Dissertation Abstracts

Archibald, Cynthia M. (2002)
Amazing Love: The Lived Experience of Nurses Caring For Neonates At The Edge Of Life.

Borglund, Susan T. (2003)
An Analysis of Outcome for Working Age Adults With a Disability With Different Types of Case Managers: Evidence from the 1994 National Health Interview Survey--Disability Supplement

Chen, Shiue (2007)
The Effect of a Creative Bonding Intervention on Nursing Students’ Self-Transcendence and Attitudes Toward Elders in Taiwan

David, Beverly A. (2001)
Adolescent Childbearing: Geographic and Demographic Disparities in Palm Beach County

DeSantis, Joseph P. (2006)
The Relationship of Depressive Symptoms, Self-Esteem And Sexual Behaviors In Urban Men At Risk For Human Immune Deficiency Virus and Sexually Transmitted Infections

Elder, Stacie J. (2006)
Critical Care Nurses’ Perspectives On End-Of-Life Decision-Making With Patients In Intensive Care Units

Fauchald, Sally K. (2004)
The Influence of Self Esteem, Self-Silencing, and Abuse on Safer Sex Behaviors of Rural Women

Figueroa-Haas, Cynthia (2005)
Effect of Breast Augmentation Mammoplasty On Self-Esteem and Sexuality: A Quantitative Analysis

Gooden, Alexa J. (2001)
Lived Experiences of Native American Nurses: The Journey to Earn a Graduate Nursing Degree

Gottlieb, Jo Ann (2007)
Vulnerability, Self-Transcendence, and the Professional Well-Being of New Graduate Registered Nurses

Gracia Jones, Sandra (2000)
The Other Side of the Pill Bottle: The Lived Experience of HIV+ Nurses on HIV Combination Drug Therapy

Hacker, Marcia Jean (2003)
The extraordinary routine: an ethnomethodological study of an inpatient alzheimer’s disease unit

Hanna, Henrietta H. (2006)
The Influence Of Self-Efficacy and Spirituality On Self-Care Behaviors and Glycemic Control In Older African Americans With Type 2 Diabetes

Hardesty, Pamela (2001)
Health Related Hardiness in an Aging Nursing Workforce

Hart, Leigh B. (2000)
The Process by which Critical Care Nurses Attain Hemodynamic Monitoring Skills: A Grounded Theory Study

Hart, Margaret (2007)
The Culturally Diverse Newly Graduated Registered Nurse’s Lived Experience of Being Mentored: A Phenomenological Study

Hartung, Sheila Quinn (2003)
Nurses' Transition From Acute Care Practice To Home Health Care Practice:
A Grounded Theory Study

Kleier, Jo Ann Sanders (2002)
Attitude, Subjective Norm, and Behavioral Intention As Predictors of Behavior of Advanced Practice Nurses Regarding Teaching Testicular Self-Examination

Lamet, Ann R. (2006)
The Relationship Among Selected Risk Factors, Resilience and Psychological Distress of Older Women Who Are Holocaust and Non-Holocaust Survivors In The Post 9/11 Environment

Little, Daniel James (2005)
The Relationship Between Professional Nursing Values and Willingness to Serve Underserved and Disenfranchised Populations In Students Entering Nursing Education Programs

Maze, Claire Denise Martino (2004)
Willingness to Serve Underserved and Disenfranchised Populations: The Influence of Registered Nurses' Demographic and Educational Characteristics, and Values

Meadus, Robert John Jr. (2005)
Adolescents Coping With Mood Disorder: A Grounded Theory Study

Medina-Shepherd, Rosario (2007)
The Efficacy of the Health Belief Model In Predicting Spanish-Speaking Hispanic Women’s Behavior Regarding Mammography Screening

Mites-Campbell, Mary
Characteristics of Adult Tobacco Smokers and Their Smoking Cessation Outcomes, After An Intervention Program

Neely-Smith, Shane L. (2003)
The Influence of Self-Esteem and Self-Silencing on Self-Efficacy for Negotiating Safer Sex Behaviors in Urban Bahamian Women

Nieto-Vazquez, Miriam (2005)
The Effects of an Osteoporosis Educational Intervention on Knowledge, Health Beliefs, And Self-Efficacy in College-Age Puerto Rican Women

Nogueras, Debbie (2005)
The Efficiacy of the Three Component Model of Commitment in Predicting Intent to Leave the Nursing Profession

Perkel, Linda K. (2001)
Nurse Executives' Perception of their Personal and Organizational Value Congruence and Leadership Behaviors: Transformational, Transactional, and Laissez-faire

Radsma, Jenny (2005)
Unveiling the Smokescreen: A Grounded Theory Study of Nurses Who Smoke and Their Health Promotion Role with Patients Who Smoke

Rostock, Barbara Jeanne (2002)
The Long Good-Bye. Living with Alzheimer's Disease: The Significant Other's Perspective

Russell, Angela C. (2006)
The Efficacy of the Theory of Reasoned Action to Predict Behavioral Intention of Nurse Faculty to Engage in Faculty Practice

Scrandis, Debra A. (2003)
Is Anyone Out There? Normalizing Postpartum Depressive Symptoms With Social Support:
A Grounded Theory Study

Seaward, Susan D. (2005)
The Influence of Selected Social Economic Factors and Selected Condition/Patient-Related Factors on Glycosylated Hemoglobin as an Indicator of Adherence to Diabetic Regimen in Military Veterans

Smolinski, Karen (2003)
The Experience of Graduate Study In Nursing For Students Who Are Non-Native English Speakers

Spalding, Claudette M. (2002)
Willingness to Serve Underserved and Disenfranchised Populations: The Influence of Level of Education, University Affiliation, and Nursing Students' Spirituality

Thomas, Kathy J.(2005)
Risk, Protective Factors, and Psychological Resilience in Relation to Educational Resilience in Associate Degree Nursing Students

Werner, Helen (2007)
The Effect of a Dyphagia Educational Program on Subjective Norm and Perceived Behavioral Control in Registered Nurses as Predictors of their Behavioral Intention to Perform Dysphagia Assessment

White, Kim Wenona (2005)
Childhood Lead Exposure: Caregivers’ Knowledge, Perceptions of Risk, and Risk Reduction Behaviors

Wyckoff, Mary M. (2007)
Intracranial Hypertension: A Phenomenological Inquiry

Zander, Patricia A. (2005)
Attitudes of Physicians and Advanced Practice Nurses Toward Collaborative Practice

Zander, Patricia E. (2005)
Knowledge Development in a Vulnerable Population:
A Case Study of International Nurses as Graduate Students in the United States

The purpose of this study was to describe the experience of nurses caring for neonates at the edge of life. Nurses who are involved in the caring of critically ill newborns and their families, are constantly challenged to integrate the best of themselves, their knowledge, understanding of family dynamics, and often their personal struggles with ethical issues, in order to provide the finest care to their tiniest patients. Neonatal nurses are frequently asked,” How do you do it?” and are themselves unable to answer. Research studies have shown that patient care rewards is the reason why many nurses entered nursing, remained in nursing, and would chose nursing again.

A phenomenological study was conducted and included interviews with eight neonatal Level III nurses. Data analysis was consistent with Colaizzi’s interpretation of the method. Ten major themes described the experience: professional distress, uncertainty, satisfaction, affection, helplessness, perceived negative attitudes, parental attitudes, playing God, perception of care, and coping. The underlying theme across all protocol was amazing love despite the dissatisfaction that some of the nurses experienced.

Case management has been successfully utilized in many areas of the U.S. health care system. However, the increasing number of working age adults with a disability combined with the economic impact of their required services raises questions about the effectiveness of different types of case managers for the achievement of outcomes of importance to the age group. Guided by a theoretical adaptation of the Quality Health Outcomes Model, different types of case managers, case manager services, and client characteristics were studied for their relationship to outcomes demonstrating social participation, health maintenance behaviors, and economic productivity for working age adults with a disability. Secondary analysis of data obtained from the 1994 National Heath Interview Survey--Disability Supplement included descriptive, co-relational, and inferential methods. A sample of 371 working age adults with an identifiable disability who reported use of either a nurse, a social worker, or a family member or friend as the coordinator of medical care provided the demographic and holistic characteristics for analysis. Although 74.7% of the cases reported problems with IADL/ADLs, family members or friends predominated as the case manager of choice (78%). While past working experience was claimed by 80% of the sample, 64.4% now reported an inability to work due to activity limitations measured by ability to work. Services for nursing, social work, and independent living were received by less than 20% of the cases. Regression models, accommodating the mediating and moderating influences of correlated variables (p = <.05), were constructed for 3 of the 4 outcomes measured. The results indicate that client, system, and intervention variables were significantly related (p = <.05) to the achievement of outcomes typical for the age group. However, case manager services (interventions) and the type of case manager (system) exerted limited influence on outcomes of importance to working age adults with a disability. Given the preponderance of family members or friends as case managers, the importance of outcomes related to health maintenance behaviors needs to be addressed by health care providers and systems. Implications for case management, health care policy development, and nursing education are discussed. Future research needs to continue to focus on the identification and utilization of systems and interventions needed for successful attainment of outcomes identified as important to persons with a disability.

