This study examined nursing faculty perceptions of the importance of adequate library facilities ... more This study examined nursing faculty perceptions of the importance of adequate library facilities and their satisfaction with them. Library facilities ranked highest in importance among all job characteristics studied, with faculty who had been most productive in terms of publication assigning the highest value to them. A moderate level of satisfaction was found. Faculty most satisfied with library facilities were those teaching in large schools of nursing with graduate programs and open organizational climates and those who were less well educated and generally satisfied with their positions.
This study reports results of the 2-year follow-up phase of a randomized study comparing outcomes... more This study reports results of the 2-year follow-up phase of a randomized study comparing outcomes of patients assigned to a nurse practitioner or a physician primary care practice. In the sample of 406 adults, no differences were found between the groups in health status, disease-specific physiologic measures, satisfaction or use of specialist, emergency room or inpatient services. Physician patients averaged more primary care visits than nurse practitioner patients. The results are consistent with the 6-month findings and with a growing body of evidence that the quality of primary care delivered by nurse practitioners is equivalent to that by physicians.
The information-seeking patterns of clients have received little attention in nursing theory and ... more The information-seeking patterns of clients have received little attention in nursing theory and research, but they are important antecedents of health-related decisions and behavior. The concept of information seeking is analyzed within the framework of a six-step process model. Inter-related dimensions of the information search process are identified and the impact on cognitive and behavioral outcomes is postulated. Sociodemographic, experiential, personality, and contextual variables suggested by prior research to predict variation in search behavior are identified, and implications for nursing theory and research are discussed.
In part II of this two-part series reporting on a survey of doctorate-granting schools of nursing... more In part II of this two-part series reporting on a survey of doctorate-granting schools of nursing on scientific integrity, the authors deal with publication and authorship practices, promotion/tenure policies, and suggested strategies to promote scientific integrity at institutional and broader levels, and the role of various agents in this regard. The findings suggest the importance of the role of senior faculty in socializing and serving as role models for junior colleagues and doctoral students. Professional journals and professional organizations were similarly seen to have a role in standard setting. At the institutional level, educational/facilitative functions, as well as leadership and monitoring activities, were highlighted. The essay presents recommendations for promoting scientific integrity in a proactive manner rather than focusing on procedures for dealing with misconduct.
Context Studies have suggested that the quality of primary care delivered by nurse practitioners ... more Context Studies have suggested that the quality of primary care delivered by nurse practitioners is equal to that of physicians. However, these studies did not measure nurse practitioner practices that had the same degree of independence as the comparison physician practices, nor did previous studies provide direct comparison of outcomes for patients with nurse practitioner or physician providers. Objective To compare outcomes for patients randomly assigned to nurse practitioners or physicians for primary care follow-up and ongoing care after an emergency department or urgent care visit.
Clients ' personal experiences with illness or tragedy can uniquely qualify them as experts in ma... more Clients ' personal experiences with illness or tragedy can uniquely qualify them as experts in many researchrelevant content areas. Nurse researchers can benefit from this expertise by involving such clients in important decision-making aspects of research planning. The advantages of consulting with client-experts in the early and subsequent stages of research are discussed in this article, which uses as an example the way such consultation has worked in the development of a study of coping in polio survivors. Consultation with client-experts is especially appropriate when research involves sensitive issues or the measurement of subjects at vulnerable periods in their lives. It is advocated as a means of helping to ensure that participants are questioned in the most ethical, sensitive way possible and that the research will address the needs and concerns of the target population.
Schools of nursing with doctoral programs were surveyed to determine current approaches and elici... more Schools of nursing with doctoral programs were surveyed to determine current approaches and elicit suggestions for institutional-and professional-level strategies to promote scientific integrity. Results from 38 schools are reported in a two-part series. Part 1 reports findings concerning formal and informal instruction about responsible science and the standards, norms, and guidelines being used to direct scientific inquiry. Information on misconduct and scientific integrity was typically included in required research methods, courses, and optional workshops, but the extent and scope of the instruction was variable, and a majority of respondents judged it to be marginal or inadequate. A high value was placed on informal student-mentor interaction. Where they existed, institutional guidelines were more specific than federal guidelines, but dealt primarily with procedures for handling alleged misconduct rather than for promoting responsible science. Findings suggest the need for a more proactive and consistent approach to promoting scientific integrity in doctoral programs. J
*University of Maryland. Baltimore, MD. In recent years, so many research methods texts have been... more *University of Maryland. Baltimore, MD. In recent years, so many research methods texts have been written by and for nurses that it is often difficult to match the strengths, weaknesses, and unique contributions of each to the needs of a particular course or audience. The following is a comparative review of four recently published or updated (1987) nursing research methods texts. Each is reviewed separately with attention to its organization, content, and strengths and weaknesses. A final comparative summary includes recommendations for use.
