Marti Rice

Nurses as Imperfect Role Models for Health Promotion

The purpose of this qualitative study was to discover ways in which nurses describe themselves as health-promoting role models. Focus groups and individual interviews were conducted with nurses working in a variety of settings. Transcribed interviews were analyzed thematically. Nurses defined themselves as role models of health promotion according to the meaning they gave the term, their perceptions of societal expectations, and their self-constructed personal and professional domains. The term role model evoked diverse interpretations ranging from negative perceptions of the idealized image to a humanized, authentic representation. Nurses perceived that society expected them as role models to be informational resources and to practice what they preached. Nurses defined themselves independently of societal expectations according to personal and professional domains. Valuing health, accepting imperfections, and self-reflecting were aspects of the personal domain, whereas gaining trust, caring, and partnering were facets of the professional domain.

Relationship of Anger, Stress, and Coping With School Connectedness in Fourth-Grade Children

BACKGROUND High trait anger and stress, ineffective patterns of anger expression, and coping are risk factors for the development of disease and negative social behaviors in children and adults. School connectedness may be protective against negative consequences in adolescents, but less is known about this in school-aged children. The purposes of this study were to characterize relationships between trait anger, stress, patterns of anger expression, resources for coping, and school connectedness and to determine if race and gender moderate these relationships in elementary school-aged children. METHODS Using self-report, standardized instruments, a convenience sample of 166 fourth graders in 4 elementary schools in 1 US school district was assessed in the fifth week of the school year. RESULTS School connectedness was positively associated with social confidence and behavior control and negatively associated with trait anger, anger-out, and stress. In multiple regression analyses to test for interactions, gender did not moderate the effects of school connectedness in any of the models, while race moderated the relationships between school connectedness and both stress and social confidence. Students with higher school connectedness had lower trait anger and anger-out and higher behavior control, regardless of gender and/or race. White students higher in school connectedness had lower stress and higher social confidence. CONCLUSIONS Findings indicate the protective effect of school connectedness on trait anger, anger-out, and behavior control in school-aged children, regardless of race or gender. The protective effect of school connectedness on stress and social confidence may depend on race.

Finding meaning as a mediator of burden on the health of caregivers of spouses with dementia

Objective: The aim of this study was to examine the role of finding meaning in caregiving as a way of coping and potential mediator of the effect of caregiver burden on caregiver health, controlling for potentially influencing factors. Method: This was a cross-sectional, descriptive study of 84 community-residing spouse caregivers for persons with dementia in which participants completed questionnaires during a face-to-face meeting. Variables included background and contextual variables, caregiver burden, finding meaning through caregiving (FMTCG), and caregiver physical and mental health. Measures included the Zarit Burden Interview, the FMTCG Scale, and the Medical Outcomes Short Form-36, v2. Results: Regression analyses revealed that FMTCG partially mediated the relationship between caregiver burden and caregiver mental health. Caregiver burden was not associated with caregiver physical health. Conclusion: This study contributed new information by examining the role of finding meaning in caregiving, conceptualized from an existential perspective, as a mediator in the stress-coping process. Caregiver burden had an indirect effect on caregiver mental health that was partially mediated by finding meaning. Results underscore the importance of the positive aspects of caregiving such as finding meaning as potential buffers of the burden of caregiving.

Stress and Inflammation: A Biobehavioral Approach for Nursing Research:

Despite known advantages, the use of biobehavioral approaches in nursing research remains limited. The purposes of this article are to (1) present applications of stress and inflammation in various health conditions as examples of biobehavioral concepts and (2) stimulate similar applications of biobehavioral concepts in future nursing research. Under a biobehavioral conceptual framework, studies on stress and selective inflammatory biomarkers in cardiovascular, cancer, and pulmonary health are reviewed and summarized. Inflammation underlies many diseases, and stress is a significant source of increased inflammation. Biobehavioral concepts of stress and inflammation are highly relevant to nursing research concerned with health-related issues. Diverse biobehavioral concepts are readily applicable and should be utilized in nursing research with children and adults. To stimulate further biobehavioral research, more training and resources for nurse scientists, more unified conceptual definitions and biobehavioral conceptual frameworks, rigorous and expanded methodologies, and more collaboration are essential.

