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Hospital sisters: work attitudes, perceptions and wastage.

This study attempts to describe the attitudes and perceptions that hospital sisters have towards their work and the relationship, if any, of these attitudes and perceptions to absence, leaving intent and wastage. The theoretical approach adopted was based on the Minnesota Theory of Work Adjustment and the role stress theory originally developed at the University of Michigan, and the measures used included rating scales developed in these centres. The results indicated that most of the sisters were, in general, satisfied with their jobs, although a substantial minority were dissatisfied with and experienced role conflict and ambiguity from certain features of their working environment. Comparison of the leavers with the stayers revealed no difference between the groups on intrinsic satisfaction, absence and role ambiguity, but the leavers were less satisfied with extrinsic features of the job, and experienced more tension and role conflict than the stayers. The fairly strong 'mobility culture' reported by other research was supported and it was tentatively concluded that after a year or two, the job fails to provide the sister with sufficient challenge, and her propensity is to leave for more stimulating work. The implications of this conclusion are discussed.

Attitude of Health Personnel↗

Establishing a Swedish instrument measuring hope.

Hope has been identified as an important component for individuals coping with stress in life-threatening situations. The purpose of this study was to establish a Swedish instrument measuring hope. The instrument is based on an American hope scale developed by J.F. Miller to measure hope in adults. The Miller Hope Scale (MHS) is a 40-item 5-point Likert-type scale with a score range of 40-200. The MHS was translated into Swedish and examined in three stages before it was tested on a group of nursing students (n = 120). The test results in the Swedish sample were in accordance with Miller's evaluation of the psychometric properties of the MHS. The mean hope score was 170.4 (SD = 16.52) and the internal alpha coefficient was 0.88. The factor analysis on the Swedish sample resulted in the factors: I. Satisfaction with self, others and life; II. Avoidance of hope threats; III. Ability, capacity to influence the outcome in life.

Adaptation, Psychological↗

Verbal abuse of nurses by physicians in a private sector setting.

The aim of the study was to determine whether physicians in a private sector setting verbally abuse nurses, and to what extent. A review of the literature showed that verbal abuse by physicians accounts for the highest incidence of aggression towards nurses in health care, and that it is strongly related to turnover rates. It has also been reported in recent studies that within the context of verbally abusive episodes, patient care, work productivity, morale and job satisfaction have been negatively affected. Of the 120 questionnaires that were distributed among registered and enrolled nurses, 83 were returned in time to be used, which was a response rate of 69%. This response rate is consistent with previous studies and is exactly the same as for a study that was done in Turkey (Uzun, 2003:81). The questionnaire used was one that has been adapted from the Verbal Abuse Scale developed by Manderino and Berkey (1997:50) and the Revised Conflict Tactics Scale (CTS 2) as described by Little (1999:24), and was in the form of a 4-point Likert-scale with one open ended question. The results showed that 79% of the nurses admitted that verbal abuse was taking place. Forms of direct verbal abuse included 81% that felt they were criticised unjustly, 76% that were screamed at in front of others, and 81% that felt physicians vented their frustration on them. The results obtained in the study were consistent with previous studies done elsewhere and it indicated that nurses still experience high levels of verbal abuse in the workplace.

Adult↗

Adolescent reputation enhancement: differentiating delinquent, nondelinquent, and at-risk youths.

This research reports the findings of two studies conducted to measure and then investigate differences between delinquent, nondelinquent, and at-risk youths' orientations towards reputation enhancement. In the first study, concerning item selection and scale development, the factor structure and content validity of a potential Reputation Enhancement Scale were tested by examining the item responses of the scale completed by 230 high-school students. In the second study, the scale was validated by comparing the item responses of 80 delinquent, 90 at-risk, and 90 nondelinquent adolescents with the responses of the original students. The instrument was found to be reliable (alphas from .64 to .92), indicating that the factors are dependable across different samples, and the coefficients of congruence were sufficiently high to investigate meaningful group differences. Three second-order factors (Conforming Reputation, Nonconforming Reputation, Self-presentation) were derived from the 15 first-order factors. Although multivariate analyses revealed significant differences between the reputational orientations of delinquent, at-risk, and nondelinquent participants, the self-presentation second-order factor did not differentiate the three groups.

