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Background: Childhood acquired brain injury (ABI) often leads to impairment in cognitive functioning, resulting in disabilities in both the home and school environment. Assessing the impact of these cognitive deficits in everyday life using traditional neuropsychological tests has been challenging. This study systematically reviewed ecological measures of cognitive abilities available for children with ABI. Method: Eight databases were searched (until October 2011) for scales: (1) focused on ecological assessment of cognitive functioning; (2) with published data in an ABI population; (3) applicable to children up to 17;11 years of age; and (4) in English. The title and abstract of all papers were reviewed independently by two reviewers. Results: Database searches yielded a total of 12 504 references, of which 17 scales met the inclusion criteria for the review, focusing on executive functions ( n = 9), memory ( n = 3), general cognitive abilities ( n = 2), visuo-spatial skills ( n = 2) and attention ( n = 1). Four tasks used observation of actual performance in a natural environment, five were proxy-reports and six were functional paper and pencil type tasks, performed in an office. Conclusion: Overall, few measures were found; eight were still experimental tasks which did not provide norms. Executive functions were better represented in ecological assessment, with relatively more standardized scales available. [ABSTRACT FROM AUTHOR]

Background: As health services research (HSR) expands across the globe, researchers will adopt health services and health worker evaluation instruments developed in one country for use in another. This paper explores the cross-cultural methodological challenges involved in translating HSR in the language and context of different health systems. Objectives: To describe the pre-data collection systematic translation process used in a twelve country, eleven language nursing workforce survey. Design and settings: We illustrate the potential advantages of Content Validity Indexing (CVI) techniques to validate a nursing workforce survey developed for RN4CAST, a twelve country (Belgium, England, Finland, Germany, Greece, Ireland, Netherlands, Norway, Poland, Spain, Sweden, and Switzerland), eleven language (with modifications for regional dialects, including Dutch, English, Finnish, French, German, Greek, Italian, Norwegian, Polish, Spanish, and Swedish), comparative nursing workforce study in Europe. Participants: Expert review panels comprised of practicing nurses from twelve European countries who evaluated cross-cultural relevance, including translation, of a nursing workforce survey instrument developed by experts in the field. Methods: The method described in this paper used Content Validity Indexing (CVI) techniques with chance correction and provides researchers with a systematic approach for standardizing language translation processes while simultaneously evaluating the cross-cultural applicability of a survey instrument in the new context. Results: The cross-cultural evaluation process produced CVI scores for the instrument ranging from .61 to .95. The process successfully identified potentially problematic survey items and errors with translation. Conclusions: The translation approach described here may help researchers reduce threats to data validity and improve instrument reliability in multinational health services research studies involving comparisons across health systems and language translation. [ABSTRACT FROM AUTHOR]

Aims and objectives. This paper is a report of a study conducted to investigate differences between nurse practitioners' perceptions of the importance of required competencies and their self-evaluated existing competencies, and the main factors influencing these differences. Background. The difference between nurse practitioners' perceptions of required competencies and their existing competencies has never been investigated. Therefore, it is still uncertain whether these two competencies differ. Design. A nationwide survey study was authorised by the Department of Health (DOH) in Taiwan. Methods. For this nationwide survey study, the Questionnaire of Competencies in the Nurse Practitioner's Role was mailed to all nurse practitioners who qualified for the first annual national NP licence exam in Taiwan. Of 582 questionnaires distributed, 374 valid questionnaires were returned for a response rate of 64·2%. Results. The scores for required competencies were all higher than existing competencies. The competencies with largest differences were (in increasing order) clinical research, direct care, and leadership and reform. The competencies with smallest differences were (in ascending order) medical assistance, communication and coordination, and ethical decision-making. Differences in the total score between required and existing competencies were significantly influenced by nurse practitioners' age, seniority as nurse practitioner, whether the nurse practitioners' institution had a nurse practitioner advancement system, and the number of patients under their care. Conclusions. Nurse practitioners' perceptions of the importance of their expected role competencies were significantly greater in most cases than their actual competencies. Relevance to clinical practice. These findings could serve as a reference to improve cultivation of the NP system in Taiwan, to strengthen professional competencies in NP training programs. [ABSTRACT FROM AUTHOR]

The purpose of this paper is to provide psychometric data on the Parental Attitudes Toward Psychological Services Inventory (PATPSI), which is a revised measure to assess parents' attitudes toward outpatient mental health services. Using a sample of adults ( N = 250), Study 1 supported a 3-factor structure (RMSEA = .05, NNFI = .94, and CFI = .94), adequate internal consistency (ranging from .72 to .92), and test-retest reliability (ranging from .66 to .84). Additionally, results indicated that individuals with previous use of mental health services reported more positive views toward child mental health services. Study 2 provided confirming evidence of the 3-factor structure (NNFI = .94, RMSEA = .08, and the CFI = .95) and adequate reliability (ranging from .70 to .90) using a parent-sample ( N = 260). Additionally, discriminate validity of the PATPSI was supported. Implications for research and clinical practice are discussed. [ABSTRACT FROM AUTHOR]

Measures of self-forgiveness that merely focus on the outcome of positive self-regard risk neglecting the process through which offenders restore it. They may thus tap pseudo self-forgiveness where offenders downplay their responsibility for the wrongdoing. For genuine self-forgiveness, the process should instead involve an attenuation of the negative link between responsibility acceptance and positive self-regard. In this paper, we examine how acts of value reaffirmation facilitate genuine self-forgiveness. In Study 1, a role-play experiment (N = 90), participants either confessed their wrongdoing to the victim or not. Although responsibility acceptance was strongly negatively related to reported self-forgiveness (i.e., self-regard), this relationship was tempered when participants confessed their wrongdoing to the victim and, through this, reaffirmed the violated values. In Study 2, a longitudinal study referring to self-reported transgressions (N = 74), responsibility acceptance was negatively related to self-forgiveness measures as well as self-esteem when offenders showed little value reaffirmation, but not when they more strongly reaffirmed the violated values. Copyright © 2012 John Wiley & Sons, Ltd. [ABSTRACT FROM AUTHOR]

papastavrou e., efstathiou g., tsangari h., suhonen r., leino-kilpi h., patiraki e., karlou c., balogh z., palese a., tomietto m., jarosova d. & merkouris a. (2011) A cross-cultural study of the concept of caring through behaviours: patients' and nurses' perspectives in six different EU countries. Journal of Advanced Nursing 68(5), 1026-1037. Abstract Aim. This paper is a report of an international study of patients' and nurses' perceptions of nurse caring behaviours. Background. Current economic constraints on healthcare systems, demand to increase the quality of care and the incorporation of the consumers' perspective into care, have created a need to develop a clear understanding of nursing behaviours which convey caring. Patients in different areas of the world report different expectations of nurses' caring actions when compared to nurses' views. Method. A descriptive comparative survey design was used to analyse a sample of surgical patients ( n = 1659) and their nurses ( n = 1195) in 88 wards of 34 hospitals in Cyprus, the Czech Republic, Finland, Greece, Hungary and Italy. Data were collected in autumn 2009 using the Caring Behaviours Inventory-24. Nurses' and patients' responses were compared using both inferential and descriptive statistics. Results. Independent samples t-tests showed important differences between nurses' and patients' views. Although both groups perceived knowledge and skill as being the most important sub-scale, the nurses' responses were higher compared to patients ( P < 0·05) with important differences in the 'assurance of human presence' ( P < 0·001) and the 'respectful deference to others' ( P < 0·001) sub-scales. Cross-country comparisons showed important differences between the nurses' ( F = 24·199, P < 0·001) and patients' views on caring ( F = 26·945, P < 0·001). Conclusions. Important differences were observed between patient-nurse perceptions in the participating countries. The results form a foundation for future research into the development of a common international perspective about caring behaviours between patients and their nurses. [ABSTRACT FROM AUTHOR]

