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PubMedDate not supplied

Predicting iron-fortified soy sauce consumption intention: application of the theory of planned behavior and health belief model.

OBJECTIVE: To identify variables that significantly predict the intention of iron ethylenediaminetetraacetic acid (NaFeEDTA)-fortified soy sauce (FeSS) consumption. DESIGN: A cross-sectional questionnaire survey, based on the Theory of Planned Behavior (TPB) and Health Belief Model (HBM), was administered, and a multistage, stratified sampling method was carried out to select study samples. SETTING: Urban and rural areas in Guizhou province, China. SUBJECTS: 636 women from rural areas and 454 from urban areas completed 1090 eligible questionnaires. VARIABLES MEASURED: Women's knowledge of FeSS; perceived severity and susceptibility of iron deficiency (ID) or iron deficiency anemia (IDA); and attitudes toward behavior, control beliefs, barriers, cues, intention to buy FeSS, health value, and health behavior identity factors were measured. ANALYSIS: A path analysis was conducted to test the goodness of fit of the model and to modify the model. Scale and factor analyses were conducted to verify the scale's reliability and construct validity. The alpha level was set at .05. RESULTS: The model explained 35% to 55% of the variance of behavioral intention. FeSS knowledge directly and indirectly affected the intention to buy FeSS. The behavioral intention was also impacted by women's health value and perception of perceived susceptibility and severity of IDA through the behavior identity and attitudes toward behavior. Cues, as an external factor, greatly affected the intention. The external control belief was a weak factor affecting intention. IMPLICATIONS FOR RESEARCH AND PRACTICE: Integrated TPB and HBM explained the behavioral intention of FeSS consumption among women in Guizhou, China. Nutrition education should emphasize behavioral attitudes and identity, and improve knowledge of FeSS and perception of ID and IDA, which would relieve anxiety about FeSS.

Adult↗

PubMedDate not supplied

Children's understanding of the distinction between intentions and desires.

Much of the previous research on children's understanding of intentions confounded intentions with desires. Intentions and desires are different, in that a desire can be satisfied in a number of ways, but an intention must be satisfied by carrying out the intended action. Children 3 through 7 years of age and adults were presented with situations in which intentions were satisfied but desires were not, or vice versa, in a story-comprehension task (N = 71) and a target-hitting game (N = 45). Although 3- and 4-year-olds were unable to differentiate desires and intentions consistently, 5- and 7-year-olds often matched the adult pattern. Younger children's difficulties in understanding intentions are discussed in terms of their use of a desire-outcome matching strategy and the representational complexities of intentions.

Child↗

PubMed2006

Nurse intention to remain employed: understanding and strengthening determinants.

AIM: This paper reports a study testing a hypothesized model of the determinants of nurse intention to remain employed in current hospitals of employment. BACKGROUND: Previous research has shown that stronger nurse intention to remain employed is associated with higher job satisfaction, higher organizational commitment, higher perceived manager support, lower burnout, higher work group cohesion, being older, having more years of nursing experience and having lower levels of education. METHODS: A descriptive survey design was adopted. Over 13,000 Ontario, Canada nurses were invited to complete a mailed survey between February and May 2003. The Ontario Nurse Survey includes instruments and items measuring job satisfaction, burnout, professional nursing practice environment, demographic characteristics of nurse respondents and items about intention to remain employed. Two multiple regression models, one including all variables and the other using a stepwise method, were used to test the proposed model. RESULTS: Regression models explained 34% of variance in nurse intention to remain employed. The strongest predictors were nurse age, overall nurse job satisfaction and years of employment in the current hospital. Although the proposed model hypothesized six categories of predictors of intention to remain employed, only four of these were statistically significant determinants of nurse intention to remain: job satisfaction, personal characteristics of nurses, work group cohesion and collaboration, and organizational commitment of nurses. The other two categories of predictors, nurse burnout and nurse manager ability and support, may be predictors of job satisfaction and have indirect effects on intention to remain employed that are mediated through job satisfaction. CONCLUSION: Possible strategies to strengthen predictors of intention to remain employed include employment practices that reflect moral integrity, incorporate clear communication systems, maximize employee involvement in decision-making, promote praise and recognition, and establish a shared vision and goals.

