BACKGROUND::

Traditional statistics in longitudinal data analysis are likely to be insufficient in nursing studies, in which the time varying characteristics of explanatory variables and cumulative effects require additional consideration.

OBJECTIVES:

: The aims of this study were to introduce alternative longitudinal approaches for incorporating time-varying variables and cumulative effects, to discuss their strengths, and to highlight key issues that nursing researchers should recognize before and while undertaking such analyses.

RESULTS::

The three alternative models provide differing analytical outcomes based on the research focus. The baseline tracking model was used to estimate the stability effect of an intervention program, detecting risk factors early. The temporal sequence of potential cause and effect was incorporated further in the time-dependent model. The cumulative model was used to explore whether cumulative intervention effects existed.

CONCLUSION:

: Nurse researchers should incorporate alternative methods into the longitudinal data analysis tools they commonly use when facing explanatory variables with time variations or cumulative effects on the variable being measured.

: Previous studies assessing the validity of adolescent self-reported height and weight for estimating obesity prevalence have not accounted for, potential bias due to nonresponse in self-reports.: The aim of this study was to assess the implications of selective nonresponse in self-reports of height and weight for estimates of adolescent obesity.: The authors analyzed 613 adolescents ages 12-17 years from the 2006-2008 Los Angeles Family and Neighborhood Survey, a longitudinal study of Los Angeles County households with an oversample of poor neighborhoods. Obesity prevalence estimates were compared based on (a) self-report, (b) measured height and weight for those who did report, and (c) measured height and weight for those who did report.: Among younger teens, measured obesity prevalence was higher for those who did not report height and weight compared with those who did (40% vs. 30%). Consequently, obesity prevalence based on self-reported height and weight underestimated measured prevalence by 12 percentage points (when accounting for nonresponse) versus 9 percentage points (when nonresponse was not accounted for). Results were robust to the choice of difference child growth references.: Adolescent obesity surveillance and prevention efforts must take into account selective nonresponse for self-reported height and weight, particularly for younger teens. Results should be replicated in a nationally representative sample.

BACKGROUND::

The use of religious practices to promote mental health among African Americans is well documented. African Americans are more likely to report strong religious affiliationsand to use religion over prescribed medications for mental health problems. However, few studies have exploredhow African Americans use religious practices in response to stressful life events.

OBJECTIVE::

The aim of this study is to examine how African American women and men find comfort in using scripture passages from The Bible.

METHODS::

Fifty-four African American adults residing in the Southeastern United States participated in a qualitative descriptivestudy using open-ended semistructured interviews. Participants were asked to describe their use of scripture passages from The Bible and the personal meanings associatedwith these scriptures in the context of a family death or life-threatening illness.

RESULTS::

These participants used scripture passages categorized as God as Protector, God as Beneficent, Praise and Thanksgiving, God as Healer, Memory of Forefathers, Prayers to God, and Life after Death. Few gender differences were noted. However, women were more likely to use scripture passages of God as Protector and Life after Death, whereas men were more likely to use God as Beneficent and God as Healer.

DISCUSSION:

: The religious practice of reading scripture passages from The Bible is a mental health-promoting strategy used during stressful life events. The findings of this study have practical uses for nurses and can be used to inform acceptable and sensitive approaches in addressing mental health issues and spiritual care needs in African American patients.

BACKGROUND::

Caring for families is fundamental to pediatric nursing. However, existing measures do not capture parents' experiences with family-centered nursing care.

OBJECTIVE::

The aim of this study was to describe the development and initial psychometric testing of the Family-Centered Care Scale, a seven-item instrument designed to measure a parent's experience of nursing care that embodies core principles of family-centered care.

METHODS::

In Phase 1, 18 items describing what nurses do to engage parents of hospitalized children were derived from the literature describing mutuality. After establishing face validity, pretesting, and revision for clarity, the scale was administered to a convenience sample of 91 parents of hospitalized patients. In Phase 2, two items on parents' perceptions of being well-cared-for were added. The 20-item scale was administered to 564 parents of children recruited from all inpatient units in a children's hospital. In Phase 3, the scale was shortened to seven items and retested for validity among 454 additional parents.

RESULTS::

Internal consistency reliability was high across all versions and testing phases. Confirmatory factor analysis with data from a subsequent sample supported the final factor structure, regardless of patient type and race. There was a linear association between the scale consistency scores and overall quality of care ratings, supporting predictive validity of the scale.

DISCUSSION:

: The Family-Centered Care Scale showed initial evidence of reliability and validity among parents with hospitalized children.

BACKGROUND::

Valid assessment of family functioning can play a vital role in optimizing client outcomes. Because family functioning is influenced by family structure, socioeconomic context, and culture, existing measures of family functioning-primarily developed with nuclear, middle-class European American families-may not be valid assessments of families in diverse populations. The Family Effectiveness Measure was developed to address this limitation.

OBJECTIVES:

: The aim of this study was to test the Family Effectiveness Measure with data from a primarily low-income African American convenience sample using the Rasch measurement model.

METHODS::

A sample of 607 adult women completed the measure. Rasch analysis was used to assess unidimensionality, response category functioning, item fit, person reliability, differential item functioning by race and parental status, and item hierarchy. Criterion-related validity was tested using correlations with five other variables related to family functioning.