Adolescent↗

Impact of the Medicare fee schedule on payments to physicians.

Beginning in 1992, the Medicare program will pay physicians by the Medicare Fee Schedule, a system of geographically adjusted standardized payment rates based in part on the Resource-Based Relative Value Scale developed by Hsaio et al and in part on current Medicare payments. In our simulations of the Medicare Fee Schedule, we find that (1) redistributions of Medicare-allowed charges across specialities will be substantial but approximately only half the size projected by Hsaio, (2) there will be large redistributions among geographic areas that tend to compound the specialty redistributions, and (3) there will be wide variation within specialties as to how individual providers are affected. The majority of the redistributive impact of the Medicare Fee Schedule is attributable to implementation of a geographically adjusted system of standardized payments rather than to the particular work values developed by Hsiao et al in the Resource-Based Relative Value Scale.

Costs and Cost Analysis↗

Development and validation of the Infertility Self-Efficacy scale.

OBJECTIVE: To develop and validate a scale of perceived self-efficacy for people coping with infertility treatment. DESIGN: Self-efficacy scale development involved: [1] item generation with medical experts in reproductive health; [2] a principal components analysis with varimax rotation to identify underlying item components; [3] test-retest reliability and construct (convergent and discriminant) validity with infertility patients, who were administered the Infertility Self-Efficacy (ISE) scale with other measures; and [4] expert acceptability, as determined by reproductive health professionals. SETTING: Recruitment at a fertility center, a national infertility organization, and medical trials web pages. PATIENT(S): A total of 213 participants (159 women; 54 men) with a diagnosis of infertility in the past 2 years were recruited for the various study phases. INTERVENTION(S): None. MAIN OUTCOME MEASURE(S): Participants' infertility self-efficacy was assessed with an online assessment battery using the ISE scale; comparison mental health measures assessed current levels of fertility problem distress, perceived stress, and coping style. Reliability, validity, and component structure of the ISE was assessed. RESULT(S): Measurement development yielded a brief 16-item ISE scale that taps an infertility patient's perception about his or her ability to engage in a set of cognitive, emotional, and behavioral skills related to the medical treatment of infertility. The single component of "cognitive/affect regulation" suggests this core set of skills is relevant to successfully managing the experience of infertility. The ISE correlations with comparison mental health measures were as expected, suggesting good convergent and discriminant validity. CONCLUSION(S): The ISE scale appears to be a reliable and valid measure of an individual's self confidence in areas related to health promotion during infertility treatment. Assessing an infertility patients' self-efficacy with the ISE may be useful in clinical research and as a counseling tool to help guide patients in actively managing their fertility treatment.

Adaptation, Psychological↗

Dynamics of personality test responses: the empiricist's manifesto revisited.

This article revisits the classic empirical manifesto written by Meehl in 1945, and examines subsequent developments in structured personality assessment. The current status of personality assessment from an empirical-scale-development perspective is presented, with examples drawn from recent work on the MMPI-2. Meehl's heuristic defense of empirically based personality-scale construction was reexamined and the lasting influences of these views were highlighted. Meehl's early conceptualization of the relative unimportance of item content in personality-test construction and several alternative views were summarized, and Meehl's modified position was described. The role that test-taking attitudes can play in personality assessment was discussed in the 1945 article, and Meehl's views on the need for appraisal of invalidating conditions have been reaffirmed in contemporary test development. Finally, the so-called "dynamics" of a structured personality item response were discussed from a contemporary perspective, and some recent research was included to illustrate the continued importance of anchoring test interpretation in empirical correlates.

Empiricism↗

Development of an inexpensive and rapid two site microenzyme linked immunosorbent assay kit for human alpha fetoprotein.

