Showing papers in "Nursing Research in 1988"
TL;DR: The purpose of this study was to develop an instrument to measure hope in adults and to evaluate its psychometric properties, and to establish norms on the instrument before using it on ill subjects.
Abstract: The purpose of this study was to develop an instrument to measure hope in adults and to evaluate its psychometric properties. A 40-item Miller Hope Scale (MHS) was developed based on critical elements of hope revealed in a comprehensive review of the literature and on an exploratory study of hope in persons who survived a critical illness. The instrument was critiqued by measurement and content experts, and content validity was established. The MHS was pretested on 75 subjects. The refined instrument was next evaluated using 522 healthy adults. The intent was to establish norms on the instrument before using it on ill subjects. The range of scores on the MHS is 40 to 200, with high scores indicating high hope. Mean hope score for this healthy sample was 164.46 (SD = 16.31). A leptokurtic curve, skewed to the left, was noted in these responses. As expected, the instrument detected high hope in individuals who were screened to have no physical or mental health problems. The internal consistency alpha coefficient was .93 with a 2-week test-retest reliability of .82. Criterion-related construct validity was established by correlating the MHS to the Psychological Well-Being Scale, r = .71, the Existential Well-Being Scale, r = .82, and a 1-item hope self-assessment, r = .69. Divergent validity with the Hopelessness Scale was established, r = -.54. Maximum likelihood factor analysis with oblimin rotation resulted in a three-factor solution: I, Satisfaction with Self, Others, and Life; II, Avoidance of Hope Threats; and III, Anticipation of a Future.
464Â citations
TL;DR: Patients and husbands differed significantly in the levels of support they perceived over time; husbands perceived less support from friends, nurses, and physicians.
Abstract: Data were obtained from 50 mastectomy patients and their husbands at 3 days and 30 days postsurgery to determine the nature of the relationship between social support and the adjustment of mastectomy patients and their husbands over time. Psychosocial adjustment was related to both patients' and husbands' levels of social support. Patients and husbands who reported higher levels of social support reported fewer adjustment difficulties at both 3 days and 30 days postsurgery. Patients and husbands differed significantly in the levels of support they perceived over time; husbands perceived less support from friends, nurses, and physicians. This study underscores the importance of assessing the support resources of both patients and husbands over time.
321Â citations
TL;DR: In this study a portion of the uncertainty in illness model was tested, and event familiarity and credible authority were primarily effective in reducing the complexity surrounding treatment and the system of care.
Abstract: In this study a portion of the uncertainty in illness model was tested. Antecedents to uncertainty tested were the stimuli frame variables of symptom pattern and event familiarity and the structure provider variables of education, social support, and credible authority. Data were collected on a convenience sample of 61 women with gynecological cancer at the time of major treatment effect. Findings supported the proposed model with an empirically generated revised model presenting the influence of antecedents on specific areas of uncertainty. Divergent paths for reducing uncertainty were found. Social support, credible authority, and event familiarity had the greatest influence on lowering the level of uncertainty. Event familiarity and credible authority were primarily effective in reducing the complexity surrounding treatment and the system of care. Social support functioned to decrease the level of ambiguity concerning the state of the illness. Findings generally support the proposed explantation for uncertainty arousal and have substantive significance in identifying the sources of stimuli leading to uncertainty arousal and modification.
285Â citations
TL;DR: The findings suggest that the use of physical restraint is not a benign practice and support the need for developing alternatives more consistent with professional practice and quality care.
Abstract: Twenty elderly restrained patients and their primary nurses (N = 18) were studied to determine (a) the subjective impact of physical restraints on the patient and (b) the nurses' beliefs about use of restraints. Despite reported cognitive impairments, patients vividly described anger, discomfort, resistance, and fear in response to the experience of physical restraint. The decision to restrain posed a conflict between protection of the patient and beliefs about professional behavior for the nursing staff. Lack of interdisciplinary collaboration in decisions to use a physical restraint was also apparent. The findings suggest that the use of physical restraint is not a benign practice and support the need for developing alternatives more consistent with professional practice and quality care.
