Social cognitive factors associated with mother-adolescent communication about sex.

To better understand why some mothers talk to their children about sex and others do not, we examined the role of two social cognitive variables--self-efficacy and outcome expectancies--in explaining sex-based communication. The present study was part of a larger study to test the efficacy of two HIV prevention programs for mothers and their adolescents. Mothers and their adolescents were recruited from a large community organization that serves youth who live in disadvantaged circumstances. The sample for the present study included 486 mothers who averaged 38.4 years of age (SD = 6.73). The majority were African American (97.7%), not married (66.7%), and had a high school degree (89.5%). Their adolescents ranged in age from 11 through 14 years of age and most were male (61.3%). The results of the analysis revealed that mothers who expressed higher levels of self-efficacy and more favorable outcomes associated with talking to their children about sex were more likely to do so. In a regression analysis, we learned that the mother's degree of efficacy beliefs, along with her expected outcomes associated with talking about sex, the importance of religious beliefs to her, and the age and sex of her adolescents were important factors associated with talking with them about sex.

Identifying the social contexts of effective sex refusal.

A factorial survey was conducted to identify social situations that inhibit or promote college students' sex-refusal skills. Respondents evaluated five different situations in which sexual intercourse might occur and ranked each according to how certain the respondent would be to refuse to have sexual intercourse in that context. Regression analysis of the survey data showed that knowing the other person well, being with one's boyfriend or girlfriend, having condoms available, wanting to have sex, and both persons' wanting to have sex reduced the probability of refusal. On the other hand, having no condoms and the presence of drugs in the situation increased the probability the individual would refuse to have sex. In addition, men, individuals with previous sexual experience, and drinkers displayed diminished ability to refuse sex. However, the lack of condoms, when combined with these three respondent characteristics, acted to increase the ability to refuse sex.

Development of two instruments examining stress and adjustment in children with cancer.

The childhood cancer literature provides limited understanding of the school-age child's perception of cancer stressors and factors that contribute to adjustment in the midst of these stressors. This study evaluated the reliability and validity of two questionnaires: the Childhood Cancer Stressors Inventory (CCSI) and the Children's Adjustment to Cancer Index (CACI). The following steps were involved in the instrument development process: item development, face and content validation, internal consistency reliability, and construct validity. Questions for both instruments were developed from the literature and experience of the principal investigator. A panel of five expert pediatric oncology nurses was asked to evaluate the content validity of both instruments. All the experts rated every item a 4-5 using the content validity index, indicating that each item measured the concept addressed by the scale. Seventy-five children with cancer were asked to complete the two questionnaires and parents completed a demographic data sheet that included eight questions about the child's school attendance, performance, number of friends, and activities. Children were 7 to 13 years of age; 64% were diagnosed with a leukemia/ lymphoma, and 36% had a solid tumor. Internal coefficient reliability for the total CCSI was .82, and .91 for the CACI. The CCSI correlated negatively with the adjustment scale (r = -.63, P = 000). The number of days missed from school correlated positively with the CCSI and negatively with the CACI. Children who missed more school perceived more cancer stressors and had a lower adjustment rating. Children with lower adjustment ratings on the CACI also had fewer friends (t = 3.4(72), P = .001). Scores on both instruments demonstrated expected relationships with measures hypothesized to covary with the dimensions assessed by the new instruments. Adjustment issues for children with cancer have been difficult to assess because of the lack of appropriate instruments. These study findings indicate that the two new instruments can help to measure the child's perceptions of the cancer experience.

Nurse practitioners' reactions to persons with HIV/AIDS: the role of patient contact and education.

