Reliability and validity of the Jefferson scale of attitudes toward physician-nurse collaboration for nurse practitioners.

BACKGROUND: The Jefferson Scale of Attitudes Toward Physician-Nurse Collaboration (JSATPNC) has been used to measure attitudes regarding nurse-physician collaboration. However, psychometric evaluation is lacking for the nurse practitioner (NP) population. PURPOSE: This study details a confirmatory approach in testing the factor analytic structure of the JSATPNC against previously reported structures. METHODS: A Web survey invited 4,673 licensed NPs where 915 responded. Confirmatory factor analysis (CFA) was performed to assess factorial validity. RESULTS: A previously proposed 3-factor model based had significantly better fit compared to a 1-factor structure (delta chi2 = 165.3, delta df = 3, p < .0001). Cronbach's alpha for the 3 subscales were 0.61, 0.62, and 0.54. Reliability with all 15 items was .72. CONCLUSIONS: Three collaboration subscales could have use in measuring attitudes toward physician-NP collaboration.

Examining the metabolic syndrome in Russia.

The purpose of this study was to examine the prevalence of the metabolic syndrome and its components among residents of a small town in Russia. A descriptive design was used to examine the metabolic syndrome and its components among a convenience sample of adults aged > or = 18 years. Health assessments and screenings were conducted in a rural health clinic in southern Russia. Data on blood pressure, fasting glucose, HDL cholesterol, triglyceride cholesterol and central obesity were collected, as well as demographic, health history and lifestyle information. 147 persons chose to participate. The majority of participants were female and 92% were > or = 47 years of age. Many persons suffered from three or more metabolic syndrome components, with hypertension the most common metabolic syndrome component. In conclusion, patients at the clinic were at risk for developing cardiac disease. Health screening and health education for cardiovascular and diabetes risk is needed to assist this population in decreasing their metabolic syndrome and its consequential effects.

An intergenerational group benefits both emotionally disturbed youth and older adults.

This qualitative descriptive study examined the perceived benefits of an intergenerational program for low-income older adults residing in subsidized housing and youth who were part of a support group for emotionally disturbed youth. The intergenerational group met bimonthly for 11 months at the independent living facility for the elderly. Activities consisted of group discussions, games, talent expressions, trips, picnics, and crafts. Frequently a teen was paired with an older adult to complete a craft project. Bonding between each pair occurred over time, as the older adults became role models for the youth. The perceived benefits of including emotionally disturbed youth and vulnerable but well older adults in an intergenerational program were determined by a structured interview and then through categorization of the participants' responses to a series of emotional, attitudinal, and behavioral questions using Yalom's (1985)Therapeutic Factors. The results indicated that both of the age groups' attitudes toward each other and relationships with each other changed positively. Behavioral changes among the youth included improved social skills observed by the co-facilitators of the group.

Central obesity and the metabolic syndrome: implications for primary care providers.

PURPOSE: To describe screening measures that will determine which clients are at risk for the metabolic syndrome, common manifestations of the syndrome, preventive diagnostic considerations, and management and treatment options that primary care providers can implement. DATA SOURCES: Review of the clinical and research literature, supplemented with specific diagnostic criteria. CONCLUSIONS: Central obesity is the cornerstone of the metabolic syndrome, which may lead to type 2 diabetes and cardiovascular disease. Generalized obesity is defined as body weight that is considerably greater than the ideal weight and that is distributed on all parts of the body. Generalized obesity has long been considered a significant risk factor for developing type 2 diabetes and cardiovascular disease. Those clients of ideal body weight have been considered at less risk for developing these conditions. However, this perception may not always be accurate. Weight distribution plays a major role in acquiring the metabolic syndrome. Because waist circumference is as important as overall body weight, central obesity is key to determining the risk. IMPLICATIONS FOR PRACTICE: The metabolic syndrome has now been given a CPT code (277.7). It is more likely that clients at risk for or with the metabolic syndrome may first be seen by a primary care provider. Primary care providers need to be able to diagnose, treat, and provide preventive interventions for the metabolic syndrome. Clients at risk will likely be identified during routine health screening. Early detection of and interventions focused on the metabolic syndrome may reduce the occurrence of type 2 diabetes and cardiovascular disease. Use of a tape measure to determine waist circumference may help the provider to identify at-risk clients who are of normal weight, and thus not previously believed to be at risk, as well as those more obviously at risk. It is necessary to determine not only patients' overall body weight but also their waist circumference. A measuring tape may be the key tool for establishing a patient's early risk for the metabolic syndrome and, ultimately, for prevention of type 2 diabetes and cardiovascular disease.

Early detection of type 2 diabetes among older African Americans.

The purpose of this research was to determine whether a group of African Americans who had no diagnosis of type 2 diabetes had elevated blood glucose levels and other risk factors indicative of type 2 diabetes. A convenience sample of 20 African American adults 50 years and older participated in the pilot study. Participants were screened for elevated fasting capillary blood glucose levels and related risk factors such as hypertension, high cholesterol levels, and high body mass index. Frequency data indicated that at least 50% of participants had capillary glucose levels greater than 110 mg/dL. An overwhelming majority of the participants with elevated glucose levels had one or more other risk factors for type 2 diabetes. Evidence-based practice clearly indicates that an early detection and control of type 2 diabetes can prevent complications and also help prevent coronary artery disease.

ENTER: a care guide for successfully educating patients.

The role of the nurse as teacher is assumed and preparation for the patient at discharge becomes the ultimate responsibility of the nurse. Furthermore, patient education continues to grow in importance. Because of increasing demands on time and full schedules, nurses are in need of a quick and practical solution to offering valuable patient education. The ENTER acronym is written with the practicing nurse in mind. It is a simple framework that provides a model for staff development educators to use to assist nurses to become better patient educators.