Differences in anxiety and role experiences between three age groups of women with heart disease.

Anxiety and role experiences in women may be related to age, developmental changes, social roles, and life circumstances such as cardiac disease. One hundred fifty-five women participated in a cross sectional survey on anxiety and role experiences in early middle-age, midlife, and elderly women after heart surgery. MANOVA analysis revealed significant differences for anxiety and role experiences by age. Compared with older women, early middle-age women had lower balance between role rewards and concerns and a poorer match between ideal and actual role function, which may be a contributing factor for their increased anxiety.

A computerized system for tracking practice and prescriptive patterns of family nurse practitioner students.

Decisions about the fit between advanced practice nursing curricula and the real world of primary care practice should be based on data and not on intuition. The purpose of this article is to describe a computerized database system that can be used to: 1) track practice (including prescribing) patterns of nurse practitioner (NP) students; 2) address data issues that commonly arise; and 3) describe NP students' practice during their education to prospective employers. The database system uses both the Family Nurse Practitioners Log (FNPLOG), a faculty-developed software program, and Epi Info, a companion public domain software program. Variables are categorized as being related to sociodemographic, diagnostic, or prescriptive components of primary care. The system provides a simple, efficient, and feasible way of computerizing, analyzing, and evaluating students' clinical experience and practice patterns. The implications for advanced practice nursing education will be illustrated along with other potential uses of the database system.

The use of dietary restrictions in malnourished nursing home patients.

OBJECTIVE: To evaluate the dietary prescriptions of nursing home patients who show evidence of malnutrition. DESIGN: A descriptive chart review. SETTING: Four chronic care facilities in Milwaukee, Wisconsin. PATIENTS: A total of 336 charts were randomly selected from the four facilities. Analysis was done on the 217 charts that included a recorded serum albumin. MAIN OUTCOME MEASURES: Serum albumin, height, most recent weight, weight recorded 6 months previously, major diagnoses, and current diets were recorded. Average weight change per month and body mass index were calculated. RESULTS: In 109 of the 217 patients, the serum albumin was less than 3.5 g/dL. 75.2 percent of hypoalbuminic patients were on some sort of dietary restriction, including caloric restriction in 18% and sodium restriction in 35%. Sixty-six of the 217 patients had an average weight loss of greater than 1 pound per month, and 59% of this group were on dietary restrictions, with 21% on sodium restriction and 20% on limited calories. CONCLUSIONS: Malnutrition is a common problem in the nursing home population. A restricted diet is one possible factor that might contribute to this. While this study does not prove a causal relationship between a restricted diet and malnutrition, it would seem inappropriate that most patients with evidence of malnutrition are on diets that might discourage nutrient intake.

Stress and coping in fathers of newborns: comparisons of planned versus unplanned pregnancy.

The purpose of this survey was to identify stresses and coping styles in fathers of newborns, and to explore if these vary according to pregnancy planning. Data from 69 subjects were collected using the Ireton Personal Inventory and the Jalowiec Coping Scale. The most common and least often sources of stress or worry were reported. Fathers' predominant mode of coping was problem oriented. Compared to fathers with planned pregnancies, fathers with unplanned pregnancies were found to be significantly more stressed about numerous issues as well as feeling powerless in adapting to the arrival of a new infant. Implications for practice and research are explored.

PIP: The aim was to assess among new fathers their stresses and coping styles and to ascertain whether there was different behavior in planned versus unplanned pregnancies. The study was confined to 69 fathers with 4-6 week health infants and no other children less than one year old, and who had no prior history of institutionalization for mental health problems. Fathers were recruited from the community at large. The sample included 68% (47) planned and 32% (22) unplanned pregnancies. The mean age of the fathers was 29 years. There was wide spectrum of income levels. 88% were White, 5% Black, 2% Asian, 3% Hispanic, and 2% American Indian. 90% were married. Marriage duration averaged 2.5 years. The Ireton Personal Inventory and the Jalowiec Coping Scale were administered at the School of Nursing at the University of Wisconsin-Milwaukee. The results indicated that the stress centered around work, family health, finances, and children. Friendships and marital situation held the least stress. Significantly higher levels of stress were reported by fathers with unplanned pregnancies; subjects with unplanned pregnancies reported stress with finances, living situation, marital situation, sex, recreation, and friendships. The most common coping strategies were trying to control a situation, thinking through ways to solve the problem, finding out more about the situation, setting goals, and actively trying to change the situation. Few used the following coping strategies: taking drugs, getting mad, feeling hopeless, drinking, crying/getting depressed, or blaming others. The Jalowiec subscales identified problem-oriented, tension-modulating, and other directed styles of coping, which were similar for all fathers. Fathers did show differences on feeling powerless; fathers with unplanned pregnancies had higher scores on the powerless subscales. These findings suggest that fathers may suffer stresses after childbirth, but not (as reported) of crisis proportions. Fathers of unplanned pregnancies are clearly more at risk of stress due to feelings of powerlessness and in adapting to a newborn. Longitudinal research should be directed to how stress and coping changes over time and whether attachment to the child is affected. Nurses should be trained to assess fathers' stresses during the pregnancy, as a means of helping fathers cope later.

Personal and environmental influences on nursing home satisfaction.

Data were collected from the administrator, staff, and a sample of 289 residents in 51 nursing homes in order to assess the influence of organizational factors on residents' satisfaction with the nursing home. Longevity of personnel, level of benefits, wages for nursing assistants and their perception of the charge nurse's fairness and competence as well as the degree of personalization of residents' rooms were all related to residents' satisfaction with the nursing home.