) than the placebo group (16.8 ± 3.5) by study completion. The results suggest that more balanced n-6/n-3 ratios may be achieved efficiently in healthy, young adults with supplements containing EPA and DHA.

La Mancha Negra: Substance Abuse, Violence, and Sexual Risks Among Hispanic Males

Gonzalez-Guarda, R. M., Ortega, J., Vasquez, E. P., Santis, J. D. — Sat, 14 Nov 2009 19:29:18 PST

Hispanics are disproportionately affected by substance abuse, intimate partner violence, and HIV. Although the relationship between these conditions has been documented in the literature, few studies have explored the intersection of these health problems and their culture-related risk factors in an integrative manner. The purpose of this study is to explore the experiences that Hispanic heterosexual males in South Florida have with substance abuse, violence, and risky sexual behaviors. Three focus groups with a total of 25 Hispanic adult men are completed and analyzed using grounded theory. Three core categories emerge from the data. These include la cuna de problemas socials (the cradle of social problems), ramas de una sola mata (branches from one same tree), and la mancha negra(the black stain). This study suggests that substance abuse, violence, and risky sexual behaviors are linked conditions with common cultural and socioenvironmental risk factors and consequences.

Influence of Stress Resiliency on RN Job Satisfaction and Intent to Stay

Sat, 14 Nov 2009 19:29:20 PST

Registered nurse (RN) job satisfaction is a major predictor of intent to stay and job turnover, serious concerns to health care leaders. Predictors of job satisfaction include autonomy, control over daily practice, nurse–physician collaboration, transformational leadership, group cohesion, job stress, structural empowerment, and psychological empowerment. In the model of psychological empowerment, stress resiliency is the product of persons’ interpretive styles and influences psychological empowerment. This study has evaluated the influence of stress resiliency on job stress, psychological empowerment, job satisfaction, and intent to stay using causal modeling. Participants are 464 RNs employed in five acute care hospitals in West Virginia. The final model has provided a very good fit to the data. Stress resiliency is a predictor of psychological empowerment, situational stress, and job satisfaction. This study provides the first evidence of the influence of stress resiliency on job stress, psychological empowerment, job satisfaction, and intent to stay in a sample of RNs.

Effects of a Multifaceted Minimal-Lift Environment for Nursing Staff: Pilot Results

Zadvinskis, I. M., Salsbury, S. L. — Sat, 14 Nov 2009 19:29:19 PST

Nursing staff are at risk for musculoskeletal injuries because of the physical nature of patient handling. The purpose of this study is to examine the effectiveness of a multifaceted minimal-lift environment on reported equipment use, musculoskeletal injury rates, and workers' compensation costs for patient-handling injuries. The pilot study consists of a mixed measures design, with both descriptive and quasi-experimental design elements. The intervention consists of engineering (minimal-lift equipment), administrative (nursing policy), and behavioral (peer coach program) controls. The comparison nursing unit has received engineering controls only. The convenience sample includes nursing staff employed on two medical-surgical nursing units, who provide direct patient care at least 50% of the time. Nursing staff employed in a multifaceted lift environment report greater lift equipment use and experience less injury, with reduced worker's compensation costs.

Validity and Reliability of the Chronic Heart Failure Questionnaire Mastery Subscale in Patients With Defibrillators

Kim, J., Pressler, S. J., Welch, J. L., Groh, W. J. — Fri, 25 Sep 2009 14:27:54 PDT

Reliable, valid measures are needed to assess one’s sense of mastery, which has the potential for decreasing anxiety and depressive symptoms among patients with implantable cardioverter-defibrillators (ICDs). This study evaluates the reliability and validity of a measure of mastery, the Chronic Heart Failure Questionnaire (CHQ) mastery subscale. One hundred twenty-two (75% men, mean age 65 years) and 100 patients complete baseline and 12-month face-to-face interviews, respectively. The CHQ mastery subscale is found to have internal consistency reliability (Cronbach’s alphas = .79, .84), and its validity is supported. Factor analysis yields a single robust factor. Differences in the CHQ mastery subscale scores by the New York Heart Association (NYHA) classes are found: Patients with NYHA Class III or IV have lower mastery than those with Class I or II. Baseline younger age and less frequent ICD shocks and lower mastery are significant predictors of respectively 12-month anxiety (R² .37) and depressive symptoms (R² .45). The CHQ mastery subscale has demonstrated satisfactory reliability and validity in this sample.