Adult↗

PubMed2006

The impact of role discrepancy on nurses' intention to quit their jobs.

AIMS AND OBJECTIVE: The purpose of this study was to investigate the impact of role discrepancy on nurses' intention to quit their jobs. BACKGROUND: Nurses experience role discrepancy, which refers to incompatibility between the roles nurses desire and expect to take, and the roles they actually engage in at work. However, there is a paucity of information as to how this role discrepancy affects nurses' intention to quit their jobs. DESIGN: A correlational design was used to investigate the impact of role discrepancy on nurses' intention to quit their jobs. METHODS: A total of 346 Australian nurses participated in this study by completing questionnaires. The results were analysed by t-test, polynomial regression and response surface analysis. RESULTS: Nurses tended to experience role discrepancy, in particular, in decision making with hospital policies and provision of patient education. The overall results show that this role discrepancy contributes to nurses' intention to quit their jobs. Nurses' intention to quit their jobs also increased when they had a low desire to engage in nursing roles and when they only performed a few roles. When specific dimensions of nursing roles were examined, a role discrepancy in the use of nursing skills, such as participation in decision making and providing patient education and emotional support, had little impact on their turnover intention. On the contrary, a role discrepancy in task delegation practice showed a significant association with nurses' intention to leave their jobs. CONCLUSIONS: Role discrepancy has been experienced by many nurses, and this discrepancy partially contributes to nurses' intention to quit their jobs. RELEVANCE TO CLINICAL PRACTICE: To reduce nursing turnover, it is important to create a work environment where nurses are inspired to engage in various nursing roles and their work desires are reinforced by existing work opportunities.

Analysis of Variance↗

PubMed2004

Predictors of nurses' intent to stay at work in a university health center.

The purpose of the present study was to evaluate nurses' intent to stay at work and to determine the associations between intent to stay and various predictors. A sample of 108 nurses at a single tertiary care hospital filled in a questionnaire on intent to stay, satisfaction at work, satisfaction with administration, organizational commitment and work group cohesion. The results showed that the majority of nurses are planning to stay in their current job. Satisfaction at work and satisfaction with administration are the best predictors of intent to stay and explained 25.5% of intent to stay variance. It is possible that developing strategies based on the predictors of intent to stay at work could improve that intent. Healthcare organizations could consider this with the objective of increasing nurses' intent to stay at work and, consequently, retention.

Academic Medical Centers↗

PubMed2005

Hospital ethical climates and registered nurses' turnover intentions.

PURPOSE: To investigate (a) the effects of hospital ethical climates on positional and professional turnover intentions of registered nurses, and (b) the relationships among demographic factors, employment characteristics, and positional and professional turnover intentions of registered nurses. DESIGN: A cross-sectional study of randomly selected registered nurses (n=463) in Missouri, USA, conducted in 2003 and 2004. METHODS: A self-administered questionnaire containing the Hospital Ethical Climate Survey, the Anticipated Turnover Scale, and the Nursing Retention Index was used to assess registered nurses' perceptions of the hospital ethical climate and their intentions to leave their position or the nursing profession. Descriptive statistics, Pearson product-moment correlations, and hierarchical regression techniques were used to analyze the data. FINDINGS: The hospital ethical climate explained 25.4% of the variance in positional turnover intentions and 14.7% of the variance in professional turnover intentions. Together, hospital ethical climate, control over practice, the use of educational reimbursement as a retention strategy, gender, and staff sufficiency explained 29.7% of the variance in positional turnover intentions. Hospital ethical climate, patient load, and control over practice together explained 15.8% of the variance in professional turnover intentions. CONCLUSIONS: Of the variables included in this analysis, the hospital ethical climate was most important in explaining nurses' positional and professional turnover intentions.

Analysis of Variance↗

PubMed2005

Intentionality: evolutionary development in healing: a grounded theory study for holistic nursing.

