College student's attidudes and beliefs about the consequences of smoking: development and normative scores of a new scale.

PURPOSE: To develop an instrument that could be used to assist young adults to determine their perceived consequences about cigarette smoking. The new instrument consisted of 27 items measuring attitudes about smoking selected from the literature and to a convenience sample of 172 undergraduate college students. Psychometric assessment using an exploratory factor analysis revealed four factors (subscales) that explained 48% of the variance. These were labeled attitudes and beliefs about smoking related to emotional benefits, health hazards, self-confidence, and body image. CONCLUSIONS: Statistically significant differences between mean scores of smokers and nonsmokers were found on attitudes and beliefs about the benefits of smoking related to emotional benefits, self-confidence, and body image; smokers' answers indicated that they perceived these as positive consequences of their smoking behavior. IMPLICATIONS FOR PRACTICE: The newly constructed instrument may be a useful assessment of college students' reasons for smoking. This approach offers new hope for successful cessation counseling and for smoking prevention programs. Currently antismoking methods emphasize the health hazards of cigarette smoking and have not been sufficient in reducing the rate of smoking in the young adult population. Some young people may use smoking as strategy for dealing with stressful situations, weight control, and lack of self-confidence. Thus, smoking cessation programs should also include strategies to use in place of smoking during periods when stress and lack of self-confidence are high.

Predictors of rural critical care nurses' willingness to care for people with AIDS.

The purpose of this study was to examine the relationship between rural critical care nurses' attitudes about acquired immunedeficiency syndrome (AIDS) and people with AIDS (PWAs), and their willingness to provide care to AIDS patients. Sixty-one critical care nurses in nine rural counties in the northeastern USA completed a mailed questionnaire as part of a larger study of 957 rural nurses. A bivariate logistic regression analysis revealed a relationship between willingness to provide care and positive attitudes about homosexuality, nursing care concerns, and professional-societal concerns. However, a multivariate logistic regression indicated that the most significant factors influencing rural critical care nurses' willingness to care were their feelings of not being prepared to care for people with AIDS, and their anxiety and fears about contracting the disease from their patients. These findings add insight into the care of critically ill AIDS patients and support the need for continuing educational efforts in rural areas of the USA to address critical care nurses' concerns.

Personal and social determinants of rural nurses' willingness to care for persons with AIDS.

The purpose of this study was to investigate the individual and social determinants of rural nurses' willingness to care for people with AIDS (PWAs). Willingness to care was viewed as a function of nurses' personal attitudes about AIDS care and PWAs; the influence of normative (significant others), comparative (the nursing profession), and generalized (the rural community) reference group norms on these attitudes; and how much importance respondents placed on membership in these reference groups. Responses to a mailed questionnaire from 615 rural nurses were analyzed. Individual determinants were nurses' feelings of preparedness and favorable attitudes about their personal safety when administering care. Social determinants were the degree of upset of respondents' significant others about their caring for AIDS patients and favorable attitudes of the respondents about professional and social concerns related to AIDS.

Rural school nurses' attitudes about AIDS and homosexuality.

The AIDS epidemic has spread to rural areas of the United States. Conservative rural communities are facing the challenge of having children with HIV entering school. School nurses, as the only health care providers in the schools, are in a strong position to facilitate the education of children with HIV and to provide AIDS education to students, faculty, and parents. School nurses' knowledge and attitudes about AIDS and people with AIDS influence their effectiveness in prevention activities and care of HIV-infected children. This study examined the relationship between specific demographic, practice, and cultural variables and rural school nurses' attitudes about AIDS and homosexuality. Sixty-nine school nurses responded to a mailed questionnaire as part of a larger study of rural nurses. Results indicate attitudes about homosexuality were related to nurses' homosexual knowledge and religious beliefs while attitudes about AIDS were related to nurses' willingness to care for people with AIDS and feeling prepared to do so.

Rural nurses' use of universal precautions in relation to perceived knowledge of patient's HIV status.

The increased incidence of AIDS in rural areas of the United States has called attention to the practice of universal precautions by rural nurses. The purpose of this research was to determine protective barrier use by 555 nurses living in rural counties in Pennsylvania and New York State and the effect on this use of their knowledge of their patients' HIV status. Findings suggest that nurses increased their use of protection if they knew their patients were HIV-positive. However, if they thought that their patients were HIV-negative or if they did not know their patients' HIV status, they did not always use adequate protection. Findings are discussed as they relate to the context of rural nursing practice.

The effects of community differences on health status, health stress, and helping networks in a sample of 900 elderly.

Documenting the social and environmental conditions that promote the health and well-being of individuals is an important step in the advancement of community health nursing knowledge. With the current growth of community-based health care, it would seem to be a prerequisite for planning community-level interventions. The purpose of this research was to link structural properties of communities to the functioning of individuals. We examined the link between levels of community education and percent population change as derived from census data from 18 randomly selected communities and individual measures of health, health stress, and network support in a sample of 900 elderly living in these communities. Results indicate that when community education levels are high, community growth does not affect the health of the elderly which results in less stress with health and the need for fewer helpers. If, however, community education levels are low, and the population is growing, elderly experience poorer health and more health stress and they need more help.

