Analysis of international content of ranked nursing journals in 2005 using ex post facto design.

AIM: The purpose of this study was to examine articles in ISI-ranked nursing journals and to analyse the articles and journals, using definitions of international and article content. BACKGROUND: Growing emphasis on global health includes attention on international nursing literature. Contributions from Latin America and Africa have been reported. Attention to ranked nursing journals to support scholarship in global health is needed. METHOD: Using an ex post facto design, characteristics of 2827 articles, authors and journals of 32 ranked nursing journals for the year 2005 were analysed between June 2006 and June 2007. Using definitions of international and of article content, research questions were analysed statistically. FINDINGS: (a) 928 (32·8%) articles were international; (b) 2016 (71·3%) articles were empirical or scholarly; (c) 826 (89·3%) articles reflecting international content were scholarly or empirical; (d) among international articles more were empirical (66·3 % vs. 32·8 %; χ(2) ((1)) = 283·6, P < 0·001); (e) among non-international articles more were scholarly (29·2 % vs. 22·7 %; χ(2) ((1)) = 15·85, P < 0·001; 22·7 %); (f) 1004 (78·0 %) articles were international, based on author characteristics; (f) 20 (62·5 %) journals were led by an international editorial team; and (g) international journals had more international articles (3·6 % vs. 29·2 %; χ(2) ((1)) = 175·75, P < 0·001) and higher impact factors than non-international journals (t = -14·43, P < 0·001). CONCLUSION: Articles with empirical content appear more frequently in international journals. Results indicate the need to examine the international relevance of the nursing literature.

Online survey of nursing journal peer reviewers: indicators of quality in manuscripts.

Nursing journal peer reviewers (N = 1,675) completed a 69-item online survey that assessed their views on manuscripts' contributions to nursing, priorities in writing reviews, use of journal impact factor, and other areas related to indicators of quality. They reported using contribution to knowledge or research evidence, topic of current interest, and newly emerging area as indicators of a manuscript's contribution to nursing. In writing their reviews, research rigor and clinical relevance of the manuscript were high priorities. Those familiar with the concept of impact factor were significantly more often not nurses; not United States residents; involved in research; and most often reviewed for journals that published only research or a scholarly mix of research, reviews, policy, and theory. When judging a paper's contribution, nursing journal peer reviewers weigh both research and clinical interests. Most reviewers do not use impact factors and place clinical considerations ahead of impact factors.

Ethical concerns of nursing reviewers: an international survey.

Editors of scientific literature rely heavily on peer reviewers to evaluate the integrity of research conduct and validity of findings in manuscript submissions. The purpose of this study was to describe the ethical concerns of reviewers of nursing journals. This descriptive cross-sectional study was an anonymous online survey. The findings reported here were part of a larger investigation of experiences of reviewers. Fifty-two editors of nursing journals (six outside the USA) agreed to invite their review panels to participate. A 69-item forced-choice and open-ended survey developed by the authors based on the literature was pilot tested with 18 reviewers before being entered into SurveyMonkey(TM). A total of 1675 reviewers responded with useable surveys. Six questions elicited responses about ethical issues, such as conflict of interest, protection of human research participants, plagiarism, duplicate publication, misrepresentation of data and 'other'. The reviewers indicated whether they had experienced such a concern and notified the editor, and how satisfied they were with the outcome. They provided specific examples. Approximately 20% of the reviewers had experienced various ethical dilemmas. Although the majority reported their concerns to the editor, not all did so, and not all were satisfied with the outcomes. The most commonly reported concern perceived was inadequate protection of human participants. The least common was plagiarism, but this was most often reported to the editor and least often led to a satisfactory outcome. Qualitative responses at the end of the survey indicate this lack of satisfaction was most commonly related to feedback provided on resolution by the editor. The findings from this study suggest several areas that editors should note, including follow up with reviewers when they identify ethical concerns about a manuscript.

Scientific and statistical reviews of manuscripts submitted to Nursing Research: Comparison of completeness, quality, and usefulness.