247Â citations
TL;DR: The results of this study clearly support the notion that patient teaching has positive outcomes in diabetic adults and methodological issues were important factors which influenced these findings.
Abstract: Forty-seven studies on the effects of patient teaching on knowledge, self-care behaviors, and metabolic control were analyzed using meta-analysis. Variables, such as type of patient instruction, type of research design, and overall quality of the study, also were analyzed. The 236 effect sizes had an unweighted mean of 0.91 (SD = 0.75) and a weighted mean of 0.33 (SD = 0.01). The weighted mean effect size for studies with control groups (N = 27) was 0.40 (SD = 0.05), and the weighted mean effect size for studies using the one group pretest-posttest design (N = 20) was 0.53 (SD = 0.05). Homogeneity analyses resulted in weighted mean effect size estimates for knowledge subvariables ranging from 0.41 to 0.91; for skill performance, 0.25 to 0.38; for compliance, 0.24 to 1.01; and for metabolic control, 0.06 to 0.84. Experimental mortality was the only variable significantly correlated with the overall weighted mean effect size, r = .52, p = .002. The results of this study clearly support the notion that patient teaching has positive outcomes in diabetic adults. Furthermore, methodological issues were important factors which influenced these findings.
221Â citations
TL;DR: Patients who receive research-based nursing interventions can expect 28% better outcomes than 72% of the patients who receive standard nursing care.
Abstract: The 84 subject-studies and 4,146 individual subjects in this meta-analysis were obtained from nurse-conducted experimental research over an 8-year period. The entire universe of accessible subject-studies that met criteria was included. Although both published and unpublished research were included to protect the study from publication bias, there was no statistically significant difference in findings. The mean effect size for the sample of comparisons from the 84 studies was .59. The associated U3 value of 72.2 and r of .28 indicate that patients who receive research-based nursing interventions can expect 28% better outcomes than 72% of the patients who receive standard nursing care.
187Â citations
TL;DR: Results indicated adolescents are able to initiate effective and preferred strategies to achieve hopefulness and competence in resolving health threats.
Abstract: The purpose of this study was to explore, using grounded theory, the process through which adolescents with cancer move to achieve hopefulness. The sample, 58 adolescent oncology patients, had varying diagnoses and were in different stages of treatment. Data were collected through interviews, observations, and review of health care records. A subset of 11 adolescents was interviewed to validate study findings. Four sequential concepts (cognitive discomfort, distraction, cognitive comfort, and personal competence) emerged to represent the process adolescents experience to achieve hopefulness. The overall organizing construct, induced from the four core concepts, was labeled self-sustaining and defined as a natural progression adolescents who are experiencing serious health threats move through to comfort themselves and to achieve competence in resolving health threats. Results indicated adolescents are able to initiate effective and preferred strategies to achieve hopefulness and competence in resolving health threats.
145Â citations
TL;DR: The findings indicate that caregivers who are caring for a mentally impaired elder, who have been providing care for an extended time, and who have low social support are at high risk for psychological distress or depression.
Abstract: The effects of stress and social support and their interaction with the psychological well-being of 87 family caregivers of impaired elderly were examined. Perceived stress and satisfaction with support accounted for 32% to 36% of the variance in psychological distress or depression, p less than .001; however, when characteristics of the caregiver situation were included in the models, the effects of perceived stress were found to be spurious. The revised models accounted for 44% to 48% of the variance in psychological distress or depression, p less than .000, and included years of caregiving and mental impairment of the elder instead of perceived stress. Although there were no buffering effects for social support, main effects accounted for 19% to 22% of the variance in psychological distress or depression. The findings indicate that caregivers who are caring for a mentally impaired elder, who have been providing care for an extended time, and who have low social support are at high risk for psychological distress or depression.
142Â citations
TL;DR: Maternal anxiety, depression, and hostility did not differ based on marital status, maternal education, socioeconomic status, or maternal age at the time of infant discharge or when the infant was 9 months old.