Laboratory scale development of a two site micro enzyme linked immuno assay kit is described. The kit comprises rabbit anti human alphafetoprotein (AFP), anti human AFP IgG peroxidase conjugate and standard AFP. All the above reagents were prepared in the laboratory. The kit is eminently suitable for early screening of blood sample of pregnant women for neural tube defects of their fetuses and for the quantitation of AFP as a tumor marker. The assay kit was used to determine AFP in 76 sera from women at different stages of pregnancy. During 1st trimester AFP level was 18 to 119 ng/ml, during 2nd trimester the concentration varied from 85 to 302 ng/ml and during 3rd from 103 to 580 ng/ml. No evidence for maternal antibody to AFP was found. The above data agree with AFP level in pregnant women reported by earlier workers, using RIA or ELISA. The present ELISA kit would hopefully be much cheaper than internationally available ELISA kits for human AFP.

Enzyme-Linked Immunosorbent Assay↗

Comparison of the 1969 and 1993 standardizations of the Bayley Mental Scales of Infant Development for infants with Down's syndrome.

The Bayley Scales of Infant Development (BSID) were re-standardized in 1993 (BSID-II). The present study reports a comparison of the two versions with infants with Down's syndrome (DS). The BSID-II was used for 93 assessments of 54 children with DS (age range = 7-43 months). Comparisons were made with the 1969 standardization for 42 of these assessments, and for 45 assessments of 20 typically developing children aged between 6 and 24 months. The 1993 standardization produced significantly lower mean differences of 1.0 months mental age and 8.4 points mental development index for infants with DS, and 1.5 months mental age and 9.2 points mental development index for the typically developing group. Nineteen per cent more infants with DS had scores below two standard deviations and there was a larger decrement for lower functioning children. Both groups of children have to perform at a higher level to achieve the same relative score on BSID-II compared to BSID. This indicates that caution should be used in comparing cohorts of children tested on different versions of the Bayley scales. In addition, concerns are highlighted regarding the rules for establishing basal and ceiling levels for BSID-II for children with developmental delays.

Child, Preschool↗

[Development of a scale to measure self-care for korean patients with chronic obstructive pulmonary disease].

PURPOSE: The objective of this study was the development and validation of a scale to measure the self-care of patients with chronic obstructive pulmonary disease(COPD) in Korea. METHOD: Self-care scale was developed based on the self-care activities patients had to carry out in order to manage their COPD. The original scale contained 34 items rated along a five-point Likert scale and was reviewed by 18 professional nurses and 10 Korean patients with COPD for content validity. Subsequently, patients with COPD were asked to complete this 23-item scale and further tests were done with the 125 useable responses. RESULT: Factor analysis identified eight factors- "maintaining a clean air way", "taking medication", "support from family", "preventing infection", "managing symptoms", "breathing exercising", and "taking in nutrition". The internal consistency of the total scale was Cronbach's alpha=0.7226. These eight factors explained 60.8% of total variance. There was correlation among Korean Self-Care Scale score, administration level, and knowledge level but there was no correlation to patients' satisfaction with medical services. CONCLUSION: The 23 item questionnaire positively identified 8 areas defined important for COPD patients. Further studies are required to see how these can be integrated into patient education.

English Abstract↗

Psychometric development of a multidimensional measure of weight-related attitudes and behaviors.

Most weight control programs facilitate weight loss by encouraging participants to adopt healthy eating patterns and increase physical activity. There is a need for a relatively brief measure of eating habits and physical activity that could be used to evaluate changes in behavior during weight loss treatment. The purpose of this series of four studies was to develop and validate such a measure, which was subsequently named the Weight Loss Behavior Scale (WLBS). Study 1 (n = 533) included item and scale development and examination of the WLBS's factor structure and internal consistency. Study 2 (n = 226) evaluated the test-retest reliability and convergent validity of its subscales. Study 3 examined their reliability and internal consistency scales in a predominantly overweight sample (n = 36). Study 4 evaluated the WLBS as a treatment outcome measure in a weight loss intervention (n = 50). Study 1 found that the WLBS contained five internally consistent and stable factors: 1) Concern with Dieting and Weight, 2) Exercise, 3) Overeating, 4) Avoidance of Fattening Foods and Sweets, and 5) Emotional Eating. Study 2 found convergent validity for the WLBS by assessing the correlation of its factors/scales with established inventories of comparable constructs, e.g., dietary restraint, disinhibited eating, and physical activity. Test-retest reliability of the five scales was also supported in this second study. In Study 3, support for the internal consistency and test-retest reliability of the WLBS among overweight individuals was found. Study 4 found that all scales significantly changed in the expected directions after a 5-month behavioral weight loss treatment. The findings from this series of studies suggest that the WLBS is a reliable and valid self-report inventory of cognitive and behavioral scales associated with weight control that can be utilized as an outcome measure for weight loss interventions.

