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Aims This paper tests the mediating effect of institutional peer support on the relationship between physical declines and depressive symptoms among nursing home residents. Background As the number of older adults living in nursing homes increases, peer support received from other residents in the institutions is critical to the psychological well-being of residents who face physical declines and reduction in family support. This study tested whether institutional peer support would account for the detrimental effect of physical declines on depressive symptoms of Chinese older people residing in nursing homes. Design A cross-sectional design was used. Method The study was conducted between January-March 2009 by convenience sampling. The sample consisted of 187 nursing home residents, with 54 men and 133 women. Interviews were conducted by an experienced research assistant, and responses on physical abilities and institutional peer support were collected. Geriatric Depression Scale was used to assess depressive symptoms of each participant. Results Participants with poor physical abilities reported more depressive symptoms. Institutional peer support was negatively correlated with physical declines and depressive symptoms. Results of the regression analysis showed that the effect of physical declines on depressive symptoms was no longer significant when the influence of institutional peer support was statistically controlled, indicating a full mediation of institutional peer support on depression of older people. Conclusion Findings of this study reveal that institutional peer support positively contributes to the psychological well-being of nursing home residents. [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]

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]

linden m. & kavanagh r. (2012) Attitudes of qualified vs. student mental health nurses towards an individual diagnosed with schizophrenia. Journal of Advanced Nursing 68(6), 1359-1368. Abstract Aim. This paper is the report of a study which sought to compare the attitudes held by student and qualified mental health nurses towards individuals with schizophrenia in the Republic of Ireland. Background. Media portrayals of individuals with schizophrenia often include images of aggression and violence. With global initiatives aimed at reducing the stigma and exclusion associated with mental illness, the attitudes of those who care for people with schizophrenia are of particular interest. Methods. A survey was administered to 66 student mental health nurses, and 121 qualified mental health nurses. Participants completed the community attitudes to mental illness scale and the social interaction scale in 2009. Multivariate analysis of variance was used to test for the effects of qualification, work setting, years of experience and education on the measures. Results. Nurses employed in a community setting held more positive attitudes, when compared with colleagues who worked in an inpatient setting, as measured by the community mental health ideology subscale, indicating their desire to promote community care for individuals with schizophrenia. Nurses working in an inpatient setting held more socially restrictive attitudes indicating that they felt individuals with schizophrenia were dangerous and should be avoided. These findings were statistically significant at the P < 0·05 level. Conclusions. Mental health nurses must be alerted to the fact that holding negative attitudes may adversely affect the therapeutic relationship and ultimately lead to stigmatization and its negative consequences. [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]

scott k., white k., johnson c. & roydhouse j.k. (2011) Knowledge and skills of cancer clinical trials nurses in Australia. Journal of Advanced Nursing 68(5), 1111-1121. Abstract Aims. This paper is a report of the development and testing of a questionnaire measuring knowledge and skills of cancer clinical trials nurse in Australia. Background. The role of cancer clinical trials nurse, widely acknowledged as an integral member of the clinical research team, has evolved in recent years. Elements of the clinical trials nurse role in cancer have previously been described. To evaluate specific cancer clinical trials nurse educational and training needs, the development of a valid and reliable tool is required. Methods. In 2009, a study was conducted in three stages. Stage I: questionnaire development and pilot testing; stage II: focus group; stage III: national survey. Internal consistency reliability testing and multi-trait analysis of item convergent/divergent validity were employed. Regression analysis was used to identify predictors of clinical trials nurse knowledge and skills. Results. The national survey was a 48-item questionnaire, measuring six clinical trial knowledge and seven skills sub-scales. Of 61 respondents, 90% were women, with mean age 43 years, 19 years as a Registered Nurse and 5 years as a cancer clinical trials nurse. Self-reported knowledge and skills were satisfactory to good. Internal consistency reliability was high (Cronbach's alpha: knowledge = 0·98; skills = 0·90). Criteria for item convergent/divergent validity were met. Number of years as cancer clinical trials nurse was positively related to self-reported knowledge and skills. Conclusion. Preliminary data suggest that the national survey is reliable and valid. Data have contributed to better understanding the knowledge and skills of cancer clinical trials nurse in Australia and development of a postgraduate course in clinical trials. [ABSTRACT FROM AUTHOR]