Abstract: Anxiety, depression, and hostility in 47 mothers of high-risk preterm infants were tested at the time of infant discharge and when the infant was 9 months old. Mothers of these high-risk preterms were significantly more anxious and depressed before their infant was discharged than when the infant was 9 months old. Before infant discharge, multiparas were significantly more depressed than primiparas. Additionally, mothers whose infants remained in the hospital longer than the mean of 51 days were significantly less depressed at infant discharge than were mothers whose infants had shorter hospital stays. Maternal anxiety, depression, and hostility did not differ based on marital status, maternal education, socioeconomic status, or maternal age at the time of infant discharge or when the infant was 9 months old.
131Â citations
TL;DR: Maternal affect was unrelated to parity or type of delivery in the first postpartal week and over time and there were no differences among mothers of premature infants in initial anxiety or depression, based on the level of illness of the infant.
Abstract: This study examined differences in anxiety and depression in mothers of term and preterm infants in the first week postpartum and over the next 6 weeks. Mothers of 41 preterm infants were matched with 41 mothers of term infants on parity, type of delivery, age, and race. Sixteen mothers of preterm infants and 10 mothers of term infants completed all 7 weeks of data collection. Mothers of preterm infants were significantly more anxious and depressed than mothers of term infants in the first postpartal week but this difference did not persist over time. Maternal affect was unrelated to parity or type of delivery in the first postpartal week and over time. There were no differences among mothers of premature infants in initial anxiety or depression, based on the level of illness of the infant.
128Â citations
TL;DR: Results do not support the widely held assumption that BrF is more stressful than BoF for small preterm infants, and tcPO2 patterns suggested less ventilatory interruption during BrF thanBoF.
Abstract: Transcutaneous oxygen pressure (tcPO2) and body temperature were monitored for the duration of feeding sessions in five small preterm infants who served as their own controls for bottle-feeding (BoF) and breast-feeding (BrF) Longitudinal data were collected twice weekly for BoF and BrF sessions from infants' first oral feeding until discharge, for a total of 71 feeding sessions: 32 BoF and 39 BrF Markedly dissimilar for the two feeding methods, tcPO2 patterns suggested less ventilatory interruption during BrF than BoF Sequential tcPO2 values at baseline, immediately postfeed, and 10 minutes postfeed were significantly different for the feeding methods, with greater declines for BoF Maximal temperature change, calculated by subtracting the baseline from the most extreme temperature for each feeding session, indicated that infants became significantly warmer during BrF than BoF Although the small sample size necessitates replication, these results do not support the widely held assumption that BrF is more stressful than BoF for small preterm infants
TL;DR: A review of literature regarding barriers to care uncovers considerable confusion regarding the barrier variable both theoretically and empirically, which apparently results from lack of methodological rigor in defining and operationalizing the concept.
Abstract: Recent literature regarding barriers to care is reviewed, beginning with a discussion and comparison of the definitions of the barrier concept drawn from the health belief model and Andersen's model of health services utilization. The research literature which includes the barrier concept as a determinant in testing those models is reviewed, as well as research studies examining utilization behavior which do not have a well-articulated theoretical framework. Both nonempirical and empirical articles are reviewed to ascertain how the concept barriers to care is, or might be, operationalized. Although similar indicators are used from study to study, the review uncovers considerable confusion regarding the barrier variable both theoretically and empirically, which apparently results from lack of methodological rigor in defining and operationalizing the concept.
TL;DR: The study results support in part the relationships posited in the Pender health promotion model and previous research on women's health.
Abstract: Health locus of control, self-esteem, and health status were analyzed for their impact on health-promoting life-style activities in 262 women between 35 and 65 years of age. Negative chance health locus of control, self-esteem, current health status, health worry/concerns, post-high-school education, and internal health locus of control explained 25% of the variance of likelihood to engage in health-promoting life-style activities. Two canonical variates explained 72.8% of the variance in the criterion set, the subscale scores of the Health-Promoting Lifestyle Profile (Walker, Sechrist, & Pender, 1987). Internal health locus of control, self-esteem, current health status, and future health status explained 36.3% of the variance of the self-actualization, interpersonal support, and exercise subscales; age, negative chance health locus of control, health worry/concern, and negative (poor) prior health status explained 36.5% of the variance of the health responsibility, nutrition, and stress management subscales. The canonical correlations for the two variates were .78 and .66, respectively. The study results support in part the relationships posited in the Pender health promotion model and previous research on women's health.
