Stages of smoking acquisition of young Taiwanese adolescents: self-efficacy and decisional balance.

The objective of this study was to assess relationships of the stages of smoking acquisition with self-efficacy and decisional balance in young Taiwanese adolescents. A random sample of 401 students was recruited. Students who were at the precontemplation stage had higher self-efficacy to resist smoking initiation than those who were at the decision-making or maintenance stages. Ratings of benefits of smoking were significantly higher for those in the maintenance stage than in the precontemplation or decision-making stages. In a discriminant function analysis, self-efficacy and decisional balance correctly predicted 77.4% of membership in the three stages. Health educators could use stage-specific skills and strategies based on self-efficacy and decision balance constructs to develop smoking prevention programs.

Oral health of adolescents--it's more than dental caries.

Of all the health issues common to adolescents, oral health has not seemed to receive much attention. However, just as "eyes are the windows to the soul," the oral health of an adolescent can be a reliable and expedient indicator of general health. Lesions discovered during an oral exam can indicate systemic problems that may not otherwise be disclosed during the health history. Tobacco use, sexually transmitted infections, and type II diabetes can manifest in the mouth, and many of these lesions mimic other illnesses. It is essential that nurses who work with adolescents be aware of possible differential diagnoses beyond the typical canker sores, herpes simplex type I, and periodontal disease so commonly seen. Adolescents rarely enter the healthcare system, but school and camp nurses and nurse practitioners have access to teens on a regular basis. They can screen adolescents for oral health problems and teach them practices that may prevent health problems with lifetime consequences. Capitalizing on this opportunity to educate adolescents can be critical to their long-term health.

State regulations for the pediatric nurse practitioner in acute care.

INTRODUCTION: In response to economic factors affecting health care costs in caring for acutely ill children, pediatric nurse practitioner (PNP) practice has expanded to include the acute care pediatric nurse practitioner (PNP-AC). With this change in practice and in educational preparation, there have been changes in credentialing, certification, and, in some cases, state regulations. This study was conducted to clarify the state regulations for the PNP-AC. METHOD: A survey of the practice chairs, executive directors, or both, from each state Board of Nursing and the District of Columbia (n=51) was performed to determine whether PNP-ACs are recognized in each state and if not, what they would need to do to become eligible for recognition. RESULTS: The majority of states (31) require that PNP-ACs take the AC certification examination, and 10 require the primary care examination. The remainder of the states have variations in their requirements. DISCUSSION: Because this is an area that is changing rapidly, PNPs working in acute care settings need to stay abreast of changes in their state requirements.

The chinese version of the decisional balance scale: further validation.

BACKGROUND: Although the Decisional Balance Scale (DBS) has been established to have sound psychometric properties, the reliability and validity of this instrument have not been evaluated in different populations. OBJECTIVES: The aim of this study was to conduct psychometric validations for the Chinese version of the DBS (CDBS). METHODS: This research project was designed as a descriptive cross-sectional study. The CDBS was administered to children in Grades 5-9 (ages 11-17 years, n = 952) recruited from elementary and junior high schools in northern Taiwan. A random cluster sampling method was used. RESULTS: The pros and cons subscales were supported by Cronbach's alpha coefficients of .88 and .85, respectively. Item-to-subtotal correlation coefficients for the subscales were above .48. The results from confirmatory factor analysis, used to assess the construct validity of the CDBS, indicated that the two-factor structure was the best fit for the CDBS when it was used with Taiwanese adolescents (comparative fit index = .96). The contrasted group approach affirmed the construct validity of the pros and the cons of the CDBS. The validity and reliability of the CDBS were supported by the psychometric test results of this study. DISCUSSION: The CDBS is congruent with the culture of Taiwanese adolescents. However, to expand the usefulness of this tool across cultures, the CDBS should continue to be tested with other Chinese-speaking populations and settings.

Cross-cultural validation of the stages of the tobacco acquisition questionnaire and the decisional balance scale.

The first phase in a study of smoking behaviors of 11- to 14-year-old Taiwanese children was designed to ensure the reliability and validity of newly translated instruments. The stages of the tobacco acquisition questionnaire (STAQ) and the decisional balance scale (DBS) were translated into Chinese, then back-translated into English. The DBS was adapted based on input from a focus group with young adolescents, reviewed by a panel of experts and laypersons, and pilot-tested. The next step consisted of administering the instruments to 401 children (ages 11-14 years) for psychometric testing. Factor analysis yielded three components for the STAQ accounting for 57.8% of the total variance, with alphas of the subscales ranging from.85 to.92. The DBS had two components accounting for 59.3% of the total variance, with alphas of.87 and.90 for the subscales. Accuracy of the translated instruments was supported by the psychometric test results.

Touchpoints: changing the face of pediatric nurse practitioner education.

Touchpoints is an interdisciplinary relational model of healthcare primarily used with parents and young children. The underlying premise of the Touchpoints approach is to support the parent/child relationship during the health encounter by enhancing parents' efforts to optimize their child's physical and psychological development. Nurse practitioners who use this approach in practice find they are able to connect quickly to the parents' most urgent concerns for their child. Our experience has been that a pediatric nurse practitioner program that uses Touchpoints as the underlying framework can assist students in achieving a holistic view of families by focusing the curriculum more directly on development and relationships. Students learn that building a relationship with parents, and joining them in the care of their child, produces an atmosphere in the health encounter of mutual respect and trust. Parents leave the encounter feeling satisfied their concern for their child has been heard and questions have been seriously discussed; students leave feeling competent and valued by their patients. Touchpoints provides a model for teaching and demonstrating the development of interpersonal relationships by using the language of the child's behavior.

Validation of the smoking self-efficacy survey for Taiwanese children.

PURPOSE: To determine the psychometric properties of the Chinese version of the smoking self-efficacy (SSE) survey. DESIGN AND METHODS: The SSE survey was translated into Chinese then was back-translated into English, reviewed for content validity, pilot tested, and administered to 401 children between December 1998 and August 1999. A random cluster sampling method was used in this study. FINDINGS: Reliability was indicated by Cronbach's alpha coefficient, .98. The validity of the SSE scale was determined by face validity, item-total correlation coefficient, content validity index, and concurrent validity. Principal component analysis was done to determine the construct validity of the SSE scale. The revised SSE scale had three components accounting for 74.3% of the total variance with alpha of .96. The correlation coefficient between the SSE and revised SSE scale was .99. CONCLUSIONS: Findings show that the revised SSE scale is not only parsimonious but also it is as reliable and valid as is the original SSE scale. This translated instrument is appropriate for use in studies of smoking behavior in Taiwanese children aged 11 to 14 years. Further research will be needed to validate the SSE scale with different populations and settings in Taiwan.