The aged population, including elders in Taiwan, is growing worldwide. There is an increased need for nurses willing to care for elders; yet few young nurses have an interest in elder care. A quasi-experimental design was used to test the effect of an eight-week Creative-Bonding Intervention (CBI) on Taiwanese nursing students’ self-transcendence and attitudes toward elders. Reed’s self-transcendence theory guided the study with researcher expectation that students would have increased positive views toward elders and elder care if student self-transcendence could be stimulated. Hypotheses were that students in a CBI experimental group (n = 100) would have greater self-transcendence and increased positive attitudes toward elders when compared to a Friendly Visit (FV) control group (n = 94) and that self-transcendence and attitude scores would be positively correlated.

The researcher taught the CBI students a variety of art activities and included conversational guidelines to promote student-elder bonding in two long-term care facilities in Taiwan. Instruments were demographic data, Reed’s (1991b) Self-Transcendence Scale, Hilt and Lipschultz’s (1999) Revised Kogan’s Attitudes towards Old People statements, and open-ended questionnaires. Data were analyzed with descriptive, ANCOVA, Pearson correlation statistics, and Cronbach’s alpha reliabilities.  

Both groups had a significant improvement in their attitudes toward elders (p < .005) and the CBI group had significantly more positive attitudes than the FV control group (p < .05). In the CBI group, self-transcendence was promoted but was non-significant (ns); willingness to care for elders was significant (p < .005). Additionally, both groups of students expressed that the CBI and FV enhanced communication with elders, lessened the distance between generations, strengthened bonds between students and elders, and promoted students’ growth. The CBI appeared to stimulate young students’ self-transcendence, and changed their attitudes toward elder care.

The CBI can be used to provide an innovative approach in caring for elders and lead to a new framework for gerontological nursing education and excellence in care of elders. The CBI also can be used to build partnerships between a division of nursing and long-term care facilities to advance students’ learning and promote quality of elder care.

Palm Beach County's impoverished, pregnant, minority adolescents demonstrate extremely high childbearing rates. As a function of their geographic and demographic characteristics these vulnerable adolescents experience differential health trajectories (Cornerstone, 2001a). The purpose of this quantitative, correlational investigation was to predict what distinguished infant birth weight and childbearing adolescents in high and low birth rate zip code areas in Palm Beach County, Florida for the year 1999. Predictive discriminant analysis was used to test the ability and strength of the predictor variables: maternal age, education, race/ethnicity, prenatal care, and tobacco use in their contribution to classification in the criterion variables of high and low infant birth weight and childbearing adolescents in high and low birth rate zip code areas. The results of this investigation demonstrated that childbearing youth within Palm Beach County's high birth rate zip code areas were more likely to live in disadvantaged environments, be Black, Mexican, Central or South American Hispanic, have fewer prenatal visits, less years of education and have their infant be of less than average birth weight. A discussion of culturally competent nursing health care delivery options for at-risk populations and recommendations for nursing policy, practice and research are provided.

Men who have sex with men (MSM) have been a persecuted and stigmatized group during many points in history. This group experienced further marginalization when HIV infection emerged in 1981 and predominately affected this population. This persecution, stigmatization, and marginalization probably affect the mental health of this population.
When MSM experience depressive symptoms and lowered self-esteem, does this have an effect sexual behaviors? This quantitative research study examined the relationship of depressive symptoms, self-esteem, sexual behaviors, and selected demographic variables. A sample MSM representing the diverse ethic composition of South Florida was sampled using survey research to discover the relationship of these aforementioned variables. Data that were collected were analyzed using a variety of parametric and non-parametric statistics.

Critical care nurses, who work in intensive care units, assess and provide interventions to seriously ill patients daily. Due to the uncertainty of outcome during critical illness, patients and their families are involuntarily placed in situations that require end-of-life decision-making. Often critical care nurses are asked by patients and their families to assist in the decision-making process. At present, the literature is scarce concerning how nurses’ beliefs, attitudes and values may impact on patients and their families’ processes in making end-of-life decisions. The purpose of this exploratory study will be to describe critical care nurses’ perspectives on how they assist patients and their families in making end-of-life decisions in intensive care units. Utilizing exploratory/descriptive theory as the framework, nurses will be interviewed in a hospital in a suburban area of the Midwestern United States. Open-ended questions will explore their beliefs, attitudes and values concerning assisting patients and their families in making end-of-life decisions. Exploratory analysis will be used to identify themes of attitudes and behaviors nurses describe in aiding patients and their families in the decision-making process. The findings of this study may provide a beginning understanding of the nurse’s role in assisting patients and their families with end-of-life decision-making.

Heterosexual transmission is the leading cause of HIV infection among women. At least 38% of AIDS cases diagnosed in women in 1997 were acquired by heterosexual contact (Crosby et al., 2000); of the estimated new AIDS diagnoses among women, 68% have been attributed to heterosexual transmission (The Henry J. Kaiser Family Foundation, 2004). Women living in rural areas have experienced a rapid increase in HIV/AIDS cases, particularly from sex with male partners (Crosby et al., 2000).

To date, 24% of the newly reported cases of HIV in Minnesota are women (up from 15% in 1994). Eleven percent of those newly reported cases live in Greater Minnesota.

The purpose of this study is to identify the influence of select demographic characteristics (i.e., age, level of education, relationship status), self esteem, self-silencing, and abuse on the safer sex behaviors of rural women. The overarching framework used for this study was the ecological perspective. The ecological perspective provided a multilevel, nested approach to the study of these risk and protective factors. This approach emphasizes the importance of the reciprocity of the various factors in developing health behaviors. The four levels identified in the ecological approach provide a holistic and comprehensive view of the complexity of human behaviors while considering the environmental and relationship contexts of these individuals. Mid-range theories of self esteem, self-silencing, abuse and safer sex behaviors further inform identification of risk factors and directions for prevention interventions for rural women.

The sample included women living in rural areas of Minnesota and adjoining northern rural states (i.e., North Dakota, South Dakota, and Wisconsin) who are a minimum of 18 years old. The sample will be recruited using a community based sampling strategy; participants were recruited at public sites frequented by women. The sample consisted of women who have sex with men, women who have sex with women, and women who have sex with both.

This study will use a cross-sectional, correlational research design. Participants completed a self administered, self report 90 item questionnaire containing four research instruments and a demographic questionnaire. Data was analyzed using Pearson product-moment correlation coefficients and multiple regression analysis.

Research studies are needed to assist with the identification of HIV risk factors for rural women. Intervention strategies can be developed to assist this at-risk population to eliminate or at least minimize their risk factors and to increase their protective factors and protective health behaviors. These interventions need to be developed in culturally sensitive, gender-specific ways in order to maximize their effectiveness.

Although not extensively researched, psychological factors have attributed to the growing number of performed breast augmentation procedures. The American Society of Plastic Surgery (2003) reported a 293% increase in cosmetic surgery since 1997. The percent increase in breast augmentation procedures performed in 2003 was up 12% (280 procedures up to 401). Currently in the United States , the entertainment industry and popular images in magazines and movies convey that our society values large, symmetrically shaped breasts with a great deal of cleavage (Crooks & Baur, 2002). This continual increase in breast augmentation procedures may be due to the fact that women feel that their breasts do not fit a specific cultural ideal.

As the number of women seeking breast augmentation surgery continues to rise, an increasing number of health professionals are likely to be confronted with questions, concerns, and complications that often accompany the procedure. Consequently, it is important that health care providers comprehend the degree to which self-esteem and/or sexuality may affect their patients' outcomes. Healthcare professionals must ascertain specific nursing skills and attitudes while caring for the cosmetic surgical patient. Consequently, the increase in number of breast augmentation and cosmetic surgery in general makes breast augmentation surgery an important issue for healthcare professionals who are caring for women (Sarwer et. al., 2000). Therefore, the purpose of this research is to gain an understanding of the changes that occur in the levels of self-esteem, measured by the Rosenberg Self-Esteem Scale (1965), and sexuality, as measured by the Female Sexual Function Index (2000), following breast augmentation procedures.

