ISSN:0029-6562    

出版商:OVID    

年代:2003

数据来源: OVID

摘要:

BackgroundThe State-Trait Anger Expression Inventory (STAXI), a self-report questionnaire, is designed to measure the experience and expression of anger. Reliability and validity of the STAXI have been well established among African and European Americans aged 13 years and older. However, little is known of the use of this instrument among adolescents younger than 13 years and Hispanic American adolescents.ObjectivesObjectives were (a) to test ethnic, sex, and age group differences in STAXI scores in a sample of 11-to-16-year-old African, Hispanic, and European American adolescents; and (b) to assess the psychometric properties of the STAXI among these same adolescents with special emphasis on Hispanic youths, for whom no data are available.MethodsA cross-sectional design was used with stratified quota sampling techniques. Participants (N= 394) were African, Hispanic, and European Americans aged 11–16 years and were drawn from one public middle school and two public high schools in Houston, Texas.ResultsInternal consistency reliability for the anger scales (STAXI) ranged from 0.61 (anger-in) to 0.91 (state-anger) for the younger group (aged 11–13 years), and 0.68 (anger-in) to 0.88 (state-anger) for the older Hispanic Americans (aged 14–16). No notable differences were seen among the three ethnic groups in regards to internal consistency. Results of factor analyses of the five anger scales were similar to those reported originally by the scale author. Ethnicity and age had statistically significant main effects on the anger scales, and there was only one interaction.DiscussionThe use of the STAXI among a tri-ethnic adolescent population is warranted. The anger-in scale may be less reliable, especially among younger adolescents.

ISSN:0029-6562    

出版商:OVID    

年代:2003

数据来源: OVID

摘要:

BackgroundDespite numerous clinical and regulatory efforts, problems of poor quality of care in nursing homes continue, suggesting a need for effective management practices.ObjectiveTo test complexity hypotheses about the relationship between management practices (communication openness, decision making, relationship-oriented leadership, and formalization) and resident outcomes (aggressive behavior, restraint use, immobility of complications, and fractures), while controlling for case mix, size, ownership, and director’s tenure and experience.MethodA cross-sectional correlational field study design was used. Primary data were obtained from directors of nursing and registered nurses employed in 164 Texas nursing homes. Investigators administered self-report surveys onsite. Secondary data were obtained from 1995 Medicaid Cost Reports and the Texas nursing home Minimum Data Set (MDS) and were linked to primary data using a unique identifier.ResultsHypotheses were supported in that each management practice explained one or more of the resident outcomes. Larger size and longer director of nursing tenure and experience also explained better resident outcomes. Predictors explained 11% ñ 21% of the variance.DiscussionComplexity science was used to explain the results. The findings open the door to rethinking nursing home management practice. Practices that increase communication and interaction among people are needed for better resident outcomes.

ISSN:0029-6562    

出版商:OVID    

年代:2003

数据来源: OVID

摘要:

