Western Journal of Nursing Research recent issues

Editorial: Testing Nursing Interventions

Conn, V. S. — 2008-11-17

Qigong Improving Physical Status in Middle-Aged Women

Tsai, Y.-K., Chen, H.-H., Lin, I-H., Yeh, M.-L. — 2008-11-17

Regular exercise has been shown to benefit its practitioners and prevent and control diseases. Muscle/Tendon Change Classic (MTCC) qigong, characterized by simple, slow, and full-body exercise, is appropriate for the middle-age population. This study aims to evaluate the effect of the MTCC qigong program in improving physical status for middle-aged women. A quasi-experimental design was used. The experimental group (n = 37) received an 8-week MTCC qigong program, whereas the control group (n = 34) received none. Physiological parameters of muscular performance, body composition, and bone strength were measured before and after the program. The average age was 49 ± 4.13 years for the experimental group and 50 ± 4.74 years for the control group. The demographic characteristics were homogeneous between the two groups. There were statistically significant differences between the two groups in muscular endurance, body fat, waist-to-hip ratio, and body mass index at the completion of 8-week MTCC qigong program. The MTCC qigong could improve muscle endurance and body composition but not bone strength for middle-aged women, thereby demonstrating the qigong practice has certain health-preserving effects on women in this stage of life.

Outcomes of an Intervention to Reduce Uncertainty Among African American Women with Diabetes

Amoako, E., Skelly, A. H., Rossen, E. K. — 2008-11-17

Poor adjustment to diabetes in older African American women may result from uncertainty, stemming from a lack of information about self-care activities, a complexity of self-care activities, comorbid conditions, and a lack of resources. This study evaluated a telephone intervention to reduce uncertainty (through problem-solving strategies, information, cognitive reframing, and improved patient—provider communication)—namely, to measure its effects on diabetes self-care and psychosocial adjustment. Sixty-eight older African American women were randomly assigned to an experimental group and a control group. The experimental group received the intervention for 4 weeks, and the control group received usual care. Psychosocial adjustment and self-care were measured in all participants at baseline and 6 weeks postbaseline. The experimental group reported increased participation in exercise (self-care component; p < .001) and improvement in psychosocial adjustment (p < .001). Thus, reducing the uncertainty related to diabetes self-care improves self-care exercise, as well as psychosocial adjustment.

Factors Associated with Caregiver Burden in Heart Failure Family Caregivers

Saunders, M. M. — 2008-11-17

Fifty caregivers and 41 heart failure patients participated in a study examining the association of caregiver characteristics and the caregiving environment on caregiver burden. Using a cross-sectional design, caregivers were interviewed face-to-face using a caregiver characteristic/demographic tool designed for this study, the Centers for Epidemiological Studies Short Depression Scale, the Caregiver Reaction Assessment questionnaire, and the New York Heart Association Functional Classification Guide to obtain the caregiver's perception of patient disease severity. Patient medical records were assessed following caregiver interviews for patient demographics, comorbidities, and ejection fraction percentages. Significantly higher levels of burden were found among Caucasian caregivers, those caring for other relatives besides the patient, unemployed caregivers, and single- versus two-family caregivers (respite caregiving). Fifty-one percent of the variance in caregiver burden was accounted for by the variables caregiver advanced age, higher caregiver hours, more caregiver physical health problems, higher levels of caregiver depressive symptoms, and more patient comorbidities. This article concludes with implications for nursing practice and future research.

Knowledge and Beliefs Related to Cervical Cancer and Screening Among Korean American Women

Lee, E. E., Fogg, L., Menon, U. — 2008-11-17

The purpose of this article is to examine knowledge and health beliefs associated with cervical cancer screening among Korean American women. A telephone survey was conducted with 189 Korean American women in the Chicago area. Age, marital status, income, knowledge of early detection method for cervical cancer, and perceived beliefs about benefits of and barriers to receiving Pap tests were all related to outcomes of ever having a Pap test and having had one in the preceding 3 years. Variables uniquely related to ever having a Pap test were education, employment status, fluency in English, and proportion of life spent in the United States. Variables uniquely related to having had the test during the preceding 3 years were having a usual source of care and regular checkups. Different intervention components are suggested for the groups of Korean American women who have never had a Pap smear and for those who have not had one in the preceding 3 years, in addition to common intervention strategies that aim to increase knowledge and perceived benefit and to decrease perceived barriers to receiving Pap tests.

