Celebrating 40 Years of the Midwest Nursing Research Society.

The Midwest Nursing Research Society (MNRS) recently held its 40th annual conference and celebrated four decades of nursing research in the Midwest. MNRS continues to be one of the largest nursing research societies in the United States. Over the years, a vast majority of programmatic initiatives included education and tangible support for novice and experienced nurse researchers. In this article, the background for development of MNRS is reviewed with examination of driving forces that led to its creation. Three past presidents, Dr. Joyce Fitzpatrick, the first President of MNRS (1980-1981); Dr. Nancy Bergstrom, the eighth President (1993-1995); and Dr. Sally Lusk, the 14th President (2005-2007), discuss challenges, opportunities, and the exceptional progress made toward fostering excellence in nursing research for the Midwest and contributing to nursing science on a national and global scale. Lessons from the past as well as opportunities for the future are addressed.

Factors influencing professionalism in nursing among Korean American registered nurses.

Although significant numbers of foreign nurses are currently employed in the United States, little research about nursing professionalism exists for this population. The study assessed the levels of professionalism and examined factors associated with professionalism among Korean American registered nurses (RNs). Hall's Professionalism Inventory (HPI) scale was used for this correlational descriptive study. Data were collected, using a mailing survey, with a convenience sample of Korean American RNs living in the United States (n = 221). Current position in nursing, current employment status, work setting, total years of nursing experience, total years of nursing experience in the United States, location of final degree attainment, and duration of nursing education in the United States were associated with the level of professionalism among Korean American RNs. Variables predicting professionalism included membership in professional organizations (beta = .204, P < .000) and total years of nursing experience in the United States (beta = .198, P = .001), and they accounted for 8.6% of the total variance in the HPI score. The findings suggest that multiple internal and external factors are associated with professionalism among Korean American RNs and provide an understanding of trends in professionalism from an international perspective.

Meta-analysis as a tool for evidence-based practice: an example using the Rice meta-analysis of smoking cessation interventions.

Enhanced quality of patient care and the prevention of errors are emphasized greatly in today's health care settings. Nurses are now held accountable for the care they provide and, as a result, nurses are responsible for incorporating solid scientific evidence into their practice. Published meta-analyses represent one source of such evidence. Meta-analyses offer statistical summarizations of all studies conducted about a particular phenomenon and more objective evaluation of the research often results. This article examines seven basic processes for evaluating meta-analyses and determining the value of their results for use in nursing practice.

Employee health fair data: evidence for planning health promotion programs.

PURPOSE/OBJECTIVES: This study describes actual and perceived health status as well as health habits and needs of hospital employees. The Transtheoretical Model "stages of change" provided the study framework. SETTING, SAMPLE, AND METHODS: Employees (N = 1,295) from a large Midwestern hospital participated in 3 annual health fairs and completed questionnaires and received physical measurements of height, weight, blood pressure, and blood lipid levels. FINDINGS: During the 3-year period, 56% of individuals met body mass indices indicating overweight and obese status, 74% of the employees reported feeling overweight and desired to lose an average of 32 lb per individual, 51% of employees wanted to increase their daily physical activity levels, and 75% of participants stated they were already preparing for or taking action to change unhealthy behaviors. CONCLUSIONS AND IMPLICATIONS FOR PRACTICE: As a result of the health fair data, hospital-based clinical nurse specialists are currently piloting interventions geared specifically toward enhancing weight control and increasing exercise in hospital employees.

Smoking patterns, beliefs, and the practice of healthy behaviors in abstinent, relapsed, and recalcitrant smokers.

The purpose of this study was to perform a secondary analysis of smoking patterns and beliefs related to healthy behaviors in adult smokers (N = 71). Data for the secondary analysis were obtained from an original study that examined guided health imagery as a smoking cessation intervention. The imagery intervention resulted in significantly higher 2-year smoking abstinence rates for the intervention group of participants (26% vs. 12% for the control group). In this study, discriminant function analysis demonstrated that "well-established smoking patterns" accounted for 42% of the variance in those smokers who relapsed or never made any attempt to quit smoking. Higher baseline smoking rates, longer lifetime smoking histories, younger age at initiation of smoking, more positive beliefs about smoking (pros), and fewer healthy behaviors differentiated abstinent smokers from those who relapsed or were considered recalcitrant. Smoking patterns, belief systems related to smoking, and the practice of healthy behaviors need to be assessed as smokers enroll in cessation programs. Knowledge about relapsed and recalcitrant smokers will assist in the development of future interventions to meet smokers' unique needs and demands for cessation.

