Purpose. This study was designed to determine the perceptions of the Oregon-certified nurse practitioners (NPs) with respect to their usage, competency, and preparation for selected functions. Clarification of what NP's perceive themselves doing and with what degree of competence could give structure and direction to their preparation. In Oregon, NPs provide specialized primary care in collaboration with physicians and other health care professions and agencies. The performance of an NP may vary according to the specialty, setting, and needs of the consumer. If some functions of the NP could be brought into clearer focus, then not only could benefits come to the health care consumer, but also health care professionals could work together more efficiently and productively. Furthermore, educators could build programs with a clearer sense of purpose and structure. Procedure. The data were obtained through a survey of 574 NPs certified in Oregon. A four-part questionnaire was adapted from instruments developed by researchers of NPs in North Carolina, Arkansas, and Colorado. The analysis of service diaries provided by Oregon nurse practitioners, additions by the Oregon State Board of Nursing, and pretesting in the field resulted in statements about selected characteristics and attitudes, practice settings, and clinical and community functions of Oregon nurse practitioners. Questionnaires were mailed, and 386 were analyzed. Summary of Findings and Conclusions. Three research hypotheses were formed and tested by chi-square. The following findings and conclusions were identified: (a) Some relationships did exist between NP functions and specialty groups with respect to competency, frequency of performance, and preferred preparation. (b) Most nurse practitioners serve a large number of consumers in low or very low economic circumstances through community or home health agencies. (c) Some functions of high competency and usage are needed in the preparation of all nurse practitioners at the baccalaureate and master's level. (d) Higher education is preferred for preparation of nurse practitioners in a sequence of baccalaureate in nursing followed by a master's degree which qualifies for certification in a nursing specialty. (e) For the functions of lower competency and usage, reduced emphasis or deletion from nurse practitioner preparation is desirable. (f) Some functions are suitable for major emphasis in continuing education programs with the standards of higher education.

Menopause is a critical life-cycle transition for women, and is associated with osteoporosis and cardiovascular disease, leading causes of morbidity and mortality in US women. Efforts to curb symptoms of menopause include HRT and ERT, although conflicting evidence exists linking ERT and HRT with the risk of breast cancer. Physicians attitudes and preferred mode of treatment have been extensively studied, but with the increased utilization of nurse practitioners in the field, a new paradigm is being established. The overall goal of this study was to assess the nurse practitioners knowledge and attitudes about menopause, hormone replacement therapy and estrogen replacement therapy. More specifically, the objectives include to: 1) determine methods of patient education for menopausal women; 2) examine whether attitudes of menopause are predictors of preferred modes of treatment; and 3) determine whether demographic factors of nurse practitioners are predictors of preferred modes of treatment. A random selection of nurse practitioners from the state of Oregon were mailed a self-administered survey along with a stamped, addressed envelope. The questionnaire focused on knowledge of menopausal treatments, attitudes of menopause, continuing education in the menopause research, and methods of patient education. Follow-up surveys were mailed to non-responders at two and four-week intervals following the first mailing. Response rate was 60% with a sample size of 192. Results describe the management practices of nurse practitioners and what influenced their prescribing and management practices. The influences included the following factors: perceptions about adequacy of formal education, continuing education and attitudes about menopause and managing menopause. Only 47.4% of the respondents felt that their formal education in menopause treatment and protocols was adequate. When asked how they treated women, a majority (64.6%) of the nurse practitioners depended on the women and her beliefs about menopause, HRT, and ERT when they considered how they cared for a menopausal women. Sixty-one percent were very likely to take time during a visit to discuss the changes a woman was going through, while 23.7% were most likely to answer questions if the client had any, otherwise leave the introduction of menopause to the client. When contraindications were present, all nurse practitioners were less likely to prescribe both ERT and HRT. A surprising trend was the high number of participants who were uncertain about how they would prescribe when contraindications were present. In summary, this study describes Oregon nurse practitioners attitudes about menopause, the perceived adequacy of their formal education, and likelihood of prescribing ERT and HRT. Since almost 50% of the nurse practitioners felt their education was inadequate in menopause, a systematic analysis of masters level nurse practitioner programs in the area of menopause and menopausal treatments is needed. Ideally, a nationwide survey comparing physicians and nurse practitioners prescribing practices would help quantify differences between the two types of health care providers. / Graduation date: 1997