TL;DR: In the absence of self-regulatory feeding policies based on early hunger cues, NNS for 5 minutes prefeeding is simple, brief, and suitable for implementation in busy neonatal intensive care units.
Abstract: To describe the effect of nonnutritive sucking (NNS) on behavioral state (BSt) in preterm infants before feedings 24 preterm infants were randomly assigned and studied before each of their first 16 bottle feedings. Twelve received NNS by pacifier for 5 minutes; 12 did not receive a pacifier. BSt was measured with a 12-category scale for 30 seconds before the 5-minute period (BSt1) and for 30 seconds after (BSt2). Sleep states decreased for both groups. BSts considered more optimal for feeding increased more during NNS (86 vs. 46). Restless states were three times less frequent after NNS (23 vs. 68). Differences between groups were nonsignificant at BSt1, but were significant at BSt2, p less than .001. In the absence of self-regulatory feeding policies based on early hunger cues, NNS for 5 minutes prefeeding is simple, brief, and suitable for implementation in busy neonatal intensive care units. Nonnutritive sucking was an effective modulator of behavioral state for this sample.
TL;DR: In this paper, the authors identify and describe cognitive and behavioral coping strategies used by siblings of pediatric oncology patients using open-ended interviews using psychosocial assessments through puppet play, kinetic family drawings, cartoon story telling, a sentence completion test, and a limited number of direct questions.
Abstract: The purpose of this study was to identify and describe cognitive and behavioral coping strategies used by siblings of pediatric oncology patients. Fifteen families with 26 siblings between 7 and 11 years of age were studied. Parent data were obtained from an open-ended interview and a questionnaire. Sibling data included open-ended interviews using psychosocial assessments through puppet play, kinetic family drawings, cartoon story telling, a sentence completion test, and a limited number of direct questions. Content analysis of sibling data revealed major stressor themes of loss, fear of death, and change. Further analysis of sibling data pertinent to coping efforts led to the development of a taxonomy of cognitive and behavioral coping efforts.
TL;DR: A measure of learned helplessness based on a review of the literature, 50 items were developed for inclusion in the proposed Learned Helplessness Scale (LHS), and the instrument is believed to have adequate internal consistency.
Abstract: The purpose of this study was to develop a measure of learned helplessness. Based on a review of the literature, 50 items were developed for inclusion in the proposed Learned Helplessness Scale (LHS). On the basis of independent reviews by three experts, 20 items were selected for inclusion in the LHS. An individual's response to each item was graded, using a Likert scale. A standardized alpha reliability coefficient of .85 was obtained for a sample of 241 healthy adults. There was a positive correlation between the LHS scores and Beck's Hopelessness Scale (HS) scores (r = .252) and a negative correlation between the LHS scores and Rosenberg's Self-Esteem Scale (SES) scores (r = -.622). These correlations were in the direction postulated by various theorists. A Varimax-rotated factor analysis of the LHS data yielded five factors. Three of these factors tapped content relevant to the attributional styles of learned helplessness. Clinical data were also obtained on samples of oncology, hemodialysis, and spinal cord patients. Because the alpha reliability coefficients of the LHS and the Pearson product moment correlation coefficients between the LHS and the HS and the LHS and the SES were in the same direction, the instrument is believed to have adequate internal consistency.
TL;DR: It is suggested that the traditional 6-week recovery period from childbirth needs to be reconsidered, particularly for women experiencing cesarean deliveries or maternal or neonatal postdelivery complications.
