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Biomedical subjects

Margaret H Kearney

Publications and source records attributed to Margaret H Kearney.

15 recordsLinked to original sources
PubMed2006

Intervention fidelity: lessons learned from an unsuccessful pilot study.

Although the design of the study we undertook was randomized, the groups were statistically similar, the intervention was based on evidence of previous efficacy, and the treatment was delivered exactly as planned, this pilot study on an intervention to promote motivation for weight loss in new mothers failed to produce an effect. A closer examination using criteria for intervention fidelity revealed a number of weaknesses. Both treatment integrity and differentiation merit careful consideration in intervention design.

Adult↗
PubMed2005

Nurse editors' views on the peer review process.

A growing body of research challenges the inter-rater reliability of peer reviewers and the value of reviewer training or blinding in improving the quality of manuscript reviews, but double-blinded peer review of papers remains a relatively unexamined standard for nursing journals. Using data from a larger emailed survey, the views of 88 nurse editors on peer review were analyzed using content analysis. The majority of nurse editors reported that blinding was important in peer review, to maintain objectivity and avoid negative personal or professional consequences. The minority who saw potential benefits of open review valued increased transparency in the reviewing and editorial decision-making process. An excellent review was viewed as containing specific instructions on how the deficits in a manuscript might be remedied. Common weaknesses of reviews were lack of specificity and inappropriate focus. Virtually all editors provided some form of preparation or guidance to reviewers. Peer review has an impact on nurses' workload and careers, and training in writing and critique should be included in nursing education.

Attitude↗
PubMed2005

Ethical issues faced by nursing editors.

This study reports on ethical issues faced by editors of nursing journals, a topic which has not appeared in the nursing literature. A survey of nursing editors (n = 88)was conducted via e-mail; this article is the content analysis of survey questions about ethics. Eight categories of ethical issues emerged: problems with society/association/publisher; decisions about inflammatory submissions; informed consent or IRB issues; conflicts of interest; advertising pressures; duplicate publications and/or plagiarism; difficult interactions with authors; and authorship. Some issues were similar to those published about medical editors; however, others were unique. This study can assist authors to better understand some of the ethical issues in publishing, can help editors to view their issues in the context of what others experience, and can assist societies and publishers to work toward avoiding these ethical issues in the future. Professional discussions about ethics in nursing publications should be the subject of ongoing research and scientific inquiry.

Adult↗
PubMed2004

Qualitative metasynthesis: reflections on methodological orientation and ideological agenda.

In an era of pressure toward evidence-based health care, we are witnessing a new enthusiasm for qualitative metasynthesis as an enterprise distinct from conventional literature reviews, secondary analyses, and the many other scholarly endeavors with which it is sometimes confused. This article represents the reflections of five scholars, each ofwhom has authored a distinct qualitative metasynthesis strategy. By providing the reader a glimpse into the tradition of their various qualitative metasynthesis projects, these authors offer a finely nuanced examination of the tensions between comparison and integration, deconstruction and synthesis, and reporting and integration within the metasynthesis endeavor. In so doing, they account for many of the current confusions about representation and generalization within the products of these inquiries. Through understanding the bases of their unique angles of vision, the reader is invited to engage in their commitment to scholarly integrity and intellectual credibility in this emerging methodological challenge.

Humans↗
PubMed2003

Improving participation in Chlamydia screening programs: perspectives of high-risk youth.

BACKGROUND: Many young people at highest risk for chlamydial infection do not use chlamydia screening services. OBJECTIVES: To describe young people's beliefs and opinions about obstacles to and motivators for obtaining testing and to provide recommendations for how to improve youth participation in chlamydia screening programs. METHODS: Eight focus group interviews (4 male and 4 female groups) were conducted with young people using a semistructured interview guide. Thirty-two male and 23 female volunteers (mean age, 18.2 years; age range, 15-24 years) were recruited from Job Corps and Department of Youth Services sites. The main outcome measure was categorization of textual data using content analysis techniques. Data were coded by 2 investigators into categories of responses based on research questions and spontaneously offered comments. Satisfactory intercoder agreement was achieved. RESULTS: Participants described many obstacles to testing, including concern that someone will know they were tested or tested positive, fear about discovering they have a sexually transmitted disease, and fear of acquired immunodeficiency syndrome. Many participants were unsure what physical effects chlamydia produced or thought it was possible to die of a chlamydial infection. Participants recommended providing more information about the effects of chlamydia, availability of urine testing, and ease of treatment to motivate more young people to seek testing. They also emphasized the need to make sexually transmitted disease screening services more private and confidential. There was an overwhelming interest in using a home Chlamydia test (much like a home pregnancy test) if one were available. CONCLUSIONS: To increase youth participation in screening programs, it will be necessary to address their concerns, dispel misconceptions, and provide more information about chlamydia. A home Chlamydia test might be one way to increase screening.

Adolescent↗
PubMed2003

Birth outcomes and maternal morbidity in abused pregnant women with public versus private health insurance.

