College of Nursing
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Browsing College of Nursing by Author "Adams, Betty"
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Item Effect of Partners in Health Program on health promotion in rural Midwest infants(1998-08) Moseley, Carol Ann; Beard, Margaret; Marshall, David; Adams, BettyThe purpose of this unmatched case-control study was to examine the effects of a partnership program on the age-appropriate health promotion in rural Midwest infants and to test the researcher developed Age-Appropriate Health Promotion Model. The study sample included 35 children enrolled in the Partners in Health Program (Partners) and 105 children not enrolled in Partners (Controls). The Partners program uses a parent-held checklist of age-appropriate health promotion activities needed for children and a reminder system for parents and health care providers. The instrument used for data collection was the Denver Child Health Passport visit sheet. The study and control groups were compared on age-appropriate health care rates during the first twelve months of their life. Hypotheses regarding age-appropriate health promotion, immunizations, history taking, physical measurements, screening, education were tested with contingency tables and Chi-square. If Chi-square was significant the associated strength was computed. The relative risk was calculated using an odds ratio if appropriate. The Age-Appropriate Health Promotion Model was supported by significantly higher rates for the history taking, physical measurements, and education at the six-month visit ($\chi\sp2 = 4.98,\ p = .03,\ \phi = .19,\ RR = 1.2)$, and tuberculosis screening ($\chi\sp2 = 4.23,\ p = .04,\ \phi = .17,\ RR = 1.3).$ Results at the four, nine, and twelve-month visits were also in the direction predicted by the hypotheses. Partners accounted for significant differences between the study and control groups. The following variables were significant: moved since last visit ($\chi\sp2 = 129.55,\ p = .000,\ \phi = .96, RR = 102),$ changed payment since last visit ($\chi\sp2 = 129.55,\ p = .000,\ \phi = .96,\ RR = 102),$ documented parental worries and questions ($\chi\sp2 = 21.65,\ p$ =.000, Cramer's V =.40), and written recommendations of the health care provider to parents ($\chi\sp2$ = 37.51, p =.000, Cramer's V =.52). Nurses, as health care providers, must partner with parents, other health care providers, and community groups in order to secure age-appropriate health promotion for infants. Research and study using the researcher developed Age-Appropriate Health Promotion Model could guide local, state, and national policy decisions regarding age-appropriate health promotion in infants.Item Job stress and burnout among nurses: the mediational effect of spiritual well-being and hardiness(1997-08) Marsh, Verdell; Beard, Margaret; Niewiadomy, Rose; Adams, BettyThe purpose of this study was to determine the relationships among job stress, spiritual well-being, and burnout among nurses. A model of burnout based on Selye's stress theory and the Neuman Systems Model was empirically tested with the structural equation modeling (SEM) approach. A nonrandomized sample of 208 registered nurses completed four instruments--the Stress Diagnostic Survey, the JAREL Spiritual Well-Being Scale, the Personal Views Survey, and the Maslach Burnout Inventory. Data were analyzed using EQS 5.1 for Windows Statistical Software Package and consisted of an assessment of the shape of the sample distribution, of the residuals, of the goodness of fit indices, of the iterative summary, and of the parameter estimates. The model was found to fit the observed data and the following five hypothesized relationships were supported: (a) job stress has a direct positive effect (parameter coefficient =.55) on burnout among nurses, (b) spiritual well-being has a direct negative effect (parameter coefficient = $-$.36) on burnout among nurses, (c) spiritual well-being has a direct positive effect (parameter coefficient =.40) on hardiness among nurses, (d) hardiness has a direct negative effect (parameter coefficient = $-$.27) on burnout among nurses, (e) spiritual well-being operating through hardiness has an indirect negative effect (parameter coefficient = $-$.11) on burnout. The fit indices for the model were as follows: Bentler-Bonett Normed Fit Index =.91, Bentler-Bonett Non-normed Fit Index =.92, Robust Comparative Fit Index =.95. The following conclusions were made: (1) Job stress has a moderate direct positive effect on burnout among nurses. (2) Spiritual well-being has a moderate direct effect on burnout among nurses. (3) Spiritual