A descriptive study was used in this research, with a pretest-posttest design convenience sample group, to test the hypotheses along with an examination of; increased significance on the levels of self-esteem, sexuality, sexuality subscales, correlation between variables, and correlation between variables and the demographic questions. Participants (84 women) were obtained from privately owned cosmetic surgical centers in South and North Central Florida. An experimental design paired difference t-test was used to analyze self-esteem and sexuality as reported by women undergoing breast augmentation, preoperatively and postoperatively. Repeated measures ANOVA, SAS's Proc GLM tested differences in the sexuality six subscale scores (desire, arousal, lubrication, orgasm, satisfaction, pain), and Pearson Product-Moment Correlation Coefficients (r), measured the differences in the relationship of sexuality and self-esteem following breast augmentation. Correlations between participants' demographic profiles and their levels of self-esteem and sexuality were analyzed using ANOVA - SAS Proc GLM (General Linear Model) to determine the marginal means. The quantitative analysis was performed using a combination of Excel Solver Statistical Package and the SAS statistical system (SAS, 1999 - 2004).

Test of the study hypothesis one through four failed to be rejected, thereby, supporting significant positive relationships between the variables. Statistical analysis of H5 found positive significance between breast augmentation, self-esteem, and the demographic variables; educational level and history of previous cosmetic surgery. The literature review and the conceptual model developed for this study provided support for explaining the relationship between the concepts and answering the study variables.

The knowledge gained from this research will educate nurses regarding the relationship of breast augmentation to self-esteem and sexuality, in order for nurses to provide the best care to this patient population. Additionally, nursing education programs can greatly benefit from research obtained from studies based on cosmetic surgical procedures, namely breast augmentation. Adding this knowledge throughout educational programs regarding the psychological and or sociological changes which occur in women following cosmetic surgery can significantly enhance patient outcomes following their procedure.

Alzheimer’s disease is a progressive, pathological condition that fills the brain with amyloidal plaques and tangled fibers that render normal cognitive function impossible. Individuals with Alzheimer’s disease experience personality changes, loss of memory, and decreased verbal abilities. These devastating behavioral changes often result in the need for institutionalization of the person with Alzheimer’s disease. The aim of this ethnomethodological study was to investigate how 44 residents of an inpatient Alzheimer’s disease unit organized their everyday world, and how this organizational culture provided meaning for their lives. The methodology for this study was based on the previous works of Gubrium (1986a, 1989, 2000). Intensive fieldwork was conducted for six weeks on a special care unit in a south Florida nursing home. Forty-four residents, ranging in age from 72 to 101, participated in this study. Analysis of the data revealed eight themes by which the participants organized their everyday lives. They were: maintaining rituals, maintaining communication, maintaining family, maintaining role appointment, maintaining corporality, maintaining spatiality, maintaining relationality, and maintaining temporality. Findings from this study will provide insight into the behaviors of people with Alzheimer’s disease for everyone who is affected or has been affected by the phenomenon. Knowledge gained from this study can be used as supporting evidence for changing the staffing mix in nursing homes by increasing the direct care provided by professional registered nurses. Of utmost importance, the findings of this study gave a voice to all those who could no longer describe the meaning of this human experience.

In the United States, 18.2 million people have diabetes mellitus. Over 35 million African Americans suffer disproportionately from diabetes mortality and morbidity, severe complications and outcomes of care. Approximately 25% of blacks 65 to 74 have diabetes. Diabetes is the 5th leading cause of death among African Americans 45 to 64 years, and 3rd for those over 65 years. The death rate is 27% higher in African Americans than in White Americans. The purpose of this study was to examine the relationships of self-efficacy and spirituality to self-care behaviors and glycemic control in older African Americans with type 2 diabetes.

A descriptive correlational design was used to describe study variables and to examine their relationships. Data were collected from African Americans (N = 102) ages 55 to 88 years from various sites in southwestern Michigan. Data were collected via face-to-face interviews using three questionnaires which included: The Demographic Questionnaire; The 13-item Diabetes Activities Questionnaire (TDAQ); The 7-item Multidimensional Diabetes Questionnaire, Self-Efficacy section (MDQ); The 22-item Spiritual Involvement and Beliefs Scale-Revised (SIBS-R); and Glycosylated Hemoglobin Assay Testing (HbA1c).

Hypothesis testing was conducted using Pearson product-moment correlation coefficients (r) and multiple regression analyses. Significant negative correlations were found between HbA1c and self-efficacy (r = -.352, p = .000) and between HbA1c and diabetes activities (r = -.186, p = .03). Self-efficacy was positively correlated with spirituality (r = .437, p = .000) and with diabetes activities (r = .470, p = .000). The combined contribution of self-efficacy and spirituality to self-care behavior accounted for 25% (R² = .247) of the variance and was significant (F(2) = 16.237, p = .000). The regression of HbA1c on self-efficacy and spirituality accounted for 21% (R² = .211) of the variance and was significant (F(2) = 13.260, p = .000).

The results of this study suggest that self-efficacy and spirituality can be used to assess beliefs and predict self-care behaviors. Diabetes programs should be designed to increase self-efficacy and spirituality levels for effective diabetes management. Future research should include replication of this study with larger samples to determine relationships between study variables and select demographic variables.

The purpose of this study was to discover the meaning of the lived experiences of Native American nurses as they sought post-baccalaureate degrees and to understand these experiences. The primary question for this study was: What are the lived experiences during the educational journey of Native American registered nurses who have obtained graduate nursing degrees? The sample included 9 masters and 3 doctorally prepared nurses representing 12 Native American tribes. They were recruited using the purposive and snowball sampling techniques. Semi-structured interviews were conducted with each participant and lasted from 30 to 90 minutes. The data analysis resulted in the emergence of 9 themes: (a) honoring and remembering Indian ways, (b) encountering obstacles, (c) creating community, (d) using guides, (e) having one foot in each world, (f) giving back, (g) finishing what one start, (h) serving as a bridge, and (i) staying on the path. These findings culminated in an exhaustive description of the lived experiences of earning graduate nursing degrees: from Native American perspectives.

Background: The transition of a new graduate registered nurse (NG RN) from school to the work environment has been described as a stressful time for the new nurse. The high incidence of attrition during the first year of employment negatively impacts the personal and professional life of the NG RN and the organizations where they are employed. Dissatisfaction in the workplace has been identified as the major reason why new graduate RNs leave their first position. During this time of a severe nursing shortage, it is important to identify NG RNs who are dissatisfied and may be at risk for leaving.

Purpose: The purpose of this study was to examine the efficacy of the theory of self-transcendence in predicting new graduate registered nurses' professional well-being or job satisfaction.

Theoretical Framework: The Theory of Self-Transcendence was the theoretical framework for this study.

Methods: In addition to a demographic survey, the 79 participants were asked to complete three survey instruments: the Psychological Vulnerability Scale (PVS), the Self-Transcendence Scale (STS), and the McCloskey/Mueller Satisfaction Scale (MMSS). All instruments have been reported as psychometrically sound.

Results: The findings partially supported the theoretical relationships postulated by the Theory of Self-Transcendence. New graduate RNs’ vulnerability was a predictor of self-transcendence and NG RNs’ self-transcendence was a predictor of professional well-being, as measured by job satisfaction. None of the other variables of age, gender, and previous health care experience were found to be predictive of either NG RN self-transcendence or NG RN well-being.

Conclusions: The findings have expanded the knowledge of the Theory of Self-Transcendence and its value in predicting the professional well-being of NG RNs. There are implications for the ongoing use of the PVS, STS, and MMSS as valid and reliable instruments to provide nurse administrators with the opportunity to identify those new nurses who are dissatisfied and who may be at risk for leaving the workplace.

The purpose of this study was to describe the experience of HIV-positive nurses on HIV combination therapy. Powerful new drug "cocktails" are changing the face of HIV/AIDS from dying with AIDS (Acquired Immunodeficiency Disease Syndrome) to living with a chronic disease. Adherence to a complicated medication regime for potentially the rest of the person's life is essential for successful HIV drug therapy. Research has shown that non-adherence to the medication regimen is a common problem in chronic illnesses.