Abstract: Recovery of functional ability after childbirth was examined in a sample of 30 women who had vaginal deliveries and 40 who had cesarean births. Recovery of functional ability after childbirth was defined as the resumption of household, social and community, and occupational activities and assumption of infant care responsibilities. Only 51% of the women reported they had regained their usual level of energy by the end of the 6-week postpartum period; 72% of the vaginally delivered women reported regaining their physical energy within this period, but only 34% of the cesarean delivered women had done so. Differences were also noted between cesarean- and vaginally delivered women in the interval until assumption of infant care responsibilities and resumption of certain household tasks, socializing with friends, and participation in religious organizations. Recovery of functional ability was also found to be affected by maternal and neonatal complications, and their presence was associated with postponed return to employment. Findings suggest that the traditional 6-week recovery period from childbirth needs to be reconsidered, particularly for women experiencing cesarean deliveries or maternal or neonatal postdelivery complications.
TL;DR: The best prediction of mothers' reports of children's behavioral problems was provided by maternal everyday stressors and stressful life events considered simultaneously.
Abstract: In a sample of 115 mothers of 5- and 6-year-old children maternal everyday stressors, stressful life events, and maternal depressive symptoms were compared with mothers' reports of children's behavior problems. Maternal depressive symptoms did not mediate the relationship between either form of stress and child behavior problems. Maternal everyday stressors were more strongly associated with child behavior problems than were life events. Children of mothers indicating a high level of everyday stressors were 13 times more likely to be rated as having behavior problems than children of mothers reporting a low level of everyday stressors. The best prediction of mothers' reports of children's behavioral problems was provided by maternal everyday stressors and stressful life events considered simultaneously.
TL;DR: Results of this study showed that physiological stressors were more troublesome than psychosocial stressors, and length of time on hemodialysis was associated with problem-oriented coping, r = .26.
Abstract: To explore relationships among treatment-related stressors, coping methods, and length of time on hemodialysis the Baldree, Murphy, and Powers (1982) study was replicated. Sixty-eight subjects completed the Hemodialysis Stressor Scale and the Jalowiec Coping Scale. Although Baldree et al. reported no significant difference in ratings of physiological and psychosocial stressors, results of this study showed that physiological stressors were more troublesome than psychosocial stressors, t = 10.85, p less than .0001. Subjects used problem-oriented coping more often than affective methods to handle stress, t = 10.93, p less than .0001, supporting the Baldree et al. findings. The results did not duplicate previous study findings of no significant relationships between stressor and coping scores. Total hemodialysis stressor scores were related to total coping scores, r = .43, and physiological stressors to affective coping, r = .38. However, psychosocial stressors were associated with affective-oriented, r = .43, and problem-oriented coping, r = .33. Length of time of hemodialysis was associated with problem-oriented coping, r = .26.
TL;DR: Polyurethane was consistently superior to silicone as a tube material, and cranberry juice was consistently inferior to both Coca-Cola and water as an irrigant.
Abstract: An experimental study was conducted on 3 consecutive 12-hour days to determine if selected physical properties of feeding tubes (material and diameter) affect tube clogging. Effectiveness of three irrigant fluids (cranberry juice, Coca-Cola, and water) in preventing tube clogging was studied. One hundred eight tubes were connected to gravity flow feeding bags containing isotonic enteral formula; 54 polyurethane and 54 silicone tubes were equally divided as to external diameters of 8 French (Fr), 10 Fr, and 12 Fr. At 4-hour intervals, flow regulators on the feeding bags were adjusted to a rate of 50 ml/hour. Fluid volumes delivered per minute were measured for each tube at 2-hour intervals. One set of tubes at each station was irrigated periodically with cranberry juice, Coca-Cola, or water. On each of the 3 days, analyses revealed significant, p less than .05, effects for tube material, cranberry juice contrasted with Coca-Cola and water as irrigants, and time. Polyurethane was consistently superior to silicone as a tube material, and cranberry juice was consistently inferior to both Coca-Cola and water as an irrigant. Tube diameter had no significant effect on the incidence of tube clogging.