Studies have suggested that the quality of primary care delivered by nurse practitioners is equal... more Studies have suggested that the quality of primary care delivered by nurse practitioners is equal to that of physicians. However, these studies did not measure nurse practitioner practices that had the same degree of independence as the comparison physician practices, nor did previous studies provide direct comparison of outcomes for patients with nurse practitioner or physician providers. To compare outcomes for patients randomly assigned to nurse practitioners or physicians for primary care follow-up and ongoing care after an emergency department or urgent care visit. Randomized trial conducted between August 1995 and October 1997, with patient interviews at 6 months after initial appointment and health services utilization data recorded at 6 months and 1 year after initial appointment. Four community-based primary care clinics (17 physicians) and 1 primary care clinic (7 nurse practitioners) at an urban academic medical center. Of 3397 adults originally screened, 1316 patients (mean age, 45.9 years; 76.8% female; 90.3% Hispanic) who had no regular source of care and kept their initial primary care appointment were enrolled and randomized with either a nurse practitioner (n = 806) or physician (n = 510). Patient satisfaction after initial appointment (based on 15-item questionnaire); health status (Medical Outcomes Study Short-Form 36), satisfaction, and physiologic test results 6 months later; and service utilization (obtained from computer records) for 1 year after initial appointment, compared by type of provider. No significant differences were found in patients' health status (nurse practitioners vs physicians) at 6 months (P = .92). Physiologic test results for patients with diabetes (P = .82) or asthma (P = .77) were not different. For patients with hypertension, the diastolic value was statistically significantly lower for nurse practitioner patients (82 vs 85 mm Hg; P = .04). No significant differences were found in health services utilization after either 6 months or 1 year. There were no differences in satisfaction ratings following the initial appointment (P = .88 for overall satisfaction). Satisfaction ratings at 6 months differed for 1 of 4 dimensions measured (provider attributes), with physicians rated higher (4.2 vs 4.1 on a scale where 5 = excellent; P = .05). In an ambulatory care situation in which patients were randomly assigned to either nurse practitioners or physicians, and where nurse practitioners had the same authority, responsibilities, productivity and administrative requirements, and patient population as primary care physicians, patients' outcomes were comparable.
The practice-focused doctorate is an important alternative to research-focused doctorates in nurs... more The practice-focused doctorate is an important alternative to research-focused doctorates in nursing. The goal of this article is to provide the reader with an understanding of the nature and potential benefits ofthe practice doctorate. After discussing the background of this doctoral degree and the development of the degree by the American Association of Colleges of Nursing (AACN) Task Force on the Practice Doctorate in Nursing, the article will describe patterns in practice-focused doctoral education and issues considered by the task force in developing the position paper on the practice doctorate in nursing. A look ahead provides an update on current steps being taken by AACN and others toward implementing the task force's recommendations.
This correlational study of mothers and their 6-month-old infants examined the importance of soci... more This correlational study of mothers and their 6-month-old infants examined the importance of social support and stressors for parenting and infant development. Mothers (n = 79) were primarily White, married, and ranged in socioeconomic status from low to high. All data were collected in mothers' homes when infants were 6 months old. Diversity of sources of social support and diversity of father support were positively related to parenting (quality of stimulation in the home). Diversity of sources of social support buffered the negative relationship of maternal fatigue (stressor) to parenting. Parenting was related to social, hearing-speech, locomotor, and general development. Additionally, social support and aggravation (people in the mother's said network who make life difficult) were related to infant development, independent of parenting.
