While epidemiological research has generated new knowledge about the treatment and prevention of chronic obstructive pulmonary disease (COPD) through smoking secession, the socioeconomic status (SES) of people with the disease has been under investigated. Thus, the purpose of this study was to determine the predictability of association between SES and COPD. This study was based on the ecological theory, which states that health and disease may have multiple underlying factors. This study was a secondary analysis of archived data from the Inter-University Consortium for Political and Social Research (ICPSR). The dataset was collected for the National Survey of Midlife Development in the United States (MIDUS)" study. Variables were measured at the nominal, ordinal, and continuous levels. In this cross-sectional quantitative analysis, logistic regression was used to inform the research questions. The results showed that neither education, income, nor occupation was a predictor of COPD. The logistic regression reported the significance of the predictability of education, income, and occupation to be Ï? = 1.000, Ï? = .498, Ï? = .581, respectively, with odd ratios and confidence interval of 1.007 (.987, 1.028), 1.018 (.948, 1.094), 1.429 (.684, 2.988). Neither education, income, nor occupation yielded a significant statistic value for a Ï? Ë? .05 or a p Ë? .01. These non-significant results regarding the relationship between the SES of a person and COPD reaffirmed that cigarette smoking remains the known determinant of the disease. The social implications of these research findings are that more stringent laws and mandates need to be enacted to discourage easy access to the proven determining factor of COPD: cigarettes smoking.

Zimbabwean men at risk of developing prostate cancer (PC) are diagnosed late or not at all. A cross sectional, quantitative study was done in Zimbabwe to establish physicians' attitudes and beliefs towards PC screening and diagnosis. Descriptive statistics were obtained to determine physicians' beliefs and attitudes using the Physician Attitudes and Beliefs Questionnaire Survey. The instrument incorporated validated instruments, the Burns' Cancer Belief Scale and Physician Survey on Prostate Cancer Screening, and demographic questions to measure specific independent variables, potentially influencing attitudes and beliefs. Means and standard deviations were conducted for continuous variables for beliefs and attitudes, and frequencies and percentages for categorical variables were calculated. Data from 206 respondents were analyzed utilizing multiple regression and MANOVA analysis to determine significance. The average Belief score was 3.96 (SD = 1.04), which reflected an overall belief score falling in the neutral range of response options. Linear regression results were significant, F(19, 178) = 2.09, p = 0.007, R2 = 0.18, suggesting that screening, stage of cancer, gender, training location, culture, total years in practice, and specialty accounted for 18% of the variance in Belief score. Attitude score predicted by screening (p = .000), stage of cancer (p = .005), race (p = .000), and culture (p = .020), was also significant. Screening and training location were significant predictors. Results will benefit physicians improve their attitudes using suggested continued education, resulting in improved screening practices and PC diagnosis. The public health system will potentially see PC death rates decline over time increasing life expectancy.

Social support and acute care facility providers need information about how to help improve the practices and knowledge of caregivers related to the stages of palliative care. The purpose of this study was to examine whether there was a significant association between social support and psychological distress and behavioral outcomes among palliative care caregivers, and to determine to what extent social support buffered psychological distress and behavioral outcomes. The quality-of-life model guided the study. The study used a quantitative cross-sectional research design with secondary data analyses. The sample included 320 adult family caregivers who were part of a telephone survey on caregiver burden collected in 2000 representing the U.S. population. The independent variable was social support (caregivers' awareness of resources and receipt of direct support) and the dependent variables were psychological distress (anxiety, stress, and depression) and behavioral outcomes (sleep deprivation and patient abuse). Caregivers' receipt of direct social support significantly predicted reduction of psychological distress: anxiety (OR = .434, p < .001), stress (OR = .603, p < .041), and depression (OR = .464, p < .013). Social support was not a predictor of behavioral outcomes. The positive social change implications of this study include use of findings by healthcare providers and social service agents to formulate services to aid caregivers in reducing the burden of negative behavioral outcomes and improve quality of life of caregivers and their families.

