Reliability and validity of the Overeating Tension Scale.

This study presents the development and testing of the Overeating Tension Scale. Overeating tension was defined operationally as the total discrepancy score resulting from differences between subjects' ratings of actual and desired feelings before overeating. The 32-item Overeating Tension Scale, derived from Apter's Reversal Theory, measures reported overall tension and motivation-specific tension. The scale initially included 48 items, six items for each of eight motivational states. After two instrument development studies (N = 373, N = 208), items were refined and reduced to a total of 32, or four for each of eight motivational states. The final version of the instrument was tested in two additional studies (N = 330, N = 130) that provided evidence to support the internal consistency reliability of the Overeating Tension Scale. There was support for construct validity using contrasted groups (overweight and normal weight subjects), convergent validity, and factor analysis.

Use of the BULIT bulimia screening questionnaire to assess risk and progress in weight management for overweight women who weight cycle. BULImia Test.

A bulimia screening questionnaire was examined for usefulness in assessing risk for bulimia and measuring progress in reducing binge eating in overweight women who weight cycle. In two studies the BULIT test was used to screen for risk for bulimia. Study 1 was a descriptive study of motivations for overeating in normal weight women compared to overweight women who weight cycled. In Study 2, overweight women who weight cycled were examined at baseline, 6, and 12 months for effectiveness of a clinical treatment strategy to reduce binge eating. In Study 1, BULIT scores were statistically significantly higher for overweight compared to normal weight subjects. In Study 2, subjects' BULIT scores were lower after using a long term clinical treatment strategy to gain control of eating. The BULIT test was useful for specifying four categories of eating patterns to assess risk for bulimia and progress in reducing binge eating.

A concept analysis on the process of empowerment.

Definitions of empowerment abound in contemporary literature of many disciplines. The purpose of this article is to apply strategies by Walker and Avant to analyze the concept of empowerment from the nursing discipline. Definitions of empowerment and contextual applications are examined using dictionaries and professional literature. Defining attributes are identified and listed in order of importance. Antecedents and consequences of empowerment are discussed, and model, borderline, and contrary cases also are presented. A summation of the analysis along with directions for further research are presented. Clients are limited to and defined for this article as patients and families.

Triggers of overeating and related intervention strategies for women who weight cycle.

The purpose of this study was to describe overeating episodes of overweight women who weight cycle compared with women of normal weight. Repeated overeating can be a major source of excess calories that may lead to weight gain in women who have weight cycled. Interview transcripts about overeating episodes of 45 women were subjected to a content analysis in a qualitative secondary analysis of data. Four patterns emerged from the data: planned overeating, power/control, relationships with others, and unpleasant feelings. Three intervention strategies are described to assist women who have weight cycled to understand and deal with feelings that trigger overeating, including strategies to stop overeating, feel their feelings, and fight fairly.

Overeating, reversal theory, and weight cycling.

America's overweight problem is universally recognized and escalating, despite billions of dollars spent to combat it. For the past century, a unidimensional paradigm was predominantly used to correct the overweight problem by reducing calories through dieting. As a result of the profound failure of traditional diet programs, a phenomenon known as weight cycling was born. In this article, a multidimensional paradigm is emphasized to address weight cycling. Reversal theory extends a new theoretical basis that can account for unpleasant feelings, or tension stress, as a trigger of overeating in women who weight cycle. A case example demonstrates how reversal theory explains overeating as a response to high-tension stress. Results of two studies are presented, describing overweight and normal-weight women's reversal theory states during self-reported episodes of overeating and resisting overeating. The multidimensional paradigm calls for emotional overeating behaviors to be addressed in weight management.

Socialization of new graduate nurses in critical care.

OBJECTIVE: To examine the modified contingency theory of role socialization with new graduate nurses in critical care. DESIGN: Descriptive comparative. SETTING: Six midwestern hospitals with 12 types of critical care units. SAMPLE: Fifty new graduate nurses and 89 experienced registered nurses in critical care. OUTCOME MEASUREMENTS: The socialization variables of precepting, support systems, assignment congruence, role conception, self-confidence, affective responses, commitment, job satisfaction, confronting reality, mutual influence, resolution of outside life conflicts, and resolution of conflicting demands at work were measured. New graduates responded to questionnaires about socialization at 1 to 2 weeks, 3 months, and 6 months of employment. Experienced nurses completed a questionnaire about socialization once, simultaneously with the 1- to 2-week data collection for new graduates. RESULTS: At initial employment new graduates differed from experienced nurses in role conception, self-confidence, and commitment to profession. After 6 months of employment new graduates differed from experienced nurses in self-confidence and mutual influence. For new graduates, positive precepting experiences, support systems, and assignment congruence were related to high self-confidence, low anxiety, high commitment, high job satisfaction, and low role conflict and ambiguity. These variables were also associated with the development of role conception. CONCLUSIONS: The study results lend considerable support to the modified contingency theory of role socialization. Positive precepting experiences, support systems, and assignment congruence contributed to successful socialization for the new graduates in this study.

The subjective and psychosocial nature of breathlessness.