This study examined nursing faculty perceptions of the importance of adequate library facilities ... more This study examined nursing faculty perceptions of the importance of adequate library facilities and their satisfaction with them. Library facilities ranked highest in importance among all job characteristics studied, with faculty who had been most productive in terms of publication assigning the highest value to them. A moderate level of satisfaction was found. Faculty most satisfied with library facilities were those teaching in large schools of nursing with graduate programs and open organizational climates and those who were less well educated and generally satisfied with their positions.
This study reports results of the 2-year follow-up phase of a randomized study comparing outcomes... more This study reports results of the 2-year follow-up phase of a randomized study comparing outcomes of patients assigned to a nurse practitioner or a physician primary care practice. In the sample of 406 adults, no differences were found between the groups in health status, disease-specific physiologic measures, satisfaction or use of specialist, emergency room or inpatient services. Physician patients averaged more primary care visits than nurse practitioner patients. The results are consistent with the 6-month findings and with a growing body of evidence that the quality of primary care delivered by nurse practitioners is equivalent to that by physicians.
The information-seeking patterns of clients have received little attention in nursing theory and ... more The information-seeking patterns of clients have received little attention in nursing theory and research, but they are important antecedents of health-related decisions and behavior. The concept of information seeking is analyzed within the framework of a six-step process model. Inter-related dimensions of the information search process are identified and the impact on cognitive and behavioral outcomes is postulated. Sociodemographic, experiential, personality, and contextual variables suggested by prior research to predict variation in search behavior are identified, and implications for nursing theory and research are discussed.
In part II of this two-part series reporting on a survey of doctorate-granting schools of nursing... more In part II of this two-part series reporting on a survey of doctorate-granting schools of nursing on scientific integrity, the authors deal with publication and authorship practices, promotion/tenure policies, and suggested strategies to promote scientific integrity at institutional and broader levels, and the role of various agents in this regard. The findings suggest the importance of the role of senior faculty in socializing and serving as role models for junior colleagues and doctoral students. Professional journals and professional organizations were similarly seen to have a role in standard setting. At the institutional level, educational/facilitative functions, as well as leadership and monitoring activities, were highlighted. The essay presents recommendations for promoting scientific integrity in a proactive manner rather than focusing on procedures for dealing with misconduct.
Context Studies have suggested that the quality of primary care delivered by nurse practitioners ... more Context Studies have suggested that the quality of primary care delivered by nurse practitioners is equal to that of physicians. However, these studies did not measure nurse practitioner practices that had the same degree of independence as the comparison physician practices, nor did previous studies provide direct comparison of outcomes for patients with nurse practitioner or physician providers. Objective To compare outcomes for patients randomly assigned to nurse practitioners or physicians for primary care follow-up and ongoing care after an emergency department or urgent care visit.
Clients ' personal experiences with illness or tragedy can uniquely qualify them as experts in ma... more Clients ' personal experiences with illness or tragedy can uniquely qualify them as experts in many researchrelevant content areas. Nurse researchers can benefit from this expertise by involving such clients in important decision-making aspects of research planning. The advantages of consulting with client-experts in the early and subsequent stages of research are discussed in this article, which uses as an example the way such consultation has worked in the development of a study of coping in polio survivors. Consultation with client-experts is especially appropriate when research involves sensitive issues or the measurement of subjects at vulnerable periods in their lives. It is advocated as a means of helping to ensure that participants are questioned in the most ethical, sensitive way possible and that the research will address the needs and concerns of the target population.
Schools of nursing with doctoral programs were surveyed to determine current approaches and elici... more Schools of nursing with doctoral programs were surveyed to determine current approaches and elicit suggestions for institutional-and professional-level strategies to promote scientific integrity. Results from 38 schools are reported in a two-part series. Part 1 reports findings concerning formal and informal instruction about responsible science and the standards, norms, and guidelines being used to direct scientific inquiry. Information on misconduct and scientific integrity was typically included in required research methods, courses, and optional workshops, but the extent and scope of the instruction was variable, and a majority of respondents judged it to be marginal or inadequate. A high value was placed on informal student-mentor interaction. Where they existed, institutional guidelines were more specific than federal guidelines, but dealt primarily with procedures for handling alleged misconduct rather than for promoting responsible science. Findings suggest the need for a more proactive and consistent approach to promoting scientific integrity in doctoral programs. J
*University of Maryland. Baltimore, MD. In recent years, so many research methods texts have been... more *University of Maryland. Baltimore, MD. In recent years, so many research methods texts have been written by and for nurses that it is often difficult to match the strengths, weaknesses, and unique contributions of each to the needs of a particular course or audience. The following is a comparative review of four recently published or updated (1987) nursing research methods texts. Each is reviewed separately with attention to its organization, content, and strengths and weaknesses. A final comparative summary includes recommendations for use.