This study focused on the transitioning of graduate nurses (GNs) employed by a teaching hospital in the eastern United States to the professional role of registered nurse after a 6-week orientation was the focus of this study. Benner's novice-to-expert theory served as the framework for this qualitative case study. Twelve participants were chosen from 3 specific populations: GNs, nursing preceptors, and nurse managers. Three research questions asked about the perceptions of newly licensed nurses after completion of the orientation process related to their ability to make critical decisions in the professional role of RN, how the preceptor educational training program prepared staff nurses for the role of preceptor, and the beliefs of newly licensed nurses and nurse managers regarding the role of nurse mentor. Interviews and documents were the sources of the qualitative data collected from the participants and the organization. The data were coded manually in a comparative manner to extract the themes that emerged from the findings. Participants agreed that the orientation program did not provide sufficient time and education for GNs to learn and grow professionally and did not offer training to nurses serving as preceptors. Results identified the need for revisions to the orientation program that would offer consistency and relevancy to the needs of all stakeholders. The preceptor workshop and a transition-to-practice (TTP) program were developed based on the outcomes. The TTP program could benefit this teaching hospital as well as local, state, and national health care facilities that employ newly licensed nurses. Improving the training of preceptors and implementing the orientation program for GNs for a minimum of 6 to 12 months would improve patient outcomes and increase nurse competency.

Research has shown that meaning in life is a universal human need, regardless of cultural identity or education. This research study investigated how the encounter with prostate cancer impacted men's sense of well-being and what they considered meaningful in life. An interpretative phenomenological research design was used because of its descriptive nature and its focus on the individual's perspective. The sample included 6 men between the ages of 18 and 65 who had been out of treatment for 1 year. Participants completed essays about their perceptions and experiences over 3 periods of time: before diagnosis, during treatment, and as survivors. The analysis concentrated on exploring participants' perceptions; identifying themes, commonalities and discrepancies in the data; and drawing comparisons between participants' definitions for meaning in life with the meaning making model of Park and Folkman. Study results addressed issues including a lack of information about side effects and the depth of the mental and emotional toll taken not only on the patients but also on people around them. Social change implications include the importance of (a) educating men with prostate cancer about the mental and physical health challenges they may face as they undergo treatment; (b) encouraging them to reach out for support (including professional services) should they encounter psychological difficulties over the course of dealing with their illness; and, (c) providing them with opportunities to speak about the mental, emotional, physical, and relational challenges they have faced and may still be facing in their lives as a consequence of the disease and its associated treatments.

Despite an increasing number of healthy lifestyles throughout the country, Americans, including Native Hawaiians, keep gaining weight. Unlike several American lifestyles that have resulted in weight gain within the American population, the vegetarian lifestyle is a scientifically proven method for decreasing body weight and maintaining the weight loss for more than 1 year. This study aimed to compare the lifestyle patterns of 4 vegetarian lifestyles and 1 nonvegetarian lifestyle among Native Hawaiians aged 21 and older using their body mass index (BMI). This quantitative study utilized a correlational design, which is particularly suitable for examining the relationship of BMI to eating lifestyle and such variables as physical activity. A survey with 18 questions was administered to participants (n = 300) who have chosen a specific lifestyle and have been following this lifestyle for 1 year or more. The main research question investigated the difference in the body weight of Native Hawaiians aged 21 and older who followed and maintained a vegan, lacto-ovo vegetarian, semivegetarian, or nonvegetarian diet. Participants' BMI was affected by the factors of age, self-efficacy, disease status (high blood pressure, no health risks), and eating habits (Vegetarian Lifestyle Scale). While the Vegetarian Lifestyle Scale was a significant predictor of BMI, there was no significant difference in the effect of the 2 lifestyle classifications of nonvegetarian and vegetarian on BMI, after controlling for other relevant factors. This study aimed to effect social change in the Native Hawaiian community by demonstrating the health benefits of a plant-based diet and better informing public health officials to guide their development of more effective nutrition and weight loss programs for Native Hawaiians.

Many researchers have suggested positive patient-health provider relationships can positively impact patient outcomes. A few focused explicitly on bariatric weight loss surgery (BWLS) professional-patient interactions. This study is significant because BWLS is a recommended tool to combat obesity. The purpose of this study was to analyze the perceptions of BWLS education nurses regarding their patient encounters. This mixed methods research study used an online survey combining quantitative Likert scale questions and open-ended qualitative questions, with social cognitive theory as the theoretical foundation. These explored viewpoints relate to their patient relations expressed by a health professional. Health professional beliefs incorporated into patient interactions has merit within BWLS continuum from presurgery requirements, to the procedure, and post-surgery lifestyle. Many respondents are employed in obesity services programs and received 'snowballs' from other contacted health professionals. The analyzed written response word clouds favor patient-focused care. Participation reluctance by not answering or skipping short answer perspective questions was a quantitative trend. Data revealed survey specific noticeable qualitative tendencies favorable toward patient-centered care and patient health accountability. The anticipated positive social change is a better understanding of issues surrounding the choice for and against BWLS and improved healthcare and health professional-patient communications.

