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Background and Purpose: We utilized the Perceived Racism Scale—Racism on the Job subscale—to assess how frequently Black nurses experienced racism on the job in the past year (ROTJ-Y) and throughout their lifetime (ROTJ-L). We aimed to assess the reliability and assess construct validity of each subscale in a sample of 53 nurses. Methods: Reliability was evaluated using coefficient alphas, item correlations, and interitem correlations. Construct validity was examined using exploratory factor analysis. Results: Results demonstrated that the subscales are reliable and valid. Coefficient alphas for the ROTJ-Y and ROTJ-L were.93 and.91, respectively. Exploratory factor analysis revealed a unidimensional factor for both subscales. Conclusion: This study demonstrated that the Racism on the Job subscales are psychometrically sound measures of workplace racism among Black nurses. [ABSTRACT FROM AUTHOR]

Introduction: Multiple recent critical societal/world events have impacted nurses' beliefs and emphasized the importance of the standards of behavior that frame nurses' professional values. Objectives: This study focused on the professional values of students in a Doctor of Nursing program (DNP), including the relationship between professional values, time in program, and intentions to participate in professionalism-focused activities. Methods: From fall 2019 through Spring 2021, 227 participants were invited to participate in this study through the completion of an online survey at several points in time. The survey contained various demographic variables, items from the Nurses Professional Values Scale-3 representing the dimensions of caring, activism, and professionalism, and Likert scale items that measured intentions to participate in professionalism-focused activities. Results: The overall mean NPVS-3 score was 118.30 (out of a possible range of 28–140). The highest mean score among the three dimensions was for caring (45.38), followed by activism (40.20) and then professionalism (32.71). Students indicated high intentions to participate in activities focused on professionalism (5.77 on a scale of 1 to 7). A moderate correlation between intentions and professionalism (r =.44, p <.0001) was noted. The association of intentions to caring and activism was weaker but significant (r = 0.26; p =.012) and (r = 0.37; p =.0003), respectively. Conclusion: DNP curricular efforts can strengthen nurses' professional values by focusing on the development of critically important professional attributes. Nurses, especially those who have a doctoral-level education, need to have strong professional values and understand the importance of their voice and impact as a leader in the profession. [ABSTRACT FROM AUTHOR]

Introduction/Objective: To develop a scale to measure methotrexate intolerance for use in adult rheumatoid arthritis (RA) patients and to describe its psychometric properties. Methods: A three‐phase study was conducted. During Phase 1, we conducted individual interviews with RA patients (n = 14) to inform our item development process. During Phase 2, we asked for RA patients' (n = 10) feedback on item readability, clarity and the scale's ability to measure methotrexate intolerance. During Phase 3, we had patients with RA (n = 204) complete the scale to develop a final version and to describe the scale's internal validity (Cronbach's alpha), test–retest reliability (intra‐class correlation coefficients), construct validity and discriminant validity and the ability of the scale to discriminate between past and present methotrexate users. Results: The newly developed, weighted scale (Patient‐Perceived Methotrexate Intolerance Scale [PPMIS]) includes four subscales: Methotrexate Benefits, Methotrexate Risks‐Side Effect Considerations, RA Risks and Methotrexate Risks‐Willingness to Take Methotrexate Despite Risks. Cronbach's alpha ranged from 0.79 to 0.94. Test–retest reliability at 2 weeks was 0.73–0.88. Construct validity was supported with significant logical relationships between subscale scores and the existing methotrexate intolerance scale and past/present methotrexate use. The PPMIS was able to correctly classify RA patients as a past versus present methotrexate user 77% of the time. At the cut point of 3.29, the sensitivity of the PPMIS is 74% and specificity is 72% to correctly classify patients into past/present methotrexate use. Conclusion: This is the first known scale with favourable measurement properties to evaluate methotrexate intolerance using a patient‐centred perspective. [ABSTRACT FROM AUTHOR]