gur-yaish n., zisberg a., sinoff g. & shadmi e. (2011) Development and psychometric testing of a measure of informal caregiving for hospitalized older adults. Journal of Advanced Nursing 68(4), 931-938. Abstract Aim. This paper is a report of the development and psychometric testing of the questionnaire evaluating informal caregiving for hospitalized older adults. Background. Informal caregiving of hospitalized older adults is an understudied phenomenon that lacks a valid and reliable measure to capture its multi-dimensionality. Methods. An instrument development procedure, followed by an empirical study, was conducted from February to November 2009. Instrument development included item generation and content validity, which was established by five experts. The validation study utilized a retrospective between-patients design. The sample consisted of 279 patients, aged 70 and older, who were hospitalized in a large medical centre in northern Israel. The internal consistency reliability, construct, convergent and divergent validity of the measure were tested. Results. The 14-item scale describes various aspects of informal caregiving for older adults in the hospital setting. The scale has four dimensions: Instrumental care, Supervision of care, Psychological support and Ensuring and Explaining care. Confirmatory factor analysis supported the theoretical model of the four dimensions of care. Reliability analysis revealed acceptable-to-high estimates for the total and for the dimensional scores (ranging from 0·78 to 0·89). The convergent and divergent validity coefficients were all in the expected direction. Conclusions. The preliminary psychometric properties of the measure showed acceptable results. The measure should be further explored in different cultural settings and for its ability to link between caregiving attributes, as captured by the measure, and hospitalization outcomes in older adults. [ABSTRACT FROM AUTHOR]

liu c.-c., chen y.-c., yeh y.-p. & hsieh y.-s. (2011) Effects of maternal confidence and competence on maternal parenting stress in newborn care. Journal of Advanced Nursing 68(4), 908-918. Abstract Aim. This paper is a report of a correlational study of the relations of maternal confidence and maternal competence to maternal parenting stress during newborn care. Background. Maternal role development is a cognitive and social process influenced by cultural and family contexts and mother and child characteristics. Most knowledge about maternal role development comes from western society. However, perceptions of the maternal role in contemporary Taiwanese society may be affected by contextual and environmental factors. Methods. A prospective correlational design was used to recruit 372 postpartum Taiwanese women and their infants from well-child clinics at 16 health centres in central Taiwan. Inclusion criteria for mothers were gestational age >37 weeks, ≥18 years old, and healthy, with infants <4 months old. Data were collected between August 2007 and January 2008 using a self-report questionnaire on mothers' and infants' demographic variables, maternal confidence, maternal competence and self-perceived maternal parenting stress. Results. After controlling for maternal parity and infant temperament, high maternal confidence and competence were associated with low maternal parenting stress. Maternal confidence influenced maternal parenting stress both directly and indirectly via maternal competence. Conclusion. To assist postpartum women in infant care programmes achieve positive outcomes, nurses should evaluate and bolster mothers' belief in their own abilities. Likewise, nurses should not only consider mothers' infant care skills, but also mothers' parity and infant temperament. Finally, it is crucial for nurses and researchers to recognize that infant care programmes should be tailored to mothers' specific maternal characteristics. [ABSTRACT FROM AUTHOR]

lobchuk m.m., mcpherson c.j., mcclement s.e. & cheang m. (2011) A comparison of patient and family caregiver prospective control over lung cancer. Journal of Advanced Nursing 68(5), 1122-1133. Abstract Aim. This paper is a report of our secondary analysis of patient and family caregiver prospective control in lung cancer. Background. Control beliefs underlie self-care in sickness and health. Self-care often involves 'shared' activities between the afflicted individual and caregiving family and friends. However, depending on how control is perceived, conflicts can occur in decision-making thus jeopardizing optimal self-care. We need to comprehend how control beliefs compare between patients and caregivers and how their control beliefs are linked with dealing with serious illness. Methods. Based on questionnaire data collected in our larger study between September 2005 and February 2009, we conducted exploratory comparative analyses of 304 patients' and caregivers' control beliefs in managing lung cancer. Eight 5-point response items captured prospective control. Exploratory factor analysis with promax rotation was conducted to compare dyadic perceptions on the dimensionality of prospective control. We also conducted exploratory correlations between control beliefs and smoking cessation, attributional reactions, caregiver helping and symptom reports. Results. Principal component analysis identified the same factors for patients and caregivers: factor 1, Fate control and factor 2, Team control. Patient and caregiver 'Fate' and 'Team' control sub-scales were respectively associated with hope, caregiver helping and patient smoking cessation. Conclusion. Clinicians need to support, adapt or develop a philosophy of cancer care that is inclusive of partnerships, drawing on beliefs of patients and caregivers that controlling lung cancer is a team effort which in turn is tentatively linked to patient smoking cessation, positive emotions and caregiver helping. [ABSTRACT FROM AUTHOR]

Aim This article is to report the development and psychometric testing of the Hospital Aggressive Behaviour Scale - Users. Background Workplace violence is present in many work spheres, but in the healthcare sector, nurses in particular are at more risk due to the close contact they maintain with users and clients and the special characteristics of this relationship. Design Using qualitative and quantitative methodology, an instrument was applied to a sample of 1,489 nurses from 11 public hospitals. Data collection was carried out in 2010 and 2011. Results Exploratory factor analysis yielded a 10-item instrument distributed in two factors (non-physical violence and physical violence), which was validated by means of confirmatory factor analysis. Both the resulting questionnaire and the factors identified present high internal consistency and adequate external validity, analysed by means of statistically significant correlations between the Hospital Aggressive Behaviour Scale and job satisfaction, burnout components, and psychological well-being. Conclusions The results indicate that, in nursing personnel, higher exposure to user violence leads to lower job satisfaction, more emotional exhaustion and more cynicism, and to a lower level of psychological well-being. The instrument developed in this study may be very useful in the sphere of assessment and prevention of psychosocial risks for the early detection of the problem of user violence in its two facets. [ABSTRACT FROM AUTHOR]

Aim To examine the relationships among nurses' perceptions of nurse managers' authentic leadership, nurses' overall person-job match in the six areas of worklife and their work engagement. Background Reports have highlighted the impact of demanding and unsupportive work environments on nurses' wellbeing, resulting in a need for strong nursing leadership to build sustainable and healthier work environments. Methods A secondary analysis of data collected from a non-experimental, predictive design survey of a random sample of 280 registered nurses working in acute care hospitals was conducted. Results An overall person-job match in the six areas of worklife fully mediated the relationship between authentic leadership and work engagement. Further, authentic leadership, overall person-job match in the six areas of worklife and years of nursing experience explained 33.1% of the variance in work engagement. Conclusions Findings suggest that nurses who work for managers demonstrating higher levels of authentic leadership report a greater overall person-job match in the six areas of worklife and greater work engagement. Implications for nursing management As nurse managers' play a key role in promoting work engagement among nurses, authentic leadership development for nurse managers focusing on self-awareness, relational transparency, ethics and balanced processing would be beneficial. [ABSTRACT FROM AUTHOR]

Aim To translate the validated measure, Self- Management of Type 1 Diabetes in Adolescents, into the Mandarin Chinese language and to test the psychometric properties of the Chinese version. Background Although research on self-management of Type 1 diabetes has been increasing over the past 20 years, few health-related instruments have been available in the Chinese language for youth with Type 1 diabetes. Design A two-phase design was used in this study, including instrument translation and psychometric testing. Methods The instrument translation, from October 2008-April 2009, included three steps: forward translation, back translation, and comparison of versions via Translation Validity Index - with multiple rounds, group discussion, and achievement of consensus at each step. Psychometric properties of the Chinese version Schilling's Self- Management of Type 1 Diabetes for Adolescents scale was assessed in a convenience sample of 136 Chinese youth (ages 8-19) with Type 1 diabetes between June 2009-August 2009. Results The internal consistency and test-retest reliabilities indicated generally good consistency and temporal stability of the Chinese version. Evidence of construct validity and criterion-related validity was obtained via correlations of subscales with established measures of diabetes adherence and quality of life and also with haemoglobin A1c. Results from hypothesis testing also supported construct validity. Conclusion The Chinese version of Self- Management of Type 1 Diabetes for Adolescents scale is sound and will facilitate cross-cultural studies, while also enabling nurses to monitor and enhance the diabetes self-management of Chinese youth with Type 1 diabetes. [ABSTRACT FROM AUTHOR]