Although intentionality has been implicated as a causal variable in healing research, its definition has been inconsistent and vague. The objective of this grounded theory study is to develop a substantive theory of intentionality in a naturalistic encounter between nurse-healers and their healee-clients, and to consider the implications for practice and research. Six expert nurse-healers and six healee-clients were interviewed as individuals and in dyads before and after treatments. Interviews and observational data were analyzed using the constant comparative method and synthesized analysis. Participants described their experience of intentionality in healing as an evolutionary process characterized by distinctive shifts. The theory of intentionality: the matrix for healing (IMH) includes definitions of intentionality and a conceptual framework of three developmental phases of intentionality (generic, healing, and transforming intentionalities). The predominant attribute, development, is described. The theory contributes to knowledge about healing and intentionality and has implications for practice and future research.

Adult↗

PubMed2006

Exercise use as complementary therapy among breast and prostate cancer survivors receiving active treatment: examination of exercise intention.

BACKGROUND: Exercise is associated with an improved quality of life among cancer survivors. Previous research has highlighted the utility of the theory of planned behavior in understanding cancer survivors' intention to exercise. The purpose of this study was to extend the research on the theory of planned behavior in relation to exercise intention in breast cancer survivors and to provide preliminary evidence supporting its application with prostate cancer survivors during treatment. METHODS: Participants consisted of 126 breast and 82 prostate cancer survivors receiving active treatment. Participants completed self-administered, mail-in questionnaires that assessed demographic and medical variables, past exercise, and the theory of planned behavior. RESULTS: For breast cancer survivors, the results revealed that attitudes, subjective norm, and perceived behavioral control explained 66% of the variance in exercise intention with the instrumental component of attitude, subjective norm, and perceived behavioral control making significant unique contributions to intention. For prostate cancer survivors, attitudes, subjective norm, and perceived behavioral control explained 57% of the variance in exercise intention, with subjective norm and perceived behavioral control making significant unique contributions to intention. CONCLUSIONS: The results provide further support that the theory of planned behavior is a useful framework for understanding determinants of exercise intention in breast cancer survivors undergoing active treatment and preliminary support for prostate cancer survivors undergoing active treatment. When designing exercise interventions, differences in breast and prostate cancer survivors' exercise intention merit consideration.

Aged↗

PubMed2006

Attitude, beliefs, and intentions to care for SARS patients among Korean clinical nurses: an application of theory of planned behavior.

PURPOSE: This study examined Korean clinical nurses' intentions to care for SARS patients and identify determinants of the intentions. Theory of planned behavior was the framework to explain the intentions of Korean nurses for SARS patients care. METHODS: A convenient sample of six hundreds and seventy nine clinical nurses from four university-affiliated hospitals located in Seoul and in Kyung-gi province was used. Self-administered (83-items) questionnaire was used to collect data. Intentions, attitude, subjective norm, perceive behavioral control, behavioral beliefs, normative beliefs, and control beliefs were the study variables. All items were measured using 7-point Likert scale (-3 to +3). Data were analyzed using descriptive statistics, Pearson correlation method, and stepwise multiple regression methods. RESULTS: Intentions and attitudes toward SARS patient care among Korean clinical nurses were moderate, but their subjective norm and perceive behavioral control of SARS patients care were negative. Stepwise multiple regression analysis indicated that attitude toward SARS patient care, perceived behavioral control, subjective norm were the determinants of the intentions for SARS patients care as theory proposed. Among the behavioral beliefs, "SARS-patient caring would be a new experience", "during SARS-patient caring, I should be apart from my family", "after completing SARS-patient caring, I would be proud of myself being able to cope with a stressful event" and "with my SARS-patient caring, patients could recover from SARS" were the significant determinants. Among the normative beliefs, colleague approval, spouse approval, and physician approval were significant determinants of the intentions. Among the control beliefs, "SARS-patient caring would be a challenge" "SARS-patient caring is a professional responsibility", "tension during the care of SARS patients" and "support from team members" were the significant determinants of the intentions. CONCLUSIONS: Korean clinical nurses in this study were not willing to care for SARS patients and showed negative attitude toward the care. They believed their friends and family were not approved their care for SARS patients. Nurses were in conflicts between professional responsibilities to care for SARS patients and personal safety. This study was the first to understand stress and burden of Korean clinical nurses who are in front line to care for newly developed communicable disease such as SARS. Under the circumstance where several fatal communicable diseases are predictable, conflicts between professional responsibility and their personal risks should be taken into considerations by nurses themselves and by nursing administrators in order to improve quality of care.

