Due to changes in health care, along with increasing technological demands, nurse's experiences increased stress. Nurses who are asked to staff another area other than their own have increased stress that can lead to increased nurse turnover, absences, and nursing dissatisfaction scores. The purpose of this quality improvement project was to assess whether limiting what units a nurse works on can reduce nurse stress, improve self-efficacy, and improve nurse job satisfaction. The design of this pilot placed like nursing units within a neighborhood staffing model for floating. The plan-do-check-act model was used as a framework to implement a change in the nurse floating practices. An electronic survey was sent to the nursing team pre and post implementation of the model. Nursing hours will also be tracked during this period of time. Data related to floating after the implementation of the neighborhood staffing model showed a significant increase in floating hours inside (13.1 vs 20.9; t=3.98, p<.001), and there was a significant decrease in hours floated outside the neighborhood (26.3 vs 18.0; t=5.15, p<.000). Self-efficacy results showed an initial decline in the nurses' self-efficacy 4 weeks after the launch and a statistically significant increase over preimplementation levels at 8 weeks (pre 28.46; post 33.51; U=5003, p<.001); on the 3rd administration of the self-efficacy survey, a statistically significant increase was seen (28.5 vs. 33.5; t=12.1, p<.001). Allowing nurses to float to similar nursing areas will result in improved self-efficacy, a precursor to reduced job stress and increased job satisfaction, which represents a positive contribution to social change for the nurses who work in the hospital system.

The purpose of this project was to highlight an intervention to increase breastfeeding initiation and exclusive breastfeeding during the birth hospitalization in a coastal mid-Atlantic inner city hospital. Although researchers and national standards promote early initiation and exclusive breastfeeding, there continues to be a significant number of women who do not breastfeed and/or supplement with formula. The advantages of breastfeeding for mother and infant are substantial and include protecting babies from allergens to reducing maternal breast and ovarian cancer. Breastfeeding rates of initiation and exclusivity at the project hospital were below benchmarks set by international, national, and state agencies. The project intervention utilized bedside RNs who were educated and trained by the Perinatal Unit Clinical Nurse Specialist and the unit lactation counselors on bedside lactation support. The educational intervention capitalized on Dennis's theory of breast-feeding self-efficacy, which emphasizes maternal confidence in breastfeeding success. A convenience sample of breastfeeding rates of initiation and exclusivity from one month's delivered mothers pre-intervention (n = 203) compared to one month's breastfeeding rates of delivered mothers post-intervention (n = 220) was derived from electronic medical record nursing documentation and formed the data points for analysis. Outcome measures demonstrated an institutional increase in rates of breastfeeding initiation and in breastfeeding exclusivity. Chi-square analysis of both outcomes was not statistically significant; however progression towards the benchmarks was made, demonstrating clinical significance. Future social change from the project's success will be evident in reduction of sequelae from the above named maternal and infant acute and chronic illnesses.

No description available.

Diabetes self-management has clear benefits in reducing diabetes symptoms and complications and improving the health, wellbeing and quality of life of people with diabetes. Successful intervention programs focus on the development of diabetes self-efficacy, which promotes the capacity of people with diabetes to perform diabetes self-management even in the face of difficulty. Diabetes self-management, however, presents considerable challenges for health systems that have been structured to provide acute, rather than chronic care, and health professionals who have been trained to cure illness, rather than manage behaviour. It presents further challenges for people with diabetes who live in socioeconomically disadvantaged circumstances and have limited financial resources for diabetes care and therapies, and poor access to resources for diabetes self-management, such as clean, safe exercise areas and healthy foods at low-cost. These sociostructural determinants of diabetes self-management, defined here as GP care and socioeconomic resources, have the potential to impede the uptake and effective dissemination of diabetes self-management policy and intervention. This research thesis investigated the impact of sociostructural determinants on diabetes self-management using a model developed from self-efficacy theory. The model was empirically examined using a mixed quantitative and qualitative methodology, where qualitative data were used to illuminate the findings of quantitative data. The quantitative component comprised a random cross-sectional survey of 105 people with diabetes subjected to hierarchical multiple regression with tests for moderator effects. The qualitative component comprised three group interviews of 27 English-speaking, Vietnamese-speaking and Arabic-speaking people with diabetes, analysed using the phenomenological method. Findings provided partial support for the model. Relationships between sociostructural determinants and diabetes self-management were complex. While good quality GP care facilitated diabetes self-management, it also acted as a barrier to self-monitoring of blood glucose for people with low levels of diabetes self-efficacy. Having limited access to socioeconomic resources did not impede diabetes self-management, even for people with low levels of diabetes self-efficacy, although this may have been masked by access to public health schemes and welfare support. The findings from this small-scale exploratory study suggest that self-efficacy may exert an impact on diabetes self-management, even in the face of sociostructural determinants.