Purpose: The promotion of a sustainable, healthy and productive working life attracts more and more attention. Recently the Work Role Functioning Questionnaire (WRFQ) has been cross-culturally translated and adapted to Dutch. This questionnaire aims to measure the health-related work functioning of workers with health problems. The aim of this study is to evaluate the reliability, validity (including five new items) and responsiveness of the WRFQ 2.0 in the working population. Methods: A longitudinal study was conducted among workers. The reliability (internal consistency, test-retest reliability, measurement error), validity (structural validity-factor analysis, construct validity by means of hypotheses testing) and responsiveness of the WRFQ 2.0 were evaluated. Results: A total of N = 553 workers completed the survey. The final WRFQ 2.0 has four subscales and showed very good internal consistency, moderate test-retest reliability, good construct validity and moderate responsiveness in the working population. The WRFQ was able to distinguish between groups with different levels of mental health, physical health, fatigue and need for recovery. A moderate correlation was found between WRFQ and related constructs respectively work ability and work productivity. A weak relationship was found with general self-rated health, work engagement and work involvement. Conclusion: The WRFQ 2.0 is a reliable and valid instrument to measure health-related work functioning in the working population. Further validation in larger samples is recommended, especially for test-retest reliability, responsiveness and the questionnaire's ability to predict the future course of health-related work functioning. [ABSTRACT FROM AUTHOR]

Objectives: Cocaine addiction continues to be a major public health problem in the United States. With no U.S. Food and Drug Administration-approved pharmaceutical therapy, treatment often relies on psychosocial interventions. This pilot therapy development study attempts to examine the feasibility and preliminary efficacy of adding breathing-based Integrative Meditation and Ear Acupressure (IMEA) to outpatient treatment of cocaine addiction. Design: Fifty-six (56) cocaine-dependent patients were recruited from an outpatient addiction treatment facility in Baltimore, MD and randomized into either an IMEA or a treatment as usual (TAU) group for the 12 weeks of study, with weekly meetings to monitor treatment outcomes and to facilitate meditative therapy. Outcome measures: The outcome measures consisted of treatment retention rates by week 8 and 12; abstinence rates measured by 6 continuous weeks of negative urinalysis for cocaine, and addiction-related symptoms such as anxiety, craving, depression, and withdrawal symptoms. Results: With the assistance of simplified breath training and a portable MP4 device, 80% of IMEA participants self-reported practicing breathing or meditation 5+ days a week with acceptable compliance and showed strong interest in meditative techniques. Compared to TAU, IMEA participants reported significantly higher treatment completion rates by week 8 (89% versus 63%) and week 12 (81% versus 58%), higher abstinence rates (66% versus 34%), and significantly greater reduction in craving, anxiety, and other addiction-related symptoms. Some participants continued meditation after study completion. Conclusions: It is feasible to add breathing-based IMEA to outpatient treatment of cocaine addiction. Although a number of limitations exist for this pilot study, further large-scale clinical trials and therapy-development studies of IMEA for addiction are warranted. [ABSTRACT FROM AUTHOR]

Objectives. A recent trend in clinical practice is to adopt short screening and diagnostic self-report instruments for patients with chronic pain. Brief two-item pain coping and beliefs measures have recently been developed and have poten-tial to improve decision making in clinical prac-tice. Our study examined the construct and criterion-based validity of the two-item per scale version of the Coping Strategies Questionnaire (CSQ). Design. We used data obtained on a community-based sample of 873 persons with chronic knee osteoarthritis pain from the Osteoarthritis Initiative, a large longitudinal cohort study. Persons were administered the two-item per scale version of the CSQ. The International Classification of Functioning framework was used to select a variety of criterion-based measures for comparison with the CSQ. Spearman correlations and hierarchical regression models were used to characterize construct validity and receiver operating characteristic (ROC) curves, sensitivity and specificity were used to describe criterion-based validity. Results. Construct validity of the CSQ scales was generally supported, with the Catastrophizing and Praying or Hoping scales demonstrating the stron-gest construct validity across criterion measures. Criterion-based validity for the CSQ scales varied depending on the criterion measure. The Cata-strophizing and Praying or Hoping scales also had the strongest criterion-based validity, with ROC curve areas as high as 0.71 (95% confidence inter-val =0.67, 0.75), P< 0.001, for identifying persons with substantial physical function deficits. Conclusions. The findings suggest that several of the two-item CSQ scales demonstrate a modest level of construct validity along with fair criterion-based validity. The Catastrophizing and Praying or Hoping scales appear to hold the most promise for clinical applications and future longitudinal research. [ABSTRACT FROM AUTHOR]

This study validated a brief stigma-by-association scale for use with South African youth (adapted from the HIV Stigma-by-Association Scale for Adolescents). Participants were 723 youth (364 male, 359 female) from poor urban communities around Cape Town. Youths completed the brief stigma-by-association scale and measures of bullying victimisation and peer-problems, as well as inventories measuring symptoms of depression and anxiety. Exploratory analyses revealed that the scale consists of two subscales: (1) experience of stigma-by-association and (2) consequences of stigma-by-association. This two factor structure was obtained in the full sample and both the HIV/AIDS-affected and unaffected subgroups. The full stigma-by-association scale showed excellent reliability (α = 0.89–0.90) and reliabilities for both subscales were also good (α = 0.78–0.87). As predicted, children living in HIV/AIDS-affected households obtained significantly higher stigma-by-association scores than children in non-affected households [F(1, 693) = 46.53, p<0.001, partial η 2=0.06] and hypothesized correlations between stigma-by-association, bullying, peer problems, depression and anxiety symptoms were observed. It is concluded that the brief stigma-by-association scale is a reliable and valid instrument for use with South African youth; however, further confirmatory research regarding the structure of the scale is required. [ABSTRACT FROM PUBLISHER]

Background: This study examined symptom reports and neurocognitive outcomes in children (8-17 years) with mild traumatic brain injury (mTBI) or orthopaedic injury (OI). Method: Children and parents were initially assessed upon presentation in the Emergency Department of a local hospital and again at 3 months. Children completed the Immediate Post-Concussion Assessment and Cognitive Testing battery (ImPACT) and parents completed the Behavior Rating Inventory of Executive Function (BRIEF). The Peabody Picture Vocabulary Test, 3rd edition (PPVT-III) was completed by the children at the 3-month assessment. Results: Children with mTBI reported more symptoms than the OI group initially, but did not differ from the OI group at 3 months. Both groups reported a higher than expected number of symptoms at 3 months. On the ImPACT, children with mTBI performed significantly worse than the OI on a visual memory test at both assessments. The OI group had higher levels of parent-reported executive dysfunction on the BRIEF at initial and 3-month assessments. Discussion: As expected, more post-concussion symptoms were initially reported by children and adolescents with mTBI vs orthopaedic injury, but there was no difference at 3 months. The BRIEF and ImPACT cognitive measures did not differentiate concussed subjects from controls, with the exception of concussed subjects' lower performance on a visual memory test at both initial assessment and at 3 months. [ABSTRACT FROM AUTHOR]