Method: A descriptive phenomenological research study was conducted. Phenomenological interviews were conducted with nine HIV+ nurses who were currently taking HIV combination drug therapy. Method of data analysis was a modification of van Kaam's and Colaizzi's interpretation of the method.

Major Findings: Six essential themes described the experience: Becoming a patient; Managing and being managed by the meds; Coping with the meds; Feeling lousy; Negotiating the hassles and the costs ; and Living under a cloud . Three minor themes were identified: Serving as an advocate; Keeping the secret ; and I need a nurse . The overarching metaphor was the double-edged sword of being a nurse on the other side , in the role of patient.

The purpose of this study was to identify the nature of the relationship of health-related hardiness and work-related variables. The research question was: what is the relationship between health-related hardiness and the following work-related variables: educational preparation, job satisfaction, intent to remain employed as a staff nurse in an acute care hospital, participation in the goals of the organization, and professional commitment of registered nurses 45 to 65 years old employed in a four-hospital system located in the southeastern United States.

A cluster sample of approximately 750 practicing registered nurses ages 45 to 65 working in adult and pediatric inpatient and outpatient units in a four-hospital system was surveyed. Nurses self-selected for inclusion based on this age criteria and then chose to participate. The final sample consisted of 204 staff nurses. Three instruments were used: a researcher designed socio-demographic questionnaire, the Health-Related Hardiness Scale (Pollock & Duffy, 1990), and the McCloskey/Mueller Satisfaction Scale (Mueller & McCloskey, 1990). A correlational research design was utilized. Multiple regression analysis results produced a model for predicting health-related hardiness in staff nurses ages 45 to 65. The predictor variables were the following: (a) the job satisfaction subscale of Social Interaction, (b) recommendation of nursing as a career for others, and (c) entry-level educational preparation.

The major objective of this study was to discover the process through which nurses attain competence in one area of acute care practice. A theoretical framework is developed for the process of obtaining hemodynamic monitoring skills and the integration of this knowledge into practice by critical care nurses.

The research method used in this study was grounded theory. A combination of interviews with critical care nurses and observation of practice in the clinical area formed data for generation of the theoretical framework.

The process of attaining hemodynamic skills in the ICU environment of today involves joining theory and reality through the relationship of the following influences: (a) the dynamic ICU environment, (b) what the individual brings in, (c) the meaning of the pulmonary artery catheter to nurses, (d) the perception of value of readings to physicians/practitioners, (e) perceptions of interdisciplinary collaboration, (f) variation in the educator and the educational process, (g) variation in mentors, (h) variation in exposure, and (i) assimilation.

This theoretical framework identifies factors that facilitate and hinder the attainment of PAC skills. The following implications evolved from this study. Nursing orientation programs should be tailored to meet the needs of individual nurses. Courses offered on the PAC skill are more effective if they are presented in an organized manner. The material presented in these courses should be introduced in a series of steps including advanced concept classes for nurses with advanced competencies. The amount of PAC exposure in practice will also influence the development of PAC skills. The amount of exposure should therefore be evaluated in individual unit settings.

Future testing of this model in additional settings and with additional nursing skills would be beneficial. Skills with similar hemodynamic concepts such as use of the intraaortic balloon pump and continuous venous-venous dialysis are examples of additional skills that Hart's Model of Dynamic Interdependent PAC skill attainment may apply to. Additional studies that focus on the physician's perception of the value of PAC readings would add important information to this area of research. Studies that explore the qualities of mentors and the factors that lead to retention or loss of mentors are also needed.

Mentors have lasting influence on the socialization and commitment of nurses throughout their careers.  The purpose of the study was to explore culturally diverse newly graduated nurses’ lived experience of being mentored.  Thirteen RNs from five South Florida Hospitals who were post graduation 6 month to 2 years were interviewed.  Participants’ validation of transcripts served as member checks. Van Manen’s phenomenological methodology guided the analysis.  Four essential themes emerged, Stumbling, Connecting, Becoming, and Being.  The theory of transition elucidated the challenges of change from student nurse to professional nurse.  Positive mentoring had a significant role that mitigated the graduates’ intense distress during transition. The study supports the need for mentoring culturally diverse new graduates in transition.

With nurses leaving the acute care setting in greater numbers (American Nurses Association [ANA], 1996; Bureau of Labor Statistics [BLS], 2000), many nurses look to the community and home as a setting for professional practice. However, there is a void in the existing research that describes how acute care nurses successfully transition to home health care practice.

The purpose of this grounded theory study was to generate a theory of how professional nurses successfully transition from the acute care setting to the setting of home health care. The participants in this study were obtained by purposeful and theoretical sampling and included 12 home health nurses and two home health administrators. Data collection consisted of demographic and survey information, audiotaped interviews, transcripts of those interviews, researcher field notes and memos, and participants’ writings. Data collection and analysis were performed using the constant comparative method and progressed through open coding, axial coding, and selective coding according to Strauss and Corbin’s method (1998b).

Findings from the inquiry revealed a substantive theory that accounted for the successful transition from acute care practice to home health practice. The substantive theory that emerged, the Hartung Theory of Successful Transitioning, explicated the context and conditions that gave rise to the impetus for change, the core category, the actions/interactions, and the consequences of successful transitioning.

The core category, Journey from Ideal to Reality in Home Health Practice, began with a sequence of activities in choosing home health and proceeded through the three phases of successful transition: information marathon, closing the gaps, and crossing the goal line. Concomitant to the progression throughout the three phases of successful transition were strategies to help transitioning. The consequences of successful transition were the competence of home health skills and knowledge, functioning in the home health role, role acceptance and integration, firm commitment to home health, a feeling of fulfillment and satisfaction, and an improvement in quality of life.

The findings from this research have implications for nursing practice, administration, education, and research.

Testicular cancer, if detected early, has a favorable prognosis. To improve early detection, young men should be encouraged to practice testicular self-examination (TSE); however, few do so. This lack of adherence may be, in part, due to a failure of those professions charged with teaching TSE.

This cross-sectional, explanatory study surveyed a randomized sample of 1,490 advanced practice nurses (APN) providing care for male patients between the ages of 15 and 35. The aim was to test the Theory of Reasoned Action (Ajzen & Fishbein, 1980) in predicting the behavior of APNs regarding teaching TSE. A total of 621 (42%) APNs responded; final analyses were carried out on 532 (36%) that met the inclusion criteria.

Four hypotheses were tested to determine correlations between APN age, gender, number of patients seen daily, and percentage of age appropriate male patients seen and behavioral intention of teaching TSE. Three hypotheses tested for the magnitude of correlations between attitude and subjective norm and behavioral intention as well as behavioral intention and behavior. Statistical tests included Pearson's product moment, multiple correlation, t-tests, and multiple regression.

Results were that the APNs had a positive attitude toward teaching TSE, intended to teach TSE, and frequently acted on their behavioral intention regardless of patient load. They perceived other APNs, physician colleagues, members of their profession, and patients to also hold such teaching in high regard. The linear composite of attitude and subjective norm predicted behavioral intention to teach; attitude was shown to be the more dominate predictor.

Older adults and older Holocaust survivors lived through World War II and experienced or witnessed devastating events. Over the years, some have coped well and demonstrated resilience, whereas others have continued to experience symptoms of posttraumatic stress. These individuals are once again confronted with a potential threat to their safety. In wake of the national trauma that occurred on September 11, 2001, the purpose of this study was to examine the relationship between trait anxiety, sense of safety regarding terrorism, resilience and psychological distress in the post 9/11 environment for two groups that are known to be at high risk for psychological distress: Older adults and older Holocaust survivors. It is believed that the knowledge gained from community dwelling female older adults and older Holocaust survivors will assist nurses in developing specific interventions for individuals who are experiencing adverse reactions to the threat of terrorism . A comparative survey design was used for this study. Participants completed a researcher designed demographic tool, a Resilience Scale, a Trait Anxiety Inventory, Sense of Safety Regarding Terrorism Scale, and the Trauma Symptom Checklist (TSC-33). Data were analyzed using descriptive statistics, MANOVA to compare groups, and multiple regression to assess the relationship of the predictor variables to psychological distress. Holocaust survivors reported significantly more anxiety and greater posttraumatic sympymotology than the non-Holocaust survivor group. The relative contributions of the predictors to posttraumatic symptomotalogy scores were as follows: the largest significant contributor was anxiety, followed by sense of safety, and survivor status. Resilience did not provide a significant contribution. Specifically, greater anxiety, lower sense of safety, as self reported post 9/11, and being a Holocaust survivor were related to increased posttraumatic symptomatology scores.