Studies have suggested that the quality of primary care delivered by nurse practitioners is equal... more Studies have suggested that the quality of primary care delivered by nurse practitioners is equal to that of physicians. However, these studies did not measure nurse practitioner practices that had the same degree of independence as the comparison physician practices, nor did previous studies provide direct comparison of outcomes for patients with nurse practitioner or physician providers. To compare outcomes for patients randomly assigned to nurse practitioners or physicians for primary care follow-up and ongoing care after an emergency department or urgent care visit. Randomized trial conducted between August 1995 and October 1997, with patient interviews at 6 months after initial appointment and health services utilization data recorded at 6 months and 1 year after initial appointment. Four community-based primary care clinics (17 physicians) and 1 primary care clinic (7 nurse practitioners) at an urban academic medical center. Of 3397 adults originally screened, 1316 patients (mean age, 45.9 years; 76.8% female; 90.3% Hispanic) who had no regular source of care and kept their initial primary care appointment were enrolled and randomized with either a nurse practitioner (n = 806) or physician (n = 510). Patient satisfaction after initial appointment (based on 15-item questionnaire); health status (Medical Outcomes Study Short-Form 36), satisfaction, and physiologic test results 6 months later; and service utilization (obtained from computer records) for 1 year after initial appointment, compared by type of provider. No significant differences were found in patients' health status (nurse practitioners vs physicians) at 6 months (P = .92). Physiologic test results for patients with diabetes (P = .82) or asthma (P = .77) were not different. For patients with hypertension, the diastolic value was statistically significantly lower for nurse practitioner patients (82 vs 85 mm Hg; P = .04). No significant differences were found in health services utilization after either 6 months or 1 year. There were no differences in satisfaction ratings following the initial appointment (P = .88 for overall satisfaction). Satisfaction ratings at 6 months differed for 1 of 4 dimensions measured (provider attributes), with physicians rated higher (4.2 vs 4.1 on a scale where 5 = excellent; P = .05). In an ambulatory care situation in which patients were randomly assigned to either nurse practitioners or physicians, and where nurse practitioners had the same authority, responsibilities, productivity and administrative requirements, and patient population as primary care physicians, patients' outcomes were comparable.
The practice-focused doctorate is an important alternative to research-focused doctorates in nurs... more The practice-focused doctorate is an important alternative to research-focused doctorates in nursing. The goal of this article is to provide the reader with an understanding of the nature and potential benefits ofthe practice doctorate. After discussing the background of this doctoral degree and the development of the degree by the American Association of Colleges of Nursing (AACN) Task Force on the Practice Doctorate in Nursing, the article will describe patterns in practice-focused doctoral education and issues considered by the task force in developing the position paper on the practice doctorate in nursing. A look ahead provides an update on current steps being taken by AACN and others toward implementing the task force's recommendations.
This correlational study of mothers and their 6-month-old infants examined the importance of soci... more This correlational study of mothers and their 6-month-old infants examined the importance of social support and stressors for parenting and infant development. Mothers (n = 79) were primarily White, married, and ranged in socioeconomic status from low to high. All data were collected in mothers' homes when infants were 6 months old. Diversity of sources of social support and diversity of father support were positively related to parenting (quality of stimulation in the home). Diversity of sources of social support buffered the negative relationship of maternal fatigue (stressor) to parenting. Parenting was related to social, hearing-speech, locomotor, and general development. Additionally, social support and aggravation (people in the mother's said network who make life difficult) were related to infant development, independent of parenting.
Uploads
Papers by Elizabeth Lenz