Background: Little is known about variations in social participation among individuals with traumatic brain injury (TBI) living in different environments. Objective: To examine the social participation of individuals with moderate-to-severe TBI across various living arrangements. Methods: One hundred and thirty-six individuals with moderate-to-severe TBI, living either in natural settings (e.g. home), intermediate settings (e.g. group homes or foster families) or structured settings (e.g. nursing home or long-term care facilities) and requiring daily assistance, were interviewed using the LIFE-H tool, which measures the level of difficulty and the assistance required to carry out life habits and resulting social participation. Participation in six categories of life habits pertaining to Activities of Daily Living and five categories pertaining to Social Roles were examined. Results: The level of difficulty and the assistance required to carry out the life habits and the overall level of social participation were associated with living arrangements. Participation scores in Activities of Daily Living varied across living arrangements while Social Roles scores did not. Conclusion: Living arrangements (such as intermediate settings) may better support social participation in individuals with TBI. There is a need to further study the issue of living arrangements as they seem to facilitate the performance of life habits, which impacts the social participation of individuals with TBI. [ABSTRACT FROM AUTHOR]

colbert a.m., sereika s.m. & erlen j.a. (2012) Functional health literacy, medication-taking self-efficacy and adherence to antiretroviral therapy. Journal of Advanced Nursing 69(2), 295-304. doi: 10.1111/j.1365-2648.2012.06007.x Abstract Aims. To report a study of the relationship between functional health literacy and medication adherence, as mediated by medication-taking self-efficacy, while controlling for the effect of key demographic variables (such as race, income and level of education). Background. Medication adherence is critical to successful HIV/AIDS self-management. Despite simplified regimens and the availability of tools to assist with medication-taking, adherence remains a challenge for many people living with HIV/AIDS. Design. Cross-sectional, secondary analysis. Methods. Data for this study of 302 adults living with HIV/AIDS who were taking antiretroviral medications were collected from January 2004-December 2007. Medication adherence was measured using electronic event monitors. Bivariate analyses and stepwise regression were conducted to examine the associations among functional health literacy, medication-taking self-efficacy and HIV medication adherence. Results. Overall, functional health literacy was much higher than expected; however, adherence in this sample was sub-optimal. Higher medication-taking self-efficacy was associated with higher medication adherence; however, functional health literacy was not significantly related to either medication adherence or self-efficacy beliefs. Hence, medication-taking self-efficacy did not mediate the relationship between functional health literacy and medication adherence. Conclusions. Medication adherence continues to be an issue for people living with HIV/AIDS. Additional research is needed to understand the disparate findings related to functional health literacy and medication adherence in this and other studies examining this association. [ABSTRACT FROM AUTHOR]

lodewijckx c., sermeus w., panella m., deneckere s., leigheb f., troosters t., boto p.a., mendes r.v., decramer m. & vanhaecht k. (2012) Quality indicators for in-hospital management of exacerbation of chronic obstructive pulmonary disease: results of an international Delphi study. Journal of Advanced Nursing 69(2), 348-362. doi: 10.1111/j.1365-2648.2012.06013.x Abstract Aim. To report a Delphi study that was conducted to select process and outcome indicators that are relevant to study quality of care and impact of care pathways for patients hospitalized with exacerbation of chronic obstructive pulmonary disease. Background. Management of patients hospitalized with exacerbation of chronic obstructive pulmonary disease is suboptimal and outcomes are poor. To evaluate the impact of care pathways properly, relevant indicators need to be selected. Design. Delphi study. Methods. The study was conducted over 4 months in 2008, with 35 experts out of 15 countries, including 19 medical doctors, 8 nurses and 8 physiotherapists. Participants were asked to rate, for 72 process and 21 outcome indicators, the relevance for follow-up in care pathways for in-hospital management of exacerbation of chronic obstructive pulmonary disease. Consensus (agreement by at least 75% of the participants) that an indicator is relevant for follow-up was sought in two rounds. Results. Consensus was reached for 26 of 72 process indicators (36·1%) and 10 of 21 outcome indicators (47·6%). Highest consensus levels were found for the process indicators regarding oxygen therapy (100%), pulmonary rehabilitation (100%) and patient education (94·5-88·6%) and for the outcome indicators concerning understanding of therapy (91·4-85·7%) and self-management (88·6-88·2%). Conclusion. The selected indicators appear to be sensitive for improvement. Therefore, researchers and clinicians that want to study and improve the care for patients hospitalized with exacerbation of chronic obstructive pulmonary disease should primarily focus on these indicators. [ABSTRACT FROM AUTHOR]

To advance the conceptualization and measurement of mother-reported instrumental support, the degree to which an individual receives assistance in the completion of daily life tasks. The psychometric properties of a 9-item instrumental support scale were evaluated using classical (descriptive statistics, factor analyses, evaluation of construct validity) and modern (Rasch modeling, differential item functioning) methods. Differences in perceived instrumental support were evaluated as a function of mothers' socio-demographic characteristics. Factor analytic and differential item functioning analyses provided support for two components of instrumental support, household and childcare assistance. Instrumental support is distinct from structural support and the quality of mothers' social relationships. Socio-demographic characteristics (e.g., marital status, education level, income) are associated with access to instrumental support. Differentiating appropriately between support subtypes may reveal important differences in mother's qualitative instrumental support experiences and facilitate effective targeting of social support interventions. [ABSTRACT FROM AUTHOR]

Major depressive disorder is the diagnosis used when an individual has chronic depression that may reoccur, whereby the affected person may experience a relapse of the illness. In order to prevent relapse of a major depressive disorder, it is essential to identify predictors of a potential relapse. Thus, this case-controlled study sought to examine psychosocial factors that might predict an impending relapse among persons with a major depressive disorder. Seventy-four individuals, diagnosed with a major depressive disorder, participated in the study. The data were analyzed via descriptive statistics and binary logistic regression. The results revealed stressful life events, self-efficacy for coping with depression, and expressed emotion of family members as significant predictors of an impending relapse of a major depressive disorder. Together these three independent variables explained 52% (Cog and Snell R²) or 69.3% (Nagelkerke R²) of the variance of relapse among the subjects. Although the power of each independent variable in predicting the likelihood of a relapse of the illness was not high, the results support cognitive theory that hypothesizes stressful life events increase one's likelihood of having a depressive relapse. The findings also support those of previous studies wherein self-efficacy for coping with depression and expressed emotion of family members have been found to be factors that may influence the relapse of a major depressive disorder. [ABSTRACT FROM AUTHOR]

This quasi-experimental study sought to examine the effect of a parent training program, in conjunction with a life skills training program for school-aged children, on children's life skills, and parents' child-rearing skills and perceptions of support for child life skills development. One school was purposively selected, from which two 5th grade classes were randomly assigned to either the experimental group or the comparison group. The parent and student study participants, who met the inclusion criteria and consented/assented to take part in the study, included 26 student/parent dyads in the experimental group and 27 student/parent dyads in the comparison group. All students were recruited into the life skills training program, while only parents of the students assigned to the experimental group were recruited into the parent training program. The principle investigator based these programs on the Theory of Planned Behavior and interactive group techniques. Instruments for data collection included: a Life Skills Questionnaire for School-aged Children; and, the researcher-developed Child Life Skills Development Questionnaire for Parents. Data were collected on all participants prior to implementation of both programs, immediately following each program's completion, and one month and three months after each program's completion. Analysis of covariance (ANCOVA) and repeated measures ANOVA were used to test the effect of the parent training program. The results demonstrated no significant effect of the parent training program on the children's life skills, the parents' attitudes, and their subjective norms regarding child life skills development. Positive effects, however, were seen on the parents' child-rearing skills that supported child life skills development, self-efficacy toward child life skills development, and intention to engage in child-rearing skills that supported child life development. These findings suggest this intervention may require a longer duration of implementation, so as to improve child life skills. Recommendations for further research include a larger sample size and a longer period for outcome measurements. [ABSTRACT FROM AUTHOR]

