Eileen Gigliotti

Women’s Multiple Role Stress: Testing Neuman’s Flexible Line of Defense

Women who are both mothers and students are at high risk for experiencing multiple role stress. In this exploratory study guided by Neuman’s conceptual model, the conditions under which role stress develops in these women were examined. Specifically, the moderating capabilities of the psychological and sociocultural variables in the flexible line of defense, psychological role involvement and perceived social support, were investigated. It was found that these two variables interacted to explain role stress only in the presence of the developmental variable, maternal age. Recommendations concerning conceptual and empirical specification of Neuman’s model are presented.

A confirmation of the factor structure of the Norbeck Social Support Questionnaire.

BackgroundThe Norbeck Social Support Questionnaire was designed to measure three functional types of social support: (a) affect, (b) affirmation, and (c) aid. Due to high intercorrelations among factors, it has been impossible to empirically disentangle these three factors using exploratory factor analysis. ObjectiveTo confirm the originally hypothesized three-factor structure of the Norbeck Social Support Questionnaire by imposing theoretically motivated constraints upon the model. MethodWith pooled data (N = 457) from two previous studies, the parameters of the hypothesized LISREL model were estimated by the Generally Weighted Least Squares Method using an asymptotic covariance matrix. ResultsThe Norbeck Social Support Questionnaire measures three functional types of social support: (a) AFFECT, (b) AFFIRMATION, and (c) AID (χ2 = 8.42, df = 6, p = .208). These three factors are highly correlated and their unique error terms are uncorrelated. ConclusionsThe Norbeck Social Support Questionnaire is a valid and reliable measure of total network support, as well as three functional types of social support. The three functional types of social support should be calculated and used in analyses, when appropriate. To support the development of context-specific theories, the efficacy of specific functional types of social support from specific network members should be investigated.

Using Conceptual Models of Nursing to Guide Nursing Research: The Case of the Neuman Systems Model

Conceptual models of nursing inform thinking and give meaning and direction to nursing research. The Neuman systems model is used to exemplify the following five steps, which provide specific direction for conceptual modelbased research: (a) Develop a comprehensive understanding of the substantive content and research rules of the conceptual model, (b) review existing research guided by the conceptual model, (c) construct a conceptual-theoretical empirical structure, (d) clearly communicate the conceptual-theoretical-empirical structure, and (e) conclude the report with an evaluation of the empirical adequacy of the middle-range theory and the credibility of the conceptual model.

Use of Neuman's Lines of Defense and Resistance in Nursing Research: Conceptual and Empirical Considerations

The generation of testable nursing theory requires operationalization of the broad concepts embedded in nursings conceptual models or grand theories. Operationalization of the Neuman systems model concepts, the flexible line of defense and the lines of resistance, are explored in this article. Conceptual and empirical concerns imposed on the researcher when employing the model are discussed.

Development of the Perceived Multiple Role Stress Scale (PMRS).

Assessment of women’s perception of multiple-role stress arising from occupancy of the maternal and student role is crucial if we are to engage in prevention and intervention strategies. Existing measures do not fully address the components of multiple role stress in this population: emotional role ambiguity, person-role and inter-role conflict. This article describes the development of the Perceived Multiple Role Stress Scale (PMRS) which was derived from Kahn, Wolfe, Quinn and Snoek’s (1964) systems-based role theory. The 8-item, 3-factor PMRS measures multiple role stress in women who are both mothers and students. Review of the PMRS by role stress and women’s roles experts supported content validity. Construct validity was supported in three phases over a five-year period. It is recommended that the three correlated factors be used as one eight-item scale. The internal consistency for the PMRS was .86.

A confirmatory factor analysis of situation-specific Norbeck Social Support Questionnaire items.

Background: Situation-specific social support, measured by comparably worded Norbeck Social Support Questionnaire (NSSQ) items, holds promise in the development of context-specific theories at the practice level. However, psychometric work on situation-specific NSSQ items is lacking. Objective: The aim of this study was to explore the statistical parameters of situation-specific NSSQ items (affect, affirmation, and aid). Methods: Using data (N = 154) collected for a larger study, the parameters of three LISREL models were estimated by the generally weighted least squares method using an asymptotic covariance matrix. Results: The modified two-factor model was accepted (&khgr;2 = 11.54, df = 7, p ≤ .12). Overall, parameter estimates suggest that, in this research context, two situation-specific items (affirmation and aid) measure unique dimensions of social support. Conclusions: In this instance, situation-specific affirmation and aid items measure unique dimensions of support. Guided by strong theory, investigators should develop situation-specific items based on the original NSSQ items.