Sound statistical analysis is fundamental to high-quality reporting of quantitative studies. Peer review are also important in determining whether statistical procedures in submitted manuscripts are appropriate and effectively reported. However, the quality of statistical reviews of manuscripts submitted to nursing journals has not been previously evaluated. The purpose of this project was to compare the content and quality of statistical and scientific (general) reviews of manuscripts submitted to Nursing Research. The General Assessment of Reviews of Nursing Research (GARNR) and the Statistical Assessment of Reviews of Nursing Research (SARNR) were used to evaluate 105 reviews of 35 manuscripts assigned to both scientific and statistical review between August 2007 and February 2009. Scientific reviews were rated as more comprehensive, but most did not evaluate statistical aspects of a manuscript. Statistical reviews were more likely to identify fatal flaws, were generally rated higher in overall usefulness to the editor in making a decision on whether to publish, and were rated as more useful to authors for improving a manuscript. Statistical and scientific reviews are complementary and both are necessary. More thorough integration of substantive and methodological content in reviews of quantitative studies has potential for even greater leverage of effort and improved quality of nursing research reports.

Prevalence and impact on quality of life of lower urinary tract symptoms among a sample of employed women in Taipei: a questionnaire survey.

BACKGROUND: Previous studies about the prevalence and impact of lower urinary tract symptoms (LUTS) were focused on urinary incontinence or overactive bladder in the general population. Little research has been focused on the role that the workplace has in employed women's experiences with LUTS or the impact of LUTS on their health-related quality of life (HRQL). OBJECTIVES: To estimate the prevalence of LUTS among employed female nurses in Taipei and to compare the HRQL for nurses with and without LUTS. DESIGN: This study was a cross-sectional, questionnaire survey. SETTINGS: Three medical centers and five regional hospitals in Taipei were selected randomly. PARTICIPANTS: In the selected hospitals, 1065 female nurses were selected randomly. Data analyses were based on 907 usable surveys. All participants were native Taiwanese; most of the female nurses were 26-35 years of age (mean=31.02, SD=6.32), had normal body mass index, and had never given birth. Most nurses' bladder habits were poor or very poor and their personal habits of fluid consumption at work were inadequate. METHODS: Data were collected using the Taiwan Nurse Bladder Survey and the Short Form 36 Taiwan version. Chi-square tests were used to compare the prevalence rates of different LUTS for nurses in different age groups. Student's t-tests were conducted to compare the mean scores of HRQL for nurses with and without LUTS. RESULTS: Based on 907 usable surveys, 590 (65.0%) experienced at least one type of LUTS. The prevalence for different LUTS ranged from 8.0% to 46.5%. Nurses who reported LUTS also reported lower HRQL, more so on physical health than mental health, than nurses who did not report LUTS. CONCLUSIONS: Although most of the nurses in this study were young (< or =35 years) and nulliparous, LUTS were common among this group. The high prevalence rate of LUTS leads to concerns about nurses' possible dysfunctional voiding patterns and possible effects of working environment and poor bladder and personal habits on LUTS. Study results showed a possible negative impact of LUTS on nurses' physical health. Designing a continence-related education program for this group is essential for delivering information about LUTS prevention and management.

Quality of manuscript reviews in nursing research.

Dissemination of research findings through publication of results in peer reviewed journals is the gold standard in nursing science. Yet, little is known about quality of manuscript reviews or factors associated with review quality. The purpose of this project was to refine a methodology for assessing quality of reviews and then to evaluate review quality. We created a continuous quality improvement process to assess the narrative portion of 464 reviews of 203 manuscripts submitted to Nursing Research from August 2006-July 2007. The General Assessment of Reviews of Nursing Research (GARNR) was developed to measure quality. Inter-rater reliability of the average of 2 raters' scores was satisfactory for most items and the scales. Quality was better for technical (design and methods) rather than background (theory and review of literature) aspects of a manuscript. Based on assessment of global quality, 18.9% of the reviews were deemed poor or inadequate. On average, statistical reviews were rated more highly than regular reviews, and reviewers from research intensive institutions wrote higher quality reviews than others. Recommendations for monitoring quality in the review process and guidelines for preparation of the review narrative to improve quality are made.

Experience, time investment, and motivators of nursing journal peer reviewers.