Objective To translate the original English version of the Profile of Chronic Pain: Screen ( PCP: S) into Brazilian Portuguese and examine basic psychometric properties of the translated version. We investigated ceiling and floor effects, internal consistency, factor structure, convergent validity, and the ability of the Brazilian PCP: S ( B- PCP: S) to discriminate persons with pain who were either employed or not working, or in treatment or not in treatment. Methods The Brazilian Portuguese version of the Profile of Chronic Pain: Screen ( B- PCP: S) was administered to a sample of 414 adults (men = 67). Pain catastrophizing was also assessed. Subsamples with special conditions (working despite pain [N = 116] vs not working due to pain [N = 122], and not receiving treatment for pain [N = 119] vs receiving treatment [N = 119]) were identified to investigate the discriminative properties of B- PCP: S. Results For the B- PCP: S, Cronbach's α values were 0.76 (severity), 0.88 (interference), and 0.87 (emotional burden). Confirmatory factor analysis supported the original, English language three-factor structure, with the comparative fit index = 0.93, root mean square error of approximation = 0.075, and normed fit index = 0.93. Significant correlations were found between pain intensity, pain interference, and emotional burden, and a criterion measure of catastrophizing (correlation coefficients ranged from 0.48 to 0.66, P < 0.01). B- PCP: S scores (severity, interference, and emotional burden) were higher in subjects under a doctor's care for pain and in those not working due to pain. Conclusion This B- PCP: S version was found to be a reliable instrument, with basic evidence of validity for the evaluation of pain severity, interference, and emotional burden in Brazilian Portuguese adults. The profile of B-PCP:S scores was similar to that observed in the original version. [ABSTRACT FROM AUTHOR]

Background: Worldwide, the population is ageing, resulting in an associated increase in dementia prevalence. Forgetfulness in elderly people is often perceived as normal in some local cultures and thus, the early detection of dementia in primary care requires detection of symptoms other than memory complaints. This study was conducted to screen elderly patients for early dementia in primary care using a newly developed Early Dementia Questionnaire (EDQ) and comparing it with a standard assessment tool, the Mini Mental State Examination (MMSE). Methods: A cross-sectional study was conducted on a group of elderly patients using convenience sampling of consecutive patients. Elderly depression was excluded using the Geriatric Depression Scale (GDS). Exclusion criteria also included known cases of dementia. Inclusion criteria included a score of 5 or less in GDS and the presence of a reliable informant. A face-to-face interview was done using the EDQ with the patient and informant to elicit symptoms of early dementia. If the informant was not present, a telephone interview was used instead. The patient was then assessed with the Mini Mental State Examination (MMSE) using a cut-off point of 21. Results: Prevalence of dementia among 155 subjects was 52.3% by EDQ and 15.5% by MMSE. The EDQ demonstrated a sensitivity of 79.2% with specificity of 52.7%. Positive predictive value (PPV) of EDQ was 23.5% with the negative predictive value (NPV) of 93.2%. The strongest predictor of possible early dementia was complaints of memory problems (OR 26.22; 95% CI 2.03-338.14) followed by complaints of concentration problems (OR 14.33; 95% CI 5.53-37.12), emotional problems (OR 4.75; 95% CI 1.64-13.81) and sleep disturbances (OR 3.14; 95% CI 1.15-8.56). Socio-demographic factors, medical problems and smoking status were not associated with possible dementia (p>0.05), despite that 60-70% of the elderly had chronic illnesses. Conclusion: The EDQ is a promising alternative to MMSE for screening of early dementia in primary care. [ABSTRACT FROM AUTHOR]

Background: Anomia is a debilitating symptom of aphasia, which impacts significantly on patient quality of life. There is strong evidence in the literature to indicate that treatments for anomia are successful for individuals with aphasia, including those in the chronic stage. However, numerous limitations exist within the methodologies of relevant studies. It remains unclear which treatments provide optimal benefits for varying types and severities of aphasia. Aims: The primary aim of this study was to compare the effectiveness of two treatments, Constraint-Induced Aphasia Therapy-Plus (CIATplus) and Multi-modality Aphasia Therapy (M-MAT) for noun retrieval in individuals with severe chronic Broca's aphasia. The secondary aim was to investigate whether the use of verbal constraint is an essential element of therapy. We hypothesised that M-MAT and CIATplus would lead to equally improved naming scores for treated stimuli. Methods & Procedures: Two females with chronic Broca's aphasia (CH and MT) participated in the study. We utilised two single-participant, alternating treatment designs with multiple probes. For each treatment participants received 3.25-hour treatment sessions along with 45 minutes social interaction 4 days a week, for 2 weeks (32 hours total). Treatment involved naming items in the context of turn-taking card games and home transfer request tasks. Naming probes and assessments were conducted at baseline, following each treatment, and at 6 weeks and 3 months post treatment. Outcomes & Results: Both participants differed in their responses to the treatments. However, M-MAT proved equally efficacious as CIATplus for naming of treated items. Overall, generalisation was not observed for any of the measures. CH reported enjoying both treatments, while MT preferred M-MAT. Conclusions: As expected, a number of variables are likely to have contributed to differences in participant responses to treatment. Replication with larger, well-stratified samples is required to better ascertain the effects of CIATplus and M-MAT on anomia in different types and severities of aphasia. This information would contribute to the more effective application of client-tailored treatment practices. [ABSTRACT FROM AUTHOR]

Objective.The study presented in this article explored psychosocial and relational problems of African immigrant women in the Netherlands who underwent female genital mutilation/cutting (FGM/C), the causes they attribute to these problems – in particular, their opinions about the relationship between these problems and their circumcision – and the way they cope with these health complaints. Design. This mixed-methods study used standardised questionnaires as well as in-depth interviews among a purposive sample of 66 women who had migrated from Somalia, Sudan, Eritrea, Ethiopia or Sierra Leone to the Netherlands. Data were collected by ethnically similar female interviewers; interviews were coded and analysed by two independent researchers. Results.One in six respondents suffered from post-traumatic stress disorder (PTSD), and one-third reported symptoms related to depression or anxiety. The negative feelings caused by FGM/C became more prominent during childbirth or when suffering from physical problems. Migration to the Netherlands led to a shift in how women perceive FGM, making them more aware of the negative consequences of FGM. Many women felt ashamed to be examined by a physician and avoided visiting doctors who did not conceal their astonishment about the FGM. Conclusion.FGM/C had a lifelong impact on the majority of the women participating in the study, causing chronic mental and psychosocial problems. Migration made women who underwent FGM/C more aware of their condition. Three types of women could be distinguished according to their coping style: the adaptives, the disempowered and the traumatised. Health care providers should become more aware of their problems and more sensitive in addressing them. [ABSTRACT FROM PUBLISHER]

The purpose of this study was to investigate the relationships among the self-efficacy, professional commitment, and job satisfaction of diabetic health-care personnel. The research design was cross-sectional. Three teaching hospitals, one from each of northern, middle and southern parts of Taiwan, were selected for data collection and used questionnaires to collect data; 202 participants were recruited. The demographic data for job title and job satisfaction were not significantly different (F = 2.13, P = 0.090). Self-efficacy was significantly positively correlated with professional commitment (r = 0.29, P = 0.000) and with job satisfaction (r = 0.14, P = 0.041). A total of 34.1% of the variance in job satisfaction was explained by age, years of service in the medical or nursing field, the actual number of years caring for patients with diabetes, self-efficacy, and professional commitment. Understanding the self-efficacy and professional commitment of medical and nursing personnel can help increase job satisfaction and improve the quality of medical and nursing care. [ABSTRACT FROM AUTHOR]