Postoperative Pain Management Outcome in Chinese Inpatients

Qu Shen, , Sherwood, G. D., McNeill, J. A., Zheng Li, — 2008-11-17

In the absence of pain management outcome reports representing mainland China, the purposes of this study were to describe the outcome of postoperative pain management and the relationship between patient satisfaction and clinical outcomes in an indigenous Chinese population. From a sample of 388 second-day-postoperative inpatients, 304 (78%) reported pain in the past 24 hours and were enrolled in the study. Mean ratings for pain were moderate to severe. Patients reported mild to moderate pain-related interference with mood and physical activities. There were significant differences on worst pain intensity and pain interference with daily activity in the past 24 hours for different types of surgery. Top-ranked nonpharmacologic methods for managing pain were tolerating pain, changing positions, and family support. As measured by the Pain Management Index, 60.2% of patients were inadequately treated for pain, yet patients reported high satisfaction with pain management. Patient satisfaction, however, was inversely and significantly correlated with pain intensity. Study results indicate a need for standardized policies and guidelines about pain management and education among providers and for patients and families to overcome the suboptimal pain outcomes among this Chinese population.

Application of the Transtheoretical Model to Identify Aspects Influencing Condom Use Among Korean College Students

2008-11-17

Increasing condom use requires an understanding of the influencing factors. Previous research has used psychosocial theories such as the social cognitive theory and health belief to explain AIDS risk factors and condom use. However, it is still difficult to effectively predict the multidimensional factors associated with condom use. The present study utilizes the transtheoretical model to investigate condom use among college students by examining stages of change for condom use and measuring decisional balance and self-efficacy for each stage. The aim was to identify the variables affecting condom use so as to provide scientific data that would aid the development of effective strategies for increasing condom use.

Health Behavior in Mexican Pregnant Women with a History of Violence

Quelopana, A. M., Champion, J. D., Salazar, B. C. — 2008-11-17

This study examines the association between history of violence, attitudes toward pregnancy, and initiation of prenatal care (PNC). Pregnant women receiving their first PNC visit at a public prenatal clinic in Monterrey, Mexico, were enrolled in the study. Structured interviews collected information concerning demographics, reproductive history, current pregnancy, attitudes toward pregnancy, history of violence, and perceived barriers and benefits of PNC. Results showed that 35% of participants reported violence. A current or previous partner was the most common perpetrator. Of women experiencing abuse, 47% reported that abuse was ongoing during the current pregnancy. More women reporting violence were unmarried, did not live with a partner, and reported a lower monthly income. An experience of violence was associated with initiation of PNC, number of pregnancies, perception of barriers, and negative attitudes toward pregnancy. This issue should be emphasized in recognition of the important role that nurses and midwives have regarding violence.

The Role of Parents in Making Life Support Decisions for Extremely Premature Infants

2008-11-17

Psychometric Evaluation of the Family Effectiveness Measure Among Low-Income African American Single-Parent Families

2008-11-17

The Impact of a Pediatric RN Internship on New Graduate Nurse Job Satisfaction and Retention

Halfer, D. — 2008-11-17

Dispositional Cognitive Appraisal, Informational Coping Style, and Depressive Symptoms in Family Decision Makers of the Chronically Critically Ill

Hickman, R. L., Daly, B. J. — 2008-11-17

The Relationship Between Executive Function, AD/HD, and Obesity

Dempsey, A., Dyehouse, J. — 2008-11-17

Self-Efficacy, Outcome Expectation, Self-Care Behavior, and Glycosylated Hemoglobin Level in Persons With Type 2 Diabetes