Adult↗

PubMedDate not supplied

Intentionality forms the matrix of healing: a theory.

UNLABELLED: The understanding of intentionality in a healing context has been incomplete and confusing. Attempts have been made to describe it as a concrete mental force in healing while healing has been accepted as a nonlocal phenomenon. This paper reviews several definitions and theoretical frameworks of intentionality. It proposes a new integrative theory of intentionality, Intentionality: the Matrix of Healing. The theory proposes definitions, forms, and phases of intentionality, a process of development and mediators that sculpt intentionality in healing. The theory has implications for conceptualizing intentionality and provides a framework for continued exploration of the nature of intentionality in healing for scholars as well as clinicians. SETTING: This study was done as a Doctoral dissertation at New York University, School of Education, Division of Nursing.

Consciousness↗

PubMed1996

Childhood victims of violence. Hospital utilization by children with intentional injuries.

OBJECTIVE: To describe the utilization of hospital resources by children admitted with intentional injuries. METHODS: A sample of medical records for patients 14 years old and younger admitted to a pediatric tertiary care teaching hospital with a level I pediatric trauma center between January 1, 1991, and December 31, 1992, with intentional injuries (external cause codes E950 to E969) and unintentional injuries (E800 to E949) were reviewed after identification from the trauma center and hospital discharge registries. RESULTS: Of 1495 patients admitted for injuries, 95 had intentional injuries. Among these, 36% were caused by child abuse, 37% were caused by assaults, and the remainder were associated with suicide attempts. Compared with all unintentionally injured patients, those with intentional injuries were similar in gender and race but were significantly older (P<.001). Compared with a randomly selected sample of unintentionally injured patients matched for age, gender, and race, intentionally injured patients had longer mean hospital stays (P<.001), had more medical consultations (P<.001), were more likely to be discharged to sites other than home (P<.001), and had higher hospital charges (P=.007). While intentionally injured children had higher Injury Severity Scores (P=.002), their longer hospital stays were independent of injury severity. CONCLUSIONS: Intentionally injured children use more hospital resources and consequently incur higher hospital charges than those with unintentional injuries. Injury acuity contributes to this phenomenon, as do complex social needs. These data suggest that efforts directed at preventing intentional injuries will significantly affect injury-related health care costs.

Adolescent↗

PubMed2003

Understanding intention to undergo colonoscopy among intermediate-risk siblings of colorectal cancer patients: a test of a mediational model.

BACKGROUND: There is a need for research to identify factors influencing intentions to undergo colorectal cancer (CRC) screening among family members at risk for CRC. This study tested a mediational model primarily guided by Ronis' elaboration of the Health Belief Model in predicting intention to have colorectal cancer screening among siblings of individuals diagnosed with colorectal cancer prior to age 56 years. METHODS: Data were collected from 534 siblings of individuals diagnosed with CRC. A baseline survey was administered by telephone. Measures included perceived susceptibility, CRC severity, physician and family support for CRC screening, cancer-specific distress, the closeness of the relationship with the affected sibling, and future intention to have a colonoscopy. Participant age, gender, and number of prior colonoscopies, as well as the stage of the affected patient's cancer and time from the patient's diagnosis to the interview, were controlled for in the analyses. RESULTS: The proposed model was not a good fit to the data. A respecified model was fit to the data. In this model, physician support, family support, and sibling closeness were significantly associated with both perceived benefits and barriers. Perceived severity was associated with barriers. Benefits and barriers, as well as cancer-specific distress, were directly associated with colonoscopy intentions. Results were consistent with a mediational role for benefits and barriers in the associations of sibling closeness and with a mediational role for barriers in the association between perceived severity and colonoscopy intentions. Family and physician support impacted intentions both directly and indirectly through effects on benefits and barriers. Perceived risk was not associated with benefits, barriers, or colonoscopy intentions. CONCLUSION: Intervention efforts to increase colonoscopy intentions may benefit from targeting family influences, particularly the affected proband in the family, as well as physician influence, cancer-related distress, perceived CRC severity, and perceived benefits and barriers to colonoscopy.

