Theresa A. Kessler

The cognitive appraisal of health scale: Development and psychometric evaluation

The purpose of this study was to develop and evaluate the psychometric properties of the Cognitive Appraisal of Health Scale (CAHS). The CAHS was developed to measure multiple dimensions of primary and secondary appraisals associated with health-related events. Items were generated for primary appraisal scales of threat, harm/loss, challenge, and benign/irrelevant, and secondary appraisal coping options and resources. The CAHS was tested in a sample of 201 women with breast cancer. Following tests of item analysis, reliability, and construct and concurrent validity, the CAHS was reduced to 28 items. During factor analysis a four-factor solution explained 60% of the total variance and represented the proposed primary appraisal dimensions. Intercorrelations among primary and secondary appraisals were consistent with theory (p < 0.01). Support for concurrent validity was provided by the clinically relevant differences in appraisal by time since diagnosis. The primary appraisal scale estimates of internal consistency (theta) were all greater that .70. Findings indicated beginning support for reliability and validity of the CAHS as a measure of cognitive appraisal for health-related events.

Relationships between lifestyle, health behaviors, and health status outcomes for underserved adults

Purpose: To examine the relationships between lifestyle, health behaviors, and health status for underserved adults. Data sources: A convenience sample of 84 adults responded to a questionnaire on lifestyle, health behaviors, health indices, and health status. Health status was measured by the 12‐Item Short‐Form Health Survey (SF‐12). Conclusions: The majority of the sample was white, female, ranged in age from 19 to 64 years, and had an annual income range of

Concerns expressed by underserved individuals regarding family and community healthcare needs.

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Influence of Lifestyle, Health Behavior, and Health Indices on the Health Status of Underserved Adults

25,000. Lifestyle factors reported included smoking (44%), consuming alcohol (59%), using street drugs previously (43%), exercising regularly (45%), and having adequate sleep (M= 7.16 h). Sixty‐five percent engaged in at least one screening behavior during the past 12 months and used at least one prescription medication. Data for health indices demonstrated subjects had at least one current symptom (89%), at least one current medical condition (72%), and a body mass index classified as overweight (48%). No significant relationships were found between lifestyle and health status. Findings indicated health indices rather than lifestyle were related to health status. Implications for practice: Findings provided selective support for the links between lifestyle, health behaviors, and health status. Nurses can use the results as a basis for future assessments and interventions with underserved adults.

Evaluating the effect of teaching modules on underserved clients' perceived health.

This descriptive study examines the health concerns that underserved individuals have for their family and community. Of 82 subjects completing a self-report instrument, 29% reported specific health needs for their community and 20% reported health needs for their family. Their major concerns for the community included acquired immunodeficiency syndrome and human immunodeficiency virus; their major concerns for the family related to heart disease and diabetes. Study subjects were mostly concerned with healthcare needs facing specific individuals within their family and community. Results indicated that subjects had difficulty focusing on broader health concerns because of the multiple constraints of being underserved and uninsured.

Health Concerns and Learning Styles of Underserved and Uninsured Clients at a Nurse Managed Center

Purpose: To examine how lifestyle, health behavior, and health indices best predict health status in underserved adults. Data sources: Eighty‐four underserved adults from a nurse‐managed center completed an investigator‐developed instrument to measure lifestyle, health behavior, and health indices. The SF‐12 Health Survey measured general (SF‐1), physical (PCS), and mental (MCS) health status. Conclusions: The majority of the sample was female (64%). Sixty‐three percent were at or below 200% of the federal poverty level. For nonsmokers, five independent variables accounted for 47.1% of the variance in SF1 (p < .000), 33.5% in PCS‐12 scores (p < .001), and 23.2% in MCS‐12 scores (p = .017). For smokers, six variables accounted for 48.7% of the variance in SF1 (p = .024), 41.7% in PCS‐12 scores (p = .067), and 25.4% in MCS‐12 scores (p = .378). Implications for practice: Findings provide partial support for the impact of lifestyle and health behaviors on health status outcomes. Focusing concurrent interventions on improving multiple behaviors may have the greatest impact on health status outcomes.Purpose To examine how lifestyle, health behavior, and health indices best predict health status in underserved adults. Data sources Eighty-four underserved adults from a nurse-managed center completed an investigator-developed instrument to measure lifestyle, health behavior, and health indices. The SF-12 Health Survey measured general (SF-1), physical (PCS), and mental (MCS) health status. Conclusions The majority of the sample was female (64%). Sixty-three percent were at or below 200% of the federal poverty level. For nonsmokers, five independent variables accounted for 47.1% of the variance in SF1 (p < .000), 33.5% in PCS-12 scores (p < .001), and 23.2% in MCS-12 scores (p = .017). For smokers, six variables accounted for 48.7% of the variance in SF1 (p = .024), 41.7% in PCS-12 scores (p = .067), and 25.4% in MCS-12 scores (p = .378). Implications for practice Findings provide partial support for the impact of lifestyle and health behaviors on health status outcomes. Focusing concurrent interventions on improving multiple behaviors may have the greatest impact on health status outcomes.

Mentoring Undergraduate Nursing Students in Research

Underserved individuals need comprehensive health care. Educational resources that meet health care needs can promote wellness. This descriptive study evaluated effects of preferred teaching modules on perceived health of underserved clients of a nurse-managed center. Participants (N = 101) were between 19 and 61 (M = 38.7); the majority was female (68.3%) with a high-school education (M = 12.17). Most participants (65%) identified health education as very important; 92% used at least one teaching module. Age, gender, and education were not related to importance of health education. Use of various teaching modules was positively correlated with perceived improved health (p < .05). Participants who used a combination of videos and pamphlets reported the greatest improvement (p < .000).