Home radon testing is a primary lung cancer prevention strategy, yet the majority of Americans have not tested their home. This descriptive, ecological study uses 54,683 observed radon values collected in Kentucky homes from 1996 to 2016 to examine the association of county-level social determinants of health and environmental exposures on home radon testing rates. Multivariate linear regression analysis indicates that as median home value, rurality, and radon risk potential increased, counties experienced an increase in annual home radon testing rates. As adult smoking prevalence increased, counties experienced a decrease in annual rates of residential radon testing. These findings indicate that counties with low median home values, high adult smoking prevalence, and high incidence of lung cancer may benefit most from prevention interventions aimed at promoting home radon testing, adopting radon- and smoke-free home policies, and integrating radon risk reduction messaging into tobacco cessation and lung cancer screening programs. [ABSTRACT FROM AUTHOR]

The aim of this longitudinal study was to evaluate the long-term effects of providing a therapeutic conversation intervention, based on Family Systems Nursing, to family caregivers of a close relative with advanced cancer over the period before and during bereavement. To prevent adverse outcomes, caregivers need ongoing support that begins pre-loss and extends into the post-loss period. This study employed a one-group pre-test, post-test quasi-experimental design. Twenty-four caregivers participated in two intervention trials conducted over a 42-month period, receiving two intervention sessions pre-loss (Trial 1) and one intervention session post-loss (Trial 2). Significant decreases in anxiety and stress were noted over the three post-loss assessments. The final post-loss stress outcome was significantly lower than the first pre-loss score. For the depression score, there was not a significant change over time within the pre- or post-loss period. The findings provide evidence of decreasing anxiety and stress following the implementation of an extended family nursing intervention for bereaved family caregivers. [ABSTRACT FROM AUTHOR]

Effective communication is the foundation of quality care in palliative nursing. As frontline palliative home care providers, nurses could foster more effective bereavement coping skills through therapeutic conversations. The purpose of this study was to evaluate the impact of a nursing intervention offered to bereaved family cancer caregivers. This was a quasi-experimental design, with a posttest-only comparison of the intervention and control groups receiving usual care. Bereaved caregivers (n = 51) receiving services from a specialized palliative home care unit participated and completed measures of depression, anxiety, stress, and grief reactions 3, 5, and 6 months after their close relative had died. There was a significant decrease in anxiety symptoms in the intervention group compared with the control group across all 3 time points. Anxiety and stress symptoms also decreased over time in the 2 groups combined, but this decrease was not observed for depression. When evaluating grief reactions, the intervention group had a lower mean of controlled grief responses, across the posttest period, than the control group. Results demonstrate that providing bereaved family caregivers the opportunity to participate in a therapeutic conversation intervention might reduce distressing symptoms in early bereavement. [ABSTRACT FROM AUTHOR]

Purpose: Aspects of farming and farm life can contribute to higher levels of depressive symptoms resulting in an increased risk for injury and development of chronic disease and a decrease in overall quality of life. Rural farm women can be subjected to stressors from farming as an occupation, their role within the agrarian culture, and life in a rural area. The purpose of this study was to examine the associations of demographic characteristics, agricultural occupational factors, and health indicators with depressive symptoms among farm women aged 50 years and older. Methods: Secondary analysis of cross-sectional data from the Sustained Work Indicators of Older Farmers Study (2002-2006) was used to examine the influence of factors on depressive symptoms of older (> 50 years) female farmers (N= 358) from North Carolina and Kentucky. The study was framed by a modified version of the Biopsychosocial Model. Logistic regression was conducted to examine the relationships between demographics, perceived health status, active coping score, perceived stress, and factors specific to farm work and depressive symptoms. Findings: Participants' depressive symptoms status (high vs. low) was predicted by their race/ethnicity, years of education, adequacy of income for vacation, perceived health status, perceived stress, and active coping. Conclusion: This study increases our understanding of the factors associated with depressive symptoms in farm women, but also identifies significant gaps in our knowledge of depressive symptoms among this population. The multifaceted dimensions of depressive symptoms revealed indicate a crucial need to more fully explore the interrelationship among the dimensions of the conceptual model and the physical and mental health of farm women. Additional knowledge gained from these studies will assist in the development of assessment instruments, skills, and plan of care specific to the needs of farm women; thus optimizing the health care of farm women. [ABSTRACT FROM AUTHOR]