Kott, K. B. — 2008-11-17

Sleep Quality and Trauma Symptoms in Battered Women

Huber, L. A., Woods, S. J., Hall, R. J., Angott, D. M. — 2008-11-17

Midwest Nursing Research Society News

Rawl, S. — 2008-11-17

Editorial: Dancing With Dinosaurs

Conn, V. S. — 2008-10-08

Predictors of Job Satisfaction for Rural Acute Care Registered Nurses in Canada

Penz, K., Stewart, N. J., D'Arcy, C., Morgan, D. — 2008-10-08

This study examines predictors of job satisfaction among rural acute care registered nurses. The data are from a cross-sectional national survey, which was part of a larger project, The Nature of Nursing Practice in Rural and Remote Canada. This analysis suggests that a combination of individual, workplace, and community characteristics are interrelated predictors of job satisfaction for rural acute care nurses. There were nine variables that accounted for 38% of the total variance in job satisfaction. Four variables alone (available and up-to-date equipment and supplies, satisfaction with scheduling and shifts, lower psychological job demands, and home community satisfaction) explained 33% of the variance. Recruitment and retention strategies in rural areas must acknowledge that rural nurses' work lives and community lives are inextricably intertwined. Attention to these issues will help ensure high-quality working environments and a continued commitment to quality nursing care in the rural hospital settings in Canada.

Methodological Issues in Explaining Maternal Outcomes: Anesthesia Provider Characterizations and Resource Variation

Minnick, A. F., Needleman, J. — 2008-10-08

Anesthesia provider models were characterized based on responsibilities and technique privileges and the distribution of clinical resource and process variables using a survey of 1,135 hospitals offering obstetric care in eight representative states. The resulting models were then analyzed by resource availability. In the 40% of hospitals where certified registered nurse anesthetists (CRNAs) and anesthesiologists both practiced obstetric anesthesia, three models emerged based on consistency of privileges within the institution and permission to initiate procedures. Hospitals in which only anesthesiologists practice and those in which CRNAs practice was most restricted had more resources than other hospitals surveyed. Traditional characterizations of provider fail to capture differences in technique privileges. Clinical resource variables and the scope of technique privileges should be included in the study of anesthesia provider credentials on outcomes.

The Experience of Community-Living Women Managing Fecal Incontinence

Peden-McAlpine, C., Bliss, D., Hill, J. — 2008-10-08

Although many women suffer from fecal incontinence (FI), little is known about their day-to-day experiences. The aims of this phenomenological study were to understand the experience of women living with FI from their perspective and to elicit women's self-care and management strategies for FI. Ten women participated in audiotaped, unstructured interviews that were transcribed into a written text. The text was analyzed using Van Manen's approach for deriving themes. The findings display the women's experience of lived time, lived space, lived relationships, and lived body and the essential theme of "controlling the body out of control." The findings demonstrate that FI is a problem that affects women in all dimensions of their lifeworld experience and describes the continual attention and self-management FI requires.

Adolescents' Avoidance of Secondhand Smoke Exposure: Model Testing

Wang, W.-L., Herting, J. R., Tung, Y.-Y. — 2008-10-08

More than half of young adolescents, 13 to 15 years old, suffer exposure to secondhand smoke (SHS) at home and in public places. Despite threats to adolescent health and well-being, little research has been done to identify factors that enable adolescents to avoid SHS. The objective of this study was to develop a model to predict SHS avoidance behavior among young adolescents. The impact of gender differences on predictor variances was investigated. Model testing was conducted using structural equation modeling on data from 1,291 nonsmoking Taiwanese middle school students. Attitude toward SHS is an important factor influencing the avoidance behavior of adolescents. The explanatory model of SHS avoidance behaviors provides useful information for program development aimed at decreasing adolescent exposure to SHS. Interventions focused on influencing adolescent attitudes toward SHS and supporting avoidance self-efficacy are needed.

