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Topic: Nursing journals depend on the services of peer reviewers for their expertise in research and clinical practice. Although some research has been done with peer reviewers of biomedical journals, to date, our knowledge about reviewers of nursing journals is minimal., Methods: In this international survey of 1,675 reviewers for 41 nursing journals, reviewers were asked 69 questions about their experiences reviewing for professional nursing journals. This article examines their answers to the survey questions about training to become reviewers and the support they receive from editors., Results: Results showed that 65% wanted formal training, although only about 30% received such training in the form of orientation, manuals, practice reviews, or workshops. For most peer reviewers, it took one to five reviews before they felt comfortable with the process, although some commented that, "I still question my reviews" and "It took a few years." In this sample, 31% reported getting feedback from editors about their reviews, but 87% wanted feedback. Most (80%) wanted to see the other reviews of the manuscripts they reviewed, although only about 45% actually saw them. Reviewers reported that the editor had been helpful to them by providing feedback, demonstrating appreciation of their efforts, mentoring, and being available., Conclusions: We concluded from this research that many reviewers' needs for training and support are not being met and that both reviewers and nursing editors could profit from a better understanding of the process. Editors could consider instituting programs of orientation, training, and support such as feedback on reviews, making other reviews available, and feedback on final disposition of manuscripts. Reviewers should consider discussing these issues with editors to make their needs for feedback and training known. Intervention studies to examine the effects of such programs on reviewer satisfaction could ultimately strengthen the nursing literature.

Objective: To explore patient attitudes related to cesarean delivery on maternal request (CDMR)., Study Design: Questionnaires were distributed to patients in mid-trimester. Questions assessed patient demographics, knowledge, perceived risks, and attitudes about CDMR., Results: Three hundred and fourteen questionnaires and 188 written responses were used for analysis. Most patients (95%) did not believe that CDMR was advisable and felt that vaginal delivery (VD) was safer for both mother (93%) and baby (88%). Of patients who did not believe CDMR was advisable, the most common explanations were classified into categories of "normal is better," "risk of complications" (67%), only 1% of this group felt that the decision should be left up to the individual. Of the remaining patients (5%) who supported CDMR, 75% believed that the decision should be left up to the individual., Conclusion: The majority of women in our population do not think that CDMR is advisable.

While the compensation for many nursing roles is published and accessible, no data have heretofore been available on monetary compensation for nurse editors. Answers to questions about compensation contained in a 108-question international survey of 88 editors of nursing journals, which was designed to learn about all aspects of the role of editor, are described. This study provides a first look at editor compensation.

Objective: To assess the feasibility, utility and resident attitudes towards an interactive, Web-based computer learning program., Study Design: Pretest/ posttest evaluation of an interactive curriculum to teach current recommendations for cervical cancer screening and classification and management of abnormal Pap smears. Thirty-five Obstetrics and Gynecology (OB/ GYN) residents were encouraged to complete a Web-based computer program that consisted of a pretest, 9 educational sections (3 didactic and 6 case based), a posttest and an exit survey. Clinical cases involved virtual case management of patients' cytologic, histologic and colposcopic images. Mastery was set at 82% (or 23/28 correct answers)., Results: Thirty-one of the 35 residents (89%) completed the curriculum. No resident demonstrated mastery (82%) on the pretest; 15 of 31 residents demonstrated mastery on the posttest (p = 0.04). Mean improvement for all residents was 9 additional questions answered correctly. All the residents thought that the Web site was useful and covered all the learning objectives and would recommend it to other residents., Conclusion: A program to teach current cervical cancer screening, classification and abnormal Pap smear management guidelines was useful, feasible and well accepted by residents in this population.

