<p>Caring relationships established between nurse managers and staff nurses promote positive work environments. However, research about staff nurses&rsquo; perceptions of nurse manager caring behaviors is limited. A 94-item Caring Assessment Tool-Administration (CAT-adm^&copy;) was developed to measure staff nurses&rsquo; perceptions of nurse managers&rsquo; caring behaviors; however, it lacked robust psychometric testing. This study was undertaken to establish the CAT-adm^&copy; survey as a reliable and valid tool to measure staff nurses&rsquo; perceptions of nurse managers&rsquo; caring behaviors. </p><p> The Quality-Caring Model^&reg; (QCM^&reg;) served as the theoretical framework. Specific aims were to 1) evaluate construct validity of the CAT-adm^&copy; survey by describing factors that account for variance in staff nurses' perceptions of nurse manager caring, 2) estimate internal consistency, and 3) conduct item reduction analysis. Four research questions were: 1) Will the factor structure of observed data fit an 8-factor solution? 2) What is the internal consistency reliability of the CAT- adm^&copy;? 3) What items can be reduced while maintaining an acceptable factor structure? and 4) What are staff nurses&rsquo; perceptions of nurse manager caring behaviors? </p><p> A cross-sectional descriptive design was used. A sample of 703 staff nurses from Midwestern, Midatlantic and Southern Regions of the U.S. completed the CAT-adm^&copy; survey electronically. Analysis included Confirmatory Factor Analysis (CFA), Exploratory Factor Analysis (EFA), univariate analysis, and descriptive statistics. CFA did not support an 8-factor solution. EFA supported a two-factor solution and demonstrated significant shared variance between the two factors. This shared variance supported a one-factor solution that could conceptually be labeled <i>Caring Behaviors</i>. Random selection reduced the scale to 25-items while maintaining a Cronbach&rsquo;s Alpha of .98. Using the new 25-item scale, the composite score mean of staff nurses&rsquo; perceptions of nurse manager caring behaviors indicated a moderately high level of caring. Suggestions for nursing administration, nurse manager practice, leadership, education and for future research were given. </p><p> The new 25-item CAT-adm^&copy; survey has acceptable reliability and validity. The 25-item CAT-adm^&copy; survey provides hospital administrators, nurse managers, and researchers with an instrument to collect valuable information about the caring behaviors used by nurse managers in relationship with staff nurses. </p>

Age, salary, family status, and health status are reported to be linked to high deductible health plan (HDHP) enrollment for pre-Affordable Care Act (ACA) health plans. There has been little research on HDHP enrollment post-ACA. This study quantitatively examined the demographic variables and attitude toward risk that contribute to enrollment in a HDHP that conforms to the ACA minimum essential coverage standards. Risk taking was measured by the Domain Specific Risk Taking Scale. Other independent variables were participant age, annual salary, employee status, enrollment tier, and gender. There were 144 participants recruited from the Amazon Mechanical Turk platform who participated in the research survey. The results of binary logistic regression analysis indicated that age and the presence of children on coverage predict HDHP enrollment. Older employees and employees with at least 1 child on coverage are less likely to enroll in a HDHP. As almost 40% of adults in the United States are covered under a HDHP and this number is expected to increase, it is important to determine the factors related to HDHP enrollment. By identifying the factors related to HDHP enrollment, better educational materials may be developed for employees related to the complex and often confusing insurance decision-making process thus supporting positive social change in the health insurance industry.

Previous research has indicated that vascular disease, trauma, and cancer lead to amputations and that 1.7 million Americans are living with an amputation. The social problem of this study is that amputees have limited places to obtain social support. Alderfer's Existence, Relatedness, and Growth Theory provided the foundation for this research. The current study examined the following questions. First, does type of social support impact amputee perceived social support satisfaction? Second, does type of social support impact life satisfaction? Survey methodology was used following attendance at either peer-to-peer or group support. A purposeful sample of 184 participants were assessed using the Satisfaction with Life Scale and the Multidimensional Scale of Perceived Social Support. ANOVA first showed that peer participants reported significantly greater perceived social support satisfaction than group. Second, ANOVA showed that participants in peer support groups reported greater life satisfaction than group. These data assist anyone concerned with helping amputees make support decisions based on the amputees' specific needs. From these findings, future research utilizing other forms of social support for amputees can be generated and expanded.