Smoking patterns, beliefs, and the practice of healthy behaviors in abstinent, relapsed, and recalcitrant smokers.

The purpose of this study was to perform a secondary analysis of smoking patterns and beliefs related to healthy behaviors in adult smokers (N = 71). Data for the secondary analysis were obtained from an original study that examined guided health imagery as a smoking cessation intervention. The imagery intervention resulted in significantly higher 2-year smoking abstinence rates for the intervention group of participants (26% vs. 12% for the control group). In this study, discriminant function analysis demonstrated that "well-established smoking patterns" accounted for 42% of the variance in those smokers who relapsed or never made any attempt to quit smoking. Higher baseline smoking rates, longer lifetime smoking histories, younger age at initiation of smoking, more positive beliefs about smoking (pros), and fewer healthy behaviors differentiated abstinent smokers from those who relapsed or were considered recalcitrant. Smoking patterns, belief systems related to smoking, and the practice of healthy behaviors need to be assessed as smokers enroll in cessation programs. Knowledge about relapsed and recalcitrant smokers will assist in the development of future interventions to meet smokers' unique needs and demands for cessation.

Guided health imagery for smoking cessation and long-term abstinence.

PURPOSE: To examine the effectiveness of guided imagery for immediate smoking cessation and long-term abstinence in adult smokers. DESIGN: A repeated measures design was used with 71 smokers recruited from a hospital outpatient clinic, 38 in the intervention group, and 33 in the control group. METHODS: Both study groups received educational and counseling sessions in their homes. The intervention group was provided with additional instruction in the use of guided imagery and was encouraged to practice this imagery at least once per day with a 20-minute audio-taped exercise for reinforcement. The repeated measures included smoking rates (cigarettes per day) that were measured and confirmed through corroborating friends and family. FINDINGS: At 24-months after the intervention, smoking abstinence rates were significantly higher for the guided health imagery intervention group (26% abstinence rate versus 12% abstinence rate for the placebo-control group). CONCLUSIONS: Guided imagery was an effective intervention for long-term smoking cessation and abstinence in adult smokers.

Health promotion and cardiovascular health in adult monozygotic twins.

PURPOSE: To describe relationships among cardiovascular health indicators and health-promoting behaviors in adult monozygotic (MZ) twins. DESIGN: The descriptive, correlational design with a convenience sample of adult twins (77 twin pairs, or N = 154) obtained during a public conference held in the Midwestern United States. METHODS: Bivariate correlational analyses with twins as their own controls and with each twin pair. This double-entry approach allowed for the creation of a symmetrical scatterplot of twin characteristics and accounted for the genuine effects of outliers. Relationships were examined among cardiovascular health indicators (systolic and diastolic blood pressures, body mass indices, serum lipids) and health-promoting behaviors. FINDINGS: Thirteen intermeasure correlations for cardiovascular indicators were significant, and 74% of the variance in the cardiovascular health indicators was shared within each twin pair, thus indicating evidence of common behavioral and genetic influences. CONCLUSIONS: Both behavioral and genetic factors contributed to cardiovascular health in adult MZ twins who shared close familial and environmental ties. This finding is consistent with previous literature identifying behavioral and genetic effects on the development of cardiovascular disease.

Factors predicting health behaviors among Army Reserve, active duty Army, and civilian hospital employees.