Objective: This study was undertaken to assess whether a surgical skills laboratory improves residents' knowledge and performance of episiotomy repair., Study Design: Twenty-four first- and second-year residents were randomly assigned to either a surgical skills laboratory on episiotomy repair or traditional teaching alone. Pre- and posttests assessed basic knowledge. Blinded attending physicians assessed performance, evaluating residents on second-degree laceration/episiotomy repairs in the clinical setting with 3 validated tools: a task-specific checklist, global rating scale, and a pass-fail grade., Results: Postgraduate year 1 (PGY-1) residents participating in the laboratory scored significantly better on all 3 surgical assessment tools: the checklist, the global score, and the pass/fail analysis. All the residents who had the teaching laboratory demonstrated significant improvements on knowledge and the skills checklist. PGY-2 residents did not benefit as much as PGY-1 residents., Conclusion: A surgical skills laboratory improved residents' knowledge and performance in the clinical setting. Improvement was greatest for PGY-1 residents.

This article explores the history of the preconception movement in the United States and the current status of professional practice guidelines and standards. Professionals with varying backgrounds (nurses, nurse practitioners, family practice physicians, pediatricians, nurse midwives, obstetricians/gynecologists) are in a position to provide preconception health services; standards and guidelines for numerous professional organizations, therefore, are explored. The professional nursing organization with the most highly developed preconception health standards is the American Academy of Nurse Midwives (ACNM); for physicians, it is the American College of Obstetricians and Gynecologists (ACOG). These guidelines and standards are discussed in detail.

A growing body of research challenges the inter-rater reliability of peer reviewers and the value of reviewer training or blinding in improving the quality of manuscript reviews, but double-blinded peer review of papers remains a relatively unexamined standard for nursing journals. Using data from a larger emailed survey, the views of 88 nurse editors on peer review were analyzed using content analysis. The majority of nurse editors reported that blinding was important in peer review, to maintain objectivity and avoid negative personal or professional consequences. The minority who saw potential benefits of open review valued increased transparency in the reviewing and editorial decision-making process. An excellent review was viewed as containing specific instructions on how the deficits in a manuscript might be remedied. Common weaknesses of reviews were lack of specificity and inappropriate focus. Virtually all editors provided some form of preparation or guidance to reviewers. Peer review has an impact on nurses' workload and careers, and training in writing and critique should be included in nursing education.

This study reports on ethical issues faced by editors of nursing journals, a topic which has not appeared in the nursing literature. A survey of nursing editors (n = 88)was conducted via e-mail; this article is the content analysis of survey questions about ethics. Eight categories of ethical issues emerged: problems with society/association/publisher; decisions about inflammatory submissions; informed consent or IRB issues; conflicts of interest; advertising pressures; duplicate publications and/or plagiarism; difficult interactions with authors; and authorship. Some issues were similar to those published about medical editors; however, others were unique. This study can assist authors to better understand some of the ethical issues in publishing, can help editors to view their issues in the context of what others experience, and can assist societies and publishers to work toward avoiding these ethical issues in the future. Professional discussions about ethics in nursing publications should be the subject of ongoing research and scientific inquiry.

Introduction: The purpose of this study was to evaluate the readability of American Academy of Pediatrics (AAP) patient education brochures., Method: Seventy-four brochures were analyzed using two readability formulas., Results: Mean readability for all 74 brochures was grade 7.94 using the Flesch-Kincaid formula, and grade 10.1 with SMOG formula (P = .001). Using the SMOG formula, no brochures were of acceptably low (< or =8th grade) readability levels (range 8.3 to 12.7). Using the Flesch-Kincaid formula, 41 of the 74 had acceptable readability levels (< or =8th grade). The SMOG formula routinely assessed brochures 2 to 3 grade levels higher than did the Flesch-Kincaid formula., Discussion: Some AAP patient education brochures have acceptably low levels of readability, but at least half are written at higher than acceptable readability levels for the general public. This study also demonstrated statistically significant variability between the two different readability formulas; had only the SMOG formula been used, all of the brochures would have had unacceptably high readability levels. Readability is an essential concept for patient education materials. Professional associations that develop and market patient education materials should test for readability and publish those readability levels on each piece of patient education so health care providers will know if the materials are appropriate for their patients.