The population of students interested in studying professional nursing has become increasingly diverse with a significant increase in the number of men, people of color, and individuals with diverse ethnic backgrounds. There is also an increased number of students who are choosing nursing as a second career, resulting in an older population of students with disparate academic preparation.

This study examined the relationships among select demographic variables, professional nursing values of entry level nursing students, and self-reported willingness to serve disenfranchised and underserved populations of clients. The study focused on correlations among these variables as students began their academic nursing education as measured by use of the Nursing Professional Values Scale (NPVS) developed by Weis & Schank, (2000) and the Willingness to Serve the Underserved and Disenfranchised Scale (WSUDS) developed by Spalding (2002). A demographic questionnaire was utilized to collect data related to age, ethnicity, gender, and level of education prior to entering the nursing program, and type of nursing program (AD or BSN).

The study was conducted with 260 associate degree and baccalaureate entry-level nursing students in South Florida. Data were collected, entered into the Statistical Package for Social Sciences (SPSS) program and analyzed using: (a) frequency distributions for demographic data; (b) descriptive statistics for demographic variables and the instrument items; (c) reliability estimates of internal consistency (i.e., Cronbach's alphas) for study instruments; and (d) analysis of variance (ANOVAs), multiple regression analysis, and t-tests to test the hypotheses.

The analysis of the data revealed that there was a specific positive correlation for gender and a linear correlation for the demographic variables; and the scores on the WSUDS. There was also a positive correlation between the scores on the NPVS and the scores on the WSUDS, indicating that higher scores on NPVS predicted higher scores on the WSUDS.

These findings will assist professional nursing educators to understand the values of the changing population of nursing students enrolling in academic programs and educating students about professional values and willingness to serve underserved and disenfranchised populations of clients. Implications were extrapolated for nursing education, nursing social policy, nursing practice and nursing research.

Nurses provide care to diverse patient populations and should be aware of their biases when dealing with patients from various backgrounds. The purposes of this study were (a) to specify the relative combined contributions of age, highest level of education, gender, and nursing certification on registered nurses’ values scores; and (b) to specify the relative combined contributions of age, highest level of education, gender, nursing certification, and values on registered nurses’ willingness to serve underserved and disenfranchised populations. Hierarchical regression analysis was utilized to test two null hypotheses with a convenience sample size of 128.

Data for this study were obtained through an anonymous survey linked to the American Nurses Credentialing Center’s (AACN) website and housed on a secure server at Barry University. The survey consisted of (a) the 92-item AACN Values Questionnaire--Nurse (Tompkins, 1992), designed to assess the meaning that participants attach to seven values; (b) a 50-item Willingness to Serve the Underserved and Disenfranchised Scale (Spalding, 2002), which assessed the willingness of participants to care for members of diverse groups; and (c) a 14-item demographic questionnaire addressing personal history. Data was entered into SPSS for 11.0.1 for quantitative data analysis. Data analysis consisted of (a) frequency distributions for participants’ demographic characteristics and nursing certification specialties; (b) descriptive statistics for participants’ demographic characteristics, major study variables, and for instrument items; (c) reliability estimates of internal consistency (i.e., Cronbach’s alphas) for study instruments; and (d) hierarchical regression analysis to test two null hypotheses.

Most of the participants were European American (n = 92, 71.9%) and female (n = 118, 92.2%), with males representing 6% (n =7) of the sample. The age of the participants ranged from 22 to70 years with a mean age of 47 years. The majority of the participants had graduate degrees (n = 95, 74.2%) and a small majority of the nurses sampled (n = 69, 53.9%) were certified in a nursing specialty. Tests of study hypotheses concluded that null hypothesis one was rejected and null hypothesis two failed to be rejected. Development of nursing curricula which identify prejudicial thinking and intolerance for marginalized groups will help to decrease fears and increase nurses’ willingness to provide culturally competent health care for these populations.

A grounded theory methodology was used to explore the phenomenon of coping as experienced by adolescents with a mood disorder. Mood disorders among children and adolescents are more persistent than previously thought and have numerous negative associated features, including further episodes of depression, impaired social, academic, and vocational relationships, use of alcohol and other drugs, and an increased risk of suicide. Current literature offered little awareness of how adolescents cope with a mood disorder, as well as their perspective of how such an illness impacts their lives.

A substantive theory regarding the process of coping for adolescents with a mood disorder was generated from the data [interviews and two chart reviews] collected from one male and eight female adolescents. Using the coding procedures espoused by Strauss and Corbin (1998), a four-phase coping theory identified by the categories Feeling Different, Cutting off Connections, Facing the Challenge/Reconnecting, and Learning from the Experience was presented in a schematic theoretical model. The core category identified in this research was An Unplanned Journey: Coping Through Connections. Implications identified for nursing practice, research, policy, and education included greater attention on the prevention of adolescent mood disorders and the education of adolescents about the development and enhancement of healthy coping skills.

Approximately 46 million people in the United States smoke tobacco. Although smoking has declined over the past 10 years, it remains a major contributor to lung and other cancers, heart disease, and stroke. Minority low-income smokers are at special risk.

This retrospective, longitudinal study involved 223 randomly selected ethnic minority (African American and Hispanic), low-income participants in an established smoking cessation program from 2001 through 2005. The program was located in a large southeastern U.S. metropolitan area, and at pre-intervention all participants in an established smoking cessation program from 2001 through 2005. The program was located I a large southeastern U.S. metropolitan area, and at pre-intervention all participants had a baseline CT scan for lung cancer. Despite much research on smoking cessation programs, no studies have focused on this population in an early lung cancer and smoking cessation program.

This study described the sample characteristics and examined selected factors (level of activity, physical health, emotional health, and stages of change) predictive of smoking cessation 12 months post-intervention. Two research questions were formulated: (a) Was there a significant change in participants’ self-reports on the five variables pre-intervention and at 12-month post-intervention? (b) if there was a significant change in these variables, what were the relatives contributions of post-intervention scores in predicting smoking status at 12-month follow-up?

Two instruments were administered at baseline pre-intervention and post-intervention: the Early Lung Cancer Action Program (ELCAP) Intake and Follow-Up Surveys. Results of t tests and logistic regression indicated that for Research Question 1, general health and physical health significantly improved, and emotional health significantly declined. Further, 57% of the participants reported not smoking at all in the month following post-intervention. For Research Question 2, none of the five variables predicted smoking cessation at post-intervention. Therefore, the program was partially effective in contributing to participants’ decreased smoking and increased general and physical health.

A major limitation was the instruments, constructed from the ELCAP program surveys, which are used exclusively for diagnosis. Further instrument validity and reliability testing is warranted.

The ELCAP program has been primarily a medical model, and this study may provide a first step toward a nursing model. Further research is suggested with similar populations in other geographic areas, especially with minority, low-income participants a high risk for lung cancer.

Postpartum depressive symptoms are a significant health problem for many women and their families. Social support has been studied as a preventative factor; however, there were no qualitative or quantitative studies in the literature that explained whether or not and in what ways postpartum women seek out support while they are depressed. The purpose of this grounded theory study was to identify the social process and generate theory of how women experiencing postpartum depressive symptoms mobilize social supports.

The study design was guided by concept analyses of postpartum depression and social support, the research literature, Meleis’s Experiencing Transition Theory, and feminist social constructivist theory. The sample included 10 adult women between 2 weeks and 1 year postpartum who were able to verbalize their experiences with postpartum depressive symptoms. Pregnant women were excluded from the study. Participants completed audiotaped interviews and the Postpartum Depression Screening Scale. The researcher debriefed the participants at the conclusion of the data collection procedure and offered a referral list of mental health providers in the area. Strauss and Corbin’s grounded theory methodology was used for data analysis. The middle range theory developed to explain this process was Normalizing Through Connection. Social support mobilization included four processes: (a) initiating socialization, (b) staying with, (c) drifting away, and (d) incorporating self into new role. This theory may assist Community health nurses in developing social support interventions appropriate for women experiencing depressive symptoms after childbirth. Recommendations for nursing practice and future research questions are also addressed.

