Lynnette Leeseberg Stamler

Breast health educational interventions. Changes in beliefs and practices of working women.

Health education programs supported by womens groups or workplaces have been successful in reaching large populations and changing intentions to perform breast health behaviors. This study examined the responses women working in the automotive industry had to two health education interventions, mailed pamphlets, and a combination of mailed material and classes at the worksite compared to a control group. A quasi-experimental design was used. Of the 948 women completing the pre-test, 437 also completed the post-test and were highly representative of the initial sample. The findings suggest that although the mailed information produced some change in practices and intentions, the classes in combination with the mailed pamphlets produced greater change. In addition, confidence in breast self examination as a method of detecting an existing breast lump increased from pre-test to post-test across all age groups. The reported influences on the womens decisions related to breast health varied across the life span. The results of this study can be used to support the development of effective health promotion programs for use at workplaces to increase the likelihood of women engaging in healthy breast practices.

Toward a Framework for Patient Education An Analysis of Enablement

Patient education is an activity that nurses engage in on a regular basis, yet in the literature it is seldom examined as a patient-centered process. The desire to describe the process of patient education in terms that were not content-driven was the guiding force for an examination of the concept of enablement. The purpose of this article is to describe an analysis that resulted in a definition of enablement and the identification of three components: means, abilities, and opportunities. Model, related, and contrary cases are provided. The findings of this examination are used to propose a potential framework for designing, implementing, and evaluating patient education across content areas.

Using the Internet to Identify Women's Sources of Breast Health Education and Screening

ABSTRACT Health professionals, womens groups, the media and the Internet have all played a role in educating the public about breast health and breast screening methods. Yet, with all the information that is available to women, their participation rates have been less than optimal. This paradox has resulted in the need to learn more about the sources that influence women to participate in breast screening. In an innovative study using the Internet, over 800 women, primarily from Canada and the United States, were surveyed about their knowledge, attitudes and influences regarding their breast screening practices. Current health status, screening practices and influences of various health professionals on womens health promotion activities were analyzed. Comparisons of the womens perceptions across age groups and national differences between Canadian and American respondents are presented. Women in the older age group reported receiving more encouragement for breast screening activities from physicians, nurses and others than did younger women. American respondents reported perceiving more support from nurses for breast screening than did their Canadian counterparts. A high number of American respondents reported having been diagnosed with breast cancer, while only a small number of Canadian respondents reported this diagnosis. The results from this study can be used in planning health promotion activities relevant to various populations of women. Benefits and limitations of using the Internet as a research medium are briefly discussed.

Appreciative inquiry: a strength-based research approach to building Canadian public health nursing capacity

In this paper we evaluate the use of appreciative inquiry in focus groups with public health nurses, managers and policy makers across Canada as part of our project to generate policy recommendations for building public health nursing capacity. The focus group protocol successfully involved participants in data collection and analysis through a unique combination of appreciative inquiry and nominal group process. This approach resulted in credible data for analysis, and the final analysis met scientific research standards. The evaluation revealed that our process was effective in engaging participants when their time available was limited, no matter what their position or public health setting, and in eliciting solution-focused results. By focusing on what works well in an organisation, appreciative inquiry enabled us to identify the positive attributes of organisations that best support public health nursing practice and to develop practical policy recommendations because they were based on participants’ experience. Further, appreciative inquiry was especially effective with public health policy makers and nurses as it is consistent with the strength-based, capacity building approaches inherent in public health nursing practice.

A conceptual framework for developing a critical thinking self-assessment scale

Nurses must be talented critical thinkers to cope with the challenges related to the ever-changing health care system, population trends, and extended role expectations. Several countries now recognize critical thinking skills (CTS) as an expected outcome of nursing education programs. Critical thinking has been defined in multiple ways by philosophers, critical thinking experts, and educators. Nursing experts conceptualize critical thinking as a process involving cognitive and affective domains of reasoning. Nurse educators are often challenged with teaching and measuring CTS because of their latent nature and the lack of a uniform definition of the concept. In this review of the critical thinking literature, we examine various definitions, identify a set of constructs that define critical thinking, and suggest a conceptual framework on which to base a self-assessment scale for measuring CTS.