Attitudes about caring for patients with HIV/AIDS (PWAs) were investigated in a survey mailed to all nurse practitioners (NPs) in Georgia. There was a 53% response rate to the survey (286 of 539 questionnaires were returned). It was hypothesized that exposure to continuing education on HIV/AIDS and to HIV-positive patients would be associated with more positive attitudes and less extreme behavioral changes associated with fear of transmission. Factor analytic procedures were used to generate three scales: resentment of PWAs (RESENT), anxiety or fear about contact with PWAs (FEELINGS), and changes in personal life related to fear of transmission after contact with PWAs (CHANGE). Descriptive findings indicated that a significant minority of NPs were worried about risk, harbored some resentment toward PWAs, and had changed their behavior out of concern about the possible transmission of HIV. Differences of means and stepwise regression analyses (with several potentially confounding variables controlled) found exposure to continuing education associated with less fear and anxiety, less resentment, and less behavioral change. Exposure to HIV-positive patients was associated with less behavioral change, as predicted, but not with less fear/anxiety or resentment. The cross-sectional survey design limits the attribution of causality, but offers some support for the role of continuing education in improving attitudes toward PWAs.

Epilepsy self-management: a test of a theoretical model.

This study examines the role of social support, self-efficacy, outcome expectancy, and anxiety as predictors of medication management in persons with epilepsy. A model based on social cognitive theory was constructed to explain managing medications under conditions of scarcity. A survey instrument was sent to 450 individuals who participated in job training programs for persons with epilepsy. One hundred ninety-five completed questionnaires were returned and met the inclusion criteria. The proposed structural model was tested using structural equation modeling procedures. The assistance aspect of social support was positively related to regimen-specific support. The paths from self-efficacy to outcome expectancy and anxiety were significant and in the predicted directions, as was the path from anxiety to self-management.

Preferences concerning epilepsy education: opinions of nurses, physicians, and persons with epilepsy.

The purpose of this study was to determine whether patients with epilepsy treated in outpatient settings would prefer to receive information about epilepsy and its treatment from physicians, nurses or other health care professionals. A second purpose of this study was to determine which health care professionals physicians and nurses believe are able to teach patients about epilepsy. Participants in this study included 59 persons with epilepsy, 73 nurses caring for people with epilepsy, and 38 neurologists and neurosurgeons. Results indicated that people with epilepsy generally prefer physicians to teach about epilepsy and its treatment. Nurses received the most responses about teaching general lifestyle information. Nurses and physicians provided very similar responses to inquiries about which health care professionals were able to teach information about epilepsy. Nurse and physician participants agreed that nurses are the preferred provider of information related to psychological concerns of patients and physicians are the preferred provider of information about the cause and treatment of epilepsy.

Recommendations by clinicians for nausea and vomiting of pregnancy.

The purpose of this study was to assess both the current use of relief measures for nausea and vomiting of pregnancy among clinicians and the basis for their decisions regarding method of treatment. With the permission of conference sponsors, questionnaires on nausea and vomiting of pregnancy relief measures were distributed at a national conference for obstetrical health care providers. Of the 600 conference participants, 130 completed questionnaires. The findings of the study indicate that clinicians generally recommend eating small, frequent meals; that clinicians modify their recommendations slightly based on the severity of the symptoms; that clinicians perceive varying degrees of effectiveness of relief measures, with no one measure being totally effective; and that clinicians look to patients as the primary resource for information about nausea and vomiting of pregnancy.

Epilepsy self-management: partial replication and extension.

The purpose of this study was to determine the association between selected social cognitive variables and self-management behaviors among a sample of adults with epilepsy. The study, based on Social Cognitive Theory, was a partial replication and extension of a previous study that explored the role of self-efficacy, social support, regimen-specific support, self-esteem, and self-management. Data collected from 80 adults attending an epilepsy clinic were analyzed using correlation and regression procedures. Statistically significant relationships were found between self-efficacy and self-management and between regimen-specific support and self-management. Regression analyses revealed that self-efficacy and regimen-specific support made significant contributions to the variance in self-management, whereas social support and self-esteem did not.

Nausea and fatigue during early pregnancy.