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wang s.-c., lee l.l., wang w.-h., sung h.-c., chang h.-k., hsu m.-y., chang s.-c. & tai c.-h. (2012) Psychometric testing of the Chinese evidence-based practice scales. Journal of Advanced Nursing 68(11), 2570-2577. Abstract Aim. This article is a report of the psychometric testing of the Chinese version of Evidence-Based Practice Implementation and Beliefs, and Barriers to, and Facilitators of Research Utilization scales. Background. Investigations into the effect of evidence-based practice on clinical care could be facilitated by instruments for measuring the levels of evidence-based practice implementation; the strength of beliefs in evidence-based practice; the barriers to, and the facilitators of research utilization. An English version of the scales measuring the above constructs has been tested whereas the Chinese one has not. Design. Instrument development. Methods. Psychometric analyses of the four evidence-based scales were conducted on a sample of 361 nurses from a medical centre in Taiwan. Both the internal consistency and squared multiple correlation coefficients were used to examine reliability. The validity testing for the four scales was estimated by examining their construct and concurrent validity. Data were collected between December 2008-January 2009. Findings. Internal consistencies exist for the Chinese Evidence-Based Practice Implementation, Beliefs, and Barriers to, and Facilitator of Research Utilization scales (≥0·85); some were greater than 0·9, which may indicate redundancy in items. Construct validity of the four scales was supported by hypotheses testing. Concurrent validity of the four scales was supported by known-group analysis, in which experienced nursing researchers had higher scores compared with clinical nurses. Conclusion. These scales may have value in discrimination between implementation of EBP and perception of barriers to, and facilitators of research utilization among nurses with different education levels, research experiences or working years in clinical setting. [ABSTRACT FROM AUTHOR]

higgins a., sharek d., nolan m., sheerin b., flanagan p., slaicuinaite s., mc donnell s. & walsh h. (2012) Mixed methods evaluation of an interdisciplinary sexuality education programme for staff working with people who have an acquired physical disability. Journal of Advanced Nursing 68(11), 2559-2569. Abstract Aim. To report a study evaluating the effectiveness of a 1-day interdisciplinary sexuality education programme for staff working with people with acquired physical disability. Background. Changes associated with an acquired physical disability can diminish a person's self-esteem, sense of attractiveness, relationships, and sexual functioning. Research suggests that people are dissatisfied with the quality of information and support around sexuality during their rehabilitation. Design. A mixed methods design was used, involving pretest and posttest questionnaires and interviews. Methods. Questionnaire data were analysed using descriptive statistics and paired samples t-tests to evaluate the effects of the programme on knowledge, skills, and comfort. Interview data were analyzed thematically, with particular emphasis on participants' opinions about the application of the course within practice. Participants were working in the area of acquired disability and rehabilitation, and were drawn from a number of disciplines. Data were collected between 2008-2009. Results. Comparison of the pre- and postmeasures, based on paired samples t-tests, showed that the programme statistically significantly increased participants' knowledge, skills, and comfort. Participants felt positive and enthusiastic about the programme and reported numerous incidents where they were more willing to raise issues for discussion and create a supportive listening space for patients to talk about their concerns around sexuality. Conclusion. Providing healthcare practitioners with a 1-day programme leads to positive changes in knowledge, skills, and comfort towards sexuality. Sexuality education may be an ideal topic for bringing practitioners together within an interdisciplinary education context. [ABSTRACT FROM AUTHOR]

Epidemiological evidence suggests that folate may lower the risk of colorectal cancer (CRC) although studies have been inconsistent and some have indicated differences in the effects of naturally occurring dietary folate and the synthetic form of this vitamin, folic acid. Most studies to date have considered CRC as a single disease; however, cancers that develop on the left and right sides of the colorectum display important phenotypic differences, suggesting they may also have different risk factors. A population-based case-control study was conducted in Western Australia to examine the relationship between intake of both natural dietary folate and supplements containing folic acid and the risk of left- and right-sided CRC. Data were available for 850 cases (575 left-sided and 275 right-sided) and 958 controls. Odds ratios were calculated using multinomial logistic regression models. There was no association between natural dietary folate intake and risk of either left-or right-sided CRC. Supplement use similarly had no significant effect on right-sided CRC. However, long-term supplement users (4+ yr) were at lower risk of left-sided CRC than those who had not taken supplements (OR = 0.65, 95% CI, 0.50–0.86) and there was a significant trend in risk reduction as duration of use increased (P < 0.01). [ABSTRACT FROM PUBLISHER]

A distinction between guilt and regret in reactions to in-group atrocities is proposed. Four studies (total N = 1249) support the notion that guilt and regret are distinct emotional reactions. Whereas guilt is a self-focused, aversive emotional reaction following from appraisals of responsibility and associated with the intention to make amends, regret follows from an empathic victim perspective, is less aversive, and is more strongly associated with positive attitudes towards the victim groups and the intention to engage in intergroup contact. These findings suggest that less aversive emotions like regret are more likely to improve intergroup attitudes after a common history of conflict, but the aversive experience of guilt might be more potent in motivating reparations. Copyright © 2012 John Wiley & Sons, Ltd. [ABSTRACT FROM AUTHOR]

moyle w., murfield j.e., griffiths s.g. & venturato l. (2012) Assessing quality of life of older people with dementia: a comparison of quantitative self-report and proxy accounts. Journal of Advanced Nursing 68(10), 2237-2246. Abstract Aims. This article reports on a study of quality of life of older people with dementia, as assessed by the person with dementia, family carer and care staff. Background. People with dementia can give meaningful assessments of their quality of life, but these often differ from proxy ratings. In understanding this discrepancy, the influence of age, extent of cognitive impairment and activity limitation has been investigated. A lack of conclusive associations between quality of life ratings and these variables indicates a need for further research. Methods. Fifty-eight triads comprising the person with dementia, family carer and member of care staff from four long-term care facilities were surveyed on the Quality of Life-Alzheimer's Disease questionnaire between August and December 2007. Results. There was an important difference in the Quality of Life-Alzheimer's Disease questionnaire total mean scores between groups, with the person with dementia providing the highest ratings. Level of impairment in Activities of Daily Living had an important effect on quality of life ratings, with proxies, particularly care staff, providing lower ratings when there was greater activity limitation. This was not replicated for assessments made by the person with dementia. Age or level of cognitive impairment did not influence any ratings. Conclusion. People with dementia can give assessments of their quality of life. However, discrepancy in ratings, with greater activity limitation affecting proxy ratings but not those made by the person with dementia, indicates the importance of including both self-report and proxy measures in research and care planning. [ABSTRACT FROM AUTHOR]

côté f., gagnon j., houme p.k., abdeljelil a.b. & gagnon m.-p. (2012) Using the Theory of Planned Behaviour to predict nurses' intention to integrate research evidence into clinical decision-making. Journal of Advanced Nursing 68(10), 2289-2298. Abstract Aims. Using an extended Theory of Planned Behaviour, this article is a report of a study to identify the factors that influence nurses' intention to integrate research evidence into their clinical decision-making. Background. Health professionals are increasingly asked to adopt evidence-based practice. The integration of research evidence in nurses' clinical decision-making would have an important impact on the quality of care provided for patients. Despite evidence supporting this practice and the availability of high quality research in the field of nursing, the gap between research and practice is still present. Design. A predictive correlational study. Methods. A total of 336 nurses working in a university hospital participated in this research. Data were collected in February and March 2008 by means of a questionnaire based on an extension of the Theory of Planned Behaviour. Descriptive statistics of the model variables, Pearson correlations between all the variables and multiple linear regression analysis were performed. Results/findings. Nurses' intention to integrate research findings into clinical decision-making can be predicted by moral norm, normative beliefs, perceived behavioural control and past behaviour. The moral norm is the most important predictor. Overall, the final model explains 70% of the variance in nurses' intention. Conclusion. The present study supports the use of an extended psychosocial theory for identifying the determinants of nurses' intention to integrate research evidence into their clinical decision-making. Interventions that focus on increasing nurses' perceptions that using research is their responsibility for ensuring good patient care and providing a supportive environment could promote an evidence-based nursing practice. [ABSTRACT FROM AUTHOR]

heilemann m.v., choudhury s.m., kury f.s. & lee k.a. (2012) Factors associated with sleep disturbance in women of Mexican descent. Journal of Advanced Nursing 68(10), 2256-2266. Abstract Aims. The aims were to identify the most useful parameters of acculturation in relation to self-reported sleep disturbance and describe risk factors for sleep disturbance in women of Mexican descent. Background. Little is known about acculturation as a factor for poor sleep in the context of other personal factors such as income or sense of resilience or mastery for Latinas in the United States. Design. This study was a secondary analysis of cross sectional survey data. Methods. Personal factors were incorporated into a modification of the Conceptual Framework of Impaired Sleep to guide our secondary analysis of self-reported sleep disturbance. Data were collected from a convenience sample of 312 women of Mexican descent of childbearing age (21-40 years) located in an urban California community were collected and previously analysed in relation to depressive symptoms and post-traumatic stress disorder. The General Sleep Disturbance Scale (in English and Spanish) was used to assess sleep disturbance. Data was collected in 1998 from September through December. Results. Early socialization to the United States during childhood was the most useful acculturation parameter for understanding self-reported sleep disturbance in this sample. In a multivariate regression analysis, three factors (higher acculturation, lower income and higher depressive symptoms) were statistically significant in accounting for 40% of the variance in sleep disturbance. Conclusion. When low income Latinas of Mexican descent report sleep problems, clinicians should probe for environmental sleep factors associated with low income, such as noise, over-crowding and exposure to trauma and violence, and refer the woman to psychotherapy and counselling rather than merely prescribing a sleep medication. [ABSTRACT FROM AUTHOR]