van de mortel t.f., kermode s., progano t. & sansoni j. (2012) A comparison of the hand hygiene knowledge, beliefs and practices of Italian nursing and medical students. Journal of Advanced Nursing 68(3), 569-579. Abstract Aim. This paper reports a study examining the hand hygiene knowledge, beliefs and practices of Italian nursing and medical students with the aim of informing undergraduate curricula. Background. In comparison with registered nurses, physician status is a risk factor for non-compliance with hand hygiene guidelines. Little research has been conducted to determine if differences between the professions in relation to hand hygiene are apparent at the undergraduate level. Cross-disciplinary studies that may provide an insight into this topic are lacking. Methods. A questionnaire was administered to a convenience sample of 117 nursing and 119 medical students in a large university in Rome, Italy, to determine their hand hygiene knowledge, beliefs and practices. The data were collected in 2007-2008. Results. Nursing students' hand hygiene knowledge ( F = 9·03(1,230); P = 0·003), percentage compliance ( Z = 6·197; P < 0·001) and self-reported hand hygiene practices ( F = 34·54(1,230); P < 0·001) were significantly higher than that of medical students. There were no statistically significant differences between hand hygiene beliefs. Mean scores on the knowledge questions were low for both groups, reflecting primarily a knowledge deficit in relation to the use of alcohol-based hand rubs to decontaminate hands in the healthcare setting. Conclusion. Statistically significant disciplinary differences in hand hygiene knowledge and self-reported practices were apparent among undergraduate Italian healthcare students. Further research is needed to determine the causative factors. The overall low scores on the knowledge items indicate that these students require further education on hand hygiene, particularly in relation to the use of alcohol-based hand rubs. [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]

Aims and objectives To evaluate the internal reliability and validity of the Brazilian Portuguese version of the Family Questionnaire among families of schizophrenia outpatients. Background The main studies about the family environment of schizophrenia patients are related to the concept of Expressed Emotion. There is currently no instrument to evaluate this concept in Brazil that is easily applicable and comparable with studies from other countries. Design Methodological and cross-sectional research design. Method A convenience sample of 130 relatives of schizophrenia outpatients was selected. The translation and cultural adaptation of the instrument involved experts in mental health and experts in the German language and included back translation, semantic evaluation of items and pretesting of the instrument with 30 relatives of schizophrenia outpatients. The psychometric properties of the instrument were studied with another 100 relatives, which fulfilled the requirements for the Brazilian Portuguese version of the instrument. The psychometric properties of the instrument were assessed by construct validity (using an analysis of its key components, comparisons between distinct groups-convergent validity with the Antonovsky's Sense of Coherence Scale) and reliability (checking the internal consistency of its items and its test-retest reproducibility). Results The analysis of main components confirmed dimensionality patterns that were comparable between the original and adapted versions. In two domains of the instrument, critical comments and emotional over-involvement had moderate and significant correlations, respectively, with Antonovsky's Sense of Coherence Scale, appropriate values of Cronbach's alpha and strong and significant correlations, respectively, in test-retest reproducibility. We observed significant differences between distinct groups of parents in the category of emotional over-involvement. Conclusion We conclude that the Portuguese-adapted version of the Family Questionnaire is valid and reliable for the study sample. Relevance to clinical practice This study provided evidence that the Family Questionnaire is a reliable and valid instrument for assessing expressed emotion. It is easy and practical to use and is acceptable for use in a Brazilian cultural population. [ABSTRACT FROM AUTHOR]

Objectives: The concept of recovery has begun shifting mental health service delivery from a medical perspective toward a client-centered recovery orientation. This shift is also beginning in Hong Kong, but its development is hampered by a dearth of available measures in Chinese. Method: This article translates two measures of recovery (mental health recovery measure and the recovery subscale of peer outcomes protocol) and one measure of recovery-promoting environments (recovery self-assessment) into Chinese and investigates their psychometric properties among 206 Hong Kong Chinese people with severe mental illness. Result: Multifactor solutions from earlier studies were not replicated; our evidence pointed to one-factor solutions. Since all recovery measures demonstrated high internal consistency reliability (.92 to .96), we analyzed total scale scores. Conclusion: Moderately high correlations among the recovery measures (.33 to .56) provide some support for construct validity, yet further investigation of recovery measures in a Chinese population is needed. [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]

Prolonging the working life of older adults has been suggested by various researchers and policymakers as a strategy to alleviate challenges posed by the inevitable ageing of the population. It is thus important to have measures with which to assess and monitor factors relevant to older adults' employment. Research indicates that negative attitudes towards older workers are at the heart of employment discrimination; hence, the current research developed and assessed a new measure of attitudes towards older workers. A questionnaire asking about older workers was prepared in three versions (male, female, and gender neutral). Each version of the Attitudes towards Older Workers Scale (AOWS) was pilot tested, refined, and field tested with random samples totalling 246 hiring decision-makers and 219 undergraduate students. Internal consistency ranged between .89 and .95 across the samples and questionnaire versions. Test-retest reliability correlations for male, female, and gender-neutral versions were .83, .78, and .90, respectively. The AOWS will be a valuable tool for research, development of interventions, and for informing policy formulation in the areas of ageing, retirement, and employment. [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]

