Gail Oneal

Retention of native American nurses working in their communities

Purpose: The purpose of this study was to describe the experiences of Native American nurses working in their tribal communities to address retention. Design: An interpretive phenomenological study guided by a Native American research agenda and a Native American nursing practice model. Methods: In-depth interviews with nine Native American nurses were conducted. Data analysis used interpretive phenomenological procedures including an iterative process with Native American consultants and researchers to develop themes. Conclusions: Native American nurses experienced a great deal of stress and illness as they attempted to fulfill their mission to help their people. The three themes were: (a) paying the price to fulfill my mission, (b) being and connecting holistically, and (c) transcending the system. Recommendations include strategies for nurse educators, tracking the ethnicity of nurses in each Indian Health Service area, documenting their reasons for leaving, and conducting further research to develop community-based interventions to improve retention.

Implementing AACN's recommendations for environmental sustainability in colleges of nursing: from concept to impact.

In 2011, the American Association of Colleges of Nursing (AACN) released a guidance report titled Toward an Environmentally Sustainable Academic Enterprise: An AACN Guide for Nursing Education. The report was developed in response to a vivid slide presentation at an AACN meeting depicting the deleterious public and environmental health effects of global industrialization. Following the presentation, AACN members capitalized on the opportunity to provide national leadership to U.S. colleges of nursing in regard to environmental sustainability and stewardship. This article summarizes key features of the AACN plan and outlines one colleges multifaceted implementation plan. The goal of the implementation plan was to translate the AACN recommendations from concept into college-specific actions. Specific steps taken by the college included the following: (a) increasing student and faculty awareness, (b) greening business operations, (c) increased participation in media events, (d) leveraging the impact of national sustainability initiatives, and (e) enhancing curricula at the undergraduate and graduate levels. Through this work, the college achieved not only a higher standard of sustainability within its own walls but also a richer appreciation of the importance of educating nurses as future stewards in an environmentally sustainable health care system.

Retest of a Principal Components Analysis of Two Household Environmental Risk Instruments.

Household Risk Perception (HRP) and Self-Efficacy in Environmental Risk Reduction (SEERR) instruments were developed for a public health nurse-delivered intervention designed to reduce home-based, environmental health risks among rural, low-income families. The purpose of this study was to test both instruments in a second low-income population that differed geographically and economically from the original sample. Participants (N = 199) were recruited from the Women, Infants, and Children (WIC) program. Paper and pencil surveys were collected at WIC sites by research-trained student nurses. Exploratory principal components analysis (PCA) was conducted, and comparisons were made to the original PCA for the purpose of data reduction. Instruments showed satisfactory Cronbach alpha values for all components. HRP components were reduced from five to four, which explained 70% of variance. The components were labeled sensed risks, unseen risks, severity of risks, and knowledge. In contrast to the original testing, environmental tobacco smoke (ETS) items was not a separate component of the HRP. The SEERR analysis demonstrated four components explaining 71% of variance, with similar patterns of items as in the first study, including a component on ETS, but some differences in item location. Although low-income populations constituted both samples, differences in demographics and risk exposures may have played a role in component and item locations. Findings provided justification for changing or reducing items, and for tailoring the instruments to population-level risks and behaviors. Although analytic refinement will continue, both instruments advance the measurement of environmental health risk perception and self-efficacy.

Rural Families' Process of Re-Forming Environmental Health Risk Messages

PURPOSE This study was undertaken to explore how rural low-income families with children process health information following a nurse-delivered intervention designed to reduce environmental risks in their homes. DESIGN AND METHOD Grounded theory methodology with a constructivist approach was used to conduct the study. Semistructured interviews of 10 primary child caregivers in rural low-income families who had participated in an environmental risk reduction intervention were completed from 2009 to 2011. Data were categorized using comparative analysis, theoretical sampling, and coding techniques. FINDINGS The three phases-(a) visiting my perception, (b) weighing the evidence, and (c) making a new meaning-explained the core process of the grounded theory of Re-Forming the Risk Message. CONCLUSIONS Rural low-income families at risk for environmental hazards in their homes determined what health information and needed subsequent actions regarding their risks were important by changing the meanings of nurse-delivered messages. CLINICAL RELEVANCE Nursing interventions designed to improve health behaviors and reduce risks are often based on stage theories that explain how change occurs through steps leading to positive actions through delivery of risk messages. However, the risk message delivered in an intervention designed to engage action is not always the risk message people decide to use. To understand whether people are ready to engage in positive behaviors through interventions, or if needed changes to the information must be made, nurses need to discover and explore reasons for the re-formed risk messages.

Views on exercise: A grounded theory exploration of the creation of exercise perceptions in Hispanic children with asthma

Introduction: There is a large prevalence of asthma, particularly among Hispanic children. Although physical activity is a good way to manage asthma, more Hispanic children with asthma lack activity than their healthy classmates. Given this, the purpose of this study was to explore the development of exercise perceptions in Hispanic children with asthma and to further develop an existing explanatory theory. Method: Grounded theory was the approach for the study. Grounded theory illuminated components of exercise perceptions from participants. Participants included Hispanic children with asthma, their families, and professionals who work with Hispanic children with asthma (n = 29). Results: Findings from this study supported the previously identified grounded theory called The Process of Creating Perceptions of Exercise. In addition, two new concepts (cultural and peer influences) were identified that further explain the category of exercise influences. Conclusion: The revised theory can be used to assist in developing nursing interventions aimed at increasing exercise participation among Hispanic children with asthma.