This study identified health-risk and health-promoting behaviors in military and civilian personnel employed in hospitals. Intrinsic self-motivation and extrinsic organizational workplace factors were examined as predictors of health behaviors. Because reservists represent a blend of military and civilian lifestyles, descriptive analyses focused on comparing Army Reserve personnel (n = 199) with active duty Army (n = 218) and civilian employees (n = 193), for a total sample of 610. Self-motivation and social support were significant factors contributing to the adoption of health-promoting behaviors; however, organizational workplace cultures were inconsistent predictors of health among the three groups. Only the active Army subgroup identified a hierarchical culture as having an influence on health promotion, possibly because of the Army's mandatory physical fitness and weight control standards. Social support and self-motivation are essential to promoting health among employees, thus hospital commanders and chief executive officers should encourage strategies that enhance and reward these behaviors.

Current factors contributing to professionalism in nursing.

A serious nursing shortage is creating a crisis in the nation's health care system. Many experienced nurses are leaving the field and young people are not selecting nursing as a potential career. Reassessment of professionalism in nursing therefore is indicated. A descriptive comparative/correlational design examined differences and relationships among levels of nursing professionalism, experience, educational degrees, organizational membership, and specialty certification in a random sample of registered nurses (RNs) (N=774). The Professionalism Inventory Scale was used to measure attitudinal attributes of professionalism and its five dimensions (use of professional organizations as major referent groups, belief in public service, autonomy, self-regulation, and a sense of calling). A series of statistical analyses revealed that professionalism was related significantly to years of experience as an RN, higher educational degrees in nursing, membership in organizations, service as an officer in the organization, and specialty certification. Today's profession of nursing is evolving as a valuable public service. Positive aspects of nursing professionalism must be recognized and implemented to retain experienced nurses in the profession and attract young people to nursing as a viable career choice.

Two quantitative approaches for estimating content validity.

Instrument content validity is often established through qualitative expert reviews, yet quantitative analysis of reviewer agreements is also advocated in the literature. Two quantitative approaches to content validity estimations were compared and contrasted using a newly developed instrument called the Osteoporosis Risk Assessment Tool (ORAT). Data obtained from a panel of eight expert judges were analyzed. A Content Validity Index (CVI) initially determined that only one item lacked interrater proportion agreement about its relevance to the instrument as a whole (CVI = 0.57). Concern that higher proportion agreement ratings might be due to random chance stimulated further analysis using a multirater kappa coefficient of agreement. An additional seven items had low kappas, ranging from 0.29 to 0.48 and indicating poor agreement among the experts. The findings supported the elimination or revision of eight items. Pros and cons to using both proportion agreement and kappa coefficient analysis are examined.

Testicular self-examination in young adult men.

PURPOSE: To describe patterns of testicular self-examination (TSE) in a sample of young adult men and to identify factors distinguishing between men who do and do not practice TSE. DESIGN: A comparative descriptive design with a convenience sample of 191 adult men aged 18-35 years, recruited from a large industrial complex in the U.S. Midwest. Data were collected during several occupational health fairs held from 1999-2001. METHODS: A self-report, 75-item health risk appraisal (HRA) was administered to identify health-related lifestyle habits. Men who did and did not perform TSE regularly were compared using Mann-Whitney U statistics for discrete variables and t tests for continuous data. Discriminant function analysis was used to identify factors allowing prediction of frequent or infrequent TSE performance. FINDINGS: Sixty-four percent of 191 participants reported rarely or never performing TSE, and 36% practiced TSE monthly or every few months. Men who infrequently performed TSE were more often African American or Hispanic and had less than a college education. Other significant factors associated with infrequent TSE practice included less satisfaction with current job assignment; less satisfaction with life in general; greater worries interfering with daily life; more serious family problems in dealing with spouse, children, or parents; and reduced availability of people to turn to for support. CONCLUSIONS: Demographic and socioeconomic variables were related to TSE knowledge and performance. Further investigation is required to determine why men, especially ethnic minority men, are not performing this important cancer-screening activity.

The osteoporosis risk assessment tool: establishing content validity through a panel of experts.

Twenty-three items were initially developed for the Atkins Osteoporosis Risk Assessment Tool (ORAT) after a thorough examination of the literature. These items were reviewed for relevance to the domain of content by a panel of eight experts using Lynn's (1986) two-stage process for content validation. The Content Validity Index and the kappa coefficient of agreement were analyzed from panelists' quantitative ratings and 15 items were retained. Qualitative suggestions from the experts were also used to improve the final items in the ORAT.