With many individuals experiencing multimorbidity, individuals are being prescribed more medications. Although there are benefits to taking medications to manage symptoms and treat disease processes, there are also risks to taking multiple medications. The purpose of this phenomenological study was to explore participants' understanding of the risks associated with practicing polypharmacy. Game theory, credibility theory, and belief bias were the conceptual frameworks used to explain how individuals experienced their care and being prescribed 5 or more medications. Eight participants residing in subsidized housing in a small Midwest city, who were taking 5 or more medications volunteered to take part in semi-structured interviews answering a series of 10 questions. Phenomenological analysis was used to organize the data and to assist with the development of themes regarding the nature of the participants' lived experiences. According to study findings, 7 out of 8 participants stated that they trusted their providers and that their providers used a more directive approach to prescribing medications instead of offering choices to the participants. In addition, participants lacked knowledge of the risks associated with taking all medications collectively, indicating that more education is needed for individuals. Results of the study may be used in both provider training and patient training to stimulate social change that may improve provider patient communication, increase understanding of provider patient interactions, elicit positive patient outcomes by providing knowledge of awareness, communication, and interaction styles, which play a role in patient outcomes.

In recent years, family support partners (FSPs) have been hired to work in the behavioral health care system for the state in which this study was conducted. FSPs are legacy caregivers, meaning they have raised a child with a mental health illness. At the time of this study, there was not a set criterion in the state to measure the effectiveness or benefits of FSPs working with families. The purpose of this quantitative, correlational study was to determine whether a caregiver's level of empowerment, as measured by the Family Empowerment Scale (FES), was increased through working with an FSP. Social learning theory provided the framework for the study. Survey data were collected from 93 caregivers using the FES. Simultaneous multiple regression analysis was conducted to examine the predictive relationship between the caregiver's gender, age, ethnicity, length of time as a caregiver of a child or youth with a mental health illness, and length of time the caregiver worked with an FSP, and the level of caregiver empowerment on the family, service system, and community/political levels. On the family level, caregiver age and length of time the caregiver worked with an FSP were statistically significant predictors. On the service system level, length of time the caregiver worked with an FSP was a statistically significant predictor. On the community/political level, caregiver age, ethnicity, and length of time the caregiver worked with an FSP were statistically significant predictors. Length of time the caregiver worked with an FSP was the only variable shown to be statistically significant on all 3 levels. Findings may be used to support peer specialists in the state this study was conducted and other states, not only in the mental health field, but in additional fields as well.

Dementia and Alzheimer's disease (AD) are highly debilitating conditions that afflict millions of elderly persons. In recent decades, biological evidence has implicated chronic stress in the etiology of these conditions. As a result, the relationship between widowhood, one of the most stressful life events, and dementia and AD has also received attention. However, studies are mixed regarding this association, and few have investigated whether this relationship is moderated by the context surrounding widowhood. This study extends this literature by investigating whether widowhood increases risk for dementia and AD and whether this risk is moderated by contextual factors including age at widowhood, remarriage after widowhood, manner of death, number of dependent and adult children at the time of widowhood, gender, presence of epsilon 4 allele of apolipoprotein E (APOE), and history of depression and antidepressant use. To do this, this investigation utilized data from the Cache County Memory Study (CCMS), a large population-based epidemiological study of dementia and AD, and the Utah Population Database (UPDB), one of the world's foremost linked genealogical databases. In Cox regression analyses that modeled time to onset of dementia and AD, gender was found to moderate the relationship between incident widowhood and dementia (HR = 1.74, 95% CI: 0.97-3.10), in that widowhood trended towards decreased risk among men (HR =0.72, CI: 0.45-1.16) but increased risk among women (HR = 1.21, CI: 0.83-1.75) in stratified models. In addition, history of depression and antidepressant use moderated the association between incident widowhood and dementia (HR = 2.63, 95% CI: 1.26-5.50) and AD (HR = 1.68, 95% CI: 1.11-2.53), in that widowhood was associated with decreased risk for dementia and AD among the never depressed (HR = 0.66, CI: 0.42-1.02 and HR = 0.54, CI: 0.31-0.92, respectively), a trend towards increased risk for AD among those with a history of antidepressant use but no depression (HR = 1.80, CI: 0.86-3.75), and with increased risk for dementia and AD among those with a history of both (HR = 1.93, CI: 0.98-3.81 and HR = 1.89, CI: 0.80-4.43). These findings advance clinical and scientific knowledge concerning the effects of widowhood on risk for dementia and AD, and underscore the importance of context in understanding this relationship.