In alcohol literature, various genetic and environmental theories have been proposed for the transfer of alcohol problems, however these have resulted in a number of unanswered questions regarding the extent that these factors influence the transmission of alcohol use behaviour. It is therefore suggested that specific cognitions related to alcohol use are fundamental in determining future alcohol use. Studies by Oei and colleagues (Baldwin, Oei, & Young, 1993; Lee & Oei, 1993; Oei & Burrow, 2000; Oei, Fergusson, & Lee, 1998) have investigated two cognitive constructs that together have shown to be predictive of the quantity and frequency of alcohol use; Alcohol Expectancies (AE) and Drinking Refusal Self-Efficacy (DRSE). Whereas a number of studies have shown that parental alcohol behaviour and attitudes can predict their offsprings’’ alcohol use, no study to date has directly assessed parents’ AE and DRSE with those of their children. The current thesis proposed a cognitive model for the Intergenerational Transference of Alcohol Use Behaviour (see Campbell & Oei, 2010) suggesting that parental alcohol cognitions and behaviour will contribute to their offsprings’ cognitions, in turn leading to their alcohol use. Study 1 (N = 1256) tested the cognitive model to determine its accuracy and the relationships it encompasses. The data was then split into younger (<12 years) and older (>12 years) child groups to determine if the model was consistent in offspring in differing maturational and cognitive stages of development and alcohol use. It was revealed that the overall data fit the model well. Different patterns were however revealed between the two groups suggesting that parental alcohol use behaviour was moderately associated with alcohol expectancies in their young children, whereas their AE and DRSE became more significant in the maintenance of their older offsprings’ alcohol use. Study 2 (N=492) tested the model across parent/offspring gender dyads in an attempt to isolate the cognitive and behavioural aspects that are specific to gender in determining the intergenerational transference of alcohol use behaviour. Same and cross gender comparisons revealed that sons were influenced by paternal, but not maternal, alcohol cognitions, whereas no influence was exerted on daughters’ cognitions or behaviour from either parent. Such findings suggest that males may be more prone to genetic influences whereas females may be more sensitive to disruptions in their home environment. As such, the role of Family Functioning was assessed in Study 3 (N =482) to determine whether this environmental factor contributes further to the overall cognitive model between sons and daughters. Results indicated that family environment was significantly related to parents higher AE and lower DRSE, but not their offsprings’. Separation of parent and child data revealed that sons, but not daughters, were influenced more by family functioning. However, upon further investigation results revealed that poor family environment had a greater impact on fathers than mothers, and that this impacted on sons but not daughters. It therefore seems plausible from these results that females (mothers and daughters) alcohol use is related to variables external to the family environment such as peers or media. The final study tested the cognitive model using longitudinal data to determine causal relationships in the transference of alcohol use behaviour. Findings suggest that the relationship between parent and offspring alcohol cognitions could explicitly predict children’s alcohol use behaviour. Specifically, the model revealed that parents’ self-efficacy beliefs, but not their expectancies, was associated with children’s DRSE, and that children’s alcohol cognitions significantly predicted their alcohol consumption six months later. The study did reveal however that children’s alcohol expectancies may become less influential in the maintenance of alcohol consumption as they get older. Overall findings suggest that the cognitive model for the intergenerational transference of alcohol problems has advantages for prevention and treatment strategies, particularly given that that cognitions, and in turn behaviours are particularly modifiable to change. Theoretical implications also exist such that a testable model adds depth to the conceptualisation of the mechanisms for the transference of alcohol problems within families. Particularly, the opportunity arises to incorporate cognitive influences into the intergenerational literature, resulting in a more thorough Genotype x Environment x Cognitive theory.