gallart a., cruz f. & zabalegui a. (2013) Factors influencing burden among non-professional immigrant caregivers: a case-control study. Journal of Advanced Nursing 69(3), 642-654. doi: 10.1111/j.1365-2648.2012.06049.x Abstract Aim. To identify factors related to the burden that is experienced by untrained immigrant caregivers. Background. There is growing concern about how to provide the care required by an ageing population. Although elder care has usually been provided by family members, this role is increasingly being fulfilled by immigrant caregivers with no formal training. Design. Case-control study (burdened/non-burdened according to the Zarit Burden Interview). Methods. The study took place between May 2005-October 2009. Anonymous questionnaires were distributed to 110 immigrant caregivers and their corresponding older care recipients ( n = 110), who were receiving care in their homes in Barcelona (Spain). The questionnaires included measures of burden, social support, quality of life and social integration, and items about the physical/psychological status of the care recipient and the nature of the care tasks. Two groups of immigrant caregivers were defined according to their scores on the Zarit Burden Interview: burdened ( n = 55) and non-burdened ( n = 55). Results. Burdened caregivers reported less social support, a poorer quality of life, and problems with social integration. Furthermore, 48% said that they lacked knowledge about the care task, while 44% had difficulty performing certain care tasks, which constitutes a risk situation. Conclusion. Burden among untrained immigrant caregivers may be reduced by improving their social support systems and quality of life, thereby helping to ensure the availability of the caregiver services, which society increasingly needs. [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]

Background: Body image refers to an individual's thoughts and feelings about his or her body and physical appearance. To date, several qualitative and quantitative findings implicate sociocultural influences, such as the media or parental pressure, in shaping female adolescents' body image perceptions. Overall, there is not much quantitative inventory of male attitudes toward elements of body image. Purpose: The present study investigated several attributes associated with body image among male and female middle school students in a diverse suburban middle school. Further, it briefly explored qualitative indicators to supplement the data set. Methods: A sample of 334 middle school students from Hopewell (OH) Junior School (approximately 50% male and 50% female) completed a 2-page survey assessing level of agreement toward various attributes associated with body image. Two open-ended responses regarding body health and body ideal were also captured. Results: The data indicate high levels of agreement (nearly 80%) among the total population that appearance is an important part of middle school children's personas. For many attributes, data for boys were parallel to the data for girls, setting a precedent for insight into boys' attitudes toward health and body image. For other attributes, girls had significantly higher levels of agreement (based on percentage of "strongly agree+agree" and mean response) for dieting (44%), depression over appearance (32%), and an inclination toward risky eating behaviors (10%) compared to their male counterparts. Discussion: Health and physical education professionals should not only maintain awareness of girls' desire to look their best physically and related influences and behaviors but acknowledge boys as having similar dispositions. Translation to Health Education Practice: Learning modules that review typical development of middle school children's bodies, how to become advertising savvy, types of dieting (e.g., binge eating), and how to recognize "at risk" groups should be developed to keep pace with the evolving societal definitions of body image and how students can take a defensive position in controlling their own definitions of a healthy body image. [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]

In addition to personal and psychological factors, structural factors may reduce the likelihood of optimal adherence to antiretroviral therapy (ART) among persons living with HIV. In this mixed-method study we report on the development of a scale to assess the salience of various structural barriers to ART adherence. After following conventional guidelines for scale development, two scales measuring structural barriers to adherence to clinic attendance and pill-taking were administered to 291 patients receiving ART at a public hospital in South Africa. Both exploratory and higher order factor analysis indicated that a single underlying general factor was appropriate for both scales. The final scales consisted of 12 items for the structural barriers to clinic attendance scale and 13 items for the structural barriers to medication-taking scale. Both scales displayed excellent internal consistency with Cronbach alpha coefficients above 0.80. Research to determine the construct validity of the scales may be a next step in this line of research. [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]

Aim. To report the development and psychometric testing of the Behavioral Health Care Competency survey, designed to measure hospital nurse perceptions of behavioral healthcare competency. Background. Hospital nurses working in general or other non-psychiatric units may lack behavioral healthcare competency to manage disruptive behaviours associated with mental illnesses. Design. Instrument development. Method. A nurse study team including clinical experts and nurse researchers from three community hospitals in southern California (USA) reviewed content validity of each item and the 31-item instrument and created a behavioral health care competency conceptual model based on the nursing process. Separate institutional review board permissions were obtained from each hospital. The study team collaborated in the timing of survey administration (November 2010), analysis of the results and survey validation. Results. A total of 844 nurses completed the survey, representing approximately 23-41% of eligible nurses from each hospital. Using principal component analysis with varimax rotation, 23 items led to a factor structure with four components. Four subscales with adequate alpha coefficients were formed: Resource Adequacy, Patient Assessment, Practice/Intervention Competency, and Psychotropic Recommendation. Conclusion. The 23-item hospital nurse Behavioral Health Care Competency survey is an adequate and valid newly developed instrument. Further testing with diverse samples is needed to strengthen generalizability and address unique and specialized nursing care needs. [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]

