Determinants of self-efficacy among persons with spinal cord injuries.

The purpose of this study was to determine the factors affecting self-efficacy among persons with spinal cord injury (SCI). The study population consisted of 105 persons with SCI who were discharged from one of eight hospitals in north central Alabama between October 1989 and September 1992. Data were derived from a retrospective acute-care medical record review and 12-month annual follow-up telephone interviews. The findings indicate that high self-efficacy is significantly associated with less severe neurological impairment, being white, employed at injury, having a high-school education or beyond, and having an unintentional injury. In terms of marital status our data indicate the odds of divorced persons having high self-efficacy are 8.2 (CL = 0.919, 74.1) times those of married persons. In addition, 64% of those who were divorced during the 12 months after injury had high self-efficacy compared to 50% of those who were divorced prior to injury.

Health outcome improvements in patients with systemic lupus erythematosus using two telephone counseling interventions.

OBJECTIVE: To examine the effectiveness of two telephone intervention strategies for improving the health outcomes of patients with systemic lupus erythematosus (SLE). METHODS: Fifty-eight SLE patients were randomly assigned to receive a 6-month telephone counseling intervention using either a treatment counseling (TC) or symptom monitoring (SM) strategy. Health outcomes were assessed using the Fatigue Severity Scale (FSS) and the Arthritis Impact Measurement Scales 2 (AIMS2). RESULTS: At the 6-month followup, the mean AIMS2 Physical Function scale and AIMS2 Social Support scale scores were significantly improved (P < 0.05) for the TC group compared to the SM groups. The mean FSS score, AIMS2 Affect score, and AIMS2 Pain score were significantly improved (P < 0.05) for both groups. CONCLUSIONS: Telephone interventions, especially using the TC approach, can be effective for improving the functional status of persons with SLE.

An educational intervention to increase use of the Glasgow Coma Scale by emergency department personnel.

Data from a large series of acutely injured patients revealed the Glasgow Coma Score was acquired in less than one half of those for whom it should have been documented. To improve these statistics, a five-part educational intervention based on an application of the PRECEDE-PROCEED model was developed. The study populations consisted of hospital-based nurse-managers and their emergency department nursing staff. Evaluation of the educational intervention's effectiveness suggested (1) simply conveying benefits of a particular patient care practice is insufficient to bring about immediate and permanent changes and (2) the most significant changes occurred in settings in which a formal policy and formal data collection procedures were established to accompany and reinforce the educational intervention. On-site advocacy and physician support are essential if changes in nursing practice are to occur in hospital emergency departments.

A three-year study of obesity and its relationship to high blood pressure in adolescents.

A sample of 356 matched cases were tracked for three years during high school. Measures taken included self-reported behavior and clinical measures of height, weight, skinfold, blood pressure, and body mass index. Data were analyzed by ethnic group, age, and sex groups. Three year (1981-1982 to 1984-1985) trends for students who were overfat, overweight, and obese revealed: a relatively greater proportion of female to male students were overfat as seniors; overweight trends for each of the four groups (ethnic group and gender) were stable over the study period; a sharp increase of obesity trends among black females was observed; and significant positive relationships existed between Percent Ideal Body Weight, skinfold thickness, Body Mass Index, and blood pressure among females of both ethnic groups. The hypothesis that the early onset of obesity is an indicator of obesity in older adolescents was supported. Students classified at risk as freshmen are more likely to remain at risk as seniors.

Citizen participation in health planning in the u.s. And the u.k.: implications for health education strategies.

The role of citizen involvement in the health planning process in Great Britain and the United States makes for interesting comparisons. Within both systems, the record of citizen participation in health planning has been mixed. Both the philosophical goals and political and economic realities of the two countries have contributed to the development of markedly different systems of health care delivery and for the perceived role of the citizens within this delivery system. While previous comparisons have primarily centered on the nature of the delivery systems and potential effectiveness and cost, this study focuses upon the citizen's role in effecting meaningful health planning in both societies. Furthermore, the study relates findings to implications for developing effective health education strategies based upon these understandings.

Enriching professional preparation in school health through international study.

This article describes how to develop, market, implement, and evaluate an international health education travel study course. The experiences described reflect an international travel study tour of England and Scotland conducted by the authors with 25 undergraduate and graduate students. The trip enhanced both the appreciation and professional knowledge of the students of a variety of perspectives in the health area. International study provides unique opportunities for student development and contributes significantly to the quality of professional preparation of school health personnel. These experiences complement traditional professional preparation programs and can result in improved health instruction and health services in schools.

The health belief model and the contraceptive behavior of college women: implications for health education.

PIP: This study applied the "health belief model" in a comparison of the subjective perceptions, attitudes and beliefs between college women who were adequate or inadequate contraceptors. The 171 sexually active subjects were ascertained from clients of the Family Planning Clinic at the University of Illinois. A questionnaire was designed and tested to measure variables of perceived susceptibility to pregnancy, seriousness of unplanned pregnancy, benefits and barriers of contraceptive use. Inadequate contraceptors or risk-takers were defined as women who used no contraception, less effective methods such as rhythm, spermicides only or withdrawal, or effective methods sporadically. 49.5% of the subjects were risk-takers. Among the inadequate contraceptors, 17% were nonusers, 29% relied on ineffective methods, and 52% used effective methods sporadically. There was no difference between the 2 groups in their belief in seriousness of an unplanned pregnancy. The groups differed significantly in their perceived susceptibility to pregnancy (p.001). They also differed significantly in perception of overall costs and benefits of contraception (p.001), a score created by combining 12 questions on topics such as difficulty and embarrassment in obtaining contraceptives and inconvenience and awkwardness in dealing with them. There was a smaller significant difference (p.05) in a score termed "general use cost benefits," but no difference in a score called "method specific perceptions." These results were corroborated by a discriminate analysis which singled out the perceived costs and benefits and the perceived susceptibility variables as accurate predictors of the adequate contraceptor group. The health belief model showed considerable utility in explaining contraceptive behavior.^ieng

Child safety programs: implications affecting use of child restraints.

Automobile deaths have been identified as the leading cause of death for children between the ages of one and fourteen. Those children who are unrestrained as passengers are at particularly high risk to injury and death. School health and safety programs need to include an understanding of this problem and implement efforts to increase restraint usage. A study of parental seatbelt and child passenger restraint use was conducted to identify frequency of use and behavioral and attitudinal factors influencing use of child restraints. Self-reported data of driver seatbelt use at all times was 19.0%, and the use of a child restraining device was 49.6%. Data recorded in a previous observational study noted a driver seatbelt usage rate of 14.2% and use of a child restraining device at 25.6%. Major reasons for non-use of seatbelts by drivers included discomfort and restricted movement. Reasons for non-use of child restraints focused upon the dislike and discomfort of the child for the restraint.

Representation of providers on health planning boards.

PL 93-641, The National Health Planning and Resources Development Act of 1974, called for broad representation of health care providers, in addition to consumers, on Health Systems Agency (HSA) governing boards. Analysis of data submitted to the U.S. Department of Health, Education, and Welfare by the HSAs indicated that HSA provider board members are not representative of the overall provider work force or general population. Direct providers outnumber indirect providers by roughly seven to one. Physicians and hospital-nursing administrators are overrepresented, and nurses and other provider groups underrepresented, in relation to their numbers in the work force. Evidence also shows that HSA provider board members are mostly white males, although nonwhites and females are significantly represented in the work force and population.