Limited association between perceived control and health-related quality of life in patients with heart failure.

BACKGROUND: Perceived control has been suggested as a modifiable factor associated with health-related quality of life (HRQOL). However, the relationship between perceived control and HRQOL has not been evaluated in patients with heart failure (HF). The purpose of this study was to determine whether perceived control independently predicts HRQOL in HF patients. METHODS: A total of 423 HF patients were included. Hierarchical linear regression was performed to determine the independent association of perceived control to HRQOL after controlling for covariates. RESULTS: Higher levels of perceived control were associated with better HRQOL in univariate analysis. However, this relationship was strongly attenuated after controlling for relevant demographic, clinical, and psychological factors; the variance in HRQOL explained by the addition of perceived control to this model was small (1.4%). CONCLUSIONS: We found only a weak relationship between perceived control and HRQOL when considered in the presence of demographic, clinical, and psychological factors.

Community readiness to prevent intimate partner violence in Bexar County, Texas.

The purpose of this article is to describe the Community Readiness Model implemented by the San Antonio Safe Family Coalition in Bexar County, Texas, a coordinated community response to prevent intimate partner violence. The project used a participatory action process to (a) determine the city's and county's stage of readiness to prevent intimate partner violence; (b) identify differences in the city and county by dividing the area into sectors for the assessment; (c) engage the community in determining the accuracy and usefulness of the results of the assessment; (d) develop targeted strategies to move the city and county to a higher stage of readiness for prevention of intimate partner violence; and (e) evaluate the results of the project.

The development of a Spanish language instrument to measure genetic knowledge of diabetes mellitus type 2.

PURPOSE: The purpose of this study was to develop a Spanish-language measure of genetic knowledge relevant to type 2 diabetes for use with members of the ethnically heterogeneous U.S. Latino community. DESIGN: Review of the literature and expert content analysis guided initial instrument development. The instrument was pretested in three cognitive interview waves with 36 Latinos representative of Mexican, Central and South American, and Cuban heritage. Interview analysis indicated potential sources of response error and guided an iterative process of instrument refinement. RESULTS: Difficulties associated with item interpretation, grammatical structure, and comprehension were identified. Analysis indicated that revisions improved item quality and enhanced cultural and linguistic appropriateness of the instrument. CONCLUSIONS: Field testing suggested initial validity of a Spanish-language instrument to measure genetic knowledge relative to type 2 diabetes. IMPLICATIONS: A Spanish-language measure of genetic knowledge can guide nursing interventions that support culturally appropriate integration of genetics into health care.

Translation of family health history questions on cardiovascular disease and type 2 diabetes with implications for Latina health and nursing practice.

Cardiovascular disease (CVD) and type 2 diabetes (T2D) are leading causes of morbidity and mortality among US Latinas. Family history is increasingly used to determine risk for these chronic, multifactorial diseases and to direct prevention interventions. This article provides a brief review on family history screening for CVD and T2D risk identification and presents the results of a pilot study to translate and evaluate the use of a family history tool for Spanish-speaking Latinas. Implications for the use of family history screening to guide CVD and T2D prevention interventions with Latinas are discussed.

Understanding of genetics among older adults.

PURPOSE: To describe and compare the attitudes, knowledge, and beliefs of older adults from three ethnic groups about genetic testing and genetic research, to determine how the understanding of genetics influences informed consent, and to identify factors that are important in older adults' decisions about participation in genetic research. METHODS: Three focus groups were initially conducted with 23 African American, Caucasian, and Hispanic adults in community-based settings. Discussions were audiotaped and transcribed verbatim. Content analysis of transcripts was performed and a second session was conducted with participants from each group to confirm the analyses. FINDINGS: Four common themes related to genetics and informed consent for genetic testing were identified: (a) defining genetics, (b) justifying genetic testing, (c) family involvement, and (d) dignified agreement. CONCLUSIONS: The findings from this study indicate that although these older adults had information about genetics, the information was not always accurate. In addition, deference among this cohort to providers' opinions showed the important role of healthcare professionals in providing genetic information and obtaining consent in ways that ensure it is voluntary and informed.