Clinical Nursing Research

The purpose of this cross-cultural, correlational study was to evaluate two popular clinical/research assessment tools, the NCAST Teaching Scale and the Home Observation Measurement of the Environment (HOME) Inventory, as measures of infant health promotion behaviors for low-income, foreign-born Hispanic mothers in the United States. Based on the assumption that both measures tap universal attributes of the mother-infant relationship, it was hypothesized that maternal performance for the study group and a comparison group of U.S.-born, low-income mothers would be similar. Comparable performance on the NCAST Teaching Scale included a full range of scores, including the capacity to identify mothers most in need of clinical intervention. Study findings supported the clinical use of this assessment scale with mothers represented by the study sample. Consistently lower scores by the foreign-born Hispanic mothers on the HOME Inventory led to the conclusion that the instrument may not tap cultural universals in the mother-infant relationship.

The purpose of this study was to determine the clinical usefulness and generalizability of an infant pain assessment instrument. Earlier work showed that this instrument-an algorithm derived from a model of infant pain assessment-possessed excellent content validity, criterion-like validity, and 3-month stability (test-retest reliability). In this study, generalizability was determined by comparing the percentage agreement between inexperienced pediatric nurses and one author, both using the tool to assess pain of infants in various clinical settings, and by comparing the percentage agreement between one author who used the tool to assess pain and the infant's pediatric nurse caretaker who used his or her clinical expertise, not the tool, to assess pain across various clinical settings. The results show excellent generalizability.

Nine mothers of diabetic children participated in a qualitative study about the factors that influenced them to consent to havand how they evaluated the clinical studies their children had been in. Results suggest that mothers engage in a personal calculus before making a choice to consent.

The purpose of this study was to examine the relationship between perceived social support and general well-being in early adolescents and to test two variables, hopefulness and self-esteem, that theoretically mediate this relationship. The final sample consisted of 142 adolescents, ages 12 to 14, who responded to instruments measuring perceived social support, hopefulness, self-esteem, and general well-being in classroom settings. Correlational analysis supported the five hypothesized relationships. A series of regression analyses described by Baron and Kenny indicated that hopefulness and self-esteem each were mediators of the relationship between social support and well-being. Implications for nursing practice are addressed.

The purpose of this study was to develop and evaluate, through a participatory approach, an intervention program to promote the mental health of women caregivers in institutions. Focus groups were first organized to explore sources of stress for daughter and spousal caregivers. Workshops in which caregivers developed the content of a group program were then organized. The aims of the program were to increase empowerment and self-efficacy and to decrease stress and psychological distress of caregivers. Experimentation and qualitative evaluation of the program led to 10 weekly meetings covering the following topics: how to feel good with my relative, how to discuss with staff, how to appraise my experience differently, coping with my relative's losses, how to reorganize my life, and how to identify and ask for social support. This study provides a structured program to support family caregivers and a research method empowering families.

The purpose of this study was to determine if blood pressure measurement is affected by the leg crossed at the knee as compared with feet flat on the floor in a well-senior population. Participants (N = 110) either had their blood pressure measured with feet flat first and then crossed or the reverse of this. Results indicate that blood pressure was significantly higher when legs were crossed versus uncrossed. Systolic pressure changed by 5.9 mmHg, from 127.32 to 133.24, whereas diastolic pressure changed by 2.97, from 72.54 to 75.52. There were no significant differences between those who had their blood pressure measured first with their legs crossed versus uncrossed or between those with and without hypertension. Instructing patients to keep feet flat on the floor during blood pressure measurement is an important nursing intervention that can contribute to the accurate measurement, interpretation, and treatment of a patient's health condition.

The incidence of HIV/AIDS is rapidly increasing among adolescents and young adults with some studies linking sexual risk taking and self-esteem. A convenience sample of 39 ethnically diverse adolescents, ages 14-18, participated in a pilot study designed to assess HIV/AIDS knowledge and to build self-esteem. Adolescents selected from two centers in California completed the Coopersmith Self-Esteem Inventory and the Student Health Questionnaire (SHQ) before beginning and after completing a program of six 2-hour educational sessions. These sessions focused on HIV/AIDS knowledge and building self-esteem. Knowledge of HIV/AIDS prevention and transmission increased by 20% from pretest to posttest. Practitioners addressing the needs of adolescents should focus on in-depth information regarding HIV/AIDS, especially in the area of prevention strategies and cultural factors influencing levels of self-esteem.