Colonoscopy↗

PubMed2006

Intentionally hastening death by withholding or withdrawing treatment.

PURPOSE: This study aims to provide empirical data on physicians' intentions in withholding and withdrawing treatment, and to discuss possible implications for the ethical debate. BASIC PROCEDURES: The data presented come from EURELD, a large research project designed to investigate medical end-of-life decisions in six European countries. A continuous random sample of death certificates formed the basis for contacting doctors who had attended the deceased; the doctors were asked to complete, strictly anonymously, mail questionnaires on the decisions taken at the end of their patients' lives. MAIN FINDINGS: In the six countries studied, physicians reported they had the explicit intention of hastening the end of life in 45% of all treatments that were withheld/ withdrawn. The highest numbers of cases with an underlying intention of hastening the end of life were found in Switzerland and Sweden (52% and 51%, respectively); the lowest figures came from Denmark and Belgium (36% and 38%). Middle-ranking countries were Italy (42%) and the Netherlands (45%). Overall, dialysis and respiration were comparatively more often forgone with the explicit intent to hasten the end of life (57% and 54%, respectively), whereas a particularly low percentage of cases with such an explicit intention was found for oncotherapy (34%). PRINCIPAL CONCLUSIONS: In almost every second case, a medical decision to withhold or withdraw treatment is taken with the explicit intention of hastening the end of the patient's life. No clear association can be found between the intent to hasten the end of life and features of the treatment forgone that can be determined objectively, such as the likelihood and extent of a life-shortening effect, the immediacy of death, or the expected burden of any potential life-sustaining measure. The findings of the study challenge the usefulness of doctors' intentions with regard to hastening the end of life as criteria for moral judgements on decisions to withhold or withdraw medical treatment.

Critical Care↗

PubMed2004

Tizanidine for the treatment of intention myoclonus: a case series.

OBJECTIVE: To evaluate the effectiveness of tizanidine in treating intention myoclonus. DESIGN: Case series. SETTING: Inpatient rehabilitation center. PARTICIPANTS: Three subjects whose activities of daily living were impaired due to intention myoclonus related to mitochondrial encephalomyopathy, stroke, and multiple sclerosis (MS). INTERVENTION: Tizanidine. MAIN OUTCOME MEASURES: Reduction in intention myoclonus and change in score on the FIM instrument. RESULTS: The patient with mitochondrial encephalomyopathy had left upper- and lower-extremity intention myoclonus; the patient with stroke had left upper intention myoclonus; and the patient with MS had right upper- and left lower-intention myoclonus. In the patient with mitochondrial encephalomyopathy, the FIM score increased from 90 to 103 points over 2 days of tizanidine. The stroke patient's FIM score improved only from 74 to 79 after 4 weeks of tizanidine. The patient with MS improved from 83 to 101 after 6 days of tizanidine. All 3 patients had almost full resolution of the intention myoclonus. All continued on tizanidine except the patient with stroke, who had minimal gains and a low systolic blood pressure. None of the patients experienced significant sedation or hypotension. CONCLUSIONS: Tizanidine may be a safe and effective option for treating intention myoclonus that occurs in a variety of neurologic conditions.

Adolescent↗

PubMed2005

Understanding and sharing intentions: the origins of cultural cognition.

We propose that the crucial difference between human cognition and that of other species is the ability to participate with others in collaborative activities with shared goals and intentions: shared intentionality. Participation in such activities requires not only especially powerful forms of intention reading and cultural learning, but also a unique motivation to share psychological states with others and unique forms of cognitive representation for doing so. The result of participating in these activities is species-unique forms of cultural cognition and evolution, enabling everything from the creation and use of linguistic symbols to the construction of social norms and individual beliefs to the establishment of social institutions. In support of this proposal we argue and present evidence that great apes (and some children with autism) understand the basics of intentional action, but they still do not participate in activities involving joint intentions and attention (shared intentionality). Human children's skills of shared intentionality develop gradually during the first 14 months of life as two ontogenetic pathways intertwine: (1) the general ape line of understanding others as animate, goal-directed, and intentional agents; and (2) a species-unique motivation to share emotions, experience, and activities with other persons. The developmental outcome is children's ability to construct dialogic cognitive representations, which enable them to participate in earnest in the collectivity that is human cognition.