PURPOSE: To describe nursing journal reviewers' professional backgrounds, reviewing experience, time investment, and perceptions of their role. DESIGN: Exploratory descriptive cross-sectional study. METHODS: A 69-question survey containing both fixed-option and open-ended questions and accessed via the World Wide Web was completed by 1,675 nursing journal reviewers who had been invited to participate by editors of 52 nursing journals. FINDINGS: Participants were from 44 countries, with 74% from the US, and 90% were nurses. The majority were doctorally prepared academics who were involved in research. They reported spending an average of 5 hours on each critique and completed an average of 7-8 reviews per year. The most common reason reported for becoming involved was personal contact with an editor. Lack of time because of competing work commitments was the most commonly cited barrier to reviewing and negative aspect of the role. The most common positive aspect was keeping up to date with the field. CONCLUSIONS: Nursing journal peer reviewers express rewards and challenges similar to those reported elsewhere for biomedical journal reviewers. Based on these findings, editors might consider new approaches to recruiting and supporting reviewers, and potential reviewers might gain insight into the role. Support of these distinguished scholars in this important role is critical to sustain the quality of scholarship that informs nursing practice, education, and research. CLINICAL RELEVANCE: Clinicians, researchers, and educators who rely on the quality of the articles published in nursing journals can learn from this survey about the background and experiences of those who protect that quality by providing expert feedback to authors and editors.

Blinding in peer review: the preferences of reviewers for nursing journals.

AIM: This paper is a report of a study to assess the beliefs and preferences of reviewers for nursing journals about blinding of authors to reviewers, reviewers to authors, neither or both. BACKGROUND: Blinding of author and reviewer names in the manuscript review process has been of interest to nursing editors, but reports that are based on data rather than simply opinion concern the editorial practices of biomedical rather than nursing journals. There has been no study of nursing journal reviewer beliefs and preferences related to blinding. METHOD: A descriptive web-based survey was conducted. The sample included 1675 anonymous reviewers, recruited through 52 editors of nursing journals from their review panels. Data were collected in 2007. FINDINGS: Double-blinding of reviews was the most common method reported. Ninety per cent of respondents reported that the papers they received to review did not include author names. When author names were blinded, 62% of reviewers could not identify the authors of papers; another 17% could identify authors < or =10% of the time. Double-blinding was the method preferred by 93.6% of reviewers, although some identified some advantages to an unblinded open review process. CONCLUSION: Nursing journal reviewers are generally very satisfied with double-blinding and believe it contributes to the quality of papers published. Editors or editorial boards interested in a more open review process could consider alternatives such as offering authors and reviewers the option to unblind themselves. Simply announcing that the review process will henceforth be unblinded would probably lead to loss of reviewers.

Factors related to lower urinary tract symptoms among a sample of employed women in Taipei.

AIM: To identify factors associated with lower urinary tract symptoms (LUTS) among female elementary school teachers in Taipei. METHODS: This study is a cross-sectional, descriptive study. A total of 520 surveys were distributed to 26 elementary schools in Taipei. Logistic regression was used to identify possible factors related to individual LUTS. RESULTS: Study results were based on the information provided by 445 participants. Of the 445 teachers, 293 (65.8%) experienced at least one type of LUTS. Factors associated with urinary incontinence were body mass index (BMI), vaginal delivery, obstetric and/or gynecological surgery, bladder habits, and job control. Increased daytime urinary frequency was associated with chronic cough and chronic constipation. Bladder habits, straining to lift heavy objects at work and chronic constipation were associated with urgency. Nocturia was associated with age and caffeine consumption while intermittent stream was associated with the presence of a family history of LUTS and chronic constipation. Bladder habits and regular exercise were associated with weak urinary stream. Incomplete emptying was more likely to occur in teachers with chronic constipation and in those who did not exercise regularly. CONCLUSION: All the LUTS under logistic regression analyses were associated with 1-3 modifiable factors. Identification of these modifiable contributing factors may be useful to health care providers. Education of women may include the importance of maintaining normal body weight, good bladder/bowel habits, and regular exercise, treating chronic cough, decreasing daily caffeine consumption, and implementing feasible environmental modifications in employment settings.

Factors related to urinary incontinence in community-dwelling women.

Urinary incontinence (UI) is one of the most prevalent and costly health problems in the United States. Women participating in two clinical trials had experienced UI for a mean of 7.2 +/- 7.6 SD years. Hormone status, gynecologic surgery, alcohol intake, age, and educational attainment were significantly related to amount of urine loss. Amount of urine loss was also related to episodes of urine loss, caffeine and fluid intake, and quality of life.

Randomized clinical trial of efficacy of self-monitoring techniques to treat urinary incontinence in women.