well-being has a moderate direct effect on hardiness. (4) Hardiness has a small direct negative effect on burnout. (5) Spiritual well-being operates indirectly through hardiness to influence burnout among nurses. (6) The conceptual framework for the study was supported.Item Nurse practitioners' impact on primary health care outcomes in rural clients(2000-12-30) Taylor, Lisa; Beard, Margaret; Adams, Betty; Marshall, DavidThe purpose of this descriptive cross-sectional study was to determine if a significant difference exists in perceived primary health care outcomes of rural clients treated by nurse practitioners and those treated by physicians or physician assistants. Primary health care outcomes were defined as (a) perceived satisfaction with care, (b) compliance with antibiotic medications, and (c) perceived health. Three hypotheses were tested: (1) There is a significant difference in satisfaction with care among rural clients treated by a nurse practitioner and those treated by a physician or a physician assistant. (2) There is a significant difference in compliance with antibiotic medications among rural clients treated by a nurse practitioner and those treated by a physician or a physician assistant. (3) There is a significant difference in perceived health among rural clients treated by a nurse practitioner and those treated by a physician or a physician assistant. Descriptive statistics were used to describe the sample demographics. ANOVA and t -tests were used to test for significant group mean differences for each of the three hypotheses. The sample of 151 subjects (a) were age 18 or older, (b) could read and understand English, and (c) lived in a pre-defined rural county. The majority of subjects were female, white, and married. There was no significant difference found in satisfaction with care or compliance with antibiotic medications among rural clients treated by a nurse practitioner and those treated by a physician or physician assistant. Clients of nurse practitioners had higher levels of perceived health, general health, and physical health than clients of physicians or physician assistants. Rural clients in this study were more satisfied with nurse practitioners in relation to general satisfaction, interpersonal manner, time spent with health care provider, and accessibility and convenience. Financially, rural clients in this study were more satisfied when treated by physicians and nurse practitioners when compared to physician assistants. Nurse practitioners are independent practitioners of primary health care. This study supports nurse practitioners as valuable providers of primary health care in rural environments.Item Self-care activities and quality of life in ovarian cancer survivors(2002-05) Nicholson, Lylith Lambert; Beard, Margaret; Adams, Betty; McGadney, JoanetteThis study is a non-experimental survey to determine if self-care activities and selected basic conditioning factors affect quality of life in ovarian cancer survivors. Three hypotheses were derived from the research question: (a) self-care activities are predictors of quality of life, (b) period of cancer survivorship is a predictor of quality of life, (c) selected basic conditioning factors are predictors of quality of life. The theoretical framework of this study combined the self-care theory of Orem (1985) with Ferrell's (Ferrell, 1996; Ferrell, Dow & Leigh, 1995) conceptual model of quality of life. Participants were selected by random sampling. Ninety-five usable surveys were returned from a potential of 150 participants. Two established instruments, the Self-As-Carer Inventory and the Quality of Life-Cancer Survivor Instrument, in addition to a researcher developed demographic form, were used for data collection. Few significant differences in descriptive characteristics were found in the sample. The majority of the women in the study were Caucasian, married, well educated, and had a family income of greater than $50,000 per year. Most of the women had stage three ovarian cancer when diagnosed and length of cancer survivorship was less than two years for 51 (53.6%) of the participants. Hypotheses testing was accomplished using multiple regression. Findings supported self-care activities as a predictor of quality of life in ovarian cancer survivors. Age was a predictor of quality of life, but marital status, family income, and cancer stage were not. Self-care activities accounted for 19.7% of the variance in quality of life (Q < .001). Age accounted for 6% of the variance in quality of life (Q = < .05). Lack of participants in the extended period of cancer survivorship made analysis of Hypothesis 2 impossible.