Western Journal of Nursing Research

Rheumatoid arthritis, the most destructive and crippling of allforms of arthritis, poses a number of stressful demands on individuals. In a sample of elderly women (N = 59) and men (N = 19) with rheumatoid arthritis, the relationship between social economic status, severity of impairment, sex, stress emotions, type of coping strategy, and psychological well-being was explored. Path analysis results indicated that higher social economic status was directly related to greater use of confrontive types of coping strategies. Severity of impairment had a direct, negative influence on psychological well-being, but sex was not an important factor Optimistic coping strategies were used most often and emotive coping strategies the least.

The purpose of this qualitative study was to discover the essential structure of spiritual care by obtaining detailed descriptions ofthephenomenonfrom those who have received such care. Data were generated through open-ended interviews with 10 Christian volunteers and analyzed using Colaizzi's phenomenological approach. Findings revealed that spiritual care was given and received in a context in which the recipient was vulnerable and receptive to spiritual care. Three theme clusters included enabling transcendence of the present situationfor higher meaning and purpose, enabling hope, and establishing connectedness. Implications for nurse clinicians, educators, and researchers are discussed.

This article examines the responses from a sample of Swedish nursing home staff workers to a hypothetical ethical conflict highlighting the issue of restraint. The responses were analyzed in two ways: first, Piaget's theory of moral development was used to differentiate between "autonomous" and "heteronomous" awareness, and second, the responses were analyzedfrom the perspective of ethical principles, that is, autonomy, beneficence, nonmaleficence, and justice. The findings indicate that autonomous ethical awareness took precedence over heteronomous ethical awareness. The dominant moral values were the principle of beneficence, followed by the principle of autonomy.

The helping relationship has been identified by Brammer (1988) as central to the practice of nursing. This study explored the process of developing special relationships with cancer patients. Interviews were conducted with 32 nursing personnel. The grounded theory method of constant comparative analysis was selected for this investigation. An open-ended interview guide explored the difference between the usual relationships nurses had and the special relationships they formed with selected patients. A basic psychosocial process, "risking involvement" in special relationships with cancer patients, was identified. The willingness to risk involvement took the forms of resisting involvement or practicing involvement.

A description is provided of the process used to verify characteristics of intuitive nurses that had been reported in the literature. These characteristics supplied the frameworkfor construction of the Miller Intuitiveness Instrwnent (MII) reported earlier (Miller, 1993). Evidencefor validity of the MI! was provided in the Miller (1993) study by examiningfactor analyses and correlations with the intuitive component of the Myers-Briggs Type Indicator (MBTI). The following characteristics were subsequently verified: Intuitive nurses are willing to act on their intuitions, are skilled clinicians, and incorporate a spiritual component in their practices. In addition, intuitive nurses express an interest in the abstract nature of things and are risk takers. Intuitive nurses prefer intuition to sensing (as reflected by the MBTI) as a way to take in information. They are extroverted and express confidence in their intuitions. Likewise, nurses who delay making decisions until all the information is in are more intuitive than those who make decisions abruptly.

The purpose of this descriptive study was to explore the relationship between dimensions of structure (i.e., centralization, formalization, and complexity) and climate in schools of nursing, using the framework of contingency theory. Data were collected from 111 full-time faculty from 11 baccalaureate and 7 associate degree schools of nursing in Minnesota accredited by the National Leaguefor Nursing. Thefindings indicated a significant relationship between structure and climate in the schools of nursing. Dispersion of influence throughout the school was associated with a more favorable climate. A higher degree of supervision by superiors was related to a less favorable climate.

Sampling bias occurs in research when a large percentage of subjects who are eligible for the study refuse to participate. During Phase I of a two-phase multisite Mother-Baby Feeding Project, approximately 50% of the 235 potential participants atfour of five sites declined to enter the study. This report compares subjects who fully participated with those who minimally participated and explores factors related to subjects' refusal to participate. Data regarding sociodemographic data, breast-feeding experience, and reason for refusal were collected from 92 subjects who declined to enter but agreed to minimally participate. The fully participating subjects had more education than those who participated minimally. However, the breast-feeding outcomes studied were similarfor both groups. This provides supportfor generalizing additional studyfindings beyond the group offully participating subjects when considering breast-feeding outcomes. Findings lend insight into the problem of subject recruitment that is not well-addressed in the nursing literature.

Acquiring access to subjects for research is a problem that confronts many nurse researchers. Methods commonly used for subject recruitment may provide an inadequate subject pool for successful study completion. Computer networks can be a viable alternative for subject recruitment through the use of on-line bulletin boards and support groups for many health-related issues. The use of an on-line network to augment the subjectpool in one study is briefly described. Nurses are encouraged to use this technology as one creative way to recruit and access subjects in order to continue to be successful in the clinical research arena.

Schools of nursing are meeting the needs of students by instituting distance education courses that use two-way video technology. This article describes the structuralfeatures of the classroom that are changed and provides strategies that can be effective for teaching nursing research. These strategies are related to: teaching and demonstrating use of statisticalformulas; selecting and teaching use of software for data analysis; teaching about research design, sampling, and data collection procedures; and critiquing empirical articles.