Patterns of decision making by wives of patients with life-threatening cardiac disease.

Implementation of the Patient Self-Determination Act (PSDA) in the United States has transferred decision making from the responsibility of health care professionals to the responsibility of family members. Dilemmas occurring as a result of this responsibility may cause stress and conflict among family members. The purpose of this study is to describe the patterns of decision making by family members of patients with life-threatening cardiac disease. Purposive sampling is used to select 10 wives of patients with life-threatening cardiovascular disease. Data are gathered through unstructured interviews and are analyzed using grounded theory and theory triangulation. Analysis of the data reveal three patterns of decision making: advocacy, acquiescence, and abdication.

Predictors of father-son communication about sexuality.

Examining the factors that influence adolescents' sexual behaviors is crucial for understanding why they often engage in risky sexual behaviors. Using social cognitive theory, we examined predictors of father-son communication about sexuality. Fathers (N=155) of adolescent sons completed a survey measuring 12 variables, including self-efficacy and outcome expectations. We found that (a) son's pubertal development, father's sex-based values, father's education; father's communication with his father, outcome expectations, and general communication accounted for 36% of the variance in information sharing communication and (b) son's pubertal development, outcome expectations, general communication, and father-son contact accounted for 20% of the variance in values sharing communication. Study findings can aid professionals in designing guidelines for programs to promote father-son general communication and sex-based communication.

A home visiting asthma education program: challenges to program implementation.

This study describes the implementation of a nurse home visiting asthma education program for low-income African American families of young children with asthma. Of 55 families, 71% completed the program consisting of eight lessons. The achievement of learning objectives was predicted by caregiver factors, such as education, presence of father or surrogate father in the household, and safety of the neighborhood, but not by child factors, such as age or severity of asthma as implied by the prescribed asthma medication regimen. Incompatibility between the scheduling needs of the families and the nurse home visitors was a major obstacle in delivering the program on time, despite the flexibility of the nurse home visitors. The authors suggest that future home-based asthma education programs contain a more limited number of home visits but add telephone follow-ups and address the broader needs of low-income families that most likely function as barriers to program success.

The physical, behavioral, and psychosocial consequences of Internet use in college students.

The purposes of this study were to identify the physical, behavioral, and psychosocial consequences of Internet use in undergraduate college students; and to evaluate whether time, social norms, and adopter category predict the consequences of Internet use. Rogers' model for studying consequences of innovation was adapted for this study. A descriptive, correlational design was used. Convenience sampling yielded 293 undergraduate students who answered the online survey. Consequences of Internet use were assessed with the researcher-developed instrument, the Internet Consequences Scale (ICONS). Mean scores on the behavioral and psychosocial subscales of the ICONS indicated positive consequences of Internet use, while the physical consequences subscale revealed negative consequences. Multiple regression analyses revealed a small, but significant, amount of variance in consequences of Internet use that could be explained by time, social norms, and adopter category, thus supporting the adapted model for the study of consequences of Internet use in college students.

Home-based asthma education of young low-income children and their families.

OBJECTIVE: To conduct a controlled trial of a home-based education program for low-income caregivers of young children with asthma. METHODS: Participants were randomized to treatment-eight weekly asthma education sessions adapted from the Wee Wheezers program (n = 49)-or usual care (n = 46). Baseline and 3- and 12-month follow-up data were gathered from caregivers and from children's medical records. RESULTS: Treatment was associated with less bother from asthma symptoms, more symptom-free days, and better caregiver quality of life at follow-up for children 1-3, but not those 4-6, years of age. Treatment and control groups did not differ in caregiver asthma management behavior or children's acute care utilization. CONCLUSIONS: This home-based asthma education program was most effective with younger children; perhaps their caregivers were more motivated to learn about asthma management. Targeting psychosocial factors associated with asthma morbidity might also enhance the efficacy of asthma education for these families.