Adolescent cigarette smoking and health risk behavior.

During the past 30 years, tobacco use among adolescents has substantially increased, resulting in major health problems associated with tobacco consumption. The purpose of this study was to identify adolescent smoking behaviors and to determine the relationship among smoking, specific demographic variables, and health risk behaviors. The sample consisted of 93 self-selecting adolescents. An ex post facto design was used for this study and data were analyzed by using nonparametric statistics. Findings included a statistically significant relationship between lifetime cigarette use and ethnicity. Statistically significant relationships were also found among current cigarette use and ethnicity, alcohol use, marijuana use, suicidal thoughts, and age at first sexual intercourse. Nurses and other providers must recognize that cigarette smoking may indicate other risk behaviors common among adolescents.

Variations in feminine hygiene practices of military women in deployed and noncombat environments.

There is limited information on how military women manage feminine hygiene practices in combat and noncombat environments. The purpose of this study was to describe feminine hygiene practices of military women in deployed and noncombat (normal) environments. A nonexperimental descriptive research design was used. The study used a survey questionnaire, the Deployed Female Health Practice Questionnaire, which was developed specifically for military women to report their experiences with hygiene issues. Significant differences between deployed and normal environments were found in the areas of types of menses management products used and in douching and handwashing practices. Continuing education about safe feminine hygiene practices will help military women cope better in deployed (field) environments. Recommendations suggest further study on intervention strategies for hygiene management practices.

The Starr County Diabetes Education Study: development of the Spanish-language diabetes knowledge questionnaire.

OBJECTIVE: This study reports the psychometric properties of the 24-item version of the Diabetes Knowledge Questionnaire (DKQ). RESEARCH DESIGN AND METHODS: The original 60-item DKQ was administered to 502 adult Mexican-Americans with type 2 diabetes who are part of the Starr County Diabetes Education Study. The sample was composed of 252 participants and 250 support partners. The subjects were randomly assigned to the educational and social support intervention (n = 250) or to the wait-listed control group (n = 252). A shortened 24-item version of the DKQ was derived from the original instrument after data collection was completed. Reliability was assessed by means of Cronbach's coefficient alpha. To determine validity, differentiation between the experimental and control groups was conducted at baseline and after the educational portion of the intervention. RESULTS: The 24-item version of the DKQ (DKQ-24) attained a reliability coefficient of 0.78, indicating internal consistency, and showed sensitivity to the intervention, suggesting construct validation. CONCLUSIONS: The DKQ-24 is a reliable and valid measure of diabetes-related knowledge that is relatively easy to administer to either English or Spanish speakers.

Camp Can-Do. Outcomes of an experiential learning experience.

Because the most effective way to learn is by doing, faculty need to develop experiential learning experiences for students. The authors discuss one such experience, a multiple sclerosis camp where nursing students lived with and cared for their clients for 6 days. The camp experience illustrates how educators can partner with community organizations to the benefit of both.

Perspectives in adolescent risk-taking through instrument development.

Understanding the high-risk adolescent's perception of risk taking is essential for health professionals to determine appropriate interventions. The purpose of this study was to examine the psychometric properties of the revised Adolescent Risk-Taking Instrument (ARTI) designed to measure the high-risk adolescent's perception of risk taking. This study also examined the variables that are most predictive of social adaptation and risk taking. An ex post facto design was used to standardize data collection and to assess the psychometric properties of the revised ARTI. The nonprobability sample consisted of 167 adolescents attending school in an urban, health-underserved area. Exploratory factor analysis supported construct validity, and Chronbach's Coefficient Alpha supported internal consistency reliability. The reliability coefficient for the risk taking and social adaptation constructs were .80 and .77, respectively. Current perspectives on adolescent risk taking and implications for the use of the ARTI in clinical practice are addressed.

Family adaptation to a child's transplant: pretransplant phase.

The purpose of this study was to explore the relationship between family stress, family coping, social support, perception of stress, and family adaptation from the mother's perspective during the pretransplant period in the context of the Double ABC-X Model of Family Adaptation. The process of seeking a transplant for a child is very stressful, and before interventions can be developed, clinicians need to understand how aspects of family life are affected. Twenty-nine mothers whose children were being evaluated for a liver transplant constituted the sample for this exploratory study. Higher family strains, fewer coping skills, and higher perception of stress were related to more unhealthy family adaptation during the pre-transplant phase. Data point to the need for close evaluation not only for the child's needs but for the family's needs as the family begins the process of seeking a transplant for the child.

Problem-based learning. An outcomes study.

Problem-based learning (PBL) as a dynamic teaching methodology was detailed in the March/April 1998 issue of Nurse Educator. In this article, the second part, an outcomes study completed to evaluate PBL as a teaching methodology for registered nurse students is described. Two qualitative and two quantitative studies were conducted and are reported in this article. The results definitely support PBL as an effective teaching strategy for nursing educators.

A comparative study of cocaine-treatment completers and dropouts.

This study compared matched groups of completers and dropouts from residential treatment for cocaine abuse on a range of outcome measures, including cocaine and alcohol use, stress, coping, and social support characteristics. The most striking finding of this study was that treatment dropouts differed from treatment completers on only 2 of 14 dependent measures reflecting substance use, stress, coping, and social support characteristics during two 3-month follow-up periods. Both dropouts and completers demonstrated large decreases in cocaine and alcohol use from pretreatment to the first follow-up period. Completers and dropouts did not differ in level of substance use during either follow-up period.

Intervention for medical students: effective infection control.