The purpose of this study was to understand the relationship between powerlessness, social support, and glycemic control in Korean adults with type 2 diabetes, taking into consideration their demographic characteristics. A total of 124 adults with type 2 diabetes answered the questionnaires of powerlessness and social support. Glycemic control was measured by glycosylated hemoglobin (HbA1C). Powerlessness score differed significantly with gender, age, and occupation; social support score with education, occupation, and income; and HbA1C level with age and income. The relationship between glycemic control and powerlessness was not significant, but the one between powerlessness and social support was negative. In conclusion, higher level of powerlessness was significantly related to having less social support. Based on this outcome, it is necessary to develop, for Korean adults with type 2 diabetes, an intervention program that improves their social support, which in turn reduces their powerlessness. [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]

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. The aim of this study is to examine the subjective burden experienced by nurses when they provide care for patients with acute delirium. Background. Nurses' responses to dealing with the increased functional and copious demands associated with caring for a patient with delirium are not well explored. Design. The study was descriptive and retrospective, adopting quantitative research methodologies. Methods. The Strain of Care for Delirium Index (SCDI) was used to collect data in 2007 from a random sample of the national nurses' register ( n = 800), in the Republic of Ireland. Results. The subjective burden that nurses experience when caring for patients with delirium was high ( M = 2·97). The hyperactive/hyperalert subscale was deemed the most challenging to deal with ( M = 3·41). In relation to individual behaviours, the patients who averaged highest in terms of burden are those who are uncooperative and difficult to manage ( M = 3·58). Conclusion. This study represents the first reported measurement and examination of the subjective burden nurses experience when caring for patients with delirium, following initial development and testing of a sensitive tool ( International Journal of Nursing Studies 41, 775). Findings outlined the subtypes and behaviours that increase the burden of caring for patients with delirium. This is an issue that needs to be addressed and further research is needed to explore the impact of nurse reactions further and to identify supportive/preventative methods for nurses. A specific examination into the factors that cause high levels of strain needs is required. Relevance to clinical practice. This study highlights and confirms that nursing patients with delirium is challenging for nurses. It raises awareness of the practice and policy implications of nurses' potential negative reactions to these patients. It highlights the need for additional training and education to ensure that nurses understand this condition to provide for prevention, early detection and prompt intervention. [ABSTRACT FROM AUTHOR]

Aims and objectives. To develop an instrument to measure nurses' knowledge, risk perception and health beliefs towards influenza and influenza vaccination and their vaccination behaviours and evaluate its construct validity and internal consistency reliability. Background. Although instruments to assess predictors of nurses' vaccination behaviours have been developed, their validity and reliability have not been reported. Design. Instrument development and initial validity and reliability testing. Methods. The instrument was developed drawing on a literature review and expert consultation and was refined through pilot work. A cross-sectional survey using a revised version of the instrument was conducted among a convenience sample of 520 registered nurses (response rate 77·4%). Cronbach's alpha coefficient was calculated to determine internal consistency of the sub-scale in the instrument. Principal components analysis with varimax rotation was carried out to evaluate the instrument's construct validity and examine its internal structure. Results. Cronbach's alpha coefficients for the three newly developed scales ranged from 0·70-0·76. Principal components analysis produced a good fit and confirmed the internal design of the instrument. In the seasonal influenza knowledge sub-scale four factors explained 44·8% of the total variance; in the H1N1 knowledge sub-scale two factors explained 44·7% of the total variance. Three factors in the risk perception scale contributed 50·5% of the total variance and two factors in the vaccination behaviours scale contributed 62·1% of the total variance. Conclusions. An instrument has been developed to assess nurses' knowledge, risk perception and health beliefs towards influenza and influenza vaccination and their vaccination behaviours. The instrument was valid and reliable for the setting where it was used. Relevance to clinical practice. This instrument could be used to assess nurses' knowledge, risk perception, health beliefs towards influenza and influenza vaccination and their vaccination behaviours. The three newly developed scales could also be used independently to measure variables influencing nurses' vaccination practices. [ABSTRACT FROM AUTHOR]

Aims and objectives. The purpose of this study is to develop and evaluate the psychometric properties of the Chinese version of short-form Test of Functional Health Literacy in Adolescents. Background. Assessing health literacy is vital to design health education programme; however, there are no measurement tools exist for use specifically in Chinese adolescents. Design. A non-experimental design was used to test the psychometric properties of the Test of Functional Health Literacy in Adolescents. Methods. The short-form Test of Functional Health Literacy in Adolescents was translated and back translated into a Chinese language version. Thirty high school students were recruited to validate the scenario of Test of Functional Health Literacy in Adolescents. Based on the multiple-stage stratified random sampling method, 300 high school students from four counties in Taiwan were invited to participate in this study to evaluate the psychometric properties of Test of Functional Health Literacy in Adolescents. Results. The Functional Health Literacy in Adolescents had good internal consistency reliability and excellent test-retest reliability. Confirmatory factor analysis resulted in a one-factor solution. Conclusion. Contrary to the original version of the Test of Functional Health Literacy in Adolescents, the findings revealed that the 36-item, one-factor model for the Test of Functional Health Literacy in Adolescents is the best-fit model. Relevance to clinical practice. This is a suitable instrument to assess health literacy levels in Chinese adolescents before health education programmes can be appropriately planned, implemented and evaluated. [ABSTRACT FROM AUTHOR]