TL;DR: The reliability and validity of a recently developed Meaning of Illness Questionnaire (MIQ) is described and three of the factors of meaning given the illness had more power than coping behavior in explaining a person's adjustment to chronic illness.
Abstract: The reliability and validity of a recently developed Meaning of Illness Questionnaire (MIQ) is described. Questionnaire content was based on the work of Lazarus and Folkman (1984b). Three hundred twenty chronically ill subjects completed the 33-item MIQ and two open-ended questions. Subjects also completed the 45-item Psychosocial Adjustment to Illness--Self-Report Scale (PAIS-SR) described by Derogatis and Lopez (1983). Test-retest reliability for 70 subjects was, on the whole, substantial (kappa = .45 to 1.00) as was the ability of nurse clinicians to reliably categorize the qualitative component of the questionnaire into one of 12 categories (kappa = .64). The factor structure of the questionnaire supported the theoretical assumptions underlying the instrument. Three of the factors of meaning given the illness, R2 = .46, and/or three items, R2 = .60, had more power than coping behavior in explaining a person's adjustment to chronic illness. The questionnaire has accumulated reliability and validity in measuring a variety of concurrent yet divergent meanings that may be given an illness for three chronically ill populations--those with mixed cancer, rheumatological, and gastroenterological disorders.
TL;DR: Eight participantidentified factors seemed to have influenced exercise adherence: group homogeneity, carpooling and social networks, pleasurable feelings associated with increased energy and fitness, leader with a health-related background, time limitation of exercise program, commitment to an established goal, desire to change body image, and desire tochange health status and improve physical health.
Abstract: The purpose of this study was to determine the effect of intensity-controlled, graded dance exercise and selected components of behavior modification on exercise adherence in overweight middle-aged women. Thirty-eight moderately overweight women, aged 35 to 58, participated in a 16 1/2 week dance exercise program. Participants were randomly assigned to an experimental group (n = 20) that received intensity-controlled, graded exercise and individual and group reinforcement, or to a control group (n = 18) that exercised at a moderate intensity typical of commercial fitness classes and received no special reinforcement. Before exercise training began and at the completion of 16 1/2 weeks, a structured, open-ended interview was conducted. Ninety-four percent of the women in both groups adhered to the program, an exceptionally high adherence rate for this population. Eight participant-identified factors seemed to have influenced exercise adherence: group homogeneity, carpooling and social networks, pleasurable feelings associated with increased energy and fitness, leader with a health-related background, time limitation of exercise program, commitment to an established goal, desire to change body image, and desire to change health status and improve physical health.
TL;DR: The sensory component of in-labor pain was more severe than the affective component for both primiparas and multiparas throughout labor and delivery except during Stage III when primiparaas reported more intense affective pain.
Abstract: The purpose of this study was to systematically describe the dimensions of pain during the progression of labor in primiparas and multiparas. Fifty primiparas and 88 multiparas were assessed for pain when the cervix was dilated 2-4 cm, 5-7 cm, and 8-10 cm. The sensory component of in-labor pain was more severe than the affective component for both primiparas and multiparas throughout labor and delivery except during Stage III when primiparas reported more intense affective pain. Primiparas reported more intense sensory pain in Stages I and III and more intense affective pain in all three stages of labor than the multiparas even though they consumed significantly more pain medications than the multiparas.
TL;DR: Findings showed that 95% of research in nursing in the last decade was conducted by nurses as first authors, over half with doctoral degrees, and there was an increase in use of sophisticated research methods and better reporting of reliability and validity.
Abstract: The purpose of this study was to analyze the research focus, theoretical bases, research designs, statistical methods, and research findings of nursing practice research, 1977-1986. A secondary purpose was to assess the fit of nursing practice research topics within the North American Nursing Diagnosis Association's (NANDA) taxonomy. The sample consisted of 720 articles that met the definitional criteria of nursing practice research from six major refereed journals in nursing that primarily publish nursing research. Findings showed that 95% of research in nursing in the last decade was conducted by nurses as first authors, over half with doctoral degrees. Funded research increased as well as the trend toward multidisciplinary research and multisite studies. One-third of the studies focused on nursing intervention, and two-thirds were assessment-oriented. Although use of nursing conceptual models increased over the decade, theories or models from psychology, physiology, and sociology were used most often. There was an increase in use of sophisticated research methods and better reporting of reliability and validity. The use of NANDA as a taxonomy for classifying nursing practice research was assessed.