Anger and blood pressure readings in children

This study investigated the relationship of state and trait anger measured by the Jacobs Pediatric Anger Scale, patterns of anger expression measured by Jacobs Pediatric Anger Expression Scale, and blood pressure readings (BPR) in 230 third-grade children. Analysis of data revealed significant inverse relationships between anger suppression and diastolic BPR and anger reflection and control and both diastolic and systolic BPR. As anger suppression increased, diastolic BPR decreased. As anger reflection and control increased, both systolic and diastolic BPR decreased. When gender was considered, the relationship between anger reflection and control and systolic BPR was apparent only for girls, whereas the relationship between anger reflection and control and diastolic BPR was apparent only for boys. When correlations were computed based on gender and race, a significant inverse relationship between anger reflection and control and systolic BPR in Black girls was found. The results suggest that the influence of race and gender on the relationships between anger expression and systolic and diastolic BPR, which has been documented in adults, may be present in childhood.

Factors associated with closed head injury in a pediatric population

&NA; The purpose of this study was to identify characteristic factors in children who sustained closed head injury (CHI) between birth and less than 15 years of age. A two‐year retrospective audit of charts from a large metropolitan pediatric hospital with a trauma center yielded a sample of 138 charts that met the established criteria for inclusion in the study. Using a descriptive design, data were gathered on age, sex, race, cause of injury, severity of injury, season of accident, time of accident and length of hospital stay. Data analysis revealed that males were 1.5 times more likely to sustain CHI than females. Both sexes showed the highest incidence of CHI during the first year with a second less dramatic peak at around 6 years of age. Transportation‐related causes accounted for 57.2% of the injuries with falls accounting for another 22.5%. Of the transportation‐related injuries, 27.5% were associated with motor vehicle accidents. The lack of restraint use for subjects in the motor vehicle accident group was associated with 5 deaths as opposed to no deaths in subjects who were restrained. Over 70% of the injuries occurred in the time periods of 2:00–6:00 p.m. (31.9%) and 6:00–10.00 p.m. (40.7%). CHI occurred less frequently in the winter (13.8%) than any other season. Using the Glasgow Coma Scale scores, 56.5% of the injuries were categorized as mild, 17.4% were moderate and 26.1% were severe. There was an 8% mortality rate secondary to injury in the sample.

Accessing and Recruiting Children for Research in Schools

Gaining access to the schools and recruiting children as research participants are challenging tasks. To facilitate gaining access to the schools, multiple strategies are necessary, including understanding specific characteristics of the schools, using the proper lines of authority and communication, identifying the gatekeepers, and persuading the schools of the significance and mutual benefits from the study. Once access is gained, strategies for successful recruitment of children include use of developmentally appropriate motivators and incentives; multilevel communications with administrators, principals, teachers, staff, parents/guardians, and children; and provision of privacy and confidentiality during data collection and sharing of the findings. Specific examples from an ongoing study are used to illustrate helpful strategies.

Anger, Stress and Blood Pressure in Overweight Children

Among adults, trait anger, patterns of anger expression, and stress have been associated with blood pressure (BP). Less apparent is the effect of these variables on BP in overweight and obese children. To characterize the relationships between these psychological variables and BP, the authors conducted a secondary analysis of data from 73 overweight and obese 9- to 11-year-old children. Findings indicate a positive correlation between trait anger and systolic BP (SBP). Regression results indicate that the overall model significantly predicted SBP by explaining 15.4% of the variance and that trait anger was a significant predictor of SBP.

The self as role model in health promotion scale: development and testing.

Historically, nurses have been expected to be role models of health promotion, conceptualized and operationalized narrowly and indirectly as the practice of healthy behaviors. The purpose of the current study was to develop and test an instrument (The Self as Role Model for Health Promotion [the SARMHEP]) to measure nurses’ perceptions of themselves as role models. Data were collected from nurses working in public health, nursing education, and general practice with a 56% return rate. A series of exploratory factor analyses elicited a five-factor solution that accounted for 44% of the variance and approximated the theoretical dimensions that guided the instrument’s development. Cronbach’s alpha for the total scale was .91. The new multidimensional SARMHEP was shown to have beginning validity and reliability.

Nursing research and nursing practice--teaching the inseparable duo.

This series of research courses provides (a) an initial emphasis on learning the content at the knowledge and comprehension levels; (b) sequential and continuous courses so that research is not seen as isolated, and therefore esoteric, knowledge; (c) an application component congruent with the clinical/practice needs and interests of students; and (d) low faculty-student ratios, at least some of the time. Teaching research so that it becomes a fundamental part of nursing practice is a goal that must be met. Reading and critiquing research provides an ideal avenue for stimulating and embellishing the critical-thinking abilities that are so basic to excellence in practice. The development of nursing science and the complexities involved in enhancing patient well-being depend on the promotion of nursing research and the clinical application of nursing research findings. Knowledge about nursing research must be taught; structuring teaching so that nursing research becomes a valued and inherent part of clinical practice from the beginning is the challenge for nursing educators.