BackgroundWhile there are valid and reliable pressure ulcer risk assessment tools available for adult patients, none exist for infants and children. To remedy this, the Braden Scale was adapted for use in pediatrics, calling it the Braden Q Scale.ObjectiveThe purpose of this study was to: (a) establish the predictive validity of the Braden Q Scale in an acutely ill pediatric population; (b) determine the critical cutoff point for classifying patient risk; and (c) determine the best time to assess patient risk.MethodsA multisite prospective cohort descriptive study with a convenience sample of 322 patients on bedrest for at least 24 hours without pre-existing pressure ulcers or congenital heart disease were enrolled from three pediatric intensive care units (PICU). The Braden Q score and skin assessment were independently rated and data collectors were blind to the other measures. Patients were observed up to 3 times per week for 2 weeks and then once a week until PICU discharge for a median of 2 observations reflecting 887 skin assessments.ResultsEighty-six patients (27%) developed 199 pressure ulcers; 139 (70%) were Stage I pressure ulcers, 54 (27%) were Stage II pressure ulcers, and 6 (3%) were Stage III pressure ulcers. Most pressure ulcers (57%) were present at the first observation. Using Stage II+ pressure ulcer data obtained during the first observation, a Receiver Operator Characteristic (ROC) curve for each possible score of the Braden Q Scale was constructed. The area under the curve (AUC) was 0.83. At a cutoff score of 16, the sensitivity was 0.88 and the specificity was 0.58. The Braden Q Scale was then modified to eliminate 4 subscales with an AUC <0.7. With 3 subscales (mobility, sensory perception, tissue perfusion/oxygenation) the AUC of this Modified Braden Q Scale was maintained at 0.84. At a cutoff score of 7, the sensitivity was 0.92 and the specificity was 0.59.ConclusionsThe performance of the Braden Q Scale in a pediatric population is similar to that consistently reported for the Braden Scale in adult patients. The Modified Braden Q Scale, with 3 subscales, provides a shorter yet comparable tool.

ISSN:0029-6562    

出版商:OVID    

年代:2003

数据来源: OVID

摘要:

BackgroundThe numerous parent-child interaction measures available include few that are appropriate to brief clinical encounters or to research settings where time, cost, space, and subject burden are critical factors.ObjectivesThis study compares the newer Mother-Infant Communication Screening (MICS) with the established Nursing Child Assessment Satellite Training (NCAST) Teaching Scale (NCAT).MethodsTheoretical foundations, development, administration, support, and published psychometrics for the two scales are contrasted. Videotapes of 171 caregiver-child interactions in an urban, Hispanic, high-risk sample (children aged 5 months to 36 months) were scored by two trained coders who had established inter-rater reliabilities of .90 (NCAT) and .85 (MICS).ResultsValidity correlation coefficients werer= .504,p< .001 for total scores andr= .492,p< .001 for the two most comparable subscales. Distress was defined more narrowly by the MICS. Internal consistencies were .89 to .94 (MICS total scores) (depending on choice of subscales used) and .79 (NCAT).ConclusionsThe NCAT has established strengths for use in clinical practice and research and provides dyadic and separate mother and child scores. The MICS is more feasible for brief clinical screening and performed in this study with promising correlate validity and internal consistency across ages (infancy through 3 years). Interpretation would be strengthened if more clinical studies verifying scores with risk categories were performed and if normative data were established.

ISSN:0029-6562    

出版商:OVID    

年代:2003

数据来源: OVID

摘要:

BackgroundBlacks are under-represented in government-funded research. Epidemiological data indicate that morbidity and mortality in the United States are higher in Blacks than in Whites.ObjectiveTo examine memory performance in a sample of Black and White healthy men 70 years of age and older.MethodSixty-nine (24 Black, 45 White) men participated in a study of memory performance. All individuals lived either in private homes or subsidized high-rise apartments.ResultsBlack men had higher anxiety about their memories, used fewer internal and external memory strategies, and had less confidence and less understanding of their everyday memory than White men. Based on their depression scores, more Black men (35%) were at risk for depression than White men (10%). Even though there were no differences in the numbers of men who lived alone, White men were five times more likely to be married and live with a spouse (27 vs. 5).ConclusionIn this sample of Black and White men, there were no differences in actual memory performance, but significant differences were found in the subjective aspects of memory evaluation.