PURPOSE: To compare the effects of recent intimate partner abuse on maternal and infant health in publicly versus privately insured pregnant women. DESIGN: Exploratory descriptive analysis in 13 Massachusetts prenatal care sites from records of 2,052 women who had been screened during pregnancy for domestic violence. METHODS: Clinicians screened pregnant women for domestic violence using the Abuse Assessment Screen. After delivery, prenatal and birth outcome data and abuse screening results were extracted from medical records by project staff. Odds ratios were used to compare maternal and infant health indicators in abused and nonabused women. Data from women with public and private health insurance then were examined separately, using logistic regression to control for low education and single marital status while examining the odds of adverse maternal and infant outcomes in abused and nonabused women. FINDINGS: In the sample as a whole, recently abused women were more likely to be publicly insured and unmarried, to have less than 12 years of formal education, and to have medical and obstetrical complications. Parity, ethnic background, and infant birth outcomes did not differ in relation to abuse. In separate analyses for women with public and private health insurance, after controlling for marital status and education, abuse increased the odds of low infant Apgar scores, poor nutrition, hyperemesis, hypertension, and substance abuse in publicly insured women, and abuse increased the odds of poor nutrition and bleeding during pregnancy for privately insured women. CONCLUSIONS: The different correlates of abuse in publicly and privately insured women might be important for clinicians caring for these different populations. Screening for abuse and providing abuse-related services are indicated for pregnant women.

Adolescent↗
PubMed2003

Identity shifts as turning points in health behavior change.

The authors used a grounded formal theory approach to synthesize the findings of 14 studies, with the goal of identifying common elements in qualitative studies of individuals' efforts to change a variety of unhealthy behaviors. The combined sample of 399 participants had experiences of weight loss, smoking cessation, and alcohol and drug-abuse recovery. Data were extracted from published reports and analyzed using grounded-theory techniques. In the provisional model, a value conflict in response to distressing accumulated evidence prompts a small step toward behavior change. If successful, an identity shift begins. Increased self-awareness and self-confidence fuel continued change. Numerous constraints to success are noted at each step. The links to previous conceptions of identity shift are discussed.

Health Behavior↗
PubMedDate not supplied

Health behaviors as mediators for the effect of partner abuse on infant birth weight.

BACKGROUND: Intimate partner abuse of pregnant women has been linked to the delivery of low-birth-weight infants. Also, abused pregnant women have reported a greater prevalence of substance abuse, poor nutrition, and demographic risk factors for poor birth outcomes. These factors may play a role in the reported relation between intimate partner violence and birth weight. OBJECTIVES: To explore the role of substance abuse (smoking, alcohol, and drug use) and weight gain of less than 15 pounds during pregnancy as potential mediators of the relation between recent partner abuse and infant birth weight, and to investigate the role of demographic risk factors as potential moderators for the impact of abuse on birth weight. METHODS: Data were extracted on abuse screening results, demographics, birth outcomes, and a range of medical and obstetric risks and complications from the medical records of 1969 women who had been screened by clinicians for domestic abuse during pregnancy. Hypotheses were tested using multiple regression analysis. RESULTS: Recent physical or psychological abuse had a small but significant effect on birth weight in this sample. Smoking and low weight gain were weak but significant mediators of the relation between recent abuse and infant birth weight. Single marital status was the strongest demographic predictor of decreased birth weight. No moderator effects were found. CONCLUSIONS: Although prospective studies are warranted, nursing care to reduce smoking and promote adequate weight gain in all women along with support for women's efforts to seek safety from abuse may help to improve birth outcomes and promote maternal well-being.

Adult↗
PubMedDate not supplied

Influences on older women's adherence to a low-fat diet in the Women's Health Initiative.

OBJECTIVE: Most studies of dietary change during aging have focused on maintaining adequate intake by impaired elderly, and little is known about factors affecting dietary change for preventive purposes in older individuals. The purpose of this exploratory study was to determine the major behavioral influences on older women's adherence to a dietary fat reduction intervention. METHOD: A diverse sample of 92 women aged 55 to 80 was recruited from two East Coast sites of the Women's Health Initiative. All the women were participating in the dietary modification arm of WHI, had received the same dietary instruction, and were in the maintenance phase of the intervention. The women were classified by nutritionists as adherent or nonadherent to a diet limiting fat intake to <20% of total calories. Focus groups and telephone interviews were conducted, and textual data were coded and sorted using content analysis techniques within the four categories of the Stimuli-Organismic Factors-Response Repertoire-Consequences (SORC) behavioral model. Frequencies of responses within categories were tabulated and compared qualitatively. RESULTS: Adherent women were more likely to report assertiveness, a lifelong commitment to reduced dietary fat, satisfaction with their lifestyle changes, and having applicable knowledge and skills. Nonadherent women reported more difficulty resisting negative emotions and prior food preferences and habits; they were also more concerned about negative responses from others. CONCLUSIONS: Enhancing adherence of older women to a dietary fat reduction program will require shifting priorities away from conforming to social pressure and using high-fat foods for personal satisfaction and moving toward enhancing motivation and commitment to long-term health.

Aged↗