RESULTS::

The Family Effectiveness Measure measures two separate constructs: The Effective Family Functioning construct was a psychometrically sound measure of the target construct that was more efficient because of the deletion of 22 items. The Ineffective Family Functioning construct consisted of 16 of those deleted items but was not as strong psychometrically. Items in both constructs evidenced no differential item functioning by race. Criterion-related validity was supported for both.

DISCUSSION:

: In contrast to the prevailing conceptualization that family functioning is a single construct, assessed by positively and negatively worded items, use of the Rasch analysis suggested the existence of two constructs. Whereas the Effective Family Functioning scale is a strong and efficient measure of family functioning, the Ineffective Family Functioning scale will require additional item development and psychometric testing.

: Internationally educated registered nurses comprise 5.4% of the U.S. nursing workforce. These nurses perceive unequal treatment in the workplace. However, studies comparing their wages to U.S.-educated registered nurses are limited and inconclusive. It is unclear whether there is a wage differential in the U.S. labor market.: The aims of this study were to determine if there is a difference in the wages of internationally and U.S.-educated nurses and to determine the extent to which the wage gap relates to differences in the human capital, employment, and demographic characteristics of the two groups.: The 2008 National Sample Survey of Registered Nurses data were used for this secondary data analysis study. The sample included 988 internationally educated nurses and 21,715 U.S.-educated nurses. Multiple regression and Oaxaca decomposition were used to find predictors of log hourly wages.: Internationally educated nurses earned 5% higher log hourly wages, controlling for human capital, employment, and demographic characteristics. Male gender, working in a metropolitan area, hospital job, union representation, higher nursing experience, and higher education exerted significant positive effects on hourly wages. Oaxaca decomposition showed that 67% of the wage differential was because of the differences in the characteristics of two groups.: If there is any form of discrimination against internationally educated nurses in the United States, it does not translate into wage inequality. Predictors of economic success should be explored in future research.

: Fatigue has been shown to be a prevalent symptom in patients with rheumatoid arthritis, having a negative impact on health-related quality of life. However, aside from depression, related fatigue has not been linked to specific psychological outcomes and is not a common target in treatment programs.: The aim of the study was to examine the unique influence of rheumatoid arthritis-related fatigue on three psychological outcomes: depressive symptoms, perceived health impairment, and satisfaction with abilities.: In a large (n = 200) convenience sample of older adults who provided informed consent, multiple regression analyses were conducted to determine the direct and unique impact of demographic variables, functional impairment, pain, and fatigue on each of three psychological outcomes: depressive symptoms, perceived health impairment, and satisfaction with ability.: Fatigue significantly and uniquely contributed to each of the psychological outcomes, above and beyond pain and functional impairment. The variances of depressive symptoms, perceived health impairment, and satisfaction with ability accounted for by fatigue were highly significant.: The study indicates that rheumatoid arthritis-related fatigue contributes to diminished psychological well-being in older adults aging with rheumatoid arthritis and suggests the need for psychoeducational and management strategies that specifically target fatigue as part of an overall rheumatoid arthritis management program. Future research should attempt to obtain a larger sample of male and younger patients to determine if there are significant gender and age differences in the impact of fatigue on psychological outcomes.

Fall risk increases with age and visual impairment, yet the oldest-old adults (>85 years) are rarely studied. Partnered dance improves mobility, balance, and quality of life in older individuals with movement impairment.The aim of the study was to determine the feasibility and participant satisfaction of an adapted tango program amongst these oldest-old adults with visual impairment. Exploratory analyses were conducted to determine efficacy of the program in improving balance and gait.In a repeated-measures, one-group experimental design, 13 older adults (7 women; age: M = 86.9 years, SD = 5.9 years, range = 77-95 years) with visual impairment (best eye acuity: M = 0.63, SD = 0.6 logMAR) participated in an adapted tango program of twenty 1.5-hour lessons, within 11 weeks. Feasibility included evaluation of facility access, safety, volunteer assistant retention, and participant retention and satisfaction. Participants were evaluated for balance, lower body strength, and quality of life in two baseline observations, immediately after the program and 1 month later.Twelve participants completed the program. The facility was adequate, no injuries were sustained, and participants and volunteers were retained throughout. Participants reported enjoyment and improvements in physical well-being. Exploratory measures of dynamic postural control (p < .001), lower body strength (p = .056), and general vision-related quality of life (p = .032) scores showed improvements following training.These older individuals with visual impairment benefitted from 30 hours of tango instruction adapted for their capabilities.

Secondary lymphedema is a lifetime risk for breast cancer survivors and can severely affect quality of life. Early detection and treatment are crucial for successful lymphedema management. Limb volume measurements can be utilized not only to diagnose lymphedema but also to track progression of limb volume changes before lymphedema, which has the potential to provide insight into the development of this condition.This study aims to identify commonly occurring patterns in limb volume changes in breast cancer survivors before the development of lymphedema and to determine if there were differences in these patterns between certain patient subgroups. Furthermore, pattern differences were studied between patients who developed lymphedema quickly and those whose onset was delayed.A temporal data mining technique was used to identify and compare common patterns in limb volume measurements in patient subgroups of study participants (n = 232). Patterns were filtered initially by support and confidence values, and then t tests were used to determine statistical significance of the remaining patterns.Higher body mass index and the presence of postoperative swelling are supported as risk factors for lymphedema. In addition, a difference in trajectory to the lymphedema state was observed.The results have potential to guide clinical guidelines for assessment of latent and early-onset lymphedema.