The Nurses' Attitudes About AIDS Scale (NAAS): development and psychometric analysis.

This article describes the development and psychometric evaluation of the Nurses' Attitudes About AIDS Scale (NAAS). Based on a review of the literature on attitude theory and measurement and on HIV/AIDS, 273 items were developed for inclusion in the scale. Content validity was established by a panel of ten nurses in current practice, six experts in AIDS education and adult health nursing, and one expert in attitude and scaling theory and measurement. On this basis, 60 items were selected and pilot tested for face validity on 33 practicing nurses. Responses from a purposive sample of 731 working RNs were evaluated. A factor analysis yielded a single homosexuality factor explaining 53% of the variance in the 2 1 -item measure. This subscale was labeled attitudes about people with AIDS. Alpha reliability coefficient was .96. Two subscales were identified in the AIDS dimension: attitudes about nursing care concerns (12 items; alpha = .83) and attitudes about social-professional concerns (8 items; alpha = .72). These subscales explained 38.5% of the variance. Additional evidence of construct validity as well as predictive validity were established.

Marital status, gender roles, stress, and health in the elderly.

A model of the relationship between the social context effects of marital status and gender role differences in health was tested in a sample of noninstitutionalized elderly. The conceptual model assumed that (a) marital status is a social context; (b) social contexts give rise to social interactions; (c) social interactions result in the assumption or modification of gender roles; and (d) gender roles determine the behavior of elderly individuals with regard to health, stress, coping, and social support. A random telephone survey of 6,585 households in six northeastern states resulted in a sample of 900 elderly 65 years of age or older. Hierarchical regression analysis was used to test the main effects, the joint effects, and the combined effects of gender and marital status on the independent variables as they related to health. Findings suggested that of the four marital contexts studied (married men and married women and unmarried men and unmarried women), married women were in the poorest health and most vulnerable to stress. For them, social support in terms of both number of confidantes and access to helping networks was not protective. These findings suggest that social context affects elderly women's health. The potential for expanding theories of women's health to include the social conditions in which they live is discussed.

AIDS: experiences and attitudes of nurses from rural communities in Pennsylvania and New York.

In this study we determined rural nurses' educational preparation concerning AIDS, whether they thought their health care facilities and communities were prepared to care for persons with AIDS, their attitudes toward AIDS and homosexuality, and in what ways AIDS had or might affect their practice. A questionnaire, which included the Nurses' AIDS Attitude Scale (NAAS), was administered to 738 employed registered nurses in 9 rural counties in Pennsylvania and New York. Findings suggest that this sample held many negative attitudes towards AIDS and homosexuality and had specific educational needs, especially in the psychosocial domain. They thought rural physicians and health care facilities were not yet well prepared to care for persons with AIDS.

A study of community differences in stress among the elderly: implications for community health nursing.

It has long been known that stressful states are linked to physical and mental health. An important dimension of emotional stress is community environment. That is, communities can produce stress in individuals but can also provide the coping resources that help modify these stressors. We examined differences in stress responses among a random samples of 900 elderly living in nine metropolitan and nine non-metropolitan, randomly chosen communities in six northeastern states. Respondents were asked if, in the past year, they had experienced anything upsetting or stressful in their lives connected with family and friends, their health, and their finances. The findings support the existence of community differences in stress responses for these elderly respondents, and show evidence of a link between community structure and individual behaviors.

Elderly women and stress. Does marriage make a difference?

Although studies of gender differences in the stress/health relationship of elderly persons have been done, few have examined the combined affect of marital status and gender on health. The experience of stress may affect elderly married women differently than elderly unmarried women. The purpose of this study was to explore the differential effects of stress on elderly married women and to identify interventions that could be used in gerontological nursing practice to promote effective coping. Roy's theory is used to explain the effects of stress on elderly women and to suggest nursing interventions. According to Roy, individuals respond to stressors in four behavioral modes: physiological, self-concept, role performance, and interdependency. The results of this study indicate that, of the four groups studied in this sample, the married women were in poorest health and the most vulnerable to stress.

AIDS and homosexuality: a longitudinal study of knowledge and attitude change among rural nurses.

With no effective medical treatment or vaccine for acquired immunodeficiency syndrome (AIDS) available now or in the near future, nursing can make the most difference by providing emotional support and physical care for people with AIDS and their families. One of the least understood areas in providing such care is the feelings nurses have toward persons with AIDS, especially in rural areas. This study measured changes in knowledge and attitude toward AIDS and homosexuality before, immediately after, and three months after an all-day AIDS workshop for nurses. The program provided current knowledge about transmission of the human immune virus and risk behaviors, and addressed personal feelings regarding fear of caring for persons with AIDS as well as negative feelings associated with homosexuality. Results revealed significant positive changes in knowledge and attitudes three months later. Participants also became significantly less fearful and more willing to care for persons with AIDS. Feelings of fearfulness and willingness to care for people with AIDS were associated not with knowledge differences but with differences in attitudes toward the disease and homosexuality. Therefore, this program's affective component was more closely associated with precursors to behavior change than was cognitive education. As the education needs of rural and community nurses increase, programs specific to them must continue to be developed and studied. Future research must also explore and evaluate actual nursing care of AIDS patients in relation to education program objectives.