OBJECTIVE: The objective of this study was to understand the association of psychological empowerment (PE) with workplace bullying and intent to leave among nurse leaders. BACKGROUND: Nurse leaders who experience bullying cope in varied ways. Some leaders have higher levels of empowerment and resilience, whereas others are more negatively impacted by bullying. METHODS: This study used a descriptive, cross-sectional survey design. Instruments used in the study included 2 PE tools: a bullying instrument and an intent-to-leave tool. The analysis tested for bivariate correlations and used analysis of variance to discern differences among nurse leaders. RESULTS: PE was negatively correlated with both bullying and intent to leave. Chief nursing officers and directors had significantly higher PE than did nurse managers, but there was no significant difference in intent to leave among the leader groups. CONCLUSIONS: PE may help protect against the impact of bullying. Continued development of leaders to strengthen their PE is needed. [ABSTRACT FROM AUTHOR]

OBJECTIVES: The objectives of this study were to develop and test a scale designed to describe and assess nurse managers' practice environments. BACKGROUND: Creating practice environments supporting workers at all levels is critical to achieving excellent patient, staff, and organizational outcomes. Scales are available to assess staff nurses' practice environment; however, no comparable scale for nurse managers exists. METHODS: A cross-sectional design using an electronic survey was administered to nurse managers in 25 hospitals in 9 health systems from 6 states. RESULTS: Exploratory factor analysis with a varimax rotation produced a final solution of 44 items loading in 8 domains. Cronbach's a's ranged from .72 to .97. Mean scores ranged from 3.92 to 4.99 on a 6-point Likert scale. CONCLUSIONS: The scale demonstrated adequate psychometric properties and warrants further use and testing. Understanding the nurse manager practice environment may reveal insights to guide opportunities to improve organizational performance. [ABSTRACT FROM AUTHOR]

Objective The study examined the relationship between exposure to e-cigarette advertising and e-cigarette use by pregnancy status, including use of flavored e-cigarette products, among women of childbearing age. Design A cross-sectional, correlational design was used. Subjects Female current or former tobacco users in Central and Eastern Kentucky, 18-45 years old ( N = 194, 52% pregnant). Measures Demographics, pregnancy status, cigarette and e-cigarette use, and exposure to e-cigarette advertising. Results Younger age, white non-Hispanic race, and greater exposure to e-cigarette advertising were associated with a higher likelihood of ever using e-cigarettes ( p < .05 for each variable). Pregnancy was not associated with ever use ( p = .11). Younger age was associated with use of flavored e-cigarettes ( p = .0027). Among e-cigarette users, those who used flavored products were more likely to have seen advertisements or information about e-cigarettes on social media, compared to those who used unflavored e-cigarettes only ( p = .016). Conclusion There is a link between advertising exposure and ever use of e-cigarettes. Pregnancy status is not significantly associated with ever use. Use of flavored e-cigarettes is associated with younger age. E-cigarette users with greater exposure to advertising on social media were more likely to use flavored products. [ABSTRACT FROM AUTHOR]

Purpose/Objectives: To examine the association of smoking in the home with lung cancer worry, perceived risk, and synergistic risk, controlling for sociodemographics, family history of lung cancer, and health-related self-concept. The hypothesis is that participants with smoking in the home would have higher scores for lung cancer worry, perceived risk, and synergistic risk. Design: Cross-sectional baseline survey. Setting: Participants recruited from an outpatient clinic and pharmacy at University of Kentucky HealthCare, an academic medical center. Sample: 515 homeowners from a larger randomized, controlled trial aimed at reducing exposure to radon and secondhand smoke (SHS). Methods: Homeowners were selected via quota sampling so that about half would have a smoker or smokers in the home. Main Research Variables: Lung cancer worry and perceived risk; perception of synergistic risk of radon and SHS exposure; demographics. Findings: Participants with smoking in the home had higher rates of lung cancer worry and perceived risk. In addition, those with less education and a family history of lung cancer and who were current smokers had higher lung cancer worry and perceived lung cancer risk scores. Predictors of perception of synergistic risk were marital status and health-related self-concept. Conclusions: Homeowners with smoking in the home, less education, and a family history of lung cancer had greater lung cancer worry and perceived lung cancer risk. Lung cancer risk reduction interventions with vulnerable populations are needed. Implications for Nursing: Nurses are in a unique position to target high-risk populations and identify opportunities to create teachable moments to reduce environmental risks of radon and tobacco smoke exposure. [ABSTRACT FROM AUTHOR]