Aging↗

PubMed2000

The stability of pregnancy intentions and pregnancy-related maternal behaviors.

OBJECTIVES: Our objectives were to characterize the stability of pregnancy intention and to examine whether stability is associated with the timing of prenatal care initiation, smoking during pregnancy, and breastfeeding. METHODS: We use a sample of women from the National Longitudinal Survey of Youth (NLSY) for whom information on pregnancy intention was collected both during pregnancy and after delivery. In bivariate analyses we compare outcomes and characteristics of women whose pregnancy intention changed between the prenatal and postpartum periods. With multivariate methods, we analyze the correlates of switching pregnancy intention as well as the association between switching and maternal behaviors. RESULTS: Women whose pregnancy intention changes between the two assessments are similar in marital status and socioeconomic background to those who report both during pregnancy and after delivery that the pregnancy is unintended. Disagreement during pregnancy between the parents' pregnancy intentions is the most important predictor of instability in the mother's pregnancy intention. Effects of unintended pregnancy on the timing of initiation of prenatal care, smoking during pregnancy, and breastfeeding based on reports after delivery are smaller than those based on reports during pregnancy, although differences are not statistically significant. Adverse effects of unintended pregnancy are greater when pregnancies reported by the mother to be unintended at either assessment are combined into a single category for unintended pregnancy. CONCLUSION: Unstable pregnancy intention may be a marker for adverse maternal behaviors related to infant health.

Adolescent↗

PubMed1989

Intentional injuries among children and adolescents in Massachusetts.

We estimated age-specific and sex-specific incidence rates of intentional injuries (assaults or suicide attempts) occurring between 1979 and 1982 in a population of 87,022 Massachusetts children and adolescents under 20 years of age in 14 communities with populations of 100,000 or less. The average annual incidence of intentional injuries treated at a hospital was estimated to be 76.2 per 10,000 person-years. Overall, 1 in 130 children was treated each year for an intentional injury. More than 85 percent of the injuries resulted from assaults, such as fights, rape, and child battering; 11.4 percent were self-inflicted. Intentional injuries were most common among adolescents. Each year, 1 in 42 teenage boys was treated for an assault-related injury, and 1 in 303 teenage girls was seen for a suicide attempt. Repeated episodes of intentional injury were identified in 4.3 percent of the children. In this population, intentional injuries accounted for 3.4 percent of all injuries but 9.8 percent of hospital admissions and 15.7 percent of deaths from injury. The rate of intentional injury was directly correlated with both the degree of urbanization and the poverty level of the community of residence. We conclude that intentional injuries are relatively common in this population and that attempts to prevent them must be directed to the children who are at greatest risk.

Adolescent↗

PubMed2006

Mental health functioning (SF-36) and intentions to retire early among ageing municipal employees: the Helsinki Health Study.

AIMS: To examine the associations of mental health functioning with intentions to retire early among ageing municipal employees. METHODS: Cross-sectional survey data (n = 7,765) from the Helsinki Health Study in 2000, 2001, and 2002 were used. Intentions to retire early were sought with a question: "Have you considered retiring before normal retirement age?" The dependent variable was divided into three categories: 1 = no intentions to retire early; 2 = weak intentions; 3 = strong intentions. Mental health functioning was measured by the Short Form 36 (SF-36) mental component summary (MCS). Other variables included age, sex, physical health functioning (SF-36), limiting longstanding illness, socioeconomic status, and spouse's employment status. Multinomial regression analysis was used to examine the association of mental health functioning with intentions to retire early. RESULTS: Employees with the poorest mental health functioning were much more likely to report strong intentions to retire early (OR 6.09, 95% CI 4.97-7.47) than those with the best mental health functioning. Adjustments for physical health, socioeconomic status, and spouse's employment status did not substantially affect this association. CONCLUSIONS: The findings highlight the importance of mental health for intentions to retire early. Strategies aimed at keeping people at work for longer should emphasize the importance of mental well-being and the prevention of poor mental health. More evidence is needed on why mental problems among ageing baby-boomer employees are giving rise to increasing social consequences, although the overall prevalence of mental problems has not increased.

Adult↗