Aims and objectives. To evaluate the relationship between nurse demographics and correct identification of clinical situations warranting specific nursing actions, including activation of the medical emergency team. Background. If abnormal physiology is left untreated, the patient may develop cardiac arrest. Nurses in general wards are those who perceive any clinical deterioration in patients. Design. A descriptive, quantitative design was selected. Methods. An anonymous survey with 13 multiple choice questions was distributed to 150 randomly selected nurses working in general medical and surgical wards of a large tertiary hospital in Athens, Greece. After explanation of the purposes of the study, 94 nurses (response ratio: 62%) agreed to respond to the questionnaire. Results. Categories with the greatest nursing concern were patients with heart rate < 40/minute, an atypical thoracic pain, foreign body airway obstruction and bronchial secretions, respiratory rate < 5/minute and heart rate = 100/minute. However, almost 50% of nurses were able to accurately identify the critical nursing action for patients with respiratory rate < 4/minute, 72% for patients with airway obstruction and 73% for patients with chest pain. Nurses who had graduated from a four-year educational programme identified clinical situations that necessitated medical emergency team activation in a significantly higher rate and also scored significantly higher in questions concerning clinical evaluation than nurses who had graduated from a two-year educational programme. Conclusion. Activation of the medical emergency team is influenced by factors such as level of education and cardiopulmonary resuscitation courses attendance. Relevance to clinical practice. Graduating from a four-year educational programme helps nurses identify emergencies. However, irrespective of the educational programme they have followed, undertaking a basic life support or advanced life support provider course is critical as it helps them identify cardiac or respiratory emergencies. [ABSTRACT FROM AUTHOR]

itzhaki m., bar-tal y. & barnoy s. (2012) Reactions of staff members and lay people to family presence during resuscitation: the effect of visible bleeding, resuscitation outcome and gender. Journal of Advanced Nursing 68(9), 1967-1977. Abstract Aim. This article is a report on a study conducted to examine the views of healthcare professionals and lay people regarding the effect of family presence during resuscitation on both the staff performing the resuscitation and the relatives who witness it. Background. Family presence during resuscitation is controversial. Although many professional groups in different countries have recently issued position statements about the practice and have recommended new policy moves, the Israel Ministry of Health has not issued guidelines on the matter. Methods. Study design is factorial within-between subjects. Data were collected in Israel in 2008 from a convenience sample of 220 lay people and 201 healthcare staff (52 physicians and 149 nurses) using a questionnaire based on eight different resuscitation scenarios and manipulating blood involvement and resuscitations outcome. Data were analysed using one-way analysis of variance. Findings. Overall, both staff and lay people perceived family presence during resuscitation negatively. Visible bleeding and an unsuccessful outcome significantly influenced both staff's and lay people's perceptions. Female physicians and nurses reacted more negatively to family presence than did male physicians and nurses; lay men responded more negatively than lay women. Conclusions. Changing the current negative perceptions of family presence at resuscitation requires (a) establishing a new national policy, (b) educating healthcare staff to the benefits of the presence of close relatives and (c) training staff to support relatives who want to be present. [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]

Zini A, Sgan-Cohen H D, Marcenes W. Is religiosity related to periodontal health among the adult Jewish population in Jerusalem? J Periodont Res 2012; 47: 418-425. © 2011 John Wiley & Sons A/S Background and Objective: Religiosity may be a relevant protective factor for periodontitis, as it is for other chronic systemic diseases. The objective of the present study was to assess the relationship between periodontitis and religiosity, and whether oral health-related behaviours, spirituality and social support are included in the potential pathways that explain the association between religiosity and periodontitis. Material and Methods: Cross-sectional data were part of a retrospective study. The stratified random-sampling technique was limited to the Jerusalem Jewish population. Conceptual hierarchical data analysis modelling was adopted, assuming that socio-economic position was the most distal determinant, age and gender were confounders, and social support, spirituality and oral health behaviours were mediators in the relationship between religiosity and periodontitis. Results: Kappa intra-examiner values (0.89) were satisfactory. Response rate was 88.0%. The final sample included 123 men and 125 women. The mean age was 38.6 years (SD 3.25 years), with 33.9% declared to be 'orthodox', 33.1%'religious' and 33.1%'secular'. Higher levels of religiosity ( p = 0.01), support of internal life through spirituality ( p = 0.03), higher family social support ( p = 0.02) and low levels of plaque ( p = 0.05) were related to lower levels of periodontitis. Religiosity led to higher family social support and support of internal life through spirituality, which was related to plaque level and periodontitis. Conclusion: Religiosity had a protective effect against periodontitis through extrinsic and intrinsic pathways. This should be considered as part of aetiology and prognosis, in potential prevention and care of periodontitis. [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]

The article reports the results of a national K-12 survey conducted to explore the perceptions of the role of Professional School Counselors (PSC) that they play in dealing with childhood obesity. Some of the barriers and facilitators that affect PSCs' participation in the fight against childhood obesity were also examined. The results show that about two-thirds of PSCs thought that working with obese students was part of their role and function.