Conceptualization of Burnout From the Perspective of the Neuman Systems Model

Due to an incomplete match between Neumans definition of the core response and proposed examples, the core response has been interpreted as solely physiological in nature. As a result, the majority of Neuman systems model-based research has focused on either identification of stressors or the relations between stressors, the flexible line of defense, and normal line of defense invasion while the core response has been largely neglected. The purpose of this paper is to argue for a broader conceptualization of the core response as any and/or all of the person variables proposed by Neuman. The burnout process, which is both psychological and spiritual in nature, was developed as a core response exemplar.

Etiology of Maternal-Student Role Stress

This paper details the refinement and testing of a proposition regarding the age-related effects of psychological involvement in both the maternal role and the student role, and total network support on maternal-student role stress. Results of hierarchical multiple regression analysis showed that the independent variables contribute to an explanation of maternal-student role stress only for women aged 37 years and older. The proposition was further refined. It supports the propositions of both Neuman’s systems model and Meleis et al.’s transition framework. Implications for research and practice are discussed.

Use of averaged norbeck social support questionnaire scores.

Background. Averaged Norbeck Social Support Questionnaire (NSSQ) support scores remove the influence of network size variability but may unduly lower scores for participants with large networks. Objectives. To evaluate the use of averaged NSSQ scores. Method. Pearson correlations determined if averaged scores decreased as network size increased across three samples. Then, Pearson correlations between a criterion variable and both averaged and raw support scores were computed along with the resultant power to detect a true effect. Results. Neither averaged total functional support nor averaged affect and affirmation scores decreased as sample size increased. However, averaged aid scores did decrease as network size increased. Power also increased markedly in all averaged versus raw scores except in averaged aid scores. Discussion and Conclusions. Use of averaged aid scores is not recommended. Use of all other averaged scores appears acceptable.

Nursing Research in Turkey

Nursing was first considered a scientific discipline in universities in Turkey in 1955. Since that time, nursing research in Turkey has been slowly but steadily growing, and faculty at schools of nursing have included nursing research courses in their curricula and held seminars, conferences, and training sessions concentrated on the importance of nursing research. One such important conference, held as a follow-up to the 1996 International Council of Nursing Conference, was the 1996 Fourth National Nursing Congress at Hacettepe University. At this conference, the priorities and important dimensions of nursing research were discussed as well as strategies for development of nursing research in Turkey (Velioğlu & Oktay, 1999). This important conference was followed quickly by a nursing research workshop held at Dokuz Eylul University. As a result of these meetings, the following nursing research priorities were identified: the role of nurses in health promotion, effectiveness of nurses in solving health problems, nursing care standards, policy making, educational standards, basic healthcare services, detection of treatment and rehabilitation needs, development of nursing models, independent nursing functions, quality of nursing care, costeffectiveness, outcomes of nursing education, and improvement of nursing as a profession (Kocaman, 1996). At the same time, recognizing the importance of organizing the conduct of nursing research, the Association for Research and Development in Nursing was founded to evaluate the value of nursing research to patients and nurses and assist in the identification of national nursing research priorities in Turkey (http://www.hemarge.org. tr) (Hemşirelikte, 1996). To this end, four national nursing research symposia were conducted between 1996 and 2008. However, despite these efforts and more than 54 years as a recognized scientific discipline, we are still struggling to determine research priorities. That is, while the health profile of the Turkish people is considered in establishing curricula of Turkish nursing schools, it is not always considered in determining nursing research priorities for individual nurse researchers. Bahar (2004) noted that the most influential studies have been closely linked with national healthcare priorities. Özsoy (2008) reported that of 2,883 master’s theses and doctoral dissertations conducted, 16.1% study knowledge of health-related issues, 16.1% develop measurement scales, and 14.2% study basic nursing interventions. These studies do not reflect the primary health concerns of Turkey, which are problems of the elderly due to increased life expectancy, maternal and perinatal conditions, high infant death rate (29 of 1000 live births compared with Europe’s 8 of 1000 live births), incidence of short stature and low weight to height scores in children, living with disabilities and chronic disease (12.9% of the Turkish population), and infectious disease control (İmamecioğlu et al., 2004; Ministry of Health of Turkey, 2004). In light of this situation, the priorities for nursing research in Turkey were again considered at the 2008 Turkish Association of Research and Development in Nursing Conference. Nurse faculty were called upon to cooperate in developing nursing research programs that consider Turkish health problems and policies. As well, we recognized the need to integrate research findings into practice through the establishment of nursing research departments in hospitals and making full use of national and international data bases to advance knowledge. Finally, the establishment of a National Nursing Research Center affiliated with the Ministry of Health was recommended along with a national electronic health library and funding for nursing research into costeffectiveness of nursing care (Bahar, 2004).