Robin D. Froman

Development and evaluation of the osteoporosis self-efficacy scale

The Osteoporosis Self-Efficacy Scale was developed as a measure of self-efficacy, or confidence, for behaviors related to physical activity and calcium intake. An item pool of 21 statements, responded to on a visual analog self-report format, was reviewed by a panel of expert judges. The revised item stems were tested with a sample of 201 women, ages 35 to 95. Concurrent data on sport, leisure, and exercise activity and calcium in diet and dietary supplements were collected from the respondents. Factor analysis of responses to the self-efficacy items revealed a logical, theoretically meaningful two-factor structure, one for physical activity and one for calcium intake. Internal consistency estimates for each of the two factors were in the .90s. Convergent and discriminant validity analyses as well as hierarchical regression analyses to explain self-reports of physical activity and calcium intake were supportive. The final version of the brief, psychometrically sound scale contains items reflecting initiation, maintenance, and persistence at osteoporosis preventive behaviors; thus, the Osteoporosis Self-Efficacy Scale is a potentially beneficial research instrument.

Predictors of referral to cardiac rehabilitation and cardiac exercise self-efficacy

Cardiac rehabilitation (CR) has known benefits after myocardial infarction (MI) or coronary artery bypass surgery (CABG). Yet, only a small percentage of patients are referred for outpatient CR after hospital discharge. This study investigates patient characteristics related to referral to CR and cardiac exercise self-efficacy, a salient predictor of health behavior change and maintenance. Two hundred nineteen patients enrolled in the study. Of the 185 patients who were CR candidates, 74 were referred to CR. Logistic regression analysis was used to identify variables related to CR referral. Results indicate that patient characteristics of having had fewer MIs or CABGs, having attended CR in the past, and being less physically active during leisure time are related to an increased likelihood of being referred to CR. Multiple regression analysis indicates that leisure physical activity is a predictor of cardiac exercise self-efficacy. Implications for nurses who recruit patients for CR are discussed.

Further validation of the AIDS Attitude Scale

The AIDS Attitude Scale (AAS) is a self-report measure of attitude toward persons with AIDS. Since its introduction in 1992, the AAS has been used in over 30 research studies. Initial psychometric estimates of reliability and validity for the scale were supportive. This report summarizes emerging psychometric data from a broad range of samples. These data offer additional support for the internal consistency and stability of the two dimensions underlying the scale, as well as documenting the factorial and construct validity of the AAS.

Measurement Characteristics of the Levels of Institutionalization Scales: Examining Reliability and Validity

The Level of Institutionalization (Loin) scales were developed to assess the extent to which a health promotion program has become integrated into a health care organization. The instrument was designed specifically to measure the amount of routinization and niche saturation of four subsystems (production, maintenance, supportive, and managerial) believed to make up an organization. In this study, the Loin scales were completed for diabetes programs in 102 general hospitals and 30 home health agencies in Maryland and Pennsylvania. Reliability estimates across the four subsystems for routines (α = .61) and for niche saturation (α = .44) were substandard. Average correlation among the four subsystems for routines was .67, and among the four subsystems for niche saturation was .38, indicating moderate to large amounts of shared variance among subsystems and challenging claims of discriminant validity. Given these large correlations and a poor fit when testing the eight-factor model, higher-order confirmatory factor analyses were carried out. Results supported the existence of two second-order factors. When collapsed into two factors, the reliabilities were adequate (routines α= .90; niche saturation α = .80). Criterion-related validity also was found between length of program existence and the routine factor.

Refinement of the Habitual Physical Activity Index for use with American adults.

The relationship between physical activity and health outcomes makes the assessment of physical activity important to many health professionals. Numerous physical activity questionnaires exist but none is tailored to the assessment of physical activity in cardiac patients. Ideally, a questionnaire should be appropriate for both healthy individuals and those with cardiac disease to allow comparison of epidemiologic and intervention research. The purpose of this research is to adapt and validate an existing physical activity questionnaire for use with healthy individuals and those with coronary artery disease. The Habitual Physical Activity Index (HPAI) is an easy to administer questionnaire developed in the Netherlands by Baecke, Burema, and Frijters (1982). The factorial validity and alpha internal consistency of the HPAI were examined to evaluate its potential for use in assessing physical activity of hospitalized cardiac patients in the U.S. The sample was 213 cardiac patients. A factor analysis produced a meaningful two-factor solution that differed from the original Dutch results. This suggested the HPAI should be modified for use with American adults with cardiac disease. New items were generated and added to the HPAI. The modified HPAI was tested using classical testing theory and generalizability theory. Stability estimates are high and relative generalizability acceptable. However, the absolute generalizability estimates indicate that the addition of new items to the HPAI could improve its use for absolute decision making.

