Search

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]

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]

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]

logue m.d. & effken j.a. (2013) Validating the personal health records adoption model using a modified e-Delphi. Journal of Advanced Nursing 69(3), 685-696. doi: 10.1111/j.1365-2648.2012.06056.x Abstract Aim. To report the results of a preliminary test of validity of a proposed theoretical framework of electronic personal health record adoption by older adults. Background. Personal health records can assist older adults in managing or co-managing their chronic health conditions. Although there is interest by this population, their adoption of this technology has been slow. Without a comprehensive understanding of the reasons for this phenomenon, facilitating adoption will be difficult. Therefore, we developed a theoretical framework of adoption barriers and facilitators. Design. Survey. Methods. A modified e-Delphi methodology was used to validate the framework by obtaining consensus from a panel of experts in related healthcare fields. These data were collected over 3 months in 2010. Of 16 expert panellists, 13 completed Round 1, 12 completed Rounds 2 and 3, and 9 completed Round 4. Central tendencies and percent agreement were computed to establish consensus. Findings. The e-Delphi resulted in expert consensus on the concepts, variables, and empirical indicators that were retained in (or added to) the framework to describe barriers and/or facilitators to older adults' adoption of personal health records for self-management of chronic disease. Conclusion. The validated model will be used as the basis for developing an instrument to identify barriers and facilitators to personal health records adoption and use by older adults with chronic disease. With better understanding of the factors that influence personal health record adoption in this population, more effective strategies may be developed to increase adoption and thus improve chronic disease management. [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: 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]

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]

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]

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]

harwood l., wilson b., sontrop j. & clark a.m. (2012) Chronic kidney disease stressors influence choice of dialysis modality. Journal of Advanced Nursing 68(11), 2454-2465. Abstract Aim. This article is a report of a study examining the relationships between chronic kidney disease stressors and coping strategies with dialysis modality. Background. People with chronic kidney disease are given information to enable dialysis modality choice. This education increases awareness and may alleviate concerns and stress. Disease-related stressors and coping may affect dialysis selection. Understanding the influence of stress and coping on dialysis choices will assist in providing responsive programmes. Reducing stress and encouraging coping may increase home dialysis which, despite economic and patient benefits, remains underused. Design. A prospective correlational design was used. Methods. Information was obtained from the Chronic Kidney Disease Stress Inventory and the Jalowiec Coping Scale in 223 individuals not on dialysis between the years 2005-2007. Data were recorded with respect to modality at dialysis initiation ( n = 76) from 2005-2010. The effects of stress, coping and patient parameters on modality selection were compared using bivariate and multivariate analyses. Results. Individuals on home dialysis vs. in-centre haemodialysis reported significantly fewer pre-dialysis stressors. Coping was not associated with dialysis modality. Individuals on in-centre haemodialysis had a lower serum creatinine, less advanced kidney disease and weighed more than those who started on a home therapy. Physiological stressors were most common and are amenable to interventions. Conclusion. Pre-dialysis stress levels predicted dialysis modality. Interventional studies are recommended to address chronic kidney disease stressors with the outcome of improving home-dialysis usage. [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]

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. 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. 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]

Aims and objectives. This study was designed to examine the applicability of World Health Organization Disability Assessment Schedule 2.0 (WHODAS 2.0) in adolescents in China for internal consistency and factorial validity. Background. The conceptualisation of impairments, activity limitation and participation restriction as disability underpins WHODAS 2.0. Available evidence is mainly about the use of WHODAS 2.0 in adults with little attention to adolescents. Design. Survey design. Methods. A total 314 adolescent inpatients were recruited using a purposive sampling strategy and self-measured with a range of scales related to puberty development, family function, 36-item WHODAS 2.0, extended version of Strength and Difficulties Questionnaire (Ext-SDQ). The same amount of junior high school student data was randomly selected to facilitate the model invariance examination through confirmatory factor analysis with the assistance of amos 19 and spss 19. Results. Adolescents (mean, 14·07; SD, 2·866) varied greatly in demography, health conditions, body mass index, puberty development, family function, disability and difficulties as well as prosocial status. After the removal of the item on sexual activity, the internal consistency for the 35-item WHODAS is satisfactory, overall and dimensional. The six-factor WHODAS model was found to be a good model fit, moderately correlated with the overall difficulty measured by the 20-item four-factor SDQ, with the ability to differentiate the group of adolescent inpatients and junior high school students. Conclusion. The 35-item WHODAS is useful with adolescents with satisfactory internal reliability and factorial validity. Relevance to clinical practice. This study supports the use of 35-item WHODAS in adolescents with or without health conditions in school and hospital settings, which paves the way for a better understanding about and health service delivery to adolescents during the transition from childhood to adulthood. [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]