Background: Breast cancer is the most common form of malignancy among women worldwide. Mammography screening has shown to decrease the rate of breast cancer mortality. Hispanic women have been found to be less likely than Caucasians and African American women to participate in mammography screening. Although Hispanics constitute the most rapidly growing segment of the United States, there has been little research regarding the specific factors that influence their health behaviors. Data collection has been hampered by the scarce availability of reliable and valid Spanish language research instruments.

Purpose: The purpose was to test the efficacy of the Health Belief Model (HBM), by means data collected with the Spanish version of Champion’s Health Belief Model Scales (CHBMS), in predicting the likelihood of participating in mammography screening among this population.

Theoretical Framework: The HBM has provided the theoretical framework for this study investigating the likelihood of individuals taking recommended preventive health protective actions.

Methods: The CHBMS – Spanish was administered to a convenience sample of 200 Spanish-speaking Hispanic women, ages 45 – 75 years. Data obtained were used to estimate validity and reliability for the translated instrument and test five hypotheses.

Results: The findings only partially support the theoretical relationships postulated by the HBM. The only construct predictive of having had mammography among this sample was the perception of barriers. The relationship was inverse in that those with higher scores for barriers were less likely to have had mammography.

Conclusions: Limitations inherent in the use of a translated instrument and sample recruitment may have affected the findings. Implications include continued refinement of the translated instrument and sample recruitment from more diverse settings.

Key Words: Health Belief Model, mammography, Spanish language research instrument.

Almost 1 in 5 deaths in the U. S. is caused by smoking, and nurses are in an opportune clinical position to intervene with patients who smoke to treat tobacco use and prevent its related health consequences. Health promotion and disease prevention are nursing roles; however, up to 18% of nurses are themselves tobacco dependent, well above the Healthy People 2010 target of less than 12% of the population who smoke (USDHHS, 2000a). Despite their nursing education, professional knowledge, clinical experience, and a deluge of evidence related to the burden of disease and death resulting from tobacco use, nurses who smoke are less likely to intervene with and assist patients to quit smoking.

The aim of this grounded theory study was to explore how nurses who smoke approach the health promotion needs of patients who smoke. A convenience sample of 23 registered nurse participants, who were currently ( n = 18) or formerly ( n = 5) tobacco-dependent were interviewed. Interviews were audiotaped, transcribed, and subsequently analyzed using a constant comparative method. The findings revealed that nurses' perceptions of the patient's tobacco use needs influenced nurses' ambivalence, which in turn influenced their nursing role. The basic social process of Counteracting Ambivalence evolved from the study, wherein 4 interaction dynamics emerged to describe the types of tobacco use interactions undertaken by nurse participants with patients who smoked. These dynamics included: undervaluing/circumventing; tailoring/assisting; self-protecting/curtailing; and valuing/selecting.

Nurses who smoke have a professional responsibility to protect the health of the public, which includes working to reduce and treat tobacco dependence. Thus, the findings from this study have implications for nursing education, practice, research, and public policy, all of which entail enhancing the evidence-based tobacco-use interventions employed by nurses who are themselves tobacco dependent.

The rapidly increasing rate of HIV/AIDS among Bahamian women is daunting for the future of Bahamian society. Despite many concerted efforts, scientists are unable to find a cure for HIV disease and are faced with the multiple challenges that treatment and management strategies bring for persons living with AIDS. As a result, there is a major focus on HIV prevention. The purpose of this study was to understand the characteristics that put urban Bahamian women at risk for HIV/AIDS so that gender appropriate and culturally sensitive prevention interventions could be developed and implemented.

A cross-sectional, correlational survey design was used to study the relationships between select demographic variables (i.e., age, income, education), self-esteem, self-silencing, and self-efficacy for negotiating safer sex behaviors in urban Bahamian women. Data were collected from urban Bahamian women (N=661) ages 18 to 78 years from a variety of community sites in Nassau, Bahamas. Data were collected using an 80-item anonymous questionnaire which included: (a) The 16-item Taylor’ Self-Esteem Inventory (TSEI) Taylor & Tomasic, 1996); (b) The 31-item Silencing The Self Scale (STSS) (Jack & Dill, 1992); (c) The 12-item Self-Efficacy Scale (SES) to measure self-efficacy for negotiating safer sex behaviors (Dilorio et al., 1997); and (d) demographic and background questions.

Hypothesis testing was conducted using Pearson product-moment correlation coefficients (r) and logistic regression analyses, which revealed mixed results. Three of four hypotheses were supported, and the fourth hypothesis was partially supported. Self-esteem and self-silencing were negatively correlated (r = -.56, p<.01), self-esteem and self-efficacy for negotiating safer sex behaviors in urban Bahamian women were positively correlated (r = .22, p<.01), and self-silencing and self-efficacy for negotiating safer sex behaviors in urban Bahamian women were negatively correlated (r =.15, p<.01). Additionally, age (OR=1.02, 95% CI = 1.01-1.04), education (OR = 1.10, 95% CI = 1.00-1.20), and self-esteem (OR = 1.03, 95% CI = 1.02-1.04) were significant independent and combined predictors of self-efficacy for negotiating safer sex behaviors in urban Bahamian women.

The results of this study suggest that in addition to being gender appropriate and culturally sensitive, HIV prevention interventions developed and implemented for Bahamian women should also be tailored with respect to age and educational level and address self-esteem enhancement. Future research should include replication of this study with rural Bahamian women, urban and rural Bahamian men, and urban and rural Caribbean adults and adolescents as well as evaluation of theory-based self-esteem and skills building HIV prevention interventions.

Faculty practice is challenging and may be considered unrealistic considering the expectations of a full-time faculty position. Despite the challenges, however, practice based education is important and is a necessity, especially in advanced practice programs. Lack of faculty participation in practice may have ramifications for the student, the patient, and the nursing profession. The combination of faculty in the practice setting and practitioners in the academic setting may be an effective way to unite nursing education and practice, as well as provide quality education and care.

This study used a correlational, cross-sectional design to test the efficacy of the Theory of Reasoned Action in predicting the intention of nurse faculty to engage in faculty practice. The theoretical constructs of attitude and subjective norm were considered for their predictive value to the outcome variable, behavioral intention to engage in faculty practice. Behavioral intention was considered for its predictive value to the outcome variable, engaging in faculty practice. Data were collected by means of a self-report questionnaire completed by nurse faculty throughout the United States who were employed full-time in baccalaureate and graduate schools of nursing accredited by the Collegiate Commission on Nursing Education. Demographic data were used to describe the sample; hypothesis testing was conducted using Pearson product-moment correlation ( r ) and multiple regression ( R ) analysis.

Results from a sample of 491 nurse faculty indicated that attitude and subjective norm contributed significantly to nurse faculty's behavioral intention to engage in faculty practice, with subjective norm a more powerful predictor than attitude. Additionally, number of years teaching and mandatory faculty practice were found to influence nurse faculty's behavioral intention to engage in faculty practice. Findings suggest that faculty who had been teaching for a number of years or did not have mandatory practice as part of their faculty role had lower behavioral intention to engage in faculty practice. Behavioral intention, the immediate theoretical precursor to behavior, had a statistically significant positive relationship with the self-report of having participated in the behavior of engaging in faculty practice. Thus, behavioral intention was found to predict behavior significantly.

According to Resilience Theory, a specific combination of risk and protective factors interact when the individual confronts a threatening life situation. The outcome of this interaction affects the individual's attainment of resilience. In the case of educational resilience, it is important to study those factors that are associated with academic competence. This study examined selected risk and protective factors that affected the academic competence of a group of first year nursing students in a two-year college setting.

After consent was obtained from the appropriate institutions and from the participants, one hundred and twenty two multi-ethnic nursing students completed the three study instruments. The College Student Inventory measured the protective factors, Academic Motivation, General Coping, and Receptivity to Support Services.

Psychological Resilience was also measured as a protective factor using the Wagnild and Young Resilience Scale (1988). The risk factors of age, ethnicity, and GPA were also measured as independent variables. Whether a student passed or failed any one of Level 1, Semester 1 nursing courses served as the dependent variable. A logistic regression procedure was performed to uncover those factors that best predicted membership in either the Pass or the Fail group.

The logistic regression procedure, using the Stepwise method, identified three factors that best predicted Pass/Fail status. These factors were GPA, Receptivity to Support Services (self-reported student needs and receptivity related to academic, financial, and personal-social concerns), and a third factor which emerged in preliminary testing, Having Children. Nursing educators seeking to reduce student attrition need to be cognizant of the important role that support services can play in fostering educational resilience. Supporting and retaining students from a variety of social, economic, and cultural backgrounds should be a high priority for nursing faculty in order to ameliorate the nursing shortage that threatens the delivery of quality health care.