Objectives: The purpose of this study was to examine the reliability, validity and clinical usefulness of the Barrow Neurological Institute Fatigue Scale (BNI-FS) in patients with mild traumatic brain injuries (MTBI). Methods and procedure: Participants were 125 patients enrolled from the Emergency Department (ED) of Tampere University Hospital, Finland who had sustained an MTBI. The average number of days from injury to the interview and questionnaires was 24.1 (SD = 5.4, Range = 8-38). The patients were compared to a healthy control sample. Patients completed the Barrow Neurological Institute Fatigue Scale, Fatigue Impact Scale (FIS), Beck Depression Inventory-Second Edition (BDI-II), Rivermead Post-concussion Symptom Questionnaire (RPSQ) and the health assessment measure EuroQol five Dimension (EQ-5D) Visual Analogue Scale (VAS). Results: The MTBI group had significantly greater total scores on the BNI-FS than the control group ( p < 0.005, Cohen's d = 0.40). The internal consistency reliability for the BNI-FS, as measured by Cronbach's alpha, was 0.96 for the MTBI group and 0.87 for the control group. The 10 items were submitted to an exploratory principal components factor analysis with varimax rotation in the MTBI group. A one-factor solution, accounting for 73.3% of the total variance, appropriately summarized the data. The correlation between the BNI-FS and other measures was rs = 0.68 ( p < 0.001) for the BDI-II, rs = 0.68 ( p < 0.001) for the RPSQ, rs = −0.39 ( p < 0.001) for the EQ-5D VAS and rs = 0.84 ( p < 0.001) for the FIS. Fatigue ratings correlated positively with number of days post-injury before returning to work ( rs = 0.27, p < 0.006). Conclusion: The BNI-FS is a relatively new, brief and highly reliable measure of fatigue. [ABSTRACT FROM AUTHOR]

International Journal of Paediatric Dentistry 2012; 22: 258-264 Objective. To use the Parental-Caregivers Perceptions Questionnaire (P-CPQ) and Family Impact Scale (FIS) to determine whether dental treatment of young Auckland children under general anaesthesia (GA) improved oral-health-related quality of life (OHRQoL) for them and their families. Design. A pretest/post-test design, with a consecutive clinical sample of parents/caregivers of children (10 years or younger) treated under GA. More than half of the children were Māori or Pacific Islanders. Results. Of the 157 children in the baseline sample, 144 (91.7%) were followed up. The overall P-CPQ score showed a large decrease following treatment, along with an increase in the number scoring 0 (no impact). Similar relative changes were observed in the oral symptoms and emotional well-being subscales, whereas the other two subscales showed moderate decreases. All post-treatment FIS scores were lower than pre-treatment ones; all showed moderate effect sizes. The greatest relative changes were seen in the parental/family activity and parental emotions subscales. Conclusions. The dental treatment of young children under GA is associated with considerable improvement in their OHRQoL. The P-CPQ and the FIS are valid and responsive to treatment-associated changes in young children with early childhood caries (ECC). [ABSTRACT FROM AUTHOR]

There have been no published studies that measure health-related stigma in individuals with sickle cell disease (SCD). This study provides preliminary validity and reliability of the Sickle Cell Disease Health-Related Stigma Scale (SCD-HRSS). Using a sample of 77 young adults with SCD, ages 18-35 years, the results support the reliability of the SCD-HRSS with an overall Cronbach's alpha reliability of 0.84 and construct validity with a positive correlation between SCD-HRSS and a measure of depressive symptoms. Participants reported the highest levels of perceived stigma from the general public, then doctors, and lastly family. Limitations and directions for future research are discussed. [ABSTRACT FROM AUTHOR]

ma c., chen s., you l., luo z. & xing c. (2012) Development and psychometric evaluation of the Treatment Adherence Questionnaire for Patients with Hypertension. Journal of Advanced Nursing 68(6), 1402-1413. Abstract Aim. This article is a report of the development and psychometric testing of the Treatment Adherence Questionnaire for Patients with Hypertension. Background Hypertension is the most prevalent health problem among adult patients affecting approximately 200 million people in China and about 1 billion persons worldwide. Adherence to medication and lifestyle for hypertensive patients result in blood pressure control and reduce adverse outcomes. At present, few specific adherence instruments are available to completely evaluate medication and lifestyle for hypertensive patients. Methods. A multi-phase psychometric questionnaire development method was used to develop the instrument. The item pool was generated using literature review and focus group. Content validity was evaluated by expert panel. Then, the field testing was conducted by a convenience sampling of 278 hypertensive patients from December 2009 to May 2010 in Guangdong Province of China. Exploratory and confirmatory factor analyses were used to test construct validity. Finally, internal consistency and test-retest reliability were assessed. Results. The new measure consisted of six dimensions with 28 items, explaining 62·54% of the total variance in the data. Confirmative factor analysis supported a good overall fit of the six-factor model. Cronbach's α of the overall questionnaire was 0·86 and 0·82 for test-retest reliability. Conclusions. The questionnaire was a brief and psychometrically sound instrument to evaluate hypertensive patients' treatment adherence and to be applied in the research and clinical fields. [ABSTRACT FROM AUTHOR]