TL;DR: The empirical models differed from the hypothesized models in that variables postulated to have only indirect effects were shown to have direct effects on family function and inter-generational variables significantly expanded the theoretical model.
Abstract: A theoretical model hypothesized to predict family functioning was tested in four groups of expectant parents, followed by exploratory model building. The groups studied during the 24th to 34th weeks of pregnancy included 153 high-risk hospitalized women, 75 of their partners, 218 low-risk women from the general obstetric clinic, and 147 of their partners. Both partners in the high-risk situation reported greater discrepancy in family functioning than partners in the low-risk situation. The hypothesized models proved to have low explanatory power, accounting for 13% to 15% of the variance. The final empirical models developed explained 33% of the variance in family functioning among high-risk women and 48% among their partners, 23% among low-risk women, and 32% among their partners. The empirical models differed from the hypothesized models in that variables postulated to have only indirect effects were shown to have direct effects on family function and inter-generational variables significantly expanded the theoretical model.
TL;DR: Two alternate explanations of loneliness by Weiss (1973), the situational theory and the characterological theory, were tested in a sample of 112 boys and girls between the ages of 12 to 14.
Abstract: Two alternate explanations of loneliness by Weiss (1973), the situational theory and the characterological theory, were tested in a sample of 112 boys and girls between the ages of 12 to 14. In addition to responding to the Revised UCLA Loneliness Scale, participants completed instruments measuring variables linked to either the situational or the characterological explanations of loneliness. Using hierarchical analysis of sets, the results indicated that the set of variables used to test the situational theory explained more variance in loneliness when entered first (62%) or second (34%) in the analysis than did the characterological set when entered first (33%) or second (5%) in the analysis. The findings suggested that the situational explanation played a more significant role than the characterological explanation in understanding loneliness in early adolescents.
TL;DR: It was possible to show that nursing resource consumption increased with each increasing level of CHIRS rating, and reliability and validity were established for the tool.
Abstract: The purpose of this study was to develop and validate a patient classification method for community health that would enable the categorization of patients based on their nursing care requirements. The Community Health Intensity Rating Scale (CHIRS) was developed by integrating nursing theory with nursing practice. Groups of nurse experts in community health developed prototype definitions for 15 community health parameters that incorporated both patient characteristics and critical indicators of care as descriptors of nursing care requirements. The tool was then pilot tested using staff nurses from three home health agencies. Validation of the tool was accomplished by a retrospective rating of 560 charts from two home health agencies. By quantifying the CHIRS score using nursing visits as a measure of resource consumption, it was possible to show that nursing resource consumption increased with each increasing level of CHIRS rating. Reliability and validity were established for the tool.
TL;DR: Attitudes and perceived beliefs of others were predictive of adherence, and it was concluded that these variables need to be included in any rehabilitation program.
Abstract: One hundred three first-time myocardial infarction (MI) patients were randomly assigned to either an experimental or a control condition. Patients completed a cardiac rehabilitation program during hospitalization and were interviewed to assess intentions to follow regimen prescriptions, attitudes toward the prescriptions, coping methods, and the perceived beliefs of others concerning their intentions. Patients were visited at home 30 days after discharge and reassessed on each of the above variables except that their behavior was substituted for intentions and societal adjustment was assessed. The experimental group was given an intervention program which included a discussion of assessment data, identification of problems, and establishment of goals. The assessment was repeated 60 days after discharge. No differences were found between experimental and control groups for either medical regimen adherence or societal adjustment. There was a significant decrease in mean scores for all variables from hospital to 30 days for both groups, but no change from 30 to 60 days. Attitudes and perceived beliefs of others were predictive of adherence, and it was concluded that these variables need to be included in any rehabilitation program.