Osteoporosis primarily affects women. Young women may benefit from interventions to reinforce behaviors to prevent osteoporosis. The purpose of this experimental study was to determine the effects of an osteoporosis educational intervention on knowledge, health beliefs, and self-efficacy in college age Puerto Rican women. The Health Belief Model and the Purnell Model for Cultural Competency formed the theoretical framework for the study. The study used a pretest-posttest experimental design with one experimental group and one control group. The sample was comprised of 105 college age women between ages 18 and 25. Participants were randomly assigned to an experimental group of 51 subjects and a control group of 54 subjects. Pre-intervention data were collected using the self-report Osteoporosis Knowledge Test, Osteoporosis Health Beliefs Scale, Osteoporosis Self-Efficacy Scale, and demographic survey. Subjects completed the self-reports and the demographic survey. Following the pre-testing the experimental group received the osteoporosis educational intervention. Four weeks after the osteoporosis educational intervention, both groups completed the instruments again as post-test.

Repeated Measures of Analysis of Variance was used to compare the effects of the osteoporosis educational intervention on the experimental group with the control group to test the four hypotheses. RMANOVA allowed the comparison between groups and within groups during different periods of time. The level of significance for the study was set a priori at p <0.05. Two hypotheses were fully supported, one hypothesis was rejected, and one hypothesis was partially supported.

Statistical analysis supported that women who attended the osteoporosis educational intervention had significantly higher levels of knowledge and health beliefs measured by Osteoporosis Knowledge Test and Osteoporosis Self-Efficacy Scale than women who did not attend the osteoporosis educational intervention. Women who attended the osteoporosis educational intervention did not have a significantly higher level of self-efficacy measured by Osteoporosis Self-Efficacy Scale than women who did not attend the osteoporosis educational intervention. There was a positive difference in pretest and posttest scores in the intervention condition on osteoporosis knowledge and osteoporosis health beliefs and there was no difference in pretest and posttest scores in the intervention condition for osteoporosis self-efficacy than the control condition.

The United States (US) is experiencing a critical shortage of registered nurses (RN) that is expected to worsen. This shortage is and will continue to negatively affect the delivery of healthcare. While the problem is complex, one reason for the shortage is the large number of RNs that leave the nursing profession and seek employment in other fields. Action is needed to stem the exodus of mature nurses. The purpose of this study was to test the efficacy of the Three Component Model of Commitment in predicting RN intent to leave the nursing profession.

A national survey was conducted through a professional Internet site. A total of 908 RNs provided information used to test hypotheses. Significant positive relationships were found between the predictor variables of RN level of education and RN occupational commitment and the outcome variable of RN intent to leave the nursing profession.

Nurse leaders struggle to provide for the delivery of humanistic and holistic healthcare that is consistent with nursing values in a changing economic environment. There is concern that nurse executives find it increasingly difficult to reconcile the differences between organizational economics and their personal and professional identities.

The purpose of this study was to examine the relationship between nurse executives perceived personal and organizational value congruence, their level of education, years of administrative experience, the for-profit versus not-for profit status their employing organization, and their leadership behaviors: transformational, transactional, and laissez-faire. Value congruence was measured using The Value Analysis Worksheet (Harrington & Preziosi, 1998) (VAW) and leadership behaviors were measured using the Multifactor Leadership Questionnaire (5x Short) (MLQ) (Bass & Avolio. 1995).

A mailed survey was sent to a 27% random sample (n=900) of the Nurse Executives from a population of 3314 nurse executives from American Hospital Association hospitals located east of the Mississippi. A total of 411 (45.6%) usable responses were returned.

The mean total self-score for personal values was 82.56 while the mean total organization score was 68.84 indicating that nurse executives rated their personal values higher than the values of their employing organization. A moderate degree of congruence between personal and organizational values (r=.42) was found. The four personal values that nurse executives ranked highest were integrity, honesty, respect, and loyalty. The four values that had the greatest value incongruity were honesty, sense of humor, feedback system, and willingness to help others.

Analyses of the MLQ indicated that the nurse executives in this study perceive their leadership style to be predominantly transformational (M=3.44). Multiple regression analyses were used to assess the effect of the independent variables: value congruence score, level of education, length of management and administrative experience, and for-profit versus not-for-profit status on leadership behaviors: transformational, transactional, and laissez faire. No significant relationships were found.

Much was learned in this study about nurse executives' perception of personal and organizational values. Much more needs to done in order to understand how personal and organizational value congruence relates to leadership behavior.

Alzheimer's disease (AD) is a devastating condition that has profound effects on millions of individuals and their families. Although much is known about the downward trajectory of the illness, there has been little research addressing the experiences of significant others in coping with this reality. Thus, the aim of this study was to document the lived experience of family members and/or significant others of those who have been diagnosed and are living with AD.

The phenomenological work of van Manen and Munhall guided this study. Intensive interviews were conducted with a sample including, six females and two males, ranging in age from 39 years to 93 years. Five of the participants were spouses, and the remaining three were daughters. Sixteen themes emerged from their responses and included: Changing behavior, denial, fear, reality of this disease, heavy burden, isolation/loneliness, role change, lack of intimacy, guilt, hope, support, resentment/anger towards the system, neglect, lack of compassion, anger, helplessness/pain, and lack of resources.

Findings from this study will inform nurses and health care and social service providers about this increasingly common human experience. Findings may also encourage health care professionals to adopt an approach that would take into consideration not only caring for the patient but also caring for the Alzheimer's patient-family unit. The insights acquired through this study have practical applications in designing more effective caring strategies including advocating for clients, educating families, designing curricula that addresses AD and its implications, and shaping public policies addressing adequate funding for outreach efforts and resources.

Findings from this study suggest many avenues for future research and theory development. Future phenomenological investigations could explore in detail van Manen's (1990) four existentials: Spatiality, corporeality, temporality, and relationality or communality. Finally, knowledge of this phenomena could be extended and sharpened by comparing and contrasting experiences of family members and significant others of person with AD with those of persons with other types of dementia.

Type 2 diabetes, the most prevalent type of diabetes, is a condition in which the body is unable to maintain a normal blood glucose level and it is widespread in the United States as well as in the military veteran population. Health care costs are estimated to be $100 billion a year for direct and indirect costs related to the disease and its complications.

Glycemic control or normal levels of blood glucose is the most effective treatment in preventing the complications associated with diabetes. Adherence to the diabetic regimen is crucial in ensuring normal glucose levels and preventing complications. The objective of the study was twofold: (a) to identify relationships between selected social-economic factors (age and partnership status) and the selected condition related factor and selected patient related factors of depressive symptoms to glycosylated hemoglobin as an indicator of adherence to diabetic regimens, and (b) to identify the relative contributions of selected socio-economic factors and the selected condition related factor of depressive symptoms to glycosylated hemoglobin levels to evaluate adherence to the diabetic regimen in military veterans with Type 2 diabetes. The following items will be completed (a) informed consent, (b) the Beck Depression Inventory-II (BDI-II), and (c) the demographic questionnaire, and an information sheet. This study used correlational research, with prediction as the ultimate goal, and may be considered non-experimental research.

After informed consent was obtained, data was collected from 77 military veteran participants. The findings of this study were somewhat surprising. They found that in this sample population of veterans had very low levels of depressive symptoms (N=77, M=12.93, SD 10.32) on the (BDI-II). This is a much lower level than is found in the general population. Additionally the glycosylated hemoglobin levels of the sample were surprisingly low (N=77, M=7.91, SD=1.88). The normal range of glycosylated hemoglobin in persons without diabetes is 6.5 and below. None of the relationships were statistically significant possibly due to low levels of glycosylated hemoglobin and low levels of depressive symptomatology in this sample of military veteran population. The findings may be due at least in part to the intensive mandatory diabetes education required for diabetic military veterans to receive glucose monitoring equipment and supplies at the VA Medical Center in which this study was conducted.