Nausea and fatigue are uncomfortable, sometimes almost debilitating, symptoms of pregnancy. Anecdotally, fatigue seems worse as nausea increases. This descriptive correlational study investigated the relationship between nausea and fatigue during early pregnancy. Fifty-one women who received prenatal care at two obstetrics and gynecology nurse-midwifery practices in a large metropolitan area participated. Each women completed a nausea questionnaire, the Pearson-Byars fatigue feeling checklist, and a demographic data sheet at her first or second prenatal visit. Participants were at less than 17 weeks' gestation; 43 percent were pregnant for the first time, and 48 percent reported nausea at the time they completed the questionnaire. Women with severe nausea had higher levels of fatigue than those with no or mild and moderate nausea. Severity of nausea and level of fatigue were positively correlated, indicating that as nausea increased so did the severity of fatigue.

Learning needs of persons with epilepsy: a comparison of perceptions of persons with epilepsy, nurses and physicians.

The purpose of this study was to describe and compare patients', nurses' and physicians' perceptions of learning needs of persons with epilepsy. The study is based on adult learning theory which states that learning needs dictate receptivity to information and knowledge of learning needs can help structure teaching sessions. Study participants were recruited from patients attending epilepsy clinics, neuroscience nurses employed at study hospitals or working with neurologists or neurosurgeons and neurologists or neurosurgeons practicing in the state. The sample sizes were: 59 patients, 85 nurses and 38 physicians. Data were analyzed using frequencies, percent and analysis of variance. Data analysis revealed that patients, nurses and physicians similarly ranked major areas of learning needs. However, differences in the ranking of individual learning needs were noted between patients and health care providers. An understanding of the differences and similarities among the groups provides useful information for educational programs for epilepsy patients.

Patterns of nausea during first trimester of pregnancy.

This descriptive study examined pregnancy nausea to determine whether nausea occurred more frequently during the morning hours than during other times of day and if certain patterns of nausea exist. The 19 women who participated in the study kept daily diaries of their nausea experiences over a 7-day period, noting the time of occurrence. Nausea was reported most frequently during waking hours, ranging from 40.3% of the time between 7 p.m. and 10 p.m. and 43.9% between 3 p.m. and 6 p.m. Most nausea reported by subjects was mild, although 18% of the nausea reported between 11 p.m. and 2 a.m. was severe. Four patterns of nausea were identified: morning peak, evening peak, bimodal, and all day. Whereas some women displayed fairly consistent daily patterns of nausea, others reported variations in the occurrence or severity of nausea over the 7-day study period.

The development and testing of an instrument to measure self-efficacy in individuals with epilepsy.

The purpose of this study was to develop and test an instrument to measure self-efficacy in persons with epilepsy. With Bandura's self-efficacy theory serving as the conceptual basis for instrument development, the study was divided into two phases, an instrument development phase and a reliability and validity assessment phase. In phase one, self-efficacy and epilepsy literature along with discussions with epilepsy patients served as sources for item derivation. A panel of experts reviewed the instrument for content validity. In phase two, testing of the instrument for reliability and validity was done using different groups of epilepsy patients. Reliability coefficients ranged from .81 for test-retest reliability to .93 for internal consistency. A strong positive correlation between self-efficacy and social support (r = .48, p less than .001) and between self-efficacy and self-management (r = .50, p less than .001) provided evidence to support the construct validity of the instrument.

Cognitive-perceptual factors associated with antiepileptic medication compliance.

The purpose of this study was to determine if selected cognitive-perceptual variables discriminated between individuals who complied with antiepileptic medication therapy and those who did not. Individuals attending an epilepsy clinic and meeting specified criteria were asked to participate. Data from 64 individuals--39 who were classified as compliant and 25 noncompliant--were analyzed using discriminant analysis. The findings revealed that intimacy/assistance, social integration/affirmation of worth, unpredictability, and ambiguity were helpful in discriminating compliant from noncompliant individuals.