Deborah I. Frank

Health beliefs, health locus of control, and women's mammography behavior.

Research has shown that routine mammography screening can significantly reduce mortality from breast cancer. The use of mammography screening, however, remains well below national goals. In an effort to understand the factors that influence womens mammography behaviors, this study explored the relation between health beliefs, locus of control, and womens mammography practice. Survey instruments used were Champions health belief scales and the Multidimensional Health Locus of Control (MHLC) scales. The study used a convenience sample of 25 African Americans and 72 white women ages 35 to 84. Findings showed that women who participated in mammography screening were significantly more likely to perceive greater benefits, greater health motivation, and fewer barriers to screening than those who did not participate. These same three variables were similarly associated with greater frequency of receiving mammograms. It also was found that perceived benefits and health motivation were significantly correlated with shorter duration of time since the last mammogram. No support was found for perceived susceptibility, perceived seriousness, and health locus of control as predictors of womens mammography behavior. Implications for nursing research in further examining the MHLC and the Health Belief Model construct of susceptibility as they relate to mammography behavior are identified. Practice implications for nurses are suggested.

Caregivers of chronically ill elderly: perceived burden.

Family members play a major role in providing caregiving assistance to elderly persons and their families. The effect of stressors on family members caring for a physically or mentally ill person has been referred to as caregiver burden. It is an important concern and will become more so with the inevitable aging of the population. Community health and home health nurses must be able to recognize those factors associated with caregiver burden to effectively render care to their clients and families. This study examined caregiver characteristics and the degree to which these variables affect caregiver burden. Although much research focuses on caregivers of Alzheimers clients, this research utilized a wider variety of client diagnoses to examine caregiver burden of those clients. A sample representing 88 caregivers of elderly chronically ill persons was obtained from various sources in the community. Demographic data about the caregiver was collected. The amount of burden they experienced was recorded using the Burden Interview (Zarit et al., 1986). This study found that there was a positive correlation between increased activities of care performed by the caregiver and caregiver burden. This included both the provision of direct care such as bathing and indirect care such as running errands, preparing meals, and performing housework. It was found that sons, as caregivers, reported significantly less burden than did daughters or other relatives. Community health and home health nurses working with families in a caregiving situation have an opportunity to reduce caregiver burden. This is done by assessment of the caregiving environment and implementation of plans for early intervention.

Employer Attitudes Toward Breastfeeding in the Workplace

A descriptive, exploratory study of 69 male and female employers was done in a small rural community to determine their attitudes toward breastfeeding or expressing milk in the workplace. Business variables, such as experience working with women who have breastfed and knowledge of other businesses who have employed breastfeeding women, appeared to be better predictors of a positive level of support toward breastfeeding in the workplace than personal attributes, such as age, education level, and personal history with a spouse or friend who breastfed. The health care provider needs to become instrumental in promoting breastfeeding in the workplace by focusing on the positive effects on the business and providing employers with successful examples of workplace breastfeeding programs.

Meeting the needs of rural families during critical illness: the APN's role.

Family needs during critical illness have been a major focus of nursing research, yet the unique needs of families living in rural America still need to be investigated. This study sought to identify the needs of families in rural southern Appalachia and compare these findings to those from a study that identified the needs of families in a large metropolitan medical center. We found 13 needs to be significantly different between the rural and urban samples and suggest strategies that rural and urban critical care nurses and advanced practices nurses can use to care for families of critically ill patients from rural areas.

Gender differences in decision making about infertility treatment.

The purpose of this descriptive study was to investigate gender differences in decision making about infertility treatment. The sample included 40 male and 107 female RESOLVE members. A questionnaire was used with which subjects rank ordered the importance of 14 factors that could influence the decision to undergo various infertility treatments. Gender differences in the importance of factors considered when making decisions about medical and surgical treatment options were explored. Men accorded more importance to the potential side effects when making decisions to pursue medical or surgical options than did women. Women, on the other hand, viewed the probability that the medical-surgical regimens or procedures would be effective as a more important factor in influencing their decisions about these options than did men. The author suggests that women may place more emphasis on treatment outcome than do men. Instead, men may focus on each individual treatment step involved in the process of becoming pregnant.

The Relationship of Social Support to Women's Obtaining Mammography Screening

&NA; This study examined the relationship between social support and obtaining mammography screening. Fifty women, half of whom had undergone mammography, were matched for age and ethnicity and interviewed related to perception of their social support networks. Results revealed a significant difference in the levels of social support and mammography screening. Women who had undergone mammography perceived a higher level of social support than those who had not. Parses Theory of Human Becoming was used as a framework to discuss nursing implications of the findings.

Attitudes, practices, and role of nurses in the use of mammography

This research examined the mammography behavior of 145 nurses as well as their patient teaching practices about mammography. A subsample of 100 were identified as compliant or noncompliant with mammogram screening guidelines. Nurses who complied and those who did not comply were not significantly different on variables of age, licensure, education level, or clinical practice setting. Nor was a positive family history associated with compliance. In patient teaching about mammography, only 25% of nurses reported teaching. The vast majority of nurses, 75%, rarely or only occasionally did the patient teaching. Reasons cited for not teaching included not thinking about it and feeling unqualified to do this teaching. However, all nurses thought it was important for educating nurses about the need to teach women about mammography screening. The health belief model was applied as a framework for further research exploring nurses educating women about mammography.

Relationship factors as predictors of causal attributions about sexual experiences

This study investigated the relation between general relationship satisfaction and sexual satisfaction by seeking to identify which aspects of ones relationship would predict attributions made about sexual experiences. Subjects were 233 male and female graduate and undergraduate students who were asked to rate the extent to which self, partner, situational, and relationship factors were causes for sexually satisfying and unsatisfying experiences. General relationship satisfaction, phase of relationship involvement, depth of sexual involvement, importance of sexual satisfaction to overall relationship contentment, sexual history, and gender were variables entered into multiple regression analysis to identify the “best fit” model predicting causal attributions to each dimension. Findings revealed that relationship satisfaction and gender appeared to contribute to a reliable “best fit” model which predicted attributions to the sexual relationship for satisfying sexual outcomes. Sexual history was a strong predictor variable, occurring in the best fit models for all but two attribution dimensions; other relationship variables were not strong contributors to predictive models. Finally, the inclusion of an interpersonal attributional dimension, the relationship, appeared to be highly relevant when persons identified explanations for their sexual experience outcomes. Implications of the findings and suggestions for further research are discussed.

coping Strategies of Rural Families of Critically Ill Patients

ABSTRACT This study explored the coping strategies of families of critically ill patients in a rural Southern Appalachian setting. A convenience sample of 30 family members of 22 critically ill patients in two rural hospitals completed the Jaloweic Coping Scale. The five most frequently used coping methods were helping, thinking positively, worrying about the problem, trying to find out more about the problem and trying to handle things one step at a time. The five most effective coping strategies were talking the problem over with friends, praying, thinking about the good things in life, trying to handle things one step at a time and trying to see the good side of the situation. Findings contradicted many of the more “negative” descriptions of Appalachian people in the literature. Similarities outweighed differences when comparing the coping styles of rural and urban populations. Findings suggest that coping strategies must be considered for positive outcomes in the delivery of care to such a rural population.

Alcohol Use and Sexual Arousal Research: Application of the Health Belief Model

This article summarizes research findings related to alcohol use and sexual responsiveness within the framework of Beckers health belief model. Application is discussed in relation to the health care practitioner concerned with interventions for preventing alcohol abuse and promoting sexual health. Particular emphasis is given to clients in late adolescence.