No description available.

<p>The petrochemical field is an industry seeking to increase efficiency, improve safety of workers, and lessen environmental impacts (U.S. Chemical Safety & Hazard Investigation Board, 2007). One way to improve the performance of operators is to investigate their situation awareness (SA). Research has shown that SA is a predictor of performance (Durso et al., 1999). However, there is little consensus on how to measure SA. This study investigated two prominent techniques for measuring SA: the Situation Present Assessment Method (SPAM; Durso & Dattel, 2004) and the Situation Awareness Global Assessment Technique (SAGAT; Endsley, 1995b). These two techniques were examined for their psychometric properties in assessing SA among operators. The results of this investigation showed that probe-type SA techniques can be used to assess SA in this field. This especially applies to the SPAM technique, which was shown to predict performance, not intrude, and was preferred by a majority of operators.

<p> The Fullerton Ontological Confusion (FOC) scale was constructed to address the issues of inconsistent theory and inadequate measurement regarding paranormal, superstitious, magical, and supernatural (PSMS) beliefs. For the FOC scale, PSMS beliefs were defined as confusions of ontology, or the misattribution of core knowledge belief categories. The FOC was empirically evaluated under an Item Response Theory framework using the nominal response model (NRM) to estimate item parameters and the Wald test to evaluate within-item category variation. Using the NRM and the Wald test, the FOC scale items were revised to yield a measure that was optimally formatted and informative. Correlational analysis was used to validate the FOC scale by testing the hypothesized relationships to theoretically related and unrelated constructs. The FOC scale was found to have a good degree of validity with most of the testable validation hypotheses being supported. Compared to the available existing measures, the FOC scale could be used as a more pure and informative measure for PSMS beliefs. </p>

<p> The overarching goal of psychoanalytic and narrative therapies is to increase agency; however, few tools assess for agency. The Personal Agency Questionnaire (PAQ) was developed for this purpose and was found to be a valid and reliable instrument (Lundquist, 2012). The primary aims of this study were to (a) replicate past findings by performing correlations between the PAQ and scales measuring constructs thought to be part of agency (RSES for self-esteem; GSE for self-efficacy, and IPC for internal locus of control), (b) increase internal consistency and reliability of the PAQ through performing a factor analysis, and (c) establish additional validity by performing regressions to determine how three additional variables were related to agency: gender, perception of being overweight, and antifat attitudes. Females were expected to score lower than males on the PAQ because of the influence of gender norms on agency. Overweight status has shown a negative relation to agency, self-efficacy, and self-esteem; however, the fat- accepting individuals were expected to have greater agency compared to those who have internalized the culture&rsquo;s antifat messages. Participants accessed the online survey through postings on Craig&rsquo;s List and Yahoo discussion groups. Analyses were conducted with 280 participants, a majority of whom were White (65%), female (74%), employed (59%), highly educated (64% had college degree or greater, 33.20% attended some college), and had attended therapy (68%). Factor analysis revealed 4 factors underlying the PAQ (which replaced the previously hypothesized 6 subscales); items of the PAQ were reduced from 42 to 24, increasing reliability among the factors, with &alpha; = .78, &alpha; = .78, &alpha; = .72, &alpha; = .73, and the total reliability from &alpha; = .62 to &alpha; = .90. The new PAQ had stronger correlations than previously with the three scales that established its construct validity. Fat acceptance, age, education and therapy were significantly, positively correlated with agency. When looking at gender alone, or perceptions of being fat alone or in combination with gender, no differences in agency were evident. However when adding the antifat variable to gender and perceptions of being overweight, being female, significantly overweight, with antifat attitudes predicted reduced agency.</p>