Measuring Breast Cancer and Mammography Screening Beliefs Among Chinese American Immigrants

Lee-Lin, F., Menon, U., Pett, M., Nail, L., Lee, S., Mooney, K. — 2008-10-08

Disparities in breast cancer outcomes persist among Asian American women. Breast cancer is the most commonly diagnosed cancer among Chinese American women. This article describes the psychometric evaluation of an instrument measuring knowledge and beliefs related to breast cancer and screening among Chinese American women aged 40 or older. A sample of 100 foreign-born Chinese American women were recruited from an Asian community. Guided by the health belief model, a questionnaire was adapted from three existing questionnaires. Principal axis factoring analyses yielded a three-factor solution that accounted for 53% of the variance in the breast cancer items and a four-factor solution that accounted for 69% of the variance in the cultural items (Cronbach's alphas = .71—.89). Whereas these findings contribute to the understanding of the psychometric properties of an instrument targeted for Chinese American women, additional research is needed to evaluate its utility and efficacy for other Asian Americans.

Stress and Coping of Midlife Women in Divorce Transition

Sakraida, T. J. — 2008-10-08

This article describes stress and coping by decider status. Participants were 154 women aged 34 to 54 years who were recently divorced from their first marriage and were married 3 years prior to divorce. Participants self-selected into decider statuses as initiators, noninitiators, or mutual deciders. Noninitiators indicated not knowing the divorce experience was going to occur, not having enough time to get ready for it, saw it as something someone else did, and perceived it as a threat. Initiators and mutual deciders viewed the divorce as a challenge. Noninitiators were less positive about the divorce experience than were initiators and mutual deciders. Acceptance or resignation differed significantly for noninitiators and mutual deciders but not between noninitiators and initiators. Characterizing midlife divorce transition experiences provides a foundation for developing primary intervention to support personal growth, healing, and a healthy lifestyle.

Educators' Experience of Teaching Nursing Research to Undergraduates

Mansour, T. B., Porter, E. J. — 2008-10-08

Most research pertaining to the teaching of nursing research has focused on learning outcomes and students' attitudes toward research. Few scholars have explored what it is like to teach nursing research. The purpose of this study was to describe the experience of teaching undergraduate nursing research. Data were obtained from 12 nurse educators through e-mail interviews and analyzed using Giorgi's method of descriptive phenomenology. Four meaning units describe the experience: marketing research content, introducing the research process, enhancing student abilities to learn about research, and enhancing personal abilities to teach research. The three meaning units that focus on faculty intentions toward students are somewhat consistent with prior research but include interesting new ideas. Concerning the last meaning unit, participants reported an interest in learning about teaching strategies, advanced statistics, and informational technology. Deans and directors should explore the learning needs of such faculty and offer appropriate ongoing education.

Midwest Nursing Research Society News

Rawl, S. M. — 2008-10-08

Guest Editorial: Advancing Depression Research in Nursing Home Residents

Phillips, L. J. — 2008-09-12

Certified Nursing Assistants' Explanatory Models of Nursing Home Resident Depression

Piven, M. L., Anderson, R. A., Colon-Emeric, C. S., Sandelowski, M. — 2008-09-12

In this study, the authors describe certified nursing assistants' (CNA) Explanatory Models (EMs) of depression and aspects of their EMs that may contribute to the underdetection of depression in nursing homes. Interviews with 18 CNAs working in two nursing homes are guided by Kleinman's Explanatory Models of Illness framework. Interview data are content analyzed and CNAs' descriptions of depression are compared to the MDS 2.0 Mood Screening criteria and to the DSM-IV-TR diagnostic criteria for depression. The result is that the CNAs are unsure about the duration and normalcy of depression in residents. Although they have no formal training, CNAs feel responsible for observing for signs of depression and describe verbal and nonverbal ways of interacting when providing emotional care to residents. CNAs hold potential to improve the detection of depression and contribute to the emotional care of residents. Attention to staff knowledge deficits and facility barriers may enhance this potential.