Purpose: To describe the editorial practices of nurse editors, including proprietary arrangements, manuscript processing systems, and editorial review, and to ascertain editors' opinions on effective editorial practices., Design: A descriptive study in which an author-designed 108-question survey was distributed and collected by e-mail. Of 177 international nursing editors identified, 164 e-mail addresses could be located, and 137 nurse editors expressed willingness to participate. Ninety journals were represented in the final purposive convenience sample, including 71 published in the US and 19 outside the US. Data were analyzed using descriptive statistics, t test, chi square, and content analysis., Findings: Of the 90 journals, 78 were characterized by their editors as scholarly journals. Fifty-two were official journals of associations. The nurse editors' average age was 53, with over 20 years of experience in nursing and 8 years as editor. Although practices and compensation at U.S. and international journals did not differ significantly, scholarly journals and "other" publications such as magazines and newsletters were managed differently. Blinded peer review was in place at 98% of journals. Editors generally used manuscript reviewers as advisors rather than as voters; only 30% of editors thought their ultimate decision must agree with the majority of reviewers. Nurse editors often needed 3-5 years to feel comfortable in the role. Editors of association journals often reported struggling with the issue of editorial independence versus association control. Editors believed their role was influential in maintaining scholarly excellence and evidence-based practice, but many noted the constant pressure of deadlines and dealing with poor writing from authors as challenges of the work., Conclusions: The role of nurse editor is not part of the formal preparation of nurse scholars or clinicians; standards for nurse editors are not readily apparent, and nurse editors often work in isolation, lacking professional support. This survey included data by which nurse authors and readers of nursing journals can understand how nurse editors work and make decisions about manuscripts, ultimately influencing knowledge dissemination in nursing journals. Nurse editors can use this information to compare their practices with that of others, and advocate for adequate preparation, compensation, and assistance with production.

Nurses and nurse midwives have historically considered patient education one of their most important responsibilities. Increasingly, however, appropriate and comprehensive patient education has become more difficult to accomplish. There are many reasons for this, including the huge influx of clients of varying cultures into virtually all health care systems across the United States, the lack of time available for patient education in tightly scheduled managed care visits, the dearth of educational materials written at appropriate readability levels and/or in languages other than English, and the lack of reimbursement for time spent on patient education. In addition, many providers might not have specific training in the provision of patient education or in the development of appropriate health educational materials for the population they serve. This article discusses these issues, suggesting also that there are ethical dilemmas inherent in the provision of some aspects of patient education.

Although preterm labor and birth continues to plague us as an unsolved mystery in maternal/child health, much has actually been learned over the past few decades. Most reviews of the preterm labor literature examine the research in an interdisciplinary manner; this article instead looks at the active role that nurses have taken in the research concerning preterm labor and birth. This article will categorize research conducted by nurses over the past 30 years on preterm labor and birth, emphasizing some of the changes in nursing practice engendered by nursing's important research effort.

Objective: This study was undertaken to determine the prevalence of positive screens for postpartum depression by using the Edinburgh Postnatal Depression Scale (EPDS) in an inner-city population., Study Design: At their postpartum visits, women who were seen in two inner-city practices between February 20 and April 30, 2002, self-administered the EPDS. A threshold of 10 or more points was selected as a positive screen for postpartum depression. If the patient responded that she had thoughts of harming herself or others, she was referred immediately for social work or psychiatric evaluation. Otherwise, providers were blinded to the results of the screen., Results: Of the 443 patients who were scheduled for postpartum visits during this time period, 285 (64%) patients presented for their postpartum visit. One hundred twenty-one (42%) of these patients participated in the study and 1 patient did not complete the questionnaire. Twenty-seven (22%) of the 121 patients had a positive screen for postpartum depression. Eight patients (6.6%) reported experiencing suicidal ideation within the previous week. Without use of the screening tool, providers identified 16 (13%) patients who they thought were at risk for postpartum depression. Of those 16 patients, 14 had positive screens on the EPDS. Eight patients eventually had clinical depression diagnosed. There was a significant relationship between women with elevated scores on the EPDS and a personal history of depression (P <.0006), history of prior treatment for depression (P <.0001), and feeling depressed during the pregnancy (P <.0001). Providers failed to comment on the patient's mood in 34 (28%) of the 121 patients., Conclusion: A larger than expected number of women had a positive screen for postpartum depression in our population. This unexpected finding suggests the need for more resources to be directed toward the research, identification, and treatment of postpartum depression in inner-city populations.