Psychometric Properties of the KPAS in Diverse Ethnic Groups of Midlife Women

Lee, B., Im, E.-O., Chee, W. — Thu, 10 Sep 2009 12:35:14 PDT

The Kaiser Physical Activity Survey (KPAS), designed specifically for diverse activity domains (housework, caregiving, occupational activity), is used to assess physical activity among multiethnic midlife women. This study evaluates KPAS reliability and validity (not widely documented) in measuring physical activity among 341 groups in this classification. Internal consistency coefficients are adequate for all ethnic groups except non-Hispanic (N-H) African Americans. To evaluate construct validity, the researchers use multiple analytic approaches, including correlation between behavioral intention and KPAS scores and factor analysis. KPAS scores correlate positively with behavioral intention scores among all ethnic groups. Eight factors are extracted among all groups except N-H Asian Americans. In the convergent validity test, N-H African Americans and N-H Asian Americans show unique patterns. Overall, the KPAS proves reliable as a reasonably accurate instrument to assess physical activities among multiethnic groups of midlife women. However, cultural sensitivity among N-H African Americans and N-H Asian Americans needs further examination.

Nonspecific Effects in Psychoeducational Intervention Research

Donovan, H. S., Kwekkeboom, K. L., Rosenzweig, M. Q., Ward, S. E. — Fri, 17 Jul 2009 12:36:27 PDT

Randomized clinical trials support the efficacy of a wide range of psychoeducational interventions. However, the mechanisms through which these interventions improve outcomes are not always clear. At times, the theoretically specified factors within interventions have been shown to have specific effects on patient outcomes. But it has also been argued that other factors not identified in the intervention theory (e.g., "nonspecific" factors such as patient expectations and therapeutic patient–clinician alliances) have powerful nonspecific effects that account for most, if not all, of the observed efficacy of psychoeducational interventions. This article describes important concepts in this debate and discusses key issues in distinguishing between specific and nonspecific effects of psychoeducational nursing interventions. Four examples are used to illustrate potential methods of identifying and controlling for nonspecific effects in clinical intervention trials.

Does the Conservation of Resources Motivate Middle-Aged Women to Perform Physical Activity?

Rotem, M., Epstein, L., Ehrenfeld, M. — Wed, 15 Jul 2009 15:21:07 PDT

This article aims to examine the factors that motivate middle-aged women to engage in leisure physical activity (LPA) and to explore the relationship between resources loss and gains and engaging in LPA. It is a cross-sectional study based on a self-reported questionnaire (n = 949), using variables of the conservation of resources theory and the theory of planned behavior. Results show that women who engage in physical activity experience lower resources loss than inactive women. The longer they engage in physical activity, the less they experience losses such as youth, attractiveness, optimism, health, and beauty. Conservation of resources, perceived behavioral control, attitudes, and normative beliefs predict 41% (p < .0001) of the variance in the engagement in leisure physical activity. Findings suggest that constructing effective strategies to promote LPA requires also addressing these factors, which are valued by middle-aged women.

Preparation of Nursing Students for Change and Innovation

Kalisch, B. J., Begeny, S. — Fri, 15 May 2009 09:59:27 PDT

As health care technology advances and patients require more care, nurses will need to be prepared to change old and incorporate new care practices and systems. Nurses must not only be able to deliver quality nursing care, but will also need to be capable of creating innovative approaches, reacting quickly, and taking calculated risks. Using the Organizational Engineering Model, this study examines the informational processing styles of students entering the nursing profession and in turn, measures the way they process information at the end of their education. The information processing style predicts the ability to innovate, take risks, and change. The findings of this study demonstrate that we attract nursing students who fall within the Conservator information processing style. Conservators focus on outcome certainty and a deliberate response. Schools of nursing also graduate students with this same profile, indicating that we have not altered their information processing style during their education.

Effects of an Internet Physical Activity Intervention in Adults With Metabolic Syndrome

Bosak, K. A., Yates, B., Pozehl, B. — Wed, 08 Apr 2009 14:15:31 PDT

The Internet is a relatively new method of delivering strategies for health behavior change. The purpose of this study was to determine the feasibility of delivering a physical activity intervention by the Internet to improve outcomes in adults with the metabolic syndrome. Twenty-two participants (16 males; 6 females) were recruited from a cardiology clinic database, age range 32-66 years. Participants were randomly assigned to the Internet intervention (n = 12) or the usual care (n = 10) group. The mean total dose, in terms of the time the intervention Web site was accessed was 2 hours over 6 weeks, which was greater than the time spent delivering usual care. Overall, participants’ evaluations of the Internet intervention were positive. The costs of development and delivery of the Internet intervention were less than that of a consultation and follow-up in the cardiology clinic for this sample. The Internet intervention appears feasible for testing in a larger study.