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Objective: The purpose was to introduce the Rasch model by showing an application in nursing research., Methods: The Rasch model was used to examine the psychometric properties of the nursing self-efficacy (NSE) scale. Data were collected among nursing students in Sweden. Two sets of items were analysed more thoroughly: an original set of nine items with eleven response categories and a revised set of seven items with seven response categories. Invariance of the item functioning and the categorisation of the items were analysed. Targeting was examined by comparisons of the items and persons locations. Differential Item Functioning across sample groups such as gender was examined using analysis of variance. The final set of seven items was also analysed more closely with respect to possible multidimensionality and response dependence., Results: The Rasch analysis of the original set of nine items showed high reliability measured by a person separation index, but it also indicated severe problems with the targeting, the categorisation of the items as well as lack of invariance. Although the revised set comprising seven items with seven categories performed better than the original item set some items showed misfit according to formal test statistics. Graphical examination showed, however, that the items operated in the right direction. The formal test of local independence of the items indicated minor signs of multidimensionality, alternatively response dependence., Conclusions: The Rasch model is useful for rigorous examination and development of measurement instruments in nursing research. The Rasch model facilitates disclosure of lack of invariance and other measurement problems that may not be easily detected by traditional analyses. Hence, the NSE-scale would probably have performed much better if the developmental work had been guided by Rasch analyses. In future work on the scale, priority should be given to improving the targeting and the categorisation of the items.

Purpose: The aims for this paper are to summarize the current state of disparities in clinical research participation, discuss regulatory and interpersonal causes for these disparities, and to suggest an approach to address this problem by standardized training for consent administrators., Organizing Construct: A program based on the Precede-Proceed model for training consent administrators is proposed and described., Conclusions: The current process for informed consent for research is unstandardized and inadequate, and may contribute to racial and ethnic disparities. Researchers are urged to consider a formal training program for members of their research teams who will be obtaining participants' consent., Clinical Relevance: An educational program for consent administrators may help to reduce disparities in research participation by improving communication between research staff and potential participants.

Purpose: This paper is a description of a study about articles published about nursing in Africa from 1986 to 2006., Methods: An exhaustive database search of articles written by nurses or articles related to nursing in Africa was done. Access to the database was mainly via EBSCO (http://www.ebsco.com), which allowed searching seven electronic databases. These are major databases useful for finding and accessing articles in academic journals, repositories, and archives. Data were recorded on computer spreadsheets and analyzed using frequencies and percentages., Findings: A total of 1,860 indexed research studies were categorized and analysed for themes, content, source of publication, location, subject, scientific or nonscientific methods, nursing or non-nursing research, clinical or nonclinical nursing. A progressive increase of publications was noted. Regional variations were observed in the number of publications over the years with most from Southern Africa (67.3%) compared to West Africa (5.2%) and East Africa (3.3%). Common themes were nursing education (11.9%) HIV/AIDS (11.9%), community health care (16.1%), and professional nursing issues (10.3%). Single authorship (90.7%) outnumbered multiple authorship (9.3%), though research-based (50.5%) and nonresearch-based articles (49.5%) were almost evenly distributed., Conclusions and Recommendations: More emphasis will be required for research concerning clinical studies; and collaborations--particularly multinational and across regions of Africa--should be developed. Efforts should be intensified to continue to build research capacity among nurses., Clinical Relevance: Emphasis on African-based clinical studies which directly relate to patient care and culture can advance evidence-based practice in nursing with particular reference to African settings.

Background: Experimental research in nursing has increased considerably in recent years. To improve the quality of such research, it is critical to reduce threats to internal validity. One threat that has received inadequate attention in the nursing literature is Simpson's paradox--a case of extreme confounding that can lead to erroneous conclusions about the effects of an experimental intervention. In fact, it can lead to a conclusion about an intervention effect that is the opposite of the correct inference., Approach: The aims of this study were to describe Simpson's paradox, provide a hypothetical example, and discuss approaches to avoiding the paradox., Results: The paradox is due to the combination of an overlooked confounding variable and a disproportionate allocation of that variable among experimental groups. Different designs and analysis approaches that can be used to avoid the paradox are presented., Discussion: Simpson's paradox can be avoided by selecting an appropriate experimental design and analysis that incorporates the confounding variable in such a way as to obtain unconfounded estimates of treatment effects, thus more accurately answering the research question.