<p>Self-efficacy och socialt stöd är två fenomen som visats ha ett flertal goda effekter på individers beteende framförallt inom utbildning. Devonport och Lanes (2006) studie kunde bekräfta relationen mellan self-efficacy och prestation. Den föreliggande studiens syfte var att studera betydelsen av self-efficacy och socialt stöd för studieprestation hos en grupp studenter. Två mätningstillfällen utfördes, med 65 deltagare vid första och 49 vid andra tillfället. Resultaten visade att socialt stöd hade signifikant positivt samband med self-efficacy. Även om studien inte fann några signifikanta effekter varken av self-efficacy eller socialt stöd på prestation antyddes intressanta mönster av ändring över tid. Exempelvis visade det upplevda stödet ett mönster där individer med högt upplevt stöd presterade generellt bättre i förhållande till de med lågt.</p><p>Key words: self-efficacy, social support, academic achievement, student.</p>

<p>Sverige avsätter idag över en miljard kronor på att hjälpa arbetslösa att starta eget och därmed bli entreprenörer. Hög self-efficacy är en grundförutsättning för att lyckas som entreprenör och våra erfarenheter av att lyckas är den enskilt största källan till self-efficacy. Miljön som arbetslös är både fysiskt och psykiskt påfrestande och ofta kantad av motgångar, något som i teorin skulle kunna leda till sänkt self-efficacy. Studiens syfte var att undersöka om arbetslösas self-efficacy förändras med tiden de förblir arbetslösa. En enkätundersökning med 107 arbetslösa från en arbetsförmedling i Mellansverige genomfördes. Resultatet visade inte på något samband mellan långtidsarbetslöshet och sänkt self-efficacy. Studien visade däremot på flera intressanta skillnader i hur starkt de olika informationskällorna bidrog till self-efficacy.</p>

No description available.

<p>Syftet med studien var att undersöka kvinnors upplevelser av utbrändhet ur ett somatiskt, psy¬kiskt och socialt perspektiv. Vidare var syftet att belysa de copingstrategier som kvinnorna använt sig av för att kunna återgå till arbetet. Ett ytterligare syfte var att belysa hur ovanstående aspekter förändrats enligt kvinnorna efter utbrändheten och vilka copingstrategier de använt sig av för att förhindra ny utbrändhet. Fem kvinnor intervjuades och materialet analyserades med hjälp av teoristyrd och induktiv tematisk analys. Resultatet kopplades sedan till teo¬rin om kognitiv värdering, self-efficacy teorin och teorier om naturens och den fysiska aktivitetens betydelse för välmåendet. Resultatet visade att samtliga kvinnor upplevt somatiska, psykiska och sociala problem vid tiden innan, under och i viss mån efter utbrändheten. Kvinnorna använde sig inledningsvis av problemfokuserad coping (ex. samtalsterapi) i kombination med emotionsfokuserad coping (ex. socialt stöd) för att i slutskedet inbegripa enbart emo¬tionsfokuserad coping (socialt stöd, yoga, naturen) . Vidare var ett resultat att samtliga kvinnor upplevde högre grad av självtro och självmedvetenhet efter tiden som utbrända.</p>

The purpose of this study was to determine the impact a narrative reflecting team experience has on counselor self-efficacy. Through a quasi-experimental design, the use of a narrative reflecting team supervision model was compared to supervision as usual with graduate counseling students (N=12). The Counselor Self-Estimate Inventory (COSE) was chosen to assess self-efficacy pre and post 8 weeks of a reflecting team intervention and supervision as usual. Results from a Wilcoxon Signed Ranks Test indicate that an 8 week, 11/2 hour, narrative reflecting team experience did not elicit a significant change in counselor self-efficacy over supervision as usual. Counselor self-efficacy is an important concept to explore and emphasize as the field of counseling works to improve educational and supervision practices with developing counselors. The use of narrative techniques in a reflecting team supervision model, offers an alternative approach to supervision- an approach, which is a collaborative, empowering, and a re-storying experience for counselors in training. The research questions hierarchical, power and fear laden supervision models that negatively impact the efficacy of counselors in training. It further emphasizes a need to develop new practices, which support self-efficacy in new trainees, as their level of efficacy will impact how they will be with clients in the future. Results and suggestions for future research and practice are discussed. / Graduation date: 2013