AIM: To assess the efficacy of self-monitoring techniques to reduce urine loss and increase quality of life for women with urinary incontinence. METHODS: The design was a two arm, randomized, clinical trial with a wait list control group and 3-week intervention. Participants were 224 community-dwelling women 18 and older with UI. Self-monitoring was individualized counseling about fluid and caffeine intake, quick pelvic floor muscle contraction, voiding frequency, and management of constipation. The primary outcome measure was grams of urine loss. Secondary outcomes included episodes of urine loss, quality of life, and caffeine and fluid consumption. RESULTS: The main effect of self-monitoring on grams of urine loss was significant. After adjusting for baseline urine loss, time in the intervention or in wait list group, age, hormone status, and race the self- monitoring group lost an average of 13.3 g less urine and had improved 26.1 points in quality of life compared to the wait list group. The effect of self-monitoring on episodes of urine loss was not significant in the total sample but was more effective for women who had 9 or more episodes of urine loss, were 65 years or older, and were premenopausal or taking hormone replacement therapy. Participants in the self-monitoring group reduced their caffeine intake, but did not increase their fluid intake compared to the wait list control group. CONCLUSIONS: Since self-monitoring techniques are simple, safe, inexpensive, and within the scope of practice for most health professionals, they should be considered as first steps to treat women with UI.

Prevalence of lower urinary tract symptoms among female elementary school teachers in Taipei.

The aim of this study was to estimate the prevalence of lower urinary tract symptoms (LUTS) among female elementary school teachers in Taipei. A total of 520 self-administered surveys were distributed to 26 elementary schools in Taipei City. Data analyses were based on 445 usable surveys. The prevalence rates for different types of LUTS ranged from 9.9 to 44.5%. The prevalence of urinary incontinence (UI; 26.7%) and nocturia (16.0%) fell within the prevalence estimates of these LUTS in North American and European women. Employed women in this study were more likely to experience LUTS than women in previous epidemiological or community studies. This study extended research on UI into other LUTS among employed women in Asia. Study results suggest that the working environment may affect LUTS in female elementary school teachers. This preliminary study is important for developing future behavioral interventions for female LUTS in the workplace.

Developing and validating a Chinese instrument to measure lower urinary tract symptoms among employed women in Taiwan.

Lower urinary tract symptoms (LUTS), including urinary incontinence, negatively affect women's quality of life. Employed women are particularly prone to experiencing the negative aspects of LUTS due to their irregular access to toilet facilities. In Taiwan, about 70% of women 25-44 years of age are employed, yet little research on LUTS in the workplace has been conducted. In this article, the development of a Chinese instrument for estimating prevalence of LUTS and identifying factors related to LUTS among employed women is discussed. After instrument-generation and translations, content validity of the instrument was assessed and found to be satisfactory. Following a pilot test, psychometric testing of the instrument (which included test-retest reliability and internal consistency) was conducted. Test-retest reliability for the majority of the items and internal consistency for the construct LUTS were adequate. Based on initial psychometric testing, the authors suggest the instrument is appropriate for use with women in Taiwan. Additional testing is recommended before being used with other populations.

Awareness of urine flow in people with long-term urinary catheters.

OBJECTIVES: The purpose of this study is to acquire knowledge about urine flow in relation to fluid intake and urinary output, catheter blockage, and urinary tract infection in people with long-term urinary catheters. DESIGN: This was a community-based exploratory and descriptive study. SETTING AND SUBJECTS: The research was conducted in the homes of participants, who were interviewed in North Carolina from October 2002 to June 2003. The sample included 21 males and 9 females, aged 23-96 years; almost half were members of minority groups. INSTRUMENTS: A urinary diary was used, including intake and output recordings and narrative data, as well as a semistructured interview schedule. METHODS: Three-day fluid intake and urinary diary data were collected, followed by face-to-face tape-recorded interviews in participants' homes related to catheter experiences and practices. Analysis of data involved descriptive statistics and content analysis of narrative data. RESULTS: Although urine flow frequently was disrupted by urinary sediment or kinks in tubing, urinary tract infection was significantly related only to traumatic catheter manipulations or catheter blockage. Catheter problems associated with urinary tract infection included: (1) "rough" catheter insertions, (2) "difficult" insertions, and (3) catheter blockage. CONCLUSION: Self-monitoring of urine flow may help prevent urinary tract infection episodes through careful attention to catheter position and by preventing blockage. Further study is needed to fully understand the role of fluid intake and determine what causes traumatic catheter insertions.