Background:Tobacco media campaigns are effective, but less is known regarding the impact on college students.Purpose:The purpose was to test the effects of an on-campus Tips television campaign on frequency and believability of ads recalled and to assess demographic and personal factors associated with believability.Methods:A quasi-experimental pre–post design was used to assess the 8-week campaign with 3 Tips ads. Two randomly selected cohorts of college students (N = 1593) from a large public university completed online surveys pre- and postcampaign. Group comparisons using chi-square tests, 2-samplettests, and logistic regression, controlling for residence or cohort, and predictors of believability using proportional odds modeling were examined.Results:Ads were recalled by significantly more students (68%) postcampaign. Believability for one or more ads was lower for males, undergraduates, those belonging to fraternity/sorority, and current polytobacco users (P < .05). Believability was greater for those who recalled seeing the ads more often (P < .05).Discussion:Subgroups of college students, including males and undergraduates, reported less ad believability, which should be considered when designing communication strategies.Translation to Health Education Practice:Considering the potential impact and cost-effective nature of on-campus TV media campaigns, these ads need to be integrated into current campus tobacco control strategies. [ABSTRACT FROM PUBLISHER]

Objectives: (1) Compare social norms and perceived peer use between college student cigarette, e-cigarette, and/or hookah users and nonusers; and (2) determine variables associated with social influences.Participants: Undergraduate students attending a large university in the Southeast United States (N= 511).Methods: An April 2013 online survey assessed use of 3 types of tobacco, social norms, perception of peer use, number of smokers in life, exposure to secondhand smoke, and demographic characteristics.Results: Participants indicated greater acceptance of emerging tobacco products than for cigarettes and consistently overestimated the percent of peers who use various tobacco products. Males and current users had higher social norm scores for all 3 forms of tobacco.Conclusion: To counter marketing of alternative tobacco products, education about the dangers of their use needs to be implemented across college campuses as part of a comprehensive tobacco control strategy that also includes tobacco-free campus policies. [ABSTRACT FROM PUBLISHER]

Objective: Assess impact and feasibility of a Tobacco-Free Ambassador Program on campus policy compliance.Participants: Trained Ambassadors made 253 visits to campus sites over 15 months to observe and/or approach violators.Methods: Policy violators were observed at 23 locations during Wave 1 (April–June 2012) and/or Wave 2 (April–June 2013). For locations with at least 5 visits, average violators per visit were compared between the 2 waves using a pairedttest. Attributes of violators were summarized. Cigarette butts were collected over 3-day periods in 4 campus hotspots during each wave. Personnel time and cost to implement the program were determined.Results: There were declines in observed violators per Ambassador visit and number of cigarette butts over time. Rate of violators per visit declined from 5.47 to 1.93, a 65% decrease. Personnel time was equal to 1.5 full-time equivalents annually.Conclusions: The Ambassador Program was a feasible and potentially effective strategy to increase policy compliance. [ABSTRACT FROM AUTHOR]

Purpose A sample of 150 patients with rheumatoid arthritis (RA) participated in a predictive, descriptive, cross-sectional study which compared contextual factors of patients who perceived higher quality communication with those who perceived lower quality, and determined the predictive power of contextual factors for higher quality patient-provider communication. Data sources A validated, self-report scale measured patient perception of quality of patient-provider communication. Data were analyzed using chi-square tests of association, two-sample t-tests, and multiple linear regression. Conclusions/implications for practice There were no differences in external environmental or internal personal factors between those who perceived higher and lower quality of communication. From the linear regression, patients with fewer years of education ( p = .008), those taking a greater number of RA medications ( p = .03), and those living in an urban area ( p = .04) perceived the quality of communication more positively. The findings from this study suggest that contextual factors (years of education, residence, and the number of medications) may affect RA patient perception of the quality of patient-provider communication. This underscores the need for development of appropriate and effective interventions to improve communication and optimize RA patient outcomes. [ABSTRACT FROM AUTHOR]