Dyspnoea, also referred to as breathlessness, is a concern of nurses in most clinical settings. Nursing interventions are directed toward preventing or treating dyspnoea in a timely manner. Even though dyspnoea is a common phenomenon found in clinical settings and discussed in the literature, it has not been added formally to the list of diagnoses developed by the North American Nursing Diagnosis Association, most likely because it is an isolated, observable sign. However, breathlessness, the related construct, is a distinctly different phenomenon from dyspnoea. The terms dyspnoea and breathlessness are used interchangeably in the literature. Traditionally, dyspnoea is defined as difficult or laboured breathing observable to another person. Breathlessness is the subjective feeling of laboured breathing with and without dyspnoea and/or abnormal pulmonary functions. These authors submit that the nursing diagnosis of breathlessness consists of two essential defining criteria, the subjective feeling of difficulty in breathing and anxiety, in the presence or absence of dyspnoea and/or abnormal pulmonary functions. A biopsychosocial model is presented to guide research and nursing care for individuals who experience breathlessness.

Promoting situational support for nurses in practice.

Situational support entails promoting autonomy, control over practice, group cohesion, manager consideration, and substantive exchange. Support can reinforce nurses' coping mechanisms, preserve their integrity, and thereby promote quality patient care. Using concept clarification and case examples the authors identify support mechanisms and coping styles for nurses at work and discuss how situational support can be used to cope with stress.

Holistic Self-Care Model for permanent weight control.

Nearly one fourth of adult women in the United States are currently overweight, despite numerous approaches to weight control. Nurses are confused about appropriate interventions for overweight women who weight cycle--that is, experience repeated periods of weight loss followed by weight regain. Women continue to suffer the negative physical, psychological, and financial consequences of weight cycling, which is related to increased adiposity, an additional important health risk. Moderately successful, long-term weight control treatments are programs that have a combined intervention prescribing both controlled amounts of health food intake and aerobic exercise. Although such a physical program can promote weight loss, the psychological components often are not considered and are the reasons why so many diet/exercise programs fail. The Holistic Self-Care Model combines the successful physical, cognitive, and psychological essentials of healthy approaches for weight reduction as a means of stopping weight cycling and promoting weight control.

Advanced rehabilitation nursing care of coronary angioplasty patients using self-efficacy theory.

The rapidly increasing numbers of patients who experience coronary angioplasty have not been widely studied concerning their rehabilitation, risk factor modification, health maintenance and role resumption. Bandura's self-efficacy theory serves as the framework of a study designed to explore the efficacy expectations for and behavioural performance of walking, following a diet, health maintenance, resumption of role and return to work in angioplasty patients. Based in this study, assessment and intervention strategies used by cardiovascular clinical nurse specialist authors are described with a clinical example.

Body image measurement in overweight females.

This article details two studies of the reliability and validity of three instruments to measure body image and suggestions for their use in interventions for weight control programs. Weight control programs often fail because there is no attempt to modify clients' negative body images; hence clients may regain weight to match incorrect images. Short, easily administered instruments, such as the Nash Body Image Scale, the Body Image Photo Technique, and the Body Shape Questionnaire used in these studies, are needed to evaluate clients' progress in weight control programs. Subjects were 120 women who were either satisfied or dissatisfied with their body image and weight. All subjects completed body image measures at the outset of the study and 43 subjects completed measures again to determine trait stability of body image at 1 year. Cronbach's alpha estimates provided evidence of reliability, with internal consistency coefficients ranging from .83 to .96. Validity of the measures was supported by significant correlations with scores on the Physical subscale of the Tennessee Self-Concept Scale (r = .60 to .63) as well as by significant differences on the three measures between normal-weight and overweight groups (Nash: F = 28.03, p = .001; Photo: F = 11.58, p = .001). Body image was found to be stable over the 1-year period on the Nash Body Image Scale and the Body Image Photo Technique. These instruments can provide valuable information and potential intervention content for practitioners and researchers alike. The three body image instruments discussed were found to have sufficient reliability and validity to warrant their use in practice and research.

Compounded problem: chronic low back pain and overweight in adult females.

Overweight adult females may have negative self-concepts and body images compounded by chronic low back pain and obesity. This subgroup of clients need special attention and nursing interventions to adjust to chronic low back pain and to achieve permanent weight control. Interventions designed to improve female clients' self-concepts and body images also support their efforts toward weight control, and, in turn, improve their negative perceptions of chronic pain. Orthopaedic nurses are in an excellent position to explore the relationships among body image, overweight, and chronic low back pain.

Wellness nursing diagnoses: to be or not to be?

Problem orientation has dominated the nursing diagnosis movement since the early 1970s. The purpose of this article is to discuss how the new nursing diagnosis definition provides opportunity for a wellness perspective to be incorporated into the movement. Wellness is differentiated from illness and health, and conceptual model is offered to clarify these concepts. Work is reviewed from the growing number of authors who have supported wellness nursing diagnoses and advocated their incorporation into the current taxonomic listing. Cases of ill-well and well-ill clients and examples of wellness nursing diagnoses are included to emphasize the need for wellness diagnoses across the wide scope of nursing practice. Nurses are challenged to generate, research, and use wellness diagnoses in their practices.

Self-injury concept formation: nursing diagnosis development.

Self-inflicted injury, an increasingly common phenomenon in psychiatric settings, often is seen in borderline clients who scratch or burn themselves repeatedly. Their dysfunctional behavioral patterns present special challenges to the psychiatric/mental health nurse who seeks to interrupt such destructive means of coping. Aside from the difficult task of assisting these individuals to deal with their feelings in a constructive way, the psychiatric nurse often struggles with difficult countertransference feelings. The authors review a historical perspective of self-injury behaviors, define the phenomenon through the procedure of concept analysis, propose the creation of a new nursing diagnosis, and outline interventions appropriate for these clients.