Reg Arthur Williams

Sense of belonging and indicators of social and psychological functioning

Sense of belonging has recently been described and defined as one specific interpersonal process that influences health. The purpose of this study was to examine the relationships between sense of belonging and personal characteristics and selected indicators of social and psychological functioning in men and women. Using a sample of 379 community college students, sense of belonging was examined in relation to social support, conflict, involvement in community activities, attendance at religious services, loneliness, depression, anxiety, history of psychiatric treatment, and suicidality. Results indicated that sense of belonging is closely related to indicators of both social and psychological functioning. These relationships were generally stronger for women than for men. It appears that sense of belonging is a useful concept pertinent to exploration of social and psychological functioning.

The effects of sense of belonging, social support, conflict, and loneliness on depression.

BACKGROUND A number of interpersonal phenomena have been linked to depression, including sense of belonging, social support, conflict, and loneliness. OBJECTIVES To examine the effects of the interpersonal phenomena of sense of belonging, social support, loneliness, and conflict on depression, and to describe the predictive value of sense of belonging for depression in the context of other interpersonal phenomenon. METHOD A sample of clients with major depressive disorder and students in a midwestern community college participated in the study by completing questionnaires. RESULTS Path analysis showed significant direct paths as postulated, with 64% of the variance of depression explained by the variables in the model. Social support had only an indirect effect on depression, and this finding supported the buffer theory of social support. Sense of belonging was a better predictor of depression. CONCLUSIONS The study findings emphasize the importance of relationship-oriented experiences as part of assessment and intervention strategies for individuals with depression.

Missed nursing care: Errors of omission

This study examines what and why nursing care is missed. A sample of 459 nurses in 3 hospitals completed the Missed Nursing Care (MISSCARE) Survey. Assessment was reported to be missed by 44% of respondents while interventions, basic care, and planning were reported to be missed by > 70% of the survey respondents. Reasons for missed care were labor resources (85%), material resources (56%), and communication (38%). A comparison of the hospitals showed consistency across all 3 hospitals. Associate degree nurses reported more missed care than baccalaureate-prepared and diploma-educated nurses. The results of this study lead to the conclusion that a large proportion of all hospitalized patients are being placed in jeopardy because of missed nursing care or errors of omission. Furthermore, changes in Center for Medicare and Medicaid Services (CMS) regulations which will eliminate payment for acute care services when any one of a common set of complications occurs, such as pressure ulcers and patient falls, point to serious cost implications for hospitals.

Development and Psychometric Testing of a Tool to Measure Missed Nursing Care

Background: In a qualitative study, medical-surgical and intensive care staff nurses reported that they did not complete a significant amount of nursing care on regular basis. Thus, it was determined that a quantitative tool was needed to measure the amount and type of missed nursing care and the reasons for missing care. Objective: The authors report the results of a psychometric evaluation of this tool (The Missed Nursing Care Survey [MISSCARE Survey]) to measure missed nursing care (part A) and the reasons for missed nursing care (part B). Study Methods: Two studies were conducted-study 1 (n = 459) and study 2 (n = 639). A sample of staff nurses was drawn from 35 medical-surgical, rehabilitation, and intensive care patient units in 4 acute care hospitals. Results: Acceptability was high, with 85% of the respondents answering all items on the survey. Factor analysis with Varimax rotation resulted in a 3-factor solution for part 2 (communication, labor resources, and material resources). Cronbach &agr; values ranged from 0.64 to 0.86. Confirmatory factor analysis demonstrated a good fit of the data. Using a contrasting group approach, a comparison of nurses perceptions of missed care on intensive care units versus rehabilitation units resulted, as hypothesized, in a significantly lower amount of missed care on intensive care units. Pearson correlation coefficient on a test-retest of the same subjects yielded a value of 0.87 on part A and 0.86 on part B. Conclusion: Although further validation of the MISSCARE Survey is needed, current evidence demonstrates that the tool meets stringent psychometric standards.

Sense of belonging as a buffer against depressive symptoms

BACKGROUND: Lack of a sense of belonging has been shown to be associated with loneliness, emotional distress, psychosocial disturbance, and mental illness. Conversely, sense of belonging was found to correspond with psychosocial health. OBJECTIVE: The purpose of this study was to determine the buffering effect of sense of belonging against the development of depression. STUDY DESIGN: This study used a comparative design. The sample consisted of 443 Navy recruits in basic training who were divided into depressed and control groups based on depressive symptoms. The groups were then further stratified based on risk factors: a personal history of abuse and family histories of mental illness, alcohol, and drug abuse. RESULTS: The results refuted a significant buffering effect of sense of belonging against the development of depressive symptoms in several of the subgroups. However, sense of belonging significantly buffered those with a family history of alcohol abuse against developing depressive symptoms. CONCLUSION: Sense of belonging is a concept that has important implications for psychosocial well being. Interventions that enhance sense of belonging will be useful in the treatment and primary prevention of depression.