Rural residents are exposed to sophisticated tobacco advertising and tobacco growing represents an economic mainstay in many rural communities. There is a need for effective health messages to counter the pro-tobacco culture in these communities. To determine relevant cultural themes and key message features that affect receptivity to pro-health advertisements among rural residents, 11 exploratory focus groups and surveys with community advocates (N = 82) in three rural Kentucky counties were conducted. Participants reviewed and rated a collection of print media advertisements and branding materials used by rural communities to promote smoke-free policies. Findings reveal that negative emotional tone, loss framing, appeals to religiosity, and shifting focus away from smokers are effective strategies with rural audiences. Potential pitfalls were identified. Attacks on smokers may not be a useful strategy. Health risk messages reinforced beliefs of secondhand smoke harm but some argued that the messages needed to appeal to smokers and emphasize health hazards to smokers, rather than to non-smokers only. Messages describing ineffectiveness of smoking sections were understood but participants felt they were only relevant for restaurants and not all public spaces. Emphasis on religiosity and social norms shows promise as a culturally sensitive approach to promoting smoke-free environments in rural communities. [ABSTRACT FROM PUBLISHER]

Objective Tobacco use is the leading preventable cause of death, resulting in 443,000 US deaths per year. Rural adults have higher smoking prevalence and less access to tobacco dependence treatment than their urban counterparts. This study examined exposure to a culturally specific smoking cessation outreach intervention, assessing whether exposure was associated with cessation behaviors. Design and Sample Post-test only quasi-experimental study. Targeted adult smokers ( N = 251) living in a rural, economically distressed southeastern US county for at least 6 months. Measurements Five outreach elements (brochures/pushcards, posters, print and radio advertisements, quilt made by local artisans) based on themes from focus groups with current and former smokers and paired with brief tobacco cessation counseling, and were delivered over 6 months in 2009-2010. Exposure and cessation behavior indicators were collected via cross-sectional random-digit dial survey. The total intervention exposure score was 4.8 ( SD = 4.3, range 0-19). Results Intervention exposure was associated with having talked to a health care provider about quitting smoking in the past 6 months and planning to quit smoking in the next 6 months. Conclusions Culturally specific outreach materials based on personal narratives are a promising population-based intervention to motivate rural smokers to consider cessation. [ABSTRACT FROM AUTHOR]

Combined exposure to secondhand smoke (SHS) and radon increases lung cancer risk 10-fold. The authors assessed the feasibility and impact of a brief home screening and environmental feedback intervention to reduce radon and SHS (Freedom from Radon and Smoking in the Home [FRESH]) and measured perceived risk of lung cancer and synergistic risk perception (SHS x radon). Participants (N = 50) received home radon and SHS kits and completed baseline surveys. Test results were shared using an intervention guided by the Teachable Moment Model. Half of the participants completed online surveys two months later. Most (76%) returned the radon test kits; 48% returned SHS kits. Of the returned radon test kits, 26% were >4.0 pCi/L. Of the returned SHS kits, 38% had nicotine >.1 μg/m3. Of those with high radon, more than half had contacted a mitigation specialist or planned contact. Of those with positive air nicotine, 75% had adopted smoke-free homes. A significant increase occurred in perceived risk for lung cancer and synergistic risk perception after FRESH. [ABSTRACT FROM AUTHOR]

Aims The purpose of this study was to explore the effects of nurse manager turnover on the occurrence of adverse events. Background Nurse managers create professional nurse practice environments to support the provision of quality patient outcomes. Inconsistent findings were reported in the literature testing the relationship between nurse managers and patient outcomes. All prior studies assumed stable nursing management. Methods A longitudinal quasi-experimental study of 23 nursing units in two hospitals was used to determine whether unit characteristics, including nurse manager turnover, have an effect on patient falls or pressure ulcers. Statistical analyses included repeated measures and hierarchical modelling. Results Patients in medical/surgical units experienced more falls than in intensive care units ( F1,11 = 15.9, P = 0.002). Patients in units with a nurse manager turnover [odds ratio: 3.16; 95% confidence interval: 1.49-6.70] and intensive care units (odds ratio: 2.70; 95% confidence interval: 1.33-5.49) were more likely to develop pressure ulcers. Conclusions Nurse manager turnover and intensive care unit status were associated with more pressure ulcers. Medical/surgical unit status was associated with more falls. The study was limited by a small sample size. Implications for nurse managers Nurse manager turnover may negatively impact patient outcomes. Stable nursing management, strategic interim management and long-term succession planning may reduce adverse patient events. [ABSTRACT FROM AUTHOR]