yi m. & park e.y. (2011) Effects of breast health education conducted by trained breast cancer survivors. Journal of Advanced Nursing 68(5), 1100-1110. Abstract Aims. This article is a report on a study of the effectiveness of breast health education provided by trained breast cancer survivors on knowledge, skills, performance and self-efficacy. Background. Numerous studies have been performed to assess the effects of breast health education provided by health professionals, but few studies have examined the effects of education provided by lay persons, such as breast cancer survivors. This study focused on the role of breast cancer survivors as breast health educators. Methods. A pretest and post-test quasi-experimental design was used. Trained breast cancer survivors conducted a 60-minute breast health class that was guided by self-efficacy theory to young healthy women. The data were collected in 2008 from 22 young healthy women who participated in the class. Self-report questionnaires were used to measure the breast cancer and breast self-examinations knowledge, skills, performance and self-efficacy at pre-education, and at 1 month and 3 months post-education. Results. The scores on knowledge, skills, performance and self-efficacy before breast health education were significantly increased after 1 month and 3 months post-education. Conclusion. The results of this study demonstrate that a one-time breast health class provided by trained breast cancer survivors can be useful in motivating young women to adopt behaviours that help to prevent breast cancer morbidity and mortality. [ABSTRACT FROM AUTHOR]

mitchell m. (2011) Influence of gender and anaesthesia type on day surgery anxiety. Journal of Advanced Nursing 68(5), 1014-1025. Abstract Aim. To investigate the possible influence of gender and anaesthesia type on anxiety prior to day surgery. Background. Elective surgery undertaken on a day, short stay or 'day of surgery' basis is growing and much emphasis also placed on 'enhanced recovery' for in-patient surgery. During such brief episodes preoperative apprehension can be considerable but the opportunity to help reduce anxiety is minimal and formal plans uncommon. Method. As part of a larger study, a questionnaire was distributed to 1606 patients undergoing day surgery, with anaesthesia (2005-2007). Participants were requested to return the questionnaire by mail 24-48 hours following surgery, with 674 returned. Data were analysed using descriptive statistics and multivariate analysis of variance. Results. Of the total patients 82·4% experienced anxiety on the day of surgery with the wait, anaesthesia and possible pain being common anxiety-provoking aspects. The majority preferred to receive information between 1-4 weeks in advance and participants experiencing general anaesthesia required information at a statistically significantly earlier stage. General anaesthesia patients were statistically significantly more anxious than local anaesthesia patients and desired more information. Female patients were statistically significantly more anxious, anxiety commenced earlier and they preferred to wait with a relative/friend or talk with other patients. Conclusions. Anxiety was experienced by the majority of participants but was more prevalent amongst general anaesthesia and female patients. For general anaesthesia patients, a comprehensive level of information may be required a number of weeks prior to surgery and gender differences associated with the preoperative wait may require greater consideration. [ABSTRACT FROM AUTHOR]

Wang L, Tao H, Ellenbecker CH & Liu X (2012) Job satisfaction, occupational commitment and intent to stay among Chinese nurses: a cross-sectional questionnaire survey. Journal of Advanced Nursing 68(3), 539-549. Abstract Aim. This study was designed to identify the level of nurses' job satisfaction, occupational commitment and intent to stay among mainland Chinese nurses, to explore the relationship among them. Background. Little is known about the magnitude of Chinese nurses' intent to stay. Understanding the association among demographic characteristics and job satisfaction, occupational commitment and intent to stay among Chinese nurses is most important in a time of nurse shortages. Methods. A descriptive correlation design was used to examine the relationship among variables related to intent to stay. Data were collected by a self-administered survey questionnaire from 560 nurses working in four large hospital facilities in Shanghai in 2009. Results. The mean scores for nurses' job satisfaction, occupational commitment and intent to stay were 3·25(0·48), 3·11(0·40) and 3·56(0·65), respectively. Job satisfaction and occupational commitment were significantly related to intent to stay. A statistically significant positive correlation was found between occupational commitment and job satisfaction. Age and job position were significantly related to job satisfaction, occupational commitment and intent to stay. Conclusion. Levels of job satisfaction, occupational commitment and intent to stay reported by nurses in this study can be improved. Suggested strategies for improvement are: increasing salaries, decreasing workloads, modifying task structure, cultivating work passion and creating more professional opportunity for nurses' personal growth development and promotion. Enhancing nurses' job satisfaction and occupational commitment are vital to improve nurses' intent to stay and for strategies to address the nursing shortage. [ABSTRACT FROM AUTHOR]

