The Postpartum Support Questionnaire: Psychometric Properties in Adolescents

PROBLEM: Receiving adequate social support has been associated with positive outcomes for the postpartum adolescent and her baby. Therefore, social support is an important variable to include in research studies of postpartum adolescents. However, instruments developed for use in adults cannot be assumed to reliably and validly measure health-related concepts such as social support in adolescents (Rogler, 1999; Yarcheski, Mahon, & Yarcheski, 1992) without psychometric evaluation. PURPOSE: Therefore, the purpose of this study was to describe the reliability and validity of the Postpartum Support Questionnaire (PSQ) (Logsdon, 2002; Logsdon, Usui, Birkimer, McBride, 1996) with adolescents. METHOD: The PSQ was revised for use with adolescents, based upon focus groups with adolescents and professionals. Then, the PSQ was administered to a convenience sample of postpartum adolescents (N = 109) recruited from the Teenage Parent Program. FINDINGS: High internal consistency reliability was demonstrated for the total instrument and subscales. Factor analysis supported four factors, in line with the PSQ data with adults, with some indication for an additional adolescent factor. However, in adolescents material support and emotional support tend to load on the same factor. CONCLUSIONS: Social support may be defined differently in postpartum adolescents, but further research with a larger sample is needed to substantiate this finding. Instruments with psychometric data specific to adolescents should be chosen by researchers who study this group.     

Reconceptualization of the Nursing Diagnosis Decreased Cardiac Output

TOPIC. The parameters of the diagnoses decreased cardiac output.
PURPOSE. To propose an alternative conceptual structure for cardiac output that links conceptual parameters with clinical and hemodynamic data.
SOURCE. Past discussions and research investigations
CONCLUSION. Careful analysis illustrates several diagnoses are contained within cardiac output at differing levels of abstraction. Testing of the model, including linking diagnoses with nursing interventions and outcomes, is suggested.     

Outcome of Gastric Restriction Procedures: Weight, Psychiatric Diagnoses, and Satisfaction

Background: Weight losses following bariatric surgery have varied widely, depending on length of follow-up and various pre-surgical characteristics of patients undergoing surgery. Methods: One hundred thirty one patients had a detailed presurgical psychiatric evaluation. Patients were assessed clinically for 2 years after surgery and at follow-up a mean of 5.7 years after surgery. Results: Mean presurgical body mass index (BMI) was 52.9 kg/m²; therefore, many patients had ‘super obesity’. Two-thirds of the patients were located a mean of 5.7 years after surgery. The mean change in BMI at follow-up was 25% and the mean weight loss was 27%. One-third had excellent or good weight outcomes using the Griffen criteria. Five patients had died by follow-up. There was no relationship between age, gender, or fat content presurgically and weight loss at follow-up, although presurgical weight was associated with greater weight loss at follow-up. Weight regain began 2 years after surgery. There was no relationship between the presence or absence of a presurgical psychiatric diagnosis and weight loss at follow-up. There was also no relationship between the presence of a presurgical psychiatric diagnosis and various mental health parameters at follow-up. Satisfaction with the surgery was marginally associated with weight loss but significantly associated with improved mental and physical health. Conclusions: Mean weight losses were less than have been previously reported with gastric restriction procedures but the follow-up was longer than usually reported and many patients had ‘super obesity’ prior to surgery. The implications of ‘super obesity’ for weight loss are discussed.     

Almost Misdiagnosed: Utilization of Romhilt-Estes Electrocardiographic Criteria for Left Ventricular Hypertrophy

The diagnosis of hypertension is based on explicit guidelines presented by the Joint National Committee on Hypertension, but the methodology one uses to obtain the necessary data is up to the individual practitioner. The following case study demonstrates the necessity for the use of the most accurate and precise equipment and criteria to ensure a correct diagnosis of hypertension.