The Female Sexuality Questionnaire: instrument development.

The purpose of this study was to develop and validate a measure of female sexuality, the Female Sexuality Questionnaire (FSQ). A survey design was employed for the study. The sample included 262 adult women ages 18 to 81 (M = 32). Five hundred questionnaires were distributed to a diverse female population representing multiple geographic areas in the U.S. and Canada. Participants were healthy (as per self-report), sexually active and engaged in an intimate relationship. The majority of the sample was premenopausal. Item stems for the FSQ were developed based on the literature and the domain-referenced approach for item generation. A pool of 70 items generated to represent 6 theoretical domains of female sexuality: Reproduction, Beliefs, Intimacy, Body Image, Physical Responsiveness, and Satisfaction were subjected to systematic review by a panel of experts. A 5-point self-report response scale was appended to the 54 items surviving judges’ reviews (criterion validity index of 91.3 for the pool of retained items). Data screening and item analysis was performed and yielded 13 items which were removed prior to principal factor analysis (PFA) resulting in a sample of 218 subjects and 41 items. The PFA with quartrimax rotation resulted in a 5-factor solution. Four of the five were consistent with the hypothesized domains of Satisfaction, Physical Responsiveness, Beliefs, and Body Image. The fifth factor suggested an association with Intimacy, and was renamed Relationships. The hypothesized domain of Reproduction was not supported. Twelve items failed to load on any of the factors. Recommendations for alterations of the final version of the FSQ are based upon the empirical results of the item analysis and PFA.

Blinded review revisited.

In 1999 Judith Baggs, the editor of Research in Nursing & Health (RINAH), wrote an editorial on blinding in peer review (Baggs, 1999). After more than a decade of surveys on blinding, studies of the procedure, and other observations related to this issue, revisiting the topic appears in order. Definitions of terms and a bit of background on the blinding process is a useful place to start. Blinding refers to obscuring the identity of either (or both) the authors or the reviewers of a manuscript during the review process. I chose the term obscuring intentionally, rather than concealing identity or ensuring anonymity during the review process, as identities are sometimes revealed, either intentionally or by deduction. More is provided on this later. Blinding is the term universally used to avoid disclosing authors’ identities; both blinding and masking are terms used to refer to hiding reviewers’ identities. Here I use blinding to refer to attempts to hide either authors’ or reviewers’ identity. In single blinding, the identity of either the authors or reviewers is obscured; in double blinding both authors’ and reviewers’ identities are hidden. In open reviews one or both identities are revealed. Federal government reviews typically use reviewer blinding—revealing the identity of the panel members involved in group reviews but not individual reviewer responsibilities—but not author blinding. The double blind arrangement is most common in nursing journal reviews (Baggs, Broom, Dougherty, Freda, & Kearney, 2008). By contrast, many biomedical and other scientific journals use single blind procedures,masking only reviewers’ names (Baggs et al., 2008; Yankauer, 1991).

When you wrote it before.

In our previous editorial, we described plagiarism as using someone else’s words or ideas without acknowledging the original source. In other words, if we use the phrase ‘‘When Others Wrote it First’’ without acknowledging this as the title of a previous editorial (Froman & Jennings, 2013), then we have plagiarized. You might respond by saying, ‘‘But you are Froman and Jennings,’’ and that would be correct. In the example, however, we would have committed a special form of plagiarism— self-plagiarism—because we would have used words we wrote before, words that are now copyrighted (Baggs, 2008; Broome, 2004). The ideas emphasized in this editorial include selfplagiarism, copyright infringement, and duplicate publication. Whereas self-plagiarism and duplicate publication involve ethics, copyright infringement is a legal matter. As Broome (2004) noted, the law is less open to interpretation than are ethical considerations.

Attracting an expert, or what nurse leaders look for in academic jobs.

What factors might induce a senior nurse researcher or faculty member to respond to a job posting and accept a job offer? Results of a survey of members of the American Academy of Nursing regarding the job characteristics that initially interest them in an academic position and those that finally persuade them to take a post provide implications for attracting seasoned nurse experts.