The purpose of this article is to describe how the print media portrays secondhand smoke and smoke-free policy in rural communities. Baseline print media clips from an ongoing 5-year study of smoke-free policy development in 40 rural communities were analyzed. The authors hypothesized that community population size would be positively associated with media favorability toward smoke-free policy. Conversely, pounds of tobacco produced and adult smoking prevalence would be negatively associated with media favorability. There was a positive correlation between population size and percentage of articles favorable toward smoke-free policy. The authors did not find a correlation between adult smoking or tobacco produced and media favorability toward smoke-free policy, but we did find a positive relationship between tobacco produced and percentage of pro-tobacco articles and a negative relationship between adult smoking prevalence and percentage of articles about health/comfort. Implications for targeting pro-health media in rural communities as well as policy-based initiatives for tobacco control are discussed. [ABSTRACT FROM PUBLISHER]

The purpose of this exploratory study was to describe factors that contribute to successful postpartum smoking abstinence among women who quit smoking during pregnancy. Research questions addressed the primary motivators and lifestyle characteristics of women who do not return to postpartum smoking. Participants were recruited from a feasibility study (N = 16) based on their ability to remain smoke free for at least 6 months following delivery. Individual interviews were analyzed using content analysis strategies. Women’s narratives described the process of postpartum smoking abstinence. Four themes emerged: (a) child’s health as the primary motivator, (b) demanding a smoke-free home or environment, (c) smoking perception changes from one of primarily comfort to one of disgust, and (d) viewing abstinence as a lifelong change. Clinical implications include educating families about the effects of smoke-free environments on the health of their children while redirecting smoking habits with healthy behaviors. [ABSTRACT FROM PUBLISHER]

Aim. This paper is a report of an evaluation of the psychometric properties of the Health Beliefs Related to Cardiovascular Disease Scale designed to measure beliefs related to cardiovascular disease risk and diet and exercise in adults with diabetes. Background. Heart attack and stroke are 2-4 times more common among adults with diabetes than those without diabetes. To reduce this risk for patients with diabetes, understanding beliefs about cardiovascular disease risk and risk-reduction strategies is important. Methods. Item development for the 25-item self-report Likert scale was guided by literature review, expert panel review and focus-group feedback. It consists of four subscales, measuring four constructs of the Health Belief Model: perceived susceptibility and severity of cardiovascular disease and benefits and barriers to diet and exercise. A convenience sample of 178 adults with self-reported type 2 diabetes completed the survey between August 2006 and March 2007; 42 participants completed it again 2-3 weeks later to evaluate test-retest reliability. Results. The instrument has more than one dimension, with the best fit identified using a two-factor model specifying the Benefits and Susceptibility subscale items, rather than the four-factor solution as predicted. The Susceptibility and Benefits subscales demonstrated stable factor structure and acceptable reliability (a = 0.93 and a = 0.82 respectively). The Barriers and Severity items demonstrated unstable factor structure and poor internal consistency (a = 0.70 and a = 0.61 respectively). Conclusion. Only the Susceptibility and Benefits subscale items can be used in their current form. The Barriers and Severity items need further refinement including revised wording with clearer focus and evaluation with a larger, more diverse sample. [ABSTRACT FROM AUTHOR]

Purpose: To examine the association between strength of policy and self-reported tobacco use behavior, controlling for demographic characteristics, polytobacco use, knowledge of campus tobacco policy, and perceived policy compliance by others.Design: Cross-sectional, online survey.Setting: Ten participating State University of New York (SUNY) campuses; 5 with designated smoking/tobacco use areas and 5 with 100% tobacco-free policies.Subjects: Convenience sample of students from SUNY campuses: only tobacco users (N = 576 students) included for analysis.Measures: Items assessing tobacco use behaviors on campus, policy knowledge, and observation of others using tobacco on campus.Analysis: T tests and chi-square tests of association used to compare responses between tobacco users across campuses. Generalized estimating equations modeling used to evaluate predictors of tobacco use on campus; model estimated with students nested within campus.Results: Those on campuses without a comprehensive policy were more likely to report (in the past week) having seen others smoke on campus (98% vs 69%, P < .001), having personally smoked on campus (65% vs 36%, P < .001), and seeing others use tobacco products on campus (88% vs 67%, P < .001), compared to those on tobacco-free campuses.Conclusion: Tobacco-free campus policies provide numerous protective factors for tobacco users and nonusers. However, compliance strategies are imperative for intended policy success. [ABSTRACT FROM AUTHOR]