Objectives: To analyze scientific activity in Latin American nursing using bibliometric indicators., Materials and Methods: This is a quantitative, descriptive study of the universe of Latin American nursing journals (119) and scientific documents (13,208) published according to current library databases including: the Web of Science (WOS), Medline, LILACS, Periodica, Cuiden, and SciELO. A database was prepared using ProCite., Results: The PAHO (Pan American Health Organization) Open-access Directory of Latin American Nursing Journals includes the greatest number of the 119 journal titles (60%). The average journal longevity is 11.3 years and Brazil produces the greatest percentage (31.9%) of journals. Of the current journals, 55% do not have international readership. The non-Latin American countries that contribute most to document diffusion are Spain, the United States, and England. The doubling time of scientific production of documents is 7.3 years and the annual growth rate is 10%; 2% of researchers form the most productive group of authors. Only in recent years has the number of contributions to the ISI nursing category begun to stabilize., Conclusions: Latin American scientific nursing production is still growing exponentially and Latin American nursing contributions to knowledge being disseminated through databases of recognized scientific quality seem to be increasing. The current scientific task is to organize and improve the publication processes., Clinical Relevance: We describe the conditions in which Latin American nursing research has become institutionalized, the challenges that it has faced, and the gradual incorporation of such research into international science.

Nurses and other healthcare professionals must read professional journals on a regular basis to provide evidence-based care. Because authors often provide little detail on their methodology, it may be difficult to determine whether we should incorporate the conclusions of a study into our clinical practice. In addition, authors and readers may have a limited understanding of statistical analysis. This article gives a brief overview of how to evaluate a manuscript and some basic statistical measures that can be used to evaluate a research study.

Background: Several surveys have presented the quality of reports on randomized clinical trials (RCTs) published in general and specialty medical journals. The aim of these surveys was to raise scientific consciousness on methodological aspects pertaining to internal and external validity. These reviews have suggested that the methodological quality could be improved., Objective: We conducted a survey of reports on RCTs published in nursing journals to assess their methodological quality. The features we considered included sample size, flow of participants, assessment of baseline comparability, randomization, blinding, and statistical analysis., Methods: We collected data from all reports of RCTs published between January 1994 and December 1997 in Applied Nursing Research, Heart & Lung and Nursing Research. We hand-searched the journals and included all 54 articles in which authors reported that individuals have been randomly allocated to distinct groups. We collected data using a condensed form of the Consolidated Standards of Reporting Trials (CONSORT) statement for structured reporting of RCTs (Begg et al., 1996)., Results: Sample size calculations were included in only 22% of the reports. Only 48% of the reports provided information about the type of randomization, and a mere 22% described blinding strategies. Comparisons of baseline characteristics using hypothesis tests were abusively produced in more than 76% of the reports. Excessive use and unstructured reports of significance testing were common (59%), and all reports failed to provide magnitude of treatment differences with confidence intervals., Conclusions: Better methodological quality in reports of RCTs will contribute to increase the standards of nursing research.

Aim: This paper is a report of a systematic review to identify, critique and synthesize nursing studies of the measurement of empathy in nursing research., Background: The profound impact of empathy on quality nursing care has been recognized. Reported empathy levels among nurses range from low to well-developed and there is clearly debate about what constitutes empathy and how it can be measured and improved., Data Sources: Searches were made of the CINAHL, MEDLINE and PsycINFO databases, using the terms 'empathy', 'tool', 'scale', 'measure', 'nurse', and 'nursing', singly or in combination to identify literature published in the English language between 1987 and 2007., Methods: A systematic review was carried out. The included papers were critically reviewed, relevant data were extracted, and a narrative synthesis was conducted., Results: Thirty papers representing 29 studies met the inclusion criteria. Three types of studies were identified: descriptive studies (n = 12), studies of empathy and patient outcomes (n = 6), and evaluational studies (n = 11). Twenty scales were used, with more than one tool being applied in some studies, suggesting the need for a systematic review of empathy measures in nursing research. A range of settings were studied but some, such as genetic healthcare, have been neglected., Conclusion: Despite numerous tools being used in nursing research to assess empathy, there appears to be no consistency, suggesting the need to evaluate the rigour of empathy tools appropriately, either to inform education or for application in clinical settings.

