Modeling women's quality of life after cardiac events.

Quality of life (QOL) is presented as a global, unidimensional, and subjective assessment of one's life. This study examined the impact of perceived health status, hope, and optimism on QOL in 93 women after suffering a cardiac event. Construct validity was examined by estimating a model where QOL was measured with four indicators, and perceived health was measured with the SF-36 Health Survey. Hope was measured with the Herth Hope Index and dispositional optimism was measured with the Life Orientation Test. The unidimensionality of QOL and its response to health status, hope, and optimism were tested. Fit indices suggested that the theoretical relations posited were compatible with the data, (chi 2(42) = 44.125, p = .382, RMSEA = .0001, GFI = .942). The model explained 66% of the variance in QOL. Modeling suggested the presence of a complex latent concept composed of hope and optimism that influenced QOL.

Assessing critical thinking in baccalaureate nursing students: a longitudinal study.

The purpose of this study was to evaluate the attainment of critical thinking skills of students before and after curriculum revision of a baccalaureate nursing program. The California Critical Thinking Skills Test (CCTST) was used to measure the critical thinking ability of the students at program entry, midpoint, and at exist. The sample consisted of three cohorts of students: cohort 1 (n = 55) was the baseline class before curriculum revision, whereas cohorts 2 (n = 55) and 3 (n = 73) were the first two classes to experience the revised curriculum. The results revealed that cohort 2 achieved significantly higher critical thinking scores than the baseline cohort. Cohort 2 also improved dramatically on all subscales from test 1 to test 3. However, cohort 3 failed to demonstrate improved critical thinking scores over time. Findings have implications for measuring critical thinking.

Assessing readiness for death in hospice elders and older adults.

BACKGROUND: Readiness for death may affect the quality of the death experience and influence response to treatments. The psychologic vulnerability of the dying person is a major focus of palliative care. Accurate assessment of readiness for death may lead to earlier and more appropriate interventions. OBJECTIVE: The purpose of this study was to assess the psychometric properties of the revised readiness for death instrument. METHODS: Using a known groups technique and a cross-sectional study design, the revised instrument was administered to 52 elders in hospice care with a terminal diagnosis and 91 community dwelling adults without a terminal diagnosis. RESULTS: Instrument content validity (Kappa = 0.96) was supported by three expert panelists who were hospice researchers. Principal components factor analysis explained 43% of the variance and partially supported the proposed four-factor structure of the revised 26-item instrument. Internal consistency was acceptable (.76). Discriminant validity was significant as assessed by an independent t-test between two contrast groups (t = 5.98, p = 0.000). The factor analysis, reliability testing, and qualitative analysis of items supported deletion of 2 items. CONCLUSIONS: Results indicated that the revised instrument has sound psychometric properties but further testing with a larger sample of hospice subjects is needed to confirm the factor structure of the instrument.

A supportive-educative telephone program: impact on knowledge and anxiety after coronary artery bypass graft surgery.

The purpose of this study was to investigate the impact of a supportive-educative telephone program on the levels of knowledge and anxiety of patients undergoing coronary artery bypass graft surgery during the first 6 weeks after hospital discharge. With a posttest-only control group design, the first 74 patients scheduled, between September 1986 and February 1987, for coronary artery bypass graft surgery in a large, western Canadian teaching hospital were randomly assigned to either an experimental or a control group. The effect of the intervention, which was implemented by a cardiac rehabilitation nurse specialist, was assessed by a knowledge test and a state anxiety inventory. Data were collected without knowledge of the participants' group assignment. As hypothesized, data analysis with independent t tests revealed a statistically significant (p less than 0.05) difference between the knowledge level of the experimental and the control group in the areas of coronary artery disease, diet, medications, physical activity restrictions, exercise, and rest. A statistically significant difference between the state anxiety level of the experimental and the control group was also evident, as was a statistically significant inverse relationship between participants' knowledge and anxiety levels. From these findings, several implications and recommendations for nursing practice and research have been generated.