Needlestick injuries, which lead to the transmission of hepatitis B, hepatitis C, and the AIDS virus, are a potentially serious threat to students during their clinical experiences. Exposure to infectious diseases, blood, and hazardous body fluids is one of the most frequently reported injury events by medical students at a health science center in the southwestern region of the United States. This study was conducted to determine the effectiveness of a customized intervention about infection control for second-year medical students (N = 200). Preparation for the intervention included a needs assessment, which included both qualitative and quantitative research methods that incorporated input from fourth-year medical students, medical staff members, and local hospital infection control specialists. The intervention included a pretest, a lecture, a demonstration of standard precautions and infection control procedure with 2 clinical scenarios, an exercise on proper handwashing, and a posttest. The evaluation of the intervention demonstrated a significant increase in posttest knowledge scores about infection control (from 12.6 +/- 2.1 pretest to 16.5 +/- 1.8 posttest, P < .001). Medical students showed a significant knowledge increase about infection control after participating in the intervention . Thus we recommend that all medical colleges and universities develop and evaluate a similar customized intervention for their medical students.

The nurse as exemplar: smoking status as a predictor of attitude toward smoking and smoking cessation.

The smoking behavior of oncology nurses is of particular concern, not only because of the personal risk, but also because of the negative influence the behavior may have on the public. A survey of 316 female oncology nurses in Texas was conducted to assess smoking prevalence in this sample and the manner in which smoking status impacts the attitudes of these nurses toward their roles as exemplars and advocates for nonsmoking. The prevalence of smoking in this sample of oncology nurses was 7%, with an additional 26.2% being ex-smokers, supporting a downward trend in smoking among oncology nurses. Differences among oncology nurses who were smokers, ex-smokers, or nonsmokers concerning their attitudes toward smoking were investigated. Nonsmokers and ex-smokers showed a more positive attitude toward their roles as exemplars and in counseling the public about the health hazards of smoking.

What do students with learning disabilities think when their general education teachers make adaptations?

The purpose of this study was to investigate the perceptions of mainstreamed students with learning disabilities (LD) regarding adaptations (e.g., altering tests, homework, assignments, instruction) made by general education teachers. Furthermore, their responses were compared with those of low achieving (LA) and average/high achieving (A/HA) classmates. One hundred seventy-nine students participated in this study: 60 mainstreamed students with LD, 59 low achieving students, and 60 average/high achieving students. Students were selected from 60 teachers' classrooms (20 elementary, 20 middle school, and 20 high school). Results from the elementary level indicate that students with LD differ from their LA and A/HA classmates in that the former indicate a stronger preference for opportunities to work in groups with different students, and prefer the teacher to make adaptations when they have difficulty learning. High school and middle school students from both the LA and A/HA groups, but not the LD group, preferred the teacher who made no adaptations in homework and textbooks. Discussion focuses on the role of students' perceptions in teacher decision making.

Personality and coping styles in the prediction of dropout from treatment for cocaine abuse.

This study was designed to distinguish between dropouts and completers of residential therapeutic community treatment for cocaine abuse on the basis of the Millon Clinical Multiaxial Inventory II (MCMI-II; Millon, 1987) and Ways of Coping Checklist (WCCL; Folkman, Lazarus, Dunkel-Schetter, DeLongis, & Gruen, 1986) scales, which measure detached, dependent, and independent personality and coping styles. Dropouts were differentiated from completers in two discriminant functions defined, in part, by scores on scales that tap a fiercely independent orientation with manipulative, exploitive, and confrontive interpersonal features. Also contributing to the discriminant functions identified in this study were scores on scales that measure responsiveness to direction from others associated with strong desire for social approval and ability to establish self-control of emotional and behavioral reactions.

Cognitive motivations for drinking among alcoholics: factor structure and correlates.

The aims of this study were to: a) Identify factors reflecting reasons for drinking and expectancies regarding the effects of drinking among inpatient alcoholics; b) Examine the relationship between these cognitive "motivations" for drinking and both patterns of alcohol consumption and various personal and social consequences of consumption. The factors which emerged relate to negative mood reduction, positive mood enhancement, and social functioning. Although the factors identified in this investigation were not associated with quantity of alcohol consumed, small to moderate associations were found between scores on three of four factors and a variety of adverse physical and occupational consequences of alcohol abuse.

Development and evaluation of the revised Alcohol Evaluation Instrument.

This study reports on the development of a revised version of the Alcohol Evaluation Instrument (ALCEVAL-R). Items in the four major areas of the ALCEVAL-R were factor analyzed separately and relationships among factors were examined. Results suggest that the ALCEVAL-R measures clinically meaningful aspects of the alcoholic patient's occupational and social status, and reveals important dimensions of alcohol consumption and of the personal and social consequences of alcohol abuse.

A needs assessment investigation of continuing medical education in risk management.

Training of physicians in risk management has become an important task for continuing medical education (CME) directors, particularly in states where risk management education is required for licensure. Physicians in Florida who completed an introductory program in risk management were surveyed to determine future topics for risk management education. Physicians identified desired topics using a five-point Likert-type scaling (5 = high priority; 1 = low priority) and rated 55 topics within 10 major subject areas. The means, standard deviations, and rank order of topics within the subject areas are reported. Multivariate analysis of variance (MANOVA) revealed no significant differences between surgeons and non-surgeons with respect to the subject areas. A significant difference, however, was shown, between academic physicians and non-academic (private practice) physicians; non-academic physicians gave significantly higher scores to six subject areas: malpractice, medical records, acts or omissions constituting negligence, negligence/malpractice actions, defenses, and risk management programs. The results suggest that it is not necessary to plan separate risk management education programs for physicians according to their specialty; one should note, however, the higher priorities given by non-academic physicians and consider these differences when planning advanced risk management programs.