There is a growing body of evidence looking at the effects of cannabis use on those with schizophrenia with concerning results. This has led to the development of a number of interventions that are intended to improve outcomes for this client group. However, the methodological quality of some dual diagnosis research has been questioned in reviews for using outcome measures that are not tested as reliable and valid in the population for which they are intended for use. This literature review assesses the self-report measures that have been reliability and validity tested in populations of people with schizophrenia who use cannabis and reports on their appropriateness for use in further research studies. An overview of the most appropriate biochemical tests for cannabis is also given.

Depression is commonly present in patients with coronary heart disease (CHD) and is independently associated with increased cardiovascular morbidity and mortality. Screening tests for depressive symptoms should be applied to identify patients who may require further assessment and treatment. This multispecialty consensus document reviews the evidence linking depression with CHD and provides recommendations for healthcare providers for the assessment, referral, and treatment of depression.

The purpose of this secondary analysis is to identify and critique the instruments most frequently used to measure concepts of the Roy adaptation model. Of the 123 instruments used in 231 studies over 30 years, 20 instruments met the criteria for secondary analysis. Based on established criteria, 14 were judged to have high usefulness, three have moderate usefulness, one has limited usefulness, and two are not recommended for use with the model. Recommendations include locating and developing instruments in key content areas including adaptation in groups, and particularly developing measurement strategies consistent with the philosophical assumptions of the model and multiple ways of knowing.

Nurses are conducting their own research studies in many healthcare institutions. To conduct research, the researcher will need to gain approval from an institutional review board or ethics committee. This article describes the role of the institutional review board in clinical research with human subjects.

The National League for Nursing Core Competencies of Nurse Educators with Task Statements provide a comprehensive framework for preparing new nurse educators, implementing the nurse educator role, evaluating nurse educator practice, and advancing faculty scholarship and lifelong professional development. This article describes how one nursing department uses the core competencies with current faculty and in a graduate program that prepares nurse educators.

Many new nursing leaders assuming deanships or assistant or interim deanships have limited education, experience, or background to prepare them for the job. To assist new deans and those aspiring to be deans, the authors of this department, 2 deans, offer survival tips based on their personal experiences and insights. They address common issues, challenges, and opportunities that face academic executive teams, such as negotiating an executive contract, obtaining faculty lines, building effective work teams, managing difficult employees, and creating nimble organizational structure to respond to changing consumer, healthcare delivery, and community needs. The authors welcome counterpoint discussions with readers.

This paper outlines efforts to improve the teaching and learning methods for research on a second year pre-registration nursing programme in one university in Wales, UK. This focussed on experiential approaches supported by electronic learning resources. A subsequent evaluation aimed to elicit participating students' and lecturers' perceptions of the success of the experiential approaches and the supporting resources. A questionnaire was distributed to 53 student nurses who participated in the experiential learning and this was supplemented with an informal qualitative 'graffiti board' evaluation with the cohort; and a group interview with 4 of the lecturers who had acted as group facilitators during the experiential research sessions. The findings revealed that similar issues were pertinent for both lecturers and students and these were contained within three distinct themes relating to the structure, process and outcomes of the teaching and learning approaches. The student-led approach to evaluation offers a fresh outlook which ensures that the emic perspective is included through the study. The study sheds light on the strengths and limitations of experiential approaches to research teaching and suggest that this is a challenging approach both for students and lecturers, which should not be entered into lightly.