Aims and objectives. This study was conducted in Taiwan on couples for a month in the postpartum period to investigate the correlated factors that affect their health status. Background. Most studies have focused on the postpartum health status of mothers, but few of them mention about the postpartum health status of fathers. Design. A cross-sectional design. Methods. This study was carried out on a cross-section of couples, and the data were collected through telephone interviews conducted by a research assistant using structured questionnaires. A total of 201 couples who had given birth to a healthy single baby at a medical centre in southern Taiwan were recruited between 1 August 2007-31 November 2007. Results. The two most important factors correlated with mothers' health statuses, during the month-long postpartum period, were mothers' educational and postpartum stress levels. The result also showed that baby's Apgar score at the first minute was the main factor related to father's health status during the month-long postpartum period. Conclusions. Educational programmes should incorporate factors that affect couples' health status during the one month postpartum period to promote postnatal couples' health. Relevance to clinical practice. To improve the couples' health status during the one month postpartum period, we need to strengthen the stress-coping skills of mothers and provide them with coping resources to support their maternal roles, to provide social support to fathers and to incorporate issues of marital intimacy and parental attachment into the couples' educational programmes. Also, a father's presence at his infant's birth is encouraged to enhance parental attachment. [ABSTRACT FROM AUTHOR]

This study was designed to examine the generalizability and validity of the First Year Inventory (FYI) in Israel. Parents completed the FYI about their 12-month-olds (N = 471). Up to one month later, 17 at-risk and 38 non-risk infants participated in an assessment in which the Autism Observation Scale for Infants (AOSI) and the Mullen Scales of Early Learning (MSEL) were administered. Using the original FYI 95th percentile cutoff the risk rate in this Israeli sample was 11%. The current sample's 95th percentile cutoff was 4.8 points higher than the original US sample. Infants in the risk group obtained significantly higher AOSI scores and lower MSEL scores. Socio-demographic factors may influence risk results suggesting the need to adapt screening to serve all. [ABSTRACT FROM AUTHOR]

Scand J Caring Sci; 2012; 26; 513-518 Family caregiver views on patient-centred care at the end of life Aim: The purpose of this study was to evaluate the patient-centredness of community palliative care from the perspective of family members who were responsible for the care of a terminally ill family member. Method: A survey questionnaire was mailed to families of a deceased family member who had been designated as palliative and had received formal home care services in the central west region of the Province of Ontario, Canada. Respondents reported on service use in the last four weeks of life; the Client-Centred Care Questionnaire (CCCQ) was used to evaluate the extent to which care was patient-centred. The accessibility instrument was used to assess respondent perception of access to care. Descriptive and inferential statistics were used for data analyses. Results: Of the 243 potential participants, 111 (46.0%) family caregivers completed the survey questionnaire. On average, respondents reported that they used five different services during the last four weeks of the care recipient's life. When asked about programme accessibility, care was also perceived as largely accessible and responsive to patients' changing needs (M = 4.3 (SD = 1.04)]. Most respondents also reported that they knew what service provider to contact if they experienced any problems concerning the care of their family member. However, this service provider was not consistent among respondents. Most respondents were relatively positive about the patient-centred care they received. There were however considerable differences between some items on the CCCQ. Respondents tended to provide more negative ratings concerning practical arrangement and the organization of care: who was coming, how often and when. They also rated more negatively the observation that service providers were quick to say something was possible when it was not the case. Bivariate analyses found no significant differences in CCCQ or accessibility domain scores by caregiver age, care recipient age, income, education and caregiver sex. Conclusions: Patient-centred care represents a service attribute that should be recognized as an important outcome to assess the quality of service delivery. This study demonstrates how this attribute can be evaluated in the provision of care. [ABSTRACT FROM AUTHOR]

Scand J Caring Sci; 2012; 26; 615-623 Danish version of 'The COPD self-efficacy scale': translation and psychometric properties The aim of the study was to translate 'The COPD self-efficacy scale' (CSES) into Danish and to evaluate the psychometric properties of the Danish version (CSES-DK). CSES enables assessment of self-efficacy in individuals with chronic obstructive pulmonary disease (COPD). The scale consists of 34 items, describing situations which may cause dyspnoea in patients with COPD. The CSES was translated into Danish using a standard forward-backward translation procedure. To estimate the reliability, measurements of internal consistency and repeatability were applied. The validity of the Danish version was evaluated by examining the associations between the CSES-DK score and socio-demographic variables (age, gender, education, disease severity and self-rated health). Factor analysis was conducted to compare the internal structure of the Danish version and the American source version. The study included 151 patients with COPD, recruited from three outpatient clinics. Estimates of reliability were in accordance with the original version of CSES (Cronbach's α = 0.97, test-retest r = 0.82, p < 0.001). Significant correlations were obtained between the CSES-DK total score and vocational training and education ( r = 0.27, p = 0.001), disease severity ( r = −0.27, p = 0.001) and self-rated health ( r = −0.41, p < 0.001), indicating construct validity. Five factors were extracted from both versions of CSES. However, in the CSES-DK, only one factor concerns emotions, whereas two factors describing emotions were obtained for the original scale. Furthermore, important discrepancies exist with respect to the direction of the scoring of CSES. In some studies, a high score indicates high self-efficacy, whereas it indicates low self-efficacy in other studies, which complicates the comparison of studies. The Danish version of CSES showed acceptable measurements of reliability and validity. Potential limitations of the scale were identified, and discrepancies exist between the factor structure of the original and Danish version. Consequently, more studies of the factor structure should be conducted on both the original CSES and the translated versions of the instrument. [ABSTRACT FROM AUTHOR]

The purpose of this study was to determine whether religiosity, spirituality, and sexual attitudes accounted for differences in sexual behaviors among college students. The sample included 960 college students enrolled at four northeastern colleges. Results indicated differences in sexual attitudes, religiosity, and spirituality by gender. Moreover, sexual attitudes, religiosity, and spirituality were associated with sexual behaviors among college students. Sexual behaviors among males were influenced by their sexual attitudes, religiosity, and spirituality, while for females, their sexual behaviors were mostly influenced by their sexual attitudes. College health professionals can use these findings when discussing sexual practices with students. [ABSTRACT FROM AUTHOR]

A wide array of risk factors for problem behavior in adolescents with chronically ill parents emerges from the literature. This study aims to identify those factors with the highest impact on internalizing problem behavior (anxious, depressed and withdrawn behavior, and somatic complaints) and externalizing problem behavior (aggressive and rule-breaking behavior) as measured by the Youth Self-Report (YSR). The YSR was filled in by 160 adolescents (mean age = 15.1 years) from 100 families (102 chronically ill parents and 83 healthy spouses). Linear mixed model analyses were used, enabling separation of variance attributable to individual factors and variance attributable to family membership (i.e., family cluster effect). Predictors were child, parent, illness-related and family characteristics. The results showed that almost half of the variance in internalizing problem scores was explained by family membership, while externalizing problems were mainly explained by individual factors. Roughly 60 % of the variance in internalizing problems was predicted by illness duration, adolescents' feeling of isolation, daily hassles affecting personal life and alienation from the mother. Approximately a third of the variance in externalizing problems was predicted by adolescents' male gender, daily hassles concerning ill parents and alienation from both parents. In conclusion, the variance in adolescent problem behavior is largely accounted for by family membership, children's daily hassles and parent-child attachment. To prevent marginalization of adolescents with a chronically ill parent, it is important to be alert for signs of problem behavior and foster the peer and family support system. [ABSTRACT FROM AUTHOR]