Background: To shorten the waiting time for psychiatric treatment, nurse-led services may help in the first-line mental health consultation and interventions for patients with recent first onset of mental illness. Aims: The study evaluated the effectiveness of a six-session nurse-led, needs-based psycho-education program for Chinese patients with mental health problems newly referred to an outpatient clinic in Hong Kong, when compared with routine outpatient care. Method: A randomized controlled trial with a pre- and post-test, control group design was conducted. Seventy-nine patients were randomly assigned to either the nurse-led psycho-education program (N = 39), or to usual psychiatric outpatient care (N = 40). Multiple patient outcomes and services utilization were measured at recruitment and 2 weeks after the intervention. Results: The results of a multivariate analysis of variance test indicated that the psycho-education group had significantly greater improvements in mental and overall health status, insights into their treatment and illness, and hospitalization rates at the post-test. Implications: The findings provide evidence that nurse-led, needs-based psycho-education can improve mental health, self-efficacy and insights into mental illness in Chinese first-onset mentally ill patients. A future multi-center controlled trial of this nurse-led intervention is recommended. [ABSTRACT FROM AUTHOR]

The article presents a research which investigates the association between college freshmen's eating practices and their perceptions of parenting style. The research used Internet-based survey and data analysis of univariate and bivariate statistics along with multiple regression analysis. It informs that unhealthy eating contributes to morbidity in adolescents and college students and is an antecedent of premature mortality in adulthood.

Because multiple sclerosis (MS) is a multidimensional chronic disease, effective management of the illness requires a multidimensional approach. We describe a wellness program that was designed to facilitate positive health choices throughout the course of MS and present initial data analyses. We hypothesized that over the course of the program, participants would demonstrate improvement in the domains assessed. The wellness program included educational sessions in physical, mental, social, intellectual, and spiritual domains specifically targeting improved self-efficacy, physical functioning, coping skills, symptom management, and nutrition. An outcomes data collection software program was adapted to facilitate real-time patient self-report and clinician entry data collection for many domains throughout the wellness program. Initial assessment of serial measures (intake to discharge) from 65 people with MS showed improvement in several domains, including functional status (P < .05), fatigue (P < .05), fear-avoidance beliefs regarding physical activities (P < .05), depression (P < .05), somatization (P < .05), and pain (P < .05). In addition, using a model of risk for interpersonal distress, patients whose risk of elevated depression and anxiety decreased over the course of the program reported greater gains in functional status (P < .05). The results suggest possible future treatment strategies and indicate strengths and weaknesses of the wellness program, which are being used to improve the program. [ABSTRACT FROM AUTHOR]

Recently, Gomez and Fisher (Gomez R and Fisher JW () Pers Individ Dif 35: 1975-1991) proposed that four facets of spiritual well-being exist, namely, personal, communal, environmental, and transcendental spiritual well-being. Based on data from three independent studies, the present research effort tested the validity of a German version of (Gomez R and Fisher JW () Pers Individ Dif 35: 1975-1991) of the Spiritual Well-Being Questionnaire (SWBQ-G). It was found that the SWBQ-G was factorially valid and that each of the four SWBQ-G scales was discriminant to mental, physical, and emotional well-being. Also, it was found that the SWBQ-G predicted levels of subsequent happiness, psychological well-being (positive relationship), and stress (negative relationship). These results add to our knowledge about the validity of the construct of spiritual well-being. [ABSTRACT FROM AUTHOR]

ganz f.d., raanan o., khalaila r., bennaroch k., scherman s., bruttin m., sastiel z., fink n.f. & benbenishty j. (2012) Moral distress and structural empowerment among a national sample of Israeli intensive care nurses. Journal of Advanced Nursing 69(2), 415-424. doi: 10.1111/j.1365-2648.2012.06020.x Abstract Aim. The aim of this study was to determine levels of structural empowerment, moral distress, and the association between them among intensive care nurses. Background. Structural empowerment is the ability to access sources of power. Moral distress is the painful feelings experienced when a person knows the right thing to do but cannot do so due to external constraints. Several studies suggest a theoretical relationship between these concepts. Design. Cross-sectional, descriptive correlational study. Methods. Members of the Evidence Based Nursing Practice Committee of the Israeli Society for Cardiology and Critical Care Nurses recruited a convenience sample of intensive care nurses from their respective institutions and units. Nurses were asked to complete three questionnaires (demographic and work characteristics, Moral Distress Scale, and the Conditions of Work Effectiveness Questionnaire-II). Data were collected between May-September 2009. Results. Intensive Care nurses had moderate levels of structural empowerment, low levels of moral distress frequency, and moderately high moral distress intensity. A weak correlation was found between moral distress frequency and structural empowerment. No other structural empowerment component was associated with moral distress. Work characteristics as opposed to demographic characteristics were more associated with the study variables. Conclusions. This study weakly supports the association between structural empowerment and moral distress. It also provides further evidence to the theory of structural empowerment as characterized in the critical care environment. Further studies are indicated to determine what other factors might be associated with moral distress. [ABSTRACT FROM AUTHOR]