Measuring Physical Activity in Older Adults: Use of the Community Health Activities Model Program for Seniors Physical Activity Questionnaire and the Yale Physical Activity Survey in Three Behavior Change Consortium Studies

Resnick, B., King, A., Riebe, D., Ory, M. — 2008-09-12

The purpose of this study was to use data from three Behavior Change Consortium intervention studies to consider the practicality of use of two surveys of physical activity (PA) relevant for older adults, provide support for the validity of these surveys, and provide guidance to researchers for decisions on use of one survey as opposed to the other. The samples included 218 participants in the Community Health Advice by Telephone Study, 150 participants in the Study of Exercise and Nutrition in Older Rhode Islanders, and 150 participants from the Testing the Effectiveness of the Exercise Plus Program. PA surveys included the Yale PA Survey and the Community Health Activities Model Program for Seniors PA Questionnaire. Older adults were able to complete either survey, although for frailer participants, an interview format is recommended. The Community Health Activities Model Program for Seniors PA Questionnaire was more likely to elicit information about moderate-intensity physical activities and was more likely to be related to vitality. Conversely, the Yale PA Survey may more comprehensively describe overall PA and provide information about moderate-intensity physical activity.

A Nurse Coach Quality Improvement Intervention: Feasibility and Treatment Fidelity

Minnick, A., Catrambone, C. D., Halstead, L., Rothschild, S., Lapidos, S. — 2008-09-12

As the U.S. population ages and chronic illness prevalence increases, new approaches to care are needed. Although large health systems have begun to respond to this challenge, most Americans seek care from practitioners functioning in small office settings. Implementing systematic sustainable changes for quality improvement in this setting remains an unresolved challenge. In this study, trained Nurse Coaches (NCs) were employed to assist practices in adopting a new model of patient care called Virtual Integrated Practice (VIP). The feasibility and treatment fidelity of this approach were assessed through process measures and interviews in three practices. Findings document high acceptance of the NC approach and consistent delivery of the intervention. Enactment of the VIP model took place across practices, although to a variable degree. The study suggests that NCs may be an effective delivery method for quality and organizational improvements in small primary care practices.

Cognitive-Behavioral Therapy, Exercise, and Older Adults' Quality of Life

Kraenzle Schneider, J., Cook, J. H., Luke, D. A. — 2008-09-12

This study examined health-related quality of life (HRQL) at baseline and 6, 9, and 12 months after initiating exercise training in three groups of older adults. The conditions were cognitive-behavioral therapy, attention-control health promotion education, and a control group. Participants (N = 332) were mainly women (n = 252, 75.9%) with a mean age of 71.8 (SD = 5.1) years. Therapy participants were trained to modify their negative interpretations of exercise. Participants in the education group received information unrelated to exercise. After controlling for exercise behavior over time, the therapy group reported lower general health, more role limitations because of emotional problems, and somewhat less vitality than the control group did. The education group also reported lower general health and vitality than the control group did. Social interaction and discussion may heighten participants' awareness of these health aspects and influence their appraisal of HRQL. Findings demonstrate the complexities of HRQL and the challenge in developing effective methods for helping older adults adopt and maintain an active lifestyle.

HIV Prevention for Latino Adolescent Mothers and Their Partners

2008-09-12

This study evaluates the outcomes of a theory-based, couple-focused HIV prevention program for Latino adolescent mothers and their male partners. The sample includes 49 couples (98 individuals) who receive either the intervention or only an HIV information session (comparison). The six-session, culturally appropriate intervention was developed through a community—academic partnership. Findings at the 6-month evaluation show that the probability of unprotected sex is significantly reduced and intentions to use condoms increase over time for participants in the experimental group, compared with the comparison group (p < .001), although AIDS knowledge improves for participants in both groups. Females in both groups have higher intentions of using condoms (p < .01) and lower probability of unsafe sex (p < .05) at baseline and over time, compared with their male partners. The intervention is well accepted by the inner-city adolescents and is realistic for implementation in a community setting.