Aim: This paper is a presentation of the critical reflection on the types of findings obtained from the combination of individual interviews and focus groups, and how such triangulation contributes to knowledge production and synthesis., Background: Increasingly, qualitative method triangulation is advocated as a strategy to achieve more comprehensive understandings of phenomena. Although ontological and epistemological issues pertaining to triangulation are a topic of debate, more practical discussions are needed on its potential contributions, such as enhanced data richness and depth of inquiry., Method: Data gathered through individual interviews and focus groups from a study on patterns of cancer information-seeking behaviour are used to exemplify the added-value but also the challenges of relying on methods combination., Findings: The integration of focus group and individual interview data made three main contributions: a productive iterative process whereby an initial model of the phenomenon guided the exploration of individual accounts and successive individual data further enriched the conceptualisation of the phenomenon; identification of the individual and contextual circumstances surrounding the phenomenon, which added to the interpretation of the structure of the phenomenon; and convergence of the central characteristics of the phenomenon across focus groups and individual interviews, which enhanced trustworthiness of findings., Conclusion: Although the use of triangulation is promising, more work is needed to identify the added-value or various outcomes pertaining to method combination and data integration.

Aim: This paper is a report of a study to investigate Registered Nurses' perceptions, attitudes and knowledge/skills associated with evidence-based practice., Background: Evidence-based practice has emerged as a marker for healthcare quality. Previous studies have primarily used researcher-developed descriptive surveys to examine nurses' perceptions, as well as facilitators and barriers, related to evidence-based practice. Research suggests the value of understanding the organizational context prior to taking steps to implement evidence-based practice., Methods: This study, conducted in 2006, had a descriptive, cross-sectional survey design using a psychometrically-validated measure of evidence-based practice. All Registered Nurses (n = 1031) employed by a large medical centre in the United States of America were asked to complete the questionnaires. The final response rate was 40.9% (n = 422)., Findings: Participants had moderate scores on practice and attitudes towards evidence-based practice. The knowledge/skills mean scores were somewhat lower. Statistically significant differences were found for attitudes between those with baccalaureate and higher education compared to those with associate and diploma education. The two most cited barriers to implementing evidence-based practice were time and knowledge., Conclusion: The findings suggest the value of a methodical assessment when developing a systematic plan for implementing an institutional culture of evidence-based practice.

Actigraphy is an easily applied approach for assessing activity and circadian patterns in mother-infant dyads. However, timing and duration of actigraphic measurements can affect assessment accuracy. The purpose of this study was to determine the number of days of actigraphy data required to portray circadian rhythm in mothers and their young infants. Continuous actigraphy monitoring was performed in 20 mother-infant pairs over a 4-day period. Cycle mesor, amplitude, acrophase, and R2 were calculated and compared using from 1 to 4 days of data. Parameters based on 4 days of data were correlated with parameters derived from 1 to 3 days of data. There were no differences among mother or infant cosinor parameters except infant acrophase, which stabilized after > or = 2 days of data. Acceptable reliability (r > .80) was achieved with > or = 2 days of data. It was concluded that a recording period of 2 days adequately depicted circadian rhythm of actigraphy in mothers and infants.

Brenda Happell explains the role of the abstract in conference presentations and provides a practical guide to help nurses through the process of writing one. She also gives tips on what to avoid.

In the era of evidence-based practice (EBP), Randomized Controlled Trials (RCTs) may provide the best evidence of the efficacy of nursing interventions and yet the quality of RCT reporting in nursing literature has not been evaluated. The purposes of this study were to apply the Consolidated Standards of Reporting Trials (CONSORT) statement to published reports of nursing science, examine how adequately the published reports adhere to the statement, and examine the effect of the adoption of CONSORT on the quality of the RCT published reports. One hundred RCTs from 2002-2005 were identified from 4 nursing journals. Articles were randomly assigned to 4 reviewers and the quality of the published reports was evaluated using a modified CONSORT checklist. There was no difference between the 4 journals in the quality of the published reports of RCTs based on the modified CONSORT checklist employed (F = 1.27, P =.29). The quality of reporting of RCTs improved significantly in the only journal, Nursing Research, to adopt the CONSORT statement during the study period (t =-2.70, P =.01). Adoption of CONSORT is recommended as it may lead to an overall improvement in quality of reporting of RCTs in nursing journals. The profession may also wish to explore the use or development of standards similar to CONSORT but ones more appropriate for the types of research typical of that published by nurse scientists.