Purpose: To examine the short-term impact of a personalized environmental report-back intervention to reduce home exposure to tobacco smoke and radon on perception of synergistic risk for lung cancer. Radon-induced lung cancer is more common among those exposed to tobacco smoke.Design: Randomized controlled trial.Setting: Primary care clinics and a pharmacy waiting area at a University Medical Center in the Southeastern United States and community events.Participants: Five hundred sixty adult homeowners and renters (3-month follow-up, n = 334).Intervention: Personalized environmental report back.Measures: Single-item synergistic risk perception measure using 5-point Likert-type scale.Analysis: Change in synergistic risk from baseline to 3 months was evaluated using a generalized estimating equation model containing main effects of treatment group and time. Covariates in the model included age, gender, education, and home smoking status.Results: For treatment and control groups combined, there was a significant increase in perception of synergistic risk from baseline to 3 months, but the study groups did not differ. There was no association between perceived synergistic risk and whether or not there were smokers at home.Conclusion: Learning about combined risks for lung cancer, with or without dual home screening for secondhand smoke and radon and environmental report-back, may enhance perceived risk for combined environmental exposures. Evaluation of perceived synergistic risk with a single item is a study limitation. [ABSTRACT FROM AUTHOR]

Background: The Patient Activation Measure (PAM) is used clinically and in research to measure an individual's knowledge, skills, and confidence related to their health management engagement. Despite the use of "patient" in the title, the instrument can be used in nonpatient populations. A group at high risk for low activation concerning their own health is family caregivers of patients with chronic illnesses. The psychometric properties of the PAM have not been established in family caregivers. Objectives: This study aimed to examine the psychometric properties of the PAM 10-item version (PAM-10) in a sample of family caregivers of patients with chronic illnesses. Our focus was on family caregivers' health activation of their own healthcare needs. Methods: We evaluated the internal consistency reliability of the PAM-10 in a sample of 277 family caregivers. Item-total correlations and interitem correlations were used to assess item homogeneity. Construct validity of the PAM-10 was examined using exploratory factor analysis and testing hypotheses on known relationships. Results: The PAM-10 demonstrated adequate internal consistency. Item-total correlation coefficients and interitem correlation coefficients were acceptable. Construct validity of the instrument was supported. Factor analysis yielded two factors that explained 62.3% of the variance in the model. Lower levels of depressive symptoms were significantly associated with better activation, providing evidence of construct validity. Caregivers with high activation levels were significantly more likely to engage in and adhere to self-care behaviors such as regular exercise, eating a healthy diet, and engaging in stress reduction strategies. Discussion: This study demonstrated that the PAM-10 is a reliable and valid measure for family caregivers of patients with chronic illnesses to measure caregivers' health activation of their own healthcare needs. [ABSTRACT FROM AUTHOR]

OBJECTIVE: The aim of this study was to explore the influence of the practice environment on nurse managers' (NMs') job satisfaction and intent to leave. BACKGROUND: Nurse managers are a ready pool of talent to fill impending strategic leadership vacancies. Job satisfaction as an NM is a deciding factor for senior leadership aspirations. METHODS: This study used a secondary analysis of 2012 survey data of 355 NMs. The Nurse Manager Practice Environment Scale was used to identify organizational features that influence NMs' job satisfaction and intent to leave. RESULTS: Mean (SD) job satisfaction was 4.5 (1.1) on a 6-point scale. Mean (SD) intent to leave was 5.0 (2.1) on a scale ranging from 3 to 9. The Nurse Manager Practice Environment Scale was a significant predictor of both job satisfaction and intent to leave. CONCLUSIONS: Features of the organizational context can be modified to improve job satisfaction and reduce intent to leave among NMs. [ABSTRACT FROM AUTHOR]