Changes in directed attention and short-term memory in depression

This study examined changes in directed attention and short-term memory in depression using a newly constructed battery of computerized measures. A repeated measures design was used with two sample groups; 25 individuals meeting DSM-IV criteria for Major Depression and a group-matched comparison sample of 27. Both groups were tested at three points in time over a 10-week period. Test-retest reliability of the measures was examined. Profile analysis demonstrated that there were differences between the depressed and comparison groups in both directed attention and short-term memory. Recommendations for specific improvements in the testing battery are discussed. The ability to detect changes in directed attention and short-term memory may have clinical utility in early detection of impending onset of depression or subtle residual symptoms of an acute episode that may impair functioning or signal a relapse.

Mediators of Attachment Style, Social Support, and Sense of Belonging in Predicting Woman Abuse by African American Men

Recent studies have focused on attachment and related variables to explain partner abuse. These studies have not included significant numbers of African American men. Path analysis was used to examine the relationship between interpersonal relatedness (i.e., attachment, social support, and sense of belonging) as mediated by affect (hopelessness and depression) to explain abusive behaviors in African American men arrested for partner abuse. Data were collected using self-administered questionnaires from a convenience sample of 69 African American men 18 to 69 years of age. The strongest effect was from sense of belonging in predicting severity-weighted frequency of physical, psychological, and sexual abuse. Preoccupation with closeness had a negative direct effect on severity-weighted frequency of sexual abuse. Hopelessness and depression did not act as mediators. Implications for further research are discussed.

Trier Social Stress Test: A Method for Use in Nursing Research

Background:Researchers face the difficulty of inducing psyquitchosocial stress in a laboratory setting using a method that institutional review boards could consider an acceptable research protocol. Methods:This article describes the Trier Social Stress Test, a research protocol that can be used to induce psychosocial stress and capture the integrated aspects of an individuals biologic and psychological responses. Results:The test involves 15 minutes of psychosocial stress induced by a mock job interview and followed by a mental arithmetic challenge before a panel of three judges. The discomfort associated with performance requirements induces stress in socially acceptable ways that can be measured using physiologic and/or psychological parameters. Conclusions:This method allows stress to be induced and measured in a controlled, laboratory setting.

Symptoms of depression among female nursing students

This study examines the extent to which depressive symptoms in female nursing students are affected by specific stressors and coping styles. Three hypotheses were examined for differences in symptoms of depression scores and a model was tested for predicting depression in female nursing students. Responses were gathered from three questionnaires (Hassles and Uplifts Scales, Symptoms of Stress Inventory, and Coping Styles) from 408 female baccalaureate, masters and doctoral students from a major Midwest research university. Symptoms of depression were not significantly different among the students and were as high as a comparative group of stress management clients. Path analysis was used to examine the patterns of stressors (hassles, uplifts, personal and student-related stress), coping (coping styles, habits, quitting school, and drug use), and a biological factor (depression around the menstrual cycle) that predicted symptoms of depression. All hypothesized variables had direct paths to symptoms of depression; the path model explained 58% of the variance. Results from this study support the biological and psychological theories of depression in women and raise important questions of particular relevance to women, nursing students and educators.

Evaluation of the Facts on Aging Quizzes I & II.

The Facts on Aging Quizzes (FAQ) I and II (Palmore, 1977, 1981) were designed to assess knowledge and to measure misconceptions regarding the elderly. This study compared results on the FAQ I and II administered to freshmen nursing students. In contrast with Palmores (1981, 1988) findings, the FAQ I and II were not related (r=.04) and alpha coefficients were low (a=.45 and .32 respectively). However, use of theta coefficients (which make fewer stringent assumptions about items being parallel) resulted in values of .60 and .64 respectively. The factors emerging in this study differed from Palmores (1977, 1981, 1988) conceptual structure and explained only 45% of the variance. Results from this study suggest that while the FAQ I and II may be useful as a stimulus for discussion, revisions and testing need to be done if they are to be used for research purposes.