Modeling Parents and Nurses' Relationships

de Montigny, F., Lacharite, C. — 2008-09-12

Over the past 20 years, the transition to parenting has been widely investigated as much in nursing as in psychology. The challenges of this developmental period, such as developing parenting efficacy, and the resources available to one or both parents have been explored. Different factors have been found to influence parents' perceived efficacy, such as the quality of social support, the quality of the marital relationship, and the level of stress and anxiety. Little attention has been paid, however, to the influence of nurses' relationships with parents on parents' development of parenting efficacy, especially with multiparous parents. This information is needed to better understand nurses' contribution to parenting development. A model of the primary variables of interest—perceived parenting efficacy, critical events, and nurses' collaborative and help-giving practices—is presented.

Q-Methodology in Nursing Research: A Promising Method for the Study of Subjectivity

Akhtar-Danesh, N., Baumann, A., Cordingley, L. — 2008-09-12

This article provides an overview and application of Q-methodology for nursing researchers, with an illustration of its appropriate usage. Q-methodology has been identified as a method for the analysis of subjective viewpoints and has the strengths of both qualitative and quantitative methods. It shares with qualitative methodologies the aim of exploring subjectivity; however, statistical techniques are used to reveal the structure of views. This article describes the use of Q-methodology to examine subjectivity systematically, revealing connections between accounts that other techniques may overlook. An example from the literature is presented. Q-methodology is useful in qualitative nursing research concerned with the exploration and comparison of subjectivity and attitudes. It can be used to effectively identify attitudes, perceptions, feelings, and values as well as explore life experiences such as stress, self-esteem, body image, and satisfaction.

Midwest Nursing Research Society News

Rawl, S. — 2008-09-12

The Light Under the Bushel Basket: Unpublished Dissertations

Conn, V. S. — 2008-07-08

Structures and Practices Enabling Staff Nurses to Control Their Practice

2008-07-08

This mixed-methods study uses interviews, participant observations, and the CWEQII empowerment tool to identify structures and attributes of structures that promote control over nursing practice (CNP). Nearly 3,000 staff nurses completed the Essentials of Magnetism (EOM), an instrument that measures CNP, one of the eight staff nurse-identified essential attributes of a productive work environment. Strategic sampling is used to identify 101 high CNP-scoring clinical units in 8 high-EOM scoring magnet hospitals. In addition to 446 staff nurses, managers, and physicians on these high-scoring units, chief nursing officers, chief operating officers, and representatives from other professional departments are interviewed; participant observations are made of all unit/departmental/hospital council and interdisciplinary meetings held during a 4 to 6 day site visit. Structures and components of viable shared governance structures that enabled CNP are identified through constant comparative analysis of interviews and observations, and through analysis of quantitative measures.

Nurse Burnout and Patient Safety Outcomes: Nurse Safety Perception Versus Reporting Behavior

Halbesleben, J. R. B., Wakefield, B. J., Wakefield, D. S., Cooper, L. B. — 2008-07-08

This article examines the relationship between nurse burnout and patient safety indicators, including both safety perceptions and reporting behavior. Based on the Conservation of Resources model of stress and burnout, it is predicted that burnout will negatively affect both patient safety perceptions and perceived likelihood of reporting events. Nurses from a Veteran's Administration hospital completed the Maslach Burnout Inventory and safety outcomes subset of measures from the Agency for Healthcare Research and Quality Patient Safety Culture measure. After controlling for work-related demographics, multiple regression analysis supported the prediction that burnout was associated with the perception of lower patient safety. Burnout was not associated with event-reporting behavior but was negatively associated with reporting of mistakes that did not lead to adverse events. The findings extend previous research on the relationship between burnout and patient outcomes and offer avenues for future research on how nurse motivation resources are invested in light of their stressful work environment.