Adult↗

[Work situation and job satisfaction in an university hospital: development of questionnaires for physicians and nurses].

Aim of the present work was to develop scales for the description of the work situation of physicians and nurses. For this purpose a sample of n = 447 physicians and n = 920 nurses of an University Hospital filled out a new conception work situation questionnaire. Further on they got the subscales work and profession and financial situation of the Life Satisfaction Questionnaire (FLZ). After Principle Component Analysis and item analyses we could develop four work situation scales similar for both groups, the physicians and the nurses: 1. chief and hierarchy, 2. conflict ability of the team, 3. work conditions at the ward and 4. cooperation of the professions. The internal consistencies are medium to high with Cronbach's alpha = 0.80-0.90 for the physicians and alpha = 0.83-0.90 for the nurses. The Work Situation Questionnaire in it's forms for physicians (FAA) and for nurses (FAP) are high reliable scales. We also found positive validity indications.

Adult↗

Evaluation of computerized nursing care plan: instrument development.

With the increasingly popular use of information technology in patient care, the need for reliable instrumentation to evaluate information systems has become critical. This article describes the psychometric testing of a scale developed to evaluate a computerized nursing care plan (CNCP) system. A review of the literature generated a 44-item questionnaire, which was then administered to a convenience sample of 729 hospital nurses in Taiwan. Factor analysis (principal component analysis with varimax rotation) and item analysis were applied to establish the scale's construct validity and reliability. Twenty-two items selected from the original 44-item pool were grouped into 6 major constructs: patient care, nursing efficiency, professionalism, usage benefit, education and training, and usability. The alpha coefficient was 0.85. The statistical results showed that nurses generally valued using the CNCP system. Further psychometric analysis of the scale is suggested in other nursing populations, for subscale development and to refine item wording.

Adult↗

Developmental delay in congenital myotonic dystrophy after neonatal intensive care.

Six infants with congenital myotonic dystrophy survived after neonatal intensive care. In later childhood they were assessed by the Griffiths Mental Development Scales: five children were functioning in the mildly handicapped to borderline range of development (DQ 64.0 to 79.0) and the remaining child was severely delayed in development (DQ 33.0). The five children with higher DQ values had a history of ventilatory support of 30 days or less after birth. By contrast, the remaining child with the lowest DQ value had been ventilated for 43 days. This study provides further evidence that prolonged ventilation after birth has prognostic significance in identifying severely affected cases with congenital myotonic dystrophy.

Child, Preschool↗

[Difficulties in the evaluation of depressive symptoms in patients with dementia].

Depressive symptoms are often found in dementia (up to 86 %). Therefore, adequate treatment is necessary. Depressive symptoms appear significantly more often in vascular dementia than in dementia in Alzheimer's disease, but severity and profile of depressive symptomatology are independent of the etiology of dementia. The aim of this review is to help clinicians to select appropriate psychometric instruments to identify and measure depressive symptomatology in dementia. Frequently used scales are described, e.g. the Dementia Mood Assessment Scale and the Cornell Scale for Depression in Dementia - specific scales developed for rating severity of depression in dementia - and the Geriatric Depression Screening Scale. Methodological problems and limitations of psychopathological assessment in dementia caused by restriction of self-report, information gathered by collateral sources, manifestations of age and interference of somatic symptoms are discussed.