Aim. The aim of this study was to evaluate the internal reliability and validity of the Brazilian-Portuguese version of Duke Anticoagulation Satisfaction Scale (DASS) among cardiovascular patients. Background. Oral anticoagulation is widely used to prevent and treat thromboembolic events in several conditions, especially in cardiovascular diseases; however, this therapy can induce dissatisfaction and reduce the quality of life. Design. Methodological and cross-sectional research design. Methods. The cultural adaptation of the DASS included the translation and back-translation, discussions with healthcare professionals and patients to ensure conceptual equivalence, semantic evaluation and instrument pretest. The Brazilian-Portuguese version of the DASS was tested among subjects followed in a university hospital anticoagulation outpatient clinic. The psychometric properties were assessed by construct validity (convergent, known groups and dimensionality) and internal consistency/reliability (Cronbach's alpha). Results. A total of 180 subjects under oral anticoagulation formed the baseline validation population. DASS total score and SF-36 domain correlations were moderate for General health ( r = −0·47, p < 0·01), Vitality ( r = −0·44, p < 0·01) and Mental health ( r = −0·42, p < 0·01) (convergent). Age and length on oral anticoagulation therapy (in years) were weakly correlated with total DASS score and most of the subscales, except Limitation ( r = −0·375, p < 0·01) (Known groups). The Cronbach's alpha coefficient was 0·79 for the total scale, and it ranged from 0·76 (hassles and burdens)-0·46 (psychological impact) among the domains, confirming the internal consistency reliability. Conclusions. The Brazilian-Portuguese version of the DASS has shown levels of reliability and validity comparable with the original English version. Relevance to clinical practice. Healthcare practitioners and researchers need internationally validated measurement tools to compare outcomes of interventions in clinical management and research tools in oral anticoagulation therapy. [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]

chang c.-w., huang h.-c., chiang c.-y., hsu c.-p. & chang c.-c. (2011) Social capital and knowledge sharing: effects on patient safety. Journal of Advanced Nursing 68(6), 1793-1803. Abstract Aims. This article is a report on a study that empirically examines the influence of social capital on knowledge sharing and the impact of knowledge sharing on patient safety. Background. Knowledge sharing is linked to many desirable managerial outcomes, including learning and problem-solving, which are essential for patient safety. Rather than studying the tangible effects of rewards, this study examines whether social capital (including social interaction, trust and shared vision) directly supports individual knowledge sharing in an organization. Methods. This cross-sectional study analysed data collected through a questionnaire survey of nurses from a major medical centre in northern Taiwan. The data were collected over a 9-month period from 2008 to 2009. The data analysis was conducted using the Partial Least Squares Graph v3.0 program to evaluate the measurement properties and the structural relationships specified in the research model. Findings. Based on a large-scale survey, empirical results indicate that Registered Nurses' perceptions of trust and shared vision have statistically significant and direct effects on knowledge sharing. In addition, knowledge sharing is significantly and positively associated with patient safety. Conclusion. The findings suggest that hospital administrators should foster group trust and initiate a common vision among Registered Nurses. In addition, administrators and chief knowledge officers of hospitals should encourage positive intentions towards knowledge sharing. [ABSTRACT FROM AUTHOR]

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]

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]

This study was an exploratory study of 34 South Korean early childhood educators’ strategies for addressing behavior problems in natural settings. Factors related to teachers’ strategy implementation were also explored. Four specific teacher behaviors were observed: precorrection, behavioral-specific praise, redirection, and reprimand/punishment. Among the four types of behaviors, redirection was most frequently implemented and behavioral-specific praise was least frequently implemented. Children taught by teachers with higher education levels and stronger beliefs in developmentally appropriate practices displayed lower levels of behavior problems. Teachers’ developmentally inappropriate beliefs and severity of behavior problems of children were associated with teachers’ use of reprimands. Implications of these findings and limitations of the study are discussed. [ABSTRACT FROM PUBLISHER]

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]

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]