Type II diabetes is a significant problem in the United States that had affected almost 10% of the American population and over 13% of African Americans. Although culturally competent diabetes education and treatment programs have been significantly more successful, little is known about the cultural factors affecting type II diabetes in African Americans of Caribbean descent (AACD). The purpose of this qualitative, phenomenological study was to explore the cultural factors relevant to the treatment and prevention of type II diabetes among AACD. The theoretical framework for the study consisted of cultural adaptation theory and the transtheoretical model. Data collection consisted of in-depth, qualitative semistructured interviews. For the first research question, findings indicated that AACD viewed dietary and exercise regimens as challenging to implement. For the second question, findings indicated that AACD viewed medical advice related to diabetes as valuable and helpful, and AACD fully appreciated and perhaps even exaggerated the seriousness of diabetes, a factor that might incentivize preventative behaviors. Findings from the present study could inform new diabetes treatment and education for AACD that addresses specific cultural factors, which could lead to lower diabetes rates for this population.

Although U.S. breastfeeding rates have steadily increased since 2000, there continues to be a disparity in breastfeeding rates for African American (AA) women compared to their non-Hispanic White counterparts. A male partner's perception, specifically his positive attitude toward breastfeeding, may influence breastfeeding initiation and duration rates. This study was an exploration of AA male perceptions and attitudes toward breastfeeding and what effect masculinity ideology (gender norms) has on such attitudes. The socio-ecological model (SEM) was used as the theoretical framework to examine the various environmental levels that intersect with one another to influence these attitudes. A mixed methods study design, using (a) an online survey combining the Iowa Infant Feeding Attitudes Scale (IIFAS) and the Male Role Norms Scales (MRNS) (N =206) and (b) 3 focus group sessions (N = 17), was used to collect data. African American men ages 18 and older were eligible to participate in the study. Results of the regression analysis showed a negative correlation between positive breastfeeding attitudes and traditional masculinity ideology. Nvivo analysis of focus group transcripts revealed themes of gender norms, knowledge of breastfeeding, and public opinions. The themes from the focus groups were categorized using the 4 levels of the SEM: Individual, Relationships, Community, and Societal; themes corresponded with Levels 1 (Individual) and 4 (Societal) of the SEM. These results indicate that a gender-transformative approach may be used to strengthen breastfeeding-promotion interventions targeting AA males. The positive social change implications of this research include a paradigm shift in views on gender norms and increased engagement of men in decisions that affect infant and child health and development.

The prevalence of obesity has doubled over the past 25 years in the United States, particularly in North Carolina. Obesity is influenced by biological, social, and environmental factors; its prevalence has been found to be higher among African American women and other racial ethnic minorities. Guided by the social ecological model, the purpose of this cross sectional study was to examine the relationship of the psycho-social, psycho-behavioral factors, and body mass index levels (BMI) in African American women living in North Carolina versus their Hispanic American and European American counterparts. A logistic regression model using secondary data from the Behavioral Risk Factor Surveillance System revealed a significant association in income levels, house hold size, dietary intake, physical activity, and increased BMI levels in African American women. African American women were significantly more likely to be obese (r = 0.93 p > 0.05) compared to European American and Hispanic American women. The association of each variable to BMI assessed for African American women was as follows: income (r = 0.46, p = 0.001), dietary intake (r = 0.-17, p = 0.04), household size (r = 0.57, p = 0.001), physical activity (r = -0.16, p = 0.05), depression (r = 0.37, p = 0.001), and alcohol consumption (r = 0.39, p = 0.001). A culturally sensitive weight loss model addressing the psycho-behavioral and psychosocial risk factors that negatively influence BMI and subsequently obesity is warranted for African American women living in North Carolina to promote social change and decrease the incidence of obesity in this ethnic group.