ISSN:0029-6562    

出版商:OVID    

年代:2003

数据来源: OVID

摘要:

BackgroundWhile the effect of the maternal position on reducing labor pain has been studied, the data presented to date have not been conclusive.ObjectivesTo determine if maternal position reduced the intensity of labor pain during cervical dilatation from 6 to 8 centimeters.MethodPain intensity was measured using the visual analogue scale (VAS) on 39 primiparous and 19 multiparous women (N = 58)who alternately assumed the sitting and supine positions for 15 minutes during cervical dilatation from 6 to 8 centimeters.ResultsThe pain scores for the sitting position were significantly lower than those for the supine position. The Wilcoxon signed-ranks test showed the VAS scores for the (a) total labor pain (“total” being defined as both abdominal and lumbar pain) during contraction (p= .011), (b) continuous total labor pain (p= .001), (c) lumbar pain during contraction (p< .001), and (d) continuous lumbar pain (p< .001) in the sitting position (significantly lower than in supine position). The diminished pain scores were greater than 13 millimeters, which is the minimum clinically significant change in patient pain severity as measured with the 100 millimeter VAS. The largest decrease occurred in lower back pain. No significant differences were found for abdominal pain scores in either the sitting or supine positions.ConclusionThe sitting position offers an effective method to relieve lower back labor pain during cervical dilatation from 6 to 8 centimeters. Similar relief was experienced for women who reported pain only on contraction as well as those with continuous pain.

ISSN:0029-6562    

出版商:OVID    

年代:2003

数据来源: OVID

摘要:

BackgroundThe involvement of family and friends in nursing home care represents an important resource for an overburdened long-term care system. However, little guidance exists for researchers interested in measuring family involvement.ObjectivesThis methodological report provides an overview of approaches to measuring family involvement in nursing home care and examines agreement between family and staff on the frequency of visits and telephone calls to a resident by family and friends. Agreement is also assessed for subgroups of the sample based on characteristics of the family, staff, facility, and resident.MethodsFrom a large and representative sample of nursing home residents, 823 pairs of significant others and staff were interviewed. Primary variables were reports of visitation and telephone contact received by the resident in the preceding 2 weeks according to the significant other and staff person.ResultsSignificant other reports of visitation and telephone contact were significantly higher than staff reports (p< .001 andp< .01). Agreement (via intraclass correlation) between significant others and staff was moderate for reports of visit and telephone call frequency. With one exception, no significant differences in agreement were found between subgroups defined by characteristics of the family, staff, facility, or resident. For visits, agreement between nurse’s aides and significant others was lower than between other staff persons (e.g., LPNs and RNs) and significant others (p< .05).DiscussionDue to the complexity of nursing home settings as well as of the social support system of residents, researchers need to carefully consider their approach to the measurement of the involvement of family and friends in the nursing home.

ISSN:0029-6562    

出版商:OVID    

年代:2003

数据来源: OVID

摘要:

BackgroundAlthough publication bias is a concern when using meta-analysis, techniques for assessing for its potential appear to be underused in nursing.ObjectivesTo demonstrate several methods, both graphical and statistical, of assessing for publication bias.MethodsFour methods are described and demonstrated, ranging from the familiar fail-safe N to the trim-and-fill method, using the same contrived data set.ResultsMethods vary in their conclusion about the presence of potential publication bias in the example presented. Some limitations of the methods are noted to assist meta-analysts in determining which to consider using.ConclusionGiven that publication bias can affect the validity of meta-analytic studies, researchers are encouraged to use more than one method to assess for bias so that clinicians and decision-makers can have the best possible information available.

ISSN:0029-6562    

出版商:OVID    

年代:2003

数据来源: OVID

摘要:

BackgroundOutcomes research often compares patient and organizational outcomes across institutions, dealing with variables measured at different hierarchical levels. A traditional approach to analyzing multilevel data has been to aggregate individual-level variables at the institutional level.ObjectivesTo introduce the conceptual and statistical background of multilevel analysis and provide an example of multilevel analysis that was used to examine the relationship between nurse staffing and patient outcome.MethodsA two-level model was presented employing multilevel logistic regression analysis.ResultsOutputs from multilevel analysis were interpreted. Other statistics were presented for model specification and testing.ConclusionResearchers should consider multilevel modeling at the study design stage to select theoretically and statistically sound research methods.

ISSN:0029-6562    

出版商:OVID    

年代:2003

数据来源: OVID