Public health nursing competency instrument: scale reduction and reliability of factors.

OBJECTIVES: To reduce the number of items of the Public Health Nursing Competency Instrument (PHNCI) and to report the psychometric properties of the abbreviated instrument. DESIGN AND SAMPLE: The 193-item PHNCI was administered via an online survey tool. A national sample of 2,269 public health nurses was recruited from 25 states. MEASURES: All items of the PHNCI scale were positively stated and participants were asked to rate their skill level via a 4-point Likert scale. RESULTS: A principal component exploratory factor analysis with oblique rotation and examination of scree plot resulted in a final abbreviated scale which included 81 items and six factors: (1) Evaluation Competencies, (2) Individual/Family/Community Competencies, (3) Systems' Competencies, (4) Partnership/Collaboration Competencies, (5) Planning Competencies, and (6) Assessment Competencies. The six factors in the resulting PHNCI Abbreviated (PHNCIa ) demonstrated acceptable internal consistency, ranging from 0.92 to 0.98. CONCLUSION: The six factors of the PHNCIa integrate important concepts of both the nursing process and the intervention wheel. The instrument can be used by educators, administrators, managers, and staff members to assess strengths and challenge areas, guide discussions on performance and expectations, and enhance professional development efforts. Next steps for future research are presented.

Development of My Health Companion to enhance self-care management of chronic health conditions in rural dwellers.

Appropriate self-management support is needed to help individuals and their families meet the challenges of living with chronic health conditions. Such support is characterized by productive interactions between informed, active individuals, and their health care providers. The purposes of this paper are to describe the challenges to achieving self-management support and a tool, My Health Companion (MHC), which was developed to meet that challenge. The MHC is a paper personal health record designed to help rural women with chronic health conditions to better manage and understand their health information. The selection of content for the MHC was based on the literature, input from health care experts, and chronically ill individuals, and its development incorporated principles of personal health record and clear communication. The MHC was anecdotally shown to be useful to rural women with chronic health conditions in preparing for and enhancing their visits with health care providers. As a source of information, the MHC had potential for: being beneficial to providers in recommending appropriate treatment; contributing to more informed health decision making by ill individuals; and serving as a vehicle for the establishment of more productive interactions that contributed to the achievement of true client-provider partnerships in health care.

Translation of the multidimensional health locus of control scales for users of American sign language.

This paper describes the translation of the Multidimensional Health Locus of Control (MHLC) scales into American Sign Language (ASL). Translation is an essential first step toward validating the instrument for use in the Deaf community, a commonly overlooked minority community. This translated MHLC/ASL can be utilized by public health nurses researching the Deaf community to create and evaluate targeted health interventions. It can be used in clinical settings to guide the context of the provider-patient dialogue. The MHLC was translated using focus groups, following recommended procedures. 5 bilingual participants translated the MHLC into ASL; 5 others back-translated the ASL version into English. Both focus groups identified and addressed language and cultural problems before the final ASL version of the MHLC was permanently captured by motion picture photography for consistent administration. Nine of the 24 items were directly translatable into ASL. The remaining items required further discussion to achieve cultural equivalence with ASL expressions. The MHLC/ASL is now ready for validation within the Deaf community.

Acidente de trabalho com material biológico pérfuro-cortante

O acidente com material biológico pérfuro-cortante (MBPC) ganhou notoriedade na década de 80 com o surgimento da síndrome da imunodeficiência humana (AIDS). Os Profissionais de Saúde (PS) estão expostos a este tipo de acidente, esses estão associados ao risco de transmissão ocupacional de diversos agentes infecciosos. A possibilidade de adquirir uma patologia grave como a Hepatite B ou C ou AIDS causa um grave impacto devido as conseqüências pessoais, familiares e sociais. Objetivos: identificar as unidades com maior proporção de acidentes de trabalho com MBPC; identificar a relação entre a atividade ocupacional e o acidente com MBPC; quantificar a ocorrência dos acidentes de trabalho ocorridos com MBPC entre os PS no ano de 2005 na instituição pesquisada; relacionar o acidente de trabalho com MBPC ocorrido segundo a circunstancia do acidente. Método: esta pesquisa apresenta uma abordagem quantitativa descritiva do tipo inquérito epidemiológico, retrospectiva referente ao ano de 2005, baseado em dados secundários (formulário de investigação de acidente de trabalho com exposição a material biológico). Realizada em um hospital público da região da grande Porto Alegre, instituição de grande porte, caracterizada por ser um hospital geral. Após a aprovação pelo comitê de ética e pesquisa da instituição pesquisada, a coleta de dados foi iniciada através das informações contidas nos formulários de investigação de acidente de trabalho com exposição a material biológico, cedidos pelo setor de saúde do trabalhador. As informações foram coletadas através de questionário, e armazenadas em um banco de dados do programa Excel/windows.

Public health education and practice using geographic information system technology.

The use of geographic information system (GIS) technology allows public health practitioners to explore disparities in health, analyze disease outbreaks, and prioritize the use of limited resources for improving population health. Nursing students benefit from use of World Wide Web GIS resources as they develop knowledge and skill in assessing population health and planning interventions. This article identifies the benefits of GIS for public health practitioners, presents a communicable disease control application of GIS, and discusses a GIS module used in an undergraduate nursing education course. Uniform standards for making health data available for public use with GIS are discussed.

Evaluation of an osteoporosis workshop for women.

Osteoporosis is a serious health problem that has reached epidemic proportions among Canadian women. This disease, and its concomitant fractures, places a heavy burden on society in terms of human suffering, loss of productivity, death, and health care costs. In keeping with these concerns, a Canadian community health agency has developed a series of workshops that are designed, in part, to educate women about this disease and to encourage them to take appropriate steps to prevent it or to make informed decisions about its treatment. The present study was designed to evaluate the outcome of one of these workshops. A semi-experimental design was used to measure any changes in the participants' knowledge about osteoporosis and their prevention and treatment practices regarding this disease. The results were compared to those of a control group that consisted of members of various branches of the Women's Institute who volunteered to participate in the study. The findings indicate that the workshop was effective in increasing the participants' level of knowledge on osteoporosis, an increase that was still evident 6 months following the session. The effect of the workshop on the actual preventive and treatment practices of women who attended, however, was limited to a slight increase in the use of hormone replacement therapy (HRT) and calcium intake.

Improving EPSDT use: development and application of a practice-based model for public health nursing research.

The purposes of this article are to describe the process of adapting an existing model to create a framework suitable for public health nursing (PHN) practice and to demonstrate how the resulting model can guide research for PHN practice. Using the PRECEDE (predisposing, reinforcing, and enabling causes in educational diagnosis and evaluation) model as a base, we synthesized concepts of health behavior, health education, health promotion/disease prevention, and program evaluation to develop a model for planning and evaluating aggregate-level PHN interventions to improve the use of the Early and Periodic Screening, Diagnosis, and Treatment Program (EPSDT) in rural North Carolina. The model provided the framework for identifying variables relevant to EPSDT use, designing interventions to improve use, and planning a research evaluation of the effectiveness, efficacy, and cost effectiveness of the interventions. This model, and the process used in adapting it for PHN practice, should be helpful for others investigating methods of reaching and bringing effective health-promotion/disease-prevention information to underserved, low-education members of minority groups.