The Ages and Stages Questionnaires (ASQ) are parent-report screening tools to identify infants at risk of developmental difficulties. The purpose of this study was to examine validity and internal reliability of the fine motor developmental area of the ASQ, 2nd edition (ASQ2-FM) for screening 12-month-old infants following major surgery. The ASQ2-FM was completed by caregivers of 74 infants who had cardiac surgery in the first 90 days of life, 104 infants who had noncardiac surgery in the first 90 days of life, and a control group of 154 infants. The Rasch item response analysis revealed that the ASQ2-FM had poor ability to discriminate among levels of fine motor ability. Sensitivity was poor (20%) and specificity was good (98%) when compared with the scores for the fine motor subscale of the Bayley Scales of Infant and Toddler Development. The ASQ2-FM under-identified infants at risk for fine motor delay; internal reliability and construct validity do not support use as a screening tool of fine motor development of infants aged 12 months who have undergone major surgery. [ABSTRACT FROM AUTHOR]

Background: Information and communication technology (ICT) has become an increasingly important part of daily life. The ability to use technology is becoming essential for autonomous functioning in society. Current functional scales for patients with cognitive impairment do not evaluate the use of technology. The objective of this study was to develop and validate a new version of the Activities of Daily Livin Questionnaire (ADLQ) that incorporates an ICT subscale. Method: A new technology-based subscale was incorporated into the Spanish version of the ADLQ (SV-ADLQ), entitled the Technology version of the ADLQ (T-ADLQ). The T-ADL was administered to 63 caregivers of dementia patients, 21 proxies of mild cognitive impairment patients and 44 proxies of normal elderly subjects (mean age of the sample + SD: 73.5 + 8.30 years). We analysed the convergent validity, internal consistency, reliability cut-off point, sensitivity and specificity of the T-ADLQ. The results of the T-ADLQ were compared to the SV-ADLQ. Results:The T-ADLQ showed significant correlations with the Mini-Mental State Examination (MMSE), the Frontal Assessment Battery (FAB) as well as other measures of functional impairment and dementia severity (MMSE: r = -0.70; FAB: r = -0.65; Functional Assessment Questionnaire: r = 0.77; Instrumental Activities of Daily Living Scale: r = -0.75; Clinical Dementia Rating Scale: r = 0.72; p < 0.001).The T-ADLQ showed a good reliability with a relatively high Cronbach's a-coefficient (Cronbach's a = 0.861). When considering a functional impairment cut-off point greater than 29.25%, the sensitivity and specificity of the T-ADLQ were 82 and 90%, respectively. The area under the receiver-operating characteristic curve was 0.937 for the T-ADLQ and 0.932 for the original version of the test. Conclusions: The T-ADLQ revealed adequate indicators of validity and reliability for the functional assessment of activities of daily living in dementia patients. However, the inclusion of technology items in the T-ADLQ did not improve the performance of the scale, which may reflect the lack of widespread use of technology by elderly individuals. Thus, although it appeared reasonable to add technology use questions to the ADLQ, our experience suggested that this has to be done cautiously, since the sensitivity of these additional items could vary in different populations. The T-ADLQ needs to be validated in a different population of dementia subjects. [ABSTRACT FROM AUTHOR]

Medical Education 2012: 46: 648-656 Objectives Simulation training offers opportunities for unsupervised, self-regulated learning, yet little evidence is available to indicate the efficacy of this approach in the learning of procedural skills. We evaluated the effectiveness of directed self-regulated learning (DSRL) and instructor-regulated learning (IRL), respectively, for teaching lumbar puncture (LP) using simulation. Methods We randomly assigned internal medicine residents in postgraduate year 1 to either DSRL ('directed' to progress from easy to difficult LP simulators during self-regulated learning) or IRL (in groups of four led by an instructor). All participants practised for up to 50 minutes and completed a pre-test, post-test and delayed (by 3 months) retention test on the simulator. Pairs of blinded trained experts independently rated all videotaped performances using a validated global rating scale and a modified version of a validated checklist. Participants provided measures of LP experience and self-reported confidence. We analysed the pre-post ( n = 42) and pre-post-retention performance scores ( n = 23) using two separate repeated-measures analyses of variance ( anovas) and computed Pearson correlation coefficients between participants' confidence and performance scores. Results Inter-rater agreement was strong for both performance measures (intra-class correlation coefficient > 0.81). The groups achieved similar pre-test and post-test scores (p > 0.05) and scores in both groups improved significantly from the pre- to the post-test (p < 0.05). On retention, a significant interaction ( F2,42 = 3.92, p = 0.03) suggests the DSRL group maintained its post-test performance, whereas that in the IRL group dropped significantly (p < 0.05). Correlations between self-reported confidence and post-test performance were positive and significant for the DSRL group, and negative and non-significant for the IRL group. Conclusions Both IRL and DSRL led to improved LP performance immediately after practice. Whereas the IRL group's skills declined after 3 months, the DSRL group's performance was maintained, suggesting a potential long-term benefit of this training. Participants in the DSRL group also developed a more accurate relationship between confidence and competence following practice. Further research is needed to clarify the mechanisms of self-regulated learning and its role in simulation contexts. [ABSTRACT FROM AUTHOR]

Context: Coupling theory, based on a tight-loose continuum, describes the nature of a connection, relationship, or interaction between entities. Understanding the nature of an ATEP's relationship with intercollegiate athletic departments is important to their growth and responsiveness to environmental change. Objective: To determine program directors' general perceptions of coupling, as well as perceptions of coupling relative to personnel, physical resources, and financial resources. Design: Descriptive, exploratory. Setting: CAATE accredited undergraduate ATEPs. Participants: The participants were 151 program directors from CAATE accredited undergraduate ATEPs. Data Collection and Analysis: Program directors were queried regarding their perceptions of coupling between the ATEP and the host institution's athletic department relative to 5 subscales: general perceptions, personnel, equipment, facilities, and financial resources.Descriptive statistics were used to provide institutional and program director profiles. Composite means were used to determine the perceived degree of coupling relative to the 5 subscales. ANOVA (post-hoc analysis, p < 0.05) and independent paired samples t tests determined differences in program directors' perceptions of coupling based on individual and institutional characteristics. Results: Program directors perceived moderate generalized, equipment, and personnel coupling, and slight coupling relative to facilities and financial resources. Significant differences were related to years of program direction experience, role orientation, institutional athletic affiliation, school or college affiliation, and funding source. Conclusions: Program directors perceive a tighter degree of generalized coupling than coupling specific to equipment, facilities, personnel, or financial resources. Institutional and program director characteristics may influence perceptions of coupling. [ABSTRACT FROM AUTHOR]

Background: Paediatric head trauma is a serious health concern often leading to neurological, behavioural and cognitive impairments. In Estonia head trauma incidence is especially high in children up to 4 years. Objective: The aim was to investigate young children's pre-injury social-emotional behaviour to discover potential risk signs for brain trauma and to study social-emotional outcome 9 months post-injury. Methods: Thirty-five 3-65 month old children with mild traumatic brain injury (MTBI) and 70 matched controls were retrospectively assessed with child monitoring system Ages and Stages Questionnaires: Social-Emotional. During follow-up 27 patients and 54 controls were re-assessed after 9 months. Results: Children with MTBI showed altered social-emotional development already before the injury. Deficits were evident in self-regulation and autonomy. Age-specific social-emotional risk signs for MTBI were found. Compared to controls more pre-injury affective problems were seen in 12-month olds, self-regulation, and communication difficulties in 30-month olds and autonomy disturbances in 60-month old children. 9 months post-injury impairments in autonomy and self-regulation were still present and new difficulties in interaction had developed. Conclusions: Childhood MTBI has a serious negative effect on further development of interaction skills. To prevent possible traumas, parents should be informed of different age-specific pre-injury social-emotional risk signs. [ABSTRACT FROM AUTHOR]