Patient perceptions of satisfaction following diabetes education: use of the mastery of stress instrument.

PURPOSE The purpose of this study was to test the conceptual congruency of scores from the Mastery of Stress Instrument (MSI) with qualitative data in an effort to identify patients for whom a specific educational intervention was sufficient. METHODS A convenience sample of patients with diverse age and educational backgrounds was recruited from those who registered for a 4-session diabetes educational experience as new or refresher patients. All 57 patients completed the MSI before and after diabetes educational experiences, and half participated in before and after audiotaped interviews. All patients responded to a query about their perceptions of the educational experience. MSI scores were analyzed by demographic variables as well as compared to qualitative interviews for greater insights and explanation. RESULTS Consistency was noted between the MSI scores and the information revealed in the interviews. Additional support for the use of the MSI to identify patients at risk and in need of additional educational interventions was realized. CONCLUSIONS Further research to explore the use of the MSI with persons with different educational experiences and to standardize the MSI scores for adult persons taking diabetes or other patient education classes is needed before generalization can be achieved.

Adolescent girls' personal experience with Baby Think It Over infant simulator.

Purpose To explore adolescent girls’ personal experience with an infant simulator that had to be cared for over a period of 1 to 2 weeks. Study Design and Methods This qualitative study employed the phenomenological approach and utilized Colaizzi’s method of analysis. Participants were nine adolescent high school girls who were interviewed and audiotaped. Interview data were coded using NUD*IST 4 software. Results Three themes emerged from the data. They were (1) a parenting journey incorporating intellectual, emotive, and physical faculties; (2) recognizing the illusionary nature of previously held ideas about parenting an infant; and (3) offering counsel based on the BTIO experience. Clinical Implications The new perspectives gained by the participants about parenting a newborn infant differed markedly from the romantic fantasies they held prior to the experience. The teens started thinking more seriously about the consequences of sexual activity. Used for 1 to 2 weeks, in conjunction with budgeting exercises and provocative small-group discussions, the BTIO shows promise as an effective tool in helping to modify unrealistic and idealized teen views of adolescent pregnancy and parenting.

Preparing the community health nursing workforce: internal and external enablers and challenges influencing undergraduate nursing programs in Canada.

The Canadian Schools of Nursing (CASN) task force on public health was mandated to facilitate Schools of Nursing to provide students with the foundation required to meet the Canadian Community Health Nursing Standards of Practice. This paper reports on an environmental scan that explored barriers and enablers influencing the integration of community health nursing content in baccalaureate education in Canada. Data was collected over three phases including: 1) a pan-Canadian survey of nursing schools, 2) completion of open-ended workbook questions by educators, policy makers, administrators, and community health nursing managers attending a pan-Canadian symposium on community health nursing, and 3) recorded notes from the symposium. The response rate for the survey was 72.5% (n = 61 schools) and approximately 125 stakeholders participated in symposium activities. Internal and external enablers and challenges as well as recommendations for practice and education are presented.

The Contribution of Work Environment to Nurses' Assessments of the Quality of Patient Care

The quality of patient care was found to be significantly correlated with work environment measures in a quasi-experimental study in the Saskatoon Health Region. Since first line supervisors face multiple pressures in organizing the work of their units, they need to be supported by senior leadership for continuity in instilling a common purpose and shared values to the patient care staff. The role of supervision and leadership is crucial in strategically managing the human, financial and technical resources in our healthcare system, especially when such resources are likely to remain limited.

Review: use of pedometers increases physical activity in adults.

D M Bravata Dr D M Bravata, Primary Care and Outcomes Research, Stanford, CA, USA; dbravata@stanford.edu In adult outpatients, does the use of pedometers increase physical activity? Studies selected assessed pedometer use among >5 adult outpatients. Studies were excluded if participants were admitted to hospital or confined to a research centre, pedometers were sealed so that participants in the intervention group could not see the number of steps, or pedometers were used to measure the effects of a drug on a person’s ability to be physically active. Outcome was change in number of steps walked daily. Medline (to Feb 2007); EMBASE/Excerpta Medica, Sport Discus, …