Aged↗

Dimensionality of military job satisfaction items: an exploratory factor analysis of data from the spring 1996 Sample Survey of Military Personnel.

The Sample Survey of Military Personnel in the spring of 1996 asked detailed questions of Army personnel about job satisfaction. Maximum likelihood factor analysis yielded four factors: satisfaction with supervision, with job environment, with the duty specifically, and with opportunity for development, factors similar to those used in Smith's Job Descriptive Index, 1992. Scales developed from these factors showed acceptable internal consistency reliability and correlated as expected with measures of satisfaction with Army life, retention, morale, combat preparedness, and overall job satisfaction. Some divergent validity was established with measures of personal/family stress and with previous job stress. Demographic data suggested that soldiers with higher education found more satisfying job opportunities while those with higher rank, more years of service, and higher age reported greater satisfaction with job fulfillment, perhaps a consequence of selection effects.

Adult↗

Are life satisfaction and self-esteem distinct constructs? A black South African perspective.

As part of a longitudinal project on Quality of Life, a study was undertaken to extend the applicability of the 5-item Satisfaction With Life Scale, developed in the USA, in South Africa. Data on basic sociodemographic characteristics, the scale, and the 10-item Rosenberg Self-esteem scale were available for 360 Black South Africans (151 men and 209 women), ages 21 to 83 years (M = 38.6 yr., SD = 10.3). Factor analysis applied to scale scores gave two factors, accounting for 71% of the variance. Factor I was loaded by 10 Self-esteem items and Factor II by four of the five Life Satisfaction items. Coefficient alpha was .77 for the Satisfaction With Life Scale and .97 for the Rosenberg Self-esteem Scale. Life Satisfaction was related to Self-esteem (r = .17, p < .01). It was concluded that Life Satisfaction and Self-esteem appear to be distinct, unitary constructs, but responses to Item 5 on the Satisfaction With Life Scale require cautious interpretation and may contribute to the weak r, although so may the collectivist culture of Black South Africans.

Adult↗

[A study of factors influencing the state of adaptation of hemiplegic patients].

The purposes of this study are to delineate a profile of the state of a stroke patient's adaptation at 3 months after hospitalization and to explore the relationship between the level of adaptation and the variables which influence the adaptation of hemiplegic patients. To these ends, theoretical framework was derived basically from the stress adaptation model. The basic assumption underlying the level of adaptation is influenced by the presenting focal, contextual and residual stimuli. This group of stimuli is further operationalized and represented by a perception of stress, which is the perceived effect of the disability and by the mediating variables such as sociodemographic factors as an external conditioning variables and perceived social support and hardiness personality characteristics as an internal intervening variables. The dependent variables in this study is the level of physical, psychological and social adaptation and is hypothesized to be a function of the interaction between 3 sets of variables namely, the perceived disability effect, external conditioning variables and internal intervening variables. A total of fourty three subjects from 3 general hospitals in Seoul were observed and interviewed with the aid of 7 structured instruments. The data were collected twice on each subject: first, at the pre-discharge period and at 3 months post-discharge from hospital for the second time. The study was carried out for the period from February to August, 1988. The instruments used for the study include 4 existing scales and 3 scales developed by the researcher for this study. They are: 1) The ADL dependency scale and the scale of the clinical physical functions for the assessment of physical adaptation. 2) the SDS (self report of depression) to measure the level of psychological adaptation. 3) The scale for the amount of social activities for the measurement of the level of social adaptation. 4) The scale for the perceived effect of disability for the measurement of the focal stimuli. 5) The health related hardiness scale and the perceived interpersonal support self evaluation list (ISEL) for the measurement of the hardiness personality character and the perceived social support. The data obtained were analyzed using percentage, one way ANOVA, Pearson coefficients correlation and stepwise multiple regression. The findings provide valuable information about the present level of physical adaptation at 3 months after discharge. The patient revealed a decreased ADL dependency and lowered limitation of physical function as compared with pre-discharge state. Psychologically, the average degree of depression at follow up was within normal range of depression.(ABSTRACT TRUNCATED AT 400 WORDS)

Activities of Daily Living↗