The effect of nurse practitioners' attitudes, knowledge, or barriers on practice related to the adult with Syndrome X




Sinsel-Phillips, Pamela Kay

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This study sought to discover nurse practitioners' (NPs) attitudes, knowledge, or barriers to practice toward the adult with Syndrome X. The theory of reasoned action (Ajzen & Fishbein, 1980) was used to guide the study . A model-testing design was used to develop an equation that could be used for predicting values on the dependent variable, practice, for all members of the population. The secondary purpose was to explain the causal relationships among the variables knowledge, attitudes, and barriers. Thirdly, testing of the newly developed instrument was accomplished. Four hundred NPs specializing in family, adult, and/or gerontologic nursing practicing in the United States were randomly surveyed. Of those surveyed, 96 useable surveys were returned usable. The Syndrome X Scale was developed using input from five expert reviewers. Three of the four subscales, attitudes (a= .8156), barriers (a= . 8553), and practice (a= .9378) were judged reliable using Cronbach's coefficient alpha. Cronbach's alpha for the knowledge subscale was .2988, however, knowledge is dichotomous and "in reality criterion-referenced" (Henderson & Kashka, 2000, p. 294). As an emergent variable, "the alpha coefficient does not reflect the characteristics of the scale"(Henderson & Kashka, 2000, p. 294), but reflects the characteristics of the subjects' actual knowledge.Attitudes accounted for 27% of the variance in Models land 2. Barriers added an additional .6%. In Model 3, attitudes and barriers collectively accounted for 27.6% of the co-variance, but the pathway with barriers as a moderator in this model was stronger. Overall, the results suggested that attitudes and barriers were significant in the practice of NPs toward adults with Syndrome X, but attitudes explained the majority of the dependent variable, practice. Knowledge was not a significant predictor. Since attitudes and barriers only explained 27.6% of the co-variance of the NPs' practice, it would seem plausible that some concept may be missing from the model. An intervention aimed at increasing knowledge about Syndrome X might alter the outcome of the proposed final model. Further research in these areas is recommended.



Health and environmental sciences, Hyperinsulinemia, Nurse practitioners, Syndrome X