Powerlessness Regarding Health-Service Barriers: Construction of an Instrument

PURPOSE. The purpose of the study was to develop a scale to calculate college students' powerlessness regarding health service barriers (PHSB).
METHODS. Scale items were generated to represent two domains of interest: powerlessness and college students' powerlessness regarding health service barriers. The final 20-item instrument was subjected to multiple measures of validity with college students and panels of nurse experts in the area of nursing diagnosis. Reliability was assessed by two samples (n = 92 and n = 33) of college-age students. A final administration was conducted with 197 college students.
FINDINGS. The PHSB scale was determined to be an accurate and consistent measure.
CONCLUSIONS. This instrument will provide a reliable and valid measure to conduct research.     

Nursing Diagnosis in the International Classification for Nursing Practice (ICNP)

TOPIC. International Classification for Nursing Practice (ICNP) Classification of Nursing Phenomena.
PURPOSE. Provide a historical review of nursing diagnosis in the developing ICNP.
SOURCES. Literature, meeting notes, and experience
CONCLUSION. The development of the ICNP has benefited from contributions of many. Continued refinement depends on participation of nurses globally     

Professional Learning Partnerships: A Collaboration Between Education and Service

Escalating mental health care needs coupled with a decreasing nurse labor force demand a fundamental paradigm shift in undergraduate education and service partnerships among psychiatric-mental health nursing students and practicing nurses. The purpose of this two-group comparative study was to identify factors that contribute to a successful learning partnership between nursing students and practicing nurses engaged in a clinical specialty partnership program within an acute psychiatric-mental health setting. The convenience sample consisted of 51 partners: 33 undergraduate students and 18 practicing nurses. The Learning Partnership Survey was administered to all partners allowing comparison of ranking among factors important to the partner relationship. Contrary to previous research, student and nurse partners were more similar in their factor ranking in the present study. Statistically significant differences were noted in the ranking of 2 of the 15 factors that fostered successful learning partnerships. Implications for professional learning partnerships between nursing academia and service institutions are discussed.     

How postpartum women explain their lack of obtaining adequate prenatal care

The quality of life for infants and children is often dependent on the adequacy of the prenatal care pregnant women receive. From July through to December 1985, 15% of pregnant women in one Midwestern county were identified as having inadequate prenatal care. The purposes of the study were to identify and analyse the reasons women in that county gave for not obtaining adequate prenatal care. In addition, chi-square was used to determine the relationship between the reasons given and the three variables, age, time between knowledge of pregnancy and making an appointment for care, and source of payment. A convenience sample (n = 44) was used in a study over a 5-month period at three locations. The Health Belief Model was the conceptual framework for this study. Insufficient money to pay for care was the primary reason given for not obtaining adequate prenatal care (81%). Other reasons included motivational issues (45%) and access or lack of transportation (19%). There was a significant relationship (P = 0.05) with four reasons to the variable of age and with three reasons to both the variables of time and source of payment. The following recommendations were identified as a result of this research: the need for subsidized prenatal care and the need for a community-wide education campaign regarding the need for adequate prenatal care and the consequences of inadequate care. Prenatal care is sometimes not available to all in the United States in spite of the relationship of infant mortality and the quality of life for infants and children to adequate prenatal care.     

Sexual Abuse of Boys

TOPIC: Sexual abuse in childhood can disable self-esteem, self-concept, relationships, and ability to trust. It can also leave psychological trauma that compromises a boy's confidence in adults. While some boys who willingly participate may adjust to sexual abuse, many others face complications, such as reduced quality of life, impaired social relationships, less than optimal daily functioning, and self-destructive behavior. These problems can respond to treatment if detected. PURPOSE: In this paper, we examine the prevalence, characteristics, psychological consequences, treatment, and coping patterns of boys who have been sexually abused and their failure to disclose abuse unless asked during a therapeutic encounter. Nurses have a responsibility to detect the clues to sexual abuse, diagnose the psychological consequences, and advocate for protection and treatment. SOURCES USED: Computerized literature search of the Medline and PsychInfo literature and books on sexual abuse of boys. CONCLUSIONS: Psychological responses to abuse such as anxiety, denial, self-hypnosis, dissociation, and self-mutilation are common. Coping strategies may include being the angry avenger, the passive victim, rescuer, daredevil, or conformist. Sexual abuse may precipitate runaway behavior, chronic use of sick days, poor school or job performance, costly medical, emergency and or mental health visits. In worst cases, the boy may decide that life is not worth living and plan suicide. The nurse has a key role to play in screening, assessing, and treating sexual abuse children.