This study explored the academic experiences of non-native English speaking (NNES) nursing students. The research was a qualitative human science study based on the phenomenological models of Husserl, Merleau-Ponty and Van Manen and consisted of documentary research and a semi-structured, open-ended interview conducted with ten NNES nurses who pursued graduate nursing education in the U.S. The interviews addressed each participant’s experience of graduate nursing education, focusing on the implications of cultural differences. The strength and support of NNES students were identified. The findings also indicated that cultural insensitivity and discrimination toward NNES students; whether actually present or not, was perceived by the participants in the classrooms and clinical environments. Recommendations for expanded outreach, including academic and social support for NNES nursing students are presented, as well as suggestions for improving multicultural sensitivity of nursing division administrators, faculty, and all students.

Nursing students provide care to a variety of patient populations and need to be aware of their own potential biases and comfort level when dealing with underserved and disenfranchised populations. As human beings, everyone prefers to care for or work with some clients/patients more than others. The purpose of this study was twofold: 1. to identify relationships between select demographic variables (i.e., age, gender), educational variables, nursing students' spirituality, and willingness to serve underserved and disenfranchised populations; 2. to specify the relative contributions of (a) select demographic variables, (b) level of education, (c) school affiliation, and (d) nursing students' level of spirituality to undergraduate and graduate nursing students' willingness to serve underserved and disenfranchised populations.

A cross-sectional correlational survey design was used. A convenience sample of 473 undergraduate and graduate nursing students was obtained at four purposively selected university settings (i.e., two religious universities and two secular universities). Data for the study were obtained through an anonymous survey. The survey consisted of (a) a demographic questionnaire with items addressing personal background and educational variables, (b) a 21-item spirituality instrument with items on spiritual beliefs and involvement (Hatch et al., 1998) and two additional global indicators on spirituality and religiosity, and (c) a 50-item willingness to serve underserved and disenfranchised populations instrument (Spalding, 2002) which assessed the willingness of participants to deliver services to or provide care for members of 50 different populations or groups.

Data analysis consisted of (a) exploratory data analysis (i.e., inspection of frequency tables, histograms, and scale alphas if items deleted), (b) reliability estimates (i.e., Cronbach's alphas, Guttman's split half) for study instruments, (c) descriptive statistics and tests for group differences for demographic variables, and (d) descriptive statistics for major study variables as well as individual instrument items. Six study hypotheses were tested using bivariate correlations and multiple regression techniques.

Tests of study hypotheses yielded mixed results. Four hypotheses were supported by study data, and two hypotheses were not supported. Using multiple regression, the model was significant at each step, and the overall model was highly significant. However, only gender and spirituality were found to be significant contributors to willingness to serve, and the five variables in the model explained only 5.8% of the variance in willingness to serve scores.

Early detection and treatment of dysphagia is necessary to prevent life-threatening complications such as aspiration pneumonia and malnutrition.  The registered nurse (RN) is the healthcare professional who is at the frontline of emergent care and consequently the first to observe the signs and symptoms of dysphagia. 

There has been an increase in demand on healthcare providers to demonstrate evidence of their effectiveness.  A dysphagia assessment can be performed by a RN in the emergency room and in other patient care areas to prevent serious complications.  This study was the first to examine the relationships of the variables internal to the Theory of Planned Behavior (TPB) for their effectiveness in predicting the behavioral intent of RNs to perform a dysphagia assessment.

The study used the Dysphagia Assessment Instrument-Knowledge (Mullaney, 1992) and developed the Werner Dysphagia Assessment Inventory based on the guidelines of Ajzen and Fishbein (1980) and the process outlined by Nash, Edwards, and Nebauer (1993).  The study consisted of three phases: 1) instrument development, 2) testing the instrument for validity and reliability and 3) testing the hypotheses using a pre-experimental design with an educational intervention.  Descriptive data were collected and used to describe the sample.  Hypotheses testing were carried out by means of linear regression analyses, t-tests, and Pearson correlation.

The results of this study may assist professional nursing in the development of dysphagia continuing educational programs.  Findings may influence the support of requirements for regulating agencies.  Clinical practice may also be influenced by providing insight into dysphagia related practice activities.

Though progress has been made, lead poisoning remains a major public health problem, especially for young children. In the early 1990s, there were less than 900,000 children with blood lead levels (BLLs) greater than or equal to (≥) 10 micrograms per deciliter (μg/dL) (Centers for Disease Control and Prevention [CDC], 1997c). In 2000, more than 9% (N = 244,442) of Illinois children tested had BLLs ≥ 10 μg/dL; 3% had BLLs ≥ 15 μg/dL; and 207 had ≥ 45 μg/dL (Illinois Department of Public Health [IDPH], 2001). Healthy People 2010 (U.S. Health and Human Services, 2000) established the goal of elimination of elevated blood lead levels in children under age six. The purpose of this study was to determine the needs of caregivers of children six years and younger regarding lead poisoning and prevention. Dixon and Dixon’s Integrated Environmental Health Model (2002) was used as a guide.

Caregivers’ lead knowledge, perceptions of lead poisoning risks, lead exposure risk reduction behaviors were assessed using a 43-item questionnaire. The relative influence of caregiver’s age, educational level, gender, rural versus urban residence, receipt of lead poisoning information on lead knowledge, perceptions of risk, and risk reduction behaviors were evaluated.

A total of 350 caregivers were recruited through health departments, churches, daycares, preschools, and kindergartens in areas designated high risk for lead exposure in Southern Illinois. Caregivers had knowledge about where lead is found and its effect on children’s learning ability. A deficit existed in knowledge about transmission of lead, and risk reduction behaviors. Caregivers, male, older, more educated, with higher income, more children in their households, or who had accessed more sources of lead information had higher lead knowledge scores. Low perceptions of lead poisoning being a problem in their residential areas and a risk for their children existed. Risk reduction behaviors were mixed. No caregivers performed all of the listed behaviors routinely. The more sources of lead information caregivers had access to, the greater their perceptions of risk and the more risk reduction behaviors performed. Caregivers with higher incomes and higher educational levels were less likely to perform risk reduction activities.

This phenomenological research, based on van Manen’s philosophical underpinnings, explored the lifeworld of individuals who suffer from IH (van Manen, 1990). According to the Intracranial Hypertension Research Foundation (IHRF, 2004), intracranial hypertension (IH) was identified and documented by Heinrick Quincke in 1893. This disease presents with a constellation of symptoms that are not easily diagnosed and has caused years of suffering due to confusing treatment processes (Kleinschmidt, Digre, & Hanover, 2000). This lack of diagnosis and an increase in adverse health problems causes deterioration, which may evolve into a spiral of a chronic illness states leading to diminished quality of life (Kleinschmidt, et al.).

The purpose of this research was to describe an aspect of the phenomena of living with IH through understanding the lifeworld of these individuals. To obtain this knowledge the research participants were asked to describe what it is like to live with IH. The participants were recruited from the Pseudo Tumor Cerebri (PTC) Group and the daily digest for PTC. A maximum of 20 participants were interviewed. The data were collected through audio taped telephone interviews using open-ended questions. Each interview was transcribed, reviewed, and evaluated for consistent themes. Delineating the concept of living with IH by allowing individuals to tell their stories, facilitated an understanding of the individual’s perception of their lifeworld experiences thus allowing the voices of the silenced to be heard.

This descriptive comparative study focused on attitudes toward collaborative practice of physicians and APNs from within the state of Florida. The study was based on Freire's conceptual framework which is concerned with the imbalance of power in relationships and posits that in order for equality to occur there needs to be recognition by both participants of the role each one plays during interactions (Freire, 1992).

Data were gathered using an online survey for ARNPs and physicians who used the researcher's modified version of the Jefferson Scale of Attitudes Toward Physician/ARNP Collaboration, designed to explore physicians' and ARNPs' attitudes toward collaboration (Hojat et al., 1985). Overall, ARNPs (n = 64) had more positive attitudes on the modified Jefferson Scale than physicians (n =9). Hypotheses testing resulted in the support of more positive ARNP attitudes than physician attitudes for all 5 hypotheses of Collaborative Relationships, Shared Education, ARNPs' Autonomy, and Physicians' Authority.

This was an instrumental, exploratory case designed to determine if international nurses’, as a vulnerable population, ways of knowing changed while they were students in U. S. programs of higher education. The framework for the study was Carper’s (1975) four ways of knowing in nursing as explicated by Jacobs-Kramer and Chinn (1988) and ontologically expanded by Silva, Sorrell, and Sorrell (1995). The study’s findings revealed that the ways of knowing in nursing were universal but uniquely applied to each nurse’s practice; that the nurses’ ways of knowing changed as the result of their U. S. education; and that even though they faced several challenges as students, the nurses were not adversely affected by their vulnerable status.