Standardized Nursing Care Plan: A Case Study on Developing a Tool for Clinical Research

Vizoso, H., Lyskawa, M., Couey, P. — 2008-07-08

The National Institutes of Health have developed a new organizational consortium through a funding mechanism called the Clinical and Translational Science Award. This program funds academic institutions to create a platform for research that expedites the development and delivery of new treatments through open interdisciplinary collaboration. As a result, the adult clinical research center at San Francisco General Hospital is now part of the Clinical and Translational Science Institute at the University of California San Francisco. Nurses on this research unit have begun to employ a standardized nursing care plan that focuses on the particular needs of the research participant, an advancement that if implemented nationwide among all adult clinical research centers will be of paramount importance in fostering a collaborative relationship within the new organizational structure. This standardized nursing care plan will provide research nurses with a tool that will enable them to provide safe and quality patient care.

Child Health Promotion and Protection Among Mexican Mothers

Gallagher, M. R., Gill, S., Reifsnider, E. — 2008-07-08

For numerous reasons, children of Mexican descent experience many health disparities. One strategy for addressing these disparities is to increase health promotion and protection behaviors that mothers use with their preschool children. Limited literature is available on such practices used by mothers of Mexican descent with their healthy preschool children. This study explored child health promotion and protection practices used by mothers of Mexican descent. A naturalistic design, guided by Spradley's ethnographic interview techniques, was selected for this study. The sample included 9 Mexican-descent mothers from an urban U.S. community with healthy preschool children. Despite significant challenges, participants promoted and protected the health of their preschool children by al cuidado (taking care) and by being al pendiente (being mindful) of balancing the health of their children's bodies, minds, and souls. Understanding these mothers' approaches allows the creation of culturally sensitive health programs that can build on existing maternal strengths.

Spirituality Expressed by Caregivers of Stroke Survivors

Pierce, L. L., Steiner, V., Havens, H., Tormoehlen, K. — 2008-07-08

Thirty-six caregivers of stroke survivors who are new to that role participate in a Web-based support and education intervention over the course of a year. The authors use a secondary analysis of a total of 2,148 e-mail messages that these caregivers posted to the intervention's discussion group. Rigorous content analysis is used to analyze the narrative data coded to spirituality (n = 230 e-mails). Four themes emerge and are drawn to Friedemann's (1995) framework of systemic organization: (a) feeling the presence of a greater power, (b) practicing rituals, (c) being one with nature, and (d) interacting with family and friends. Spirituality gives these caregivers hope and sustenance, but it also helps them express themselves more fully during a difficult time of change. The e-mail discussion data presented here highlight the importance of increased awareness of addressing spirituality in nurse—client encounters and designing interventions to support the caregivers.

Correlates of Leisure-Time Physical Activity in Korean Immigrant Women

Choi, J., Wilbur, J., Miller, A., Szalacha, L., McAuley, E. — 2008-07-08

This study describes the physical activity behavior of Korean immigrant women and examines the relationships among leisure-time physical activity (LTPA) behavior, background, and intrapersonal correlates of behavior in Korean immigrant women in the United States using a cross-sectional survey design. A convenience sample of Midwestern Korean immigrant women completed the long form of the International Physical Activity Questionnaire in Korean. Among the participants, 78% were physically active, meeting the Healthy People 2010 goal for physical activity when all physical activity behaviors were considered, whereas 23% met the goal when only LTPA was considered. Women who were older, did not have a child younger than 5, used environmental resources for physical activity, had lower depressive symptoms, and had higher confidence for overcoming exercise barriers were spent more time in LTPA. Accommodating those with young children, enhancing environmental resource use, and improving exercise self-efficacy are important considerations for interventions aimed at increasing LTPA in Korean immigrant women.

Letter to the Editor: Regarding Special Issue on Dementia Care Research

Ellenchild Pinch, W. J. — 2008-07-08

Letter to the Editor: Response to the Editorial "Nursing Science and Dementia Care"

Sadak, T. I. — 2008-07-08

Response to Letters to the Editor: Regarding Special Issue on Dementia Care Research

Algase, D. L. — 2008-07-08

Midwest Nursing Research Society News

Rawl, S. M. — 2008-07-08