Western Journal of Nursing Research

Guided by Leventhal’s common sense model of illness representations, this study examined the relationship between hypertension beliefs and self-care behaviors necessary for blood pressure (BP) control in a sample of 111 community-dwelling African Americans with hypertension. Participants completed the revised Illness Perception Questionnaire, BP Self-Care Scale, and a demographic data sheet, and had BP measured. Analyses revealed that beliefs about the causes of hypertension differed by gender and educational level. Stress-related causal attributions accounted for 34.7% of the variance in hypertension beliefs. Participants who believed stress or external factors caused hypertension were less likely to engage in healthy self-care behaviors (e.g., keeping doctor visits, eating low-salt, low-fat diets). Results suggest that patients who are nonadherent with hypertension self-care recommendations may hold hypertension beliefs that are not consistent with the medically endorsed views of this disease. To more effectively treat and control BP, providers should assess patients’ hypertension beliefs.

Patient care handoffs are critical to ensuring continuity of care and patient safety. Current definitions of handoffs focus on information, but preventing errors and improving quality require knowledge. The objective of this study was to determine whether knowledge and wisdom were exchanged during medical and surgical patient care handoffs and to discover how these were expressed. The study was a directed content analysis of 93 handoffs using the data/information/knowledge/wisdom framework. Results indicated knowledge was present in all handoffs, comprising 41% of the phrases across the two types of units. No wisdom was coded. The percentage and types of knowledge phrases differed between medical and surgical units. Handoffs could be more knowledge based by linking handoff content to patient problems and goals. Future handoffs could be computationally derived, context-specific, and linked to problem-focused care plans and patient summaries. Improved data visualization and cognitive support are needed.

The assessment of user satisfaction, and the knowledge of what factors influence satisfaction are very important for the improvement of services’ quality provided. This study aims to evaluate user satisfaction with primary healthcare services. A sample of 6,113 healthcare services users was interviewed to evaluate satisfaction and determine a global satisfaction index using a Partial Least Squares Path Model. The global user satisfaction index with healthcare centers is 58.4 points on a 100-point scale, showing that users are only moderately satisfied with the service provided. The results show that the medical care and the price of services are the main predictors of user satisfaction. Other factors such as the perception of health equity and nursing services also seem to be important contributors to satisfaction. A more disturbing result is the negative relationship between perceived accessibility and satisfaction, which requires further research.

The purpose of this study was to use the Self-Regulation Model on African immigrant women, to determine the association of migration and residence in the United States with cognitive representations and dietary behavior, and also to explore migration stress and blood pressure (BP) in them. Participants included a convenience sample of 91 Nigerian immigrant women (NIW) and 38 African American women (AAW). Data collection instruments were the Acculturative Stress Scale and the Women’s and Men’s Hypertension Experiences and Emerging Lifestyle Survey of 2008-2009. Descriptive t test and ANOVA statistics were used to analyze study variables comparing groups and NIW duration of residency in the United States. Knowledge of Hypertension and Cognitive Representation of Hypertension were significantly increased in the NIW by years of residency. Migration stress had no significant relationship with BP level. A longitudinal study initiated on immigrants’ arrival in the United States is recommended to understand the trajectory of chronic illnesses such as hypertension.

Over one million American grandmothers raise grandchildren, and many experience stress that adversely affects their mental health. Teaching resourcefulness skills can minimize this stress. However, before testing effectiveness of resourcefulness training (RT), its fidelity must be established. This pilot intervention trial examined the fidelity of two methods of RT: expressive writing (journaling) and verbal disclosure (voice recording) using a quasi-experimental design with random assignment of 80 grandmothers to RT—expressive writing, RT—verbal disclosure, or expressive writing or verbal disclosure alone. Quantitative data (Resourcefulness Scale) and qualitative data (journals, recordings) were collected. Grandmothers with RT showed greater resourcefulness over time than those without RT, with similar effects for RT—expressive writing and RT—verbal disclosure. Evidence for the use of RT skills was found in journals and recordings. The findings provide support for RT intervention fidelity and support moving forward to test RT effectiveness in reducing grandmothers’ stress and promoting their mental health.

The purpose of this study is to examine the effectiveness of surgical safety checklists on teamwork, communication, morbidity, mortality, and compliance with safety measures through meta-analysis. Four meta-analyses were conducted on 19 studies that met the inclusion criteria. The effect size of checklists on teamwork and communication was 1.180 (p = .003), on morbidity and mortality was 0.123 (p = .003) and 0.088 (p = .001), respectively, and on compliance with safety measures was 0.268 (p < .001). The results indicate that surgical safety checklists improve teamwork and communication, reduce morbidity and mortality, and improve compliance with safety measures. This meta-analysis is limited in its generalizability based on the limited number of studies and the inclusion of only published research. Future research is needed to examine possible moderating variables for the effects of surgical safety checklists.

The purpose of this review is to synthesize the research evidence for the role of the work environment—workplace physical activity policies and resources and job strain factors—in explaining physical activity in white-collar workers. White-collar workers are at risk for developing a sedentary lifestyle, which contributes to all-cause mortality. Understanding how work environment can influence worker physical activity is important for the development of effective interventions. We reviewed 15 research articles that describe the relationship between work environment factors and physical activity in predominantly white-collar workers. Relatively consistent evidence was found for the effects of supportive workplace policies and resources. Weak evidence was found for the effects of job strain. Both work environment factors have the potential to influence physical activity but require further exploration to fully understand their contribution to physical activity in white-collar workers. Limitations and implications are discussed.