Determinants of health-promoting lifestyle in ambulatory cancer patients.

The Health Promotion Model was tested as an explanatory framework for health-promoting lifestyle in a sample of 385 ambulatory cancer patients undergoing treatment in 13 clinical sites in the midwestern United States. The aim of this study was to determine the extent to which cognitive/perceptual and modifying variables identified in the Health Promotion Model explain the occurrence of health-promoting behaviors in adults with cancer. A secondary aim was to determine the potential of illness-specific cognitive/perceptual and modifying variables for further explaining the occurrence of health-promoting behaviors in adults with cancer. Multiple regression analyses revealed that 23.5% of the variance in health-promoting lifestyle was explained by the model cognitive/perceptual variables definition of health, perceived health status and perceived control of health and the modifying variables education, income, age and employment. When illness-specific variables were included in the analysis, initial reaction to the diagnosis of cancer was found to be a significant contributor to the regression. Study results support the importance of both general health-related and cancer-specific cognitive/perceptual factors in explaining the occurrence of health-enhancing behaviors among ambulatory cancer patients; these factors may therefore be suitable targets for interventions to encourage adoption of healthy lifestyles.

Determining AACN's research priorities for the 90s.

The American Association of Critical-Care Nurses completed a three-phased process of priority identification for critical care nursing research. In phase 1, a 78-item survey was generated following a comprehensive review of potential research topics. In phase 2, approximately 1000 critical care nurses rated each item on the survey for importance to critical care nursing. Based on these results, the AACN Research Committee formulated a clinical and a nonclinical (contextual) list of research topics. Each list contained 25 topics. In phase 3, topics were given final rankings at a 1-day Consensus Conference on Research Priorities. Both Likert-type and magnitude estimation scaling were used to determine priority ranking of items on each list. As a result, both clinical and contextual research priorities were established for AACN.

Health-promoting life styles of older adults: comparisons with young and middle-aged adults, correlates and patterns.

The purposes of the study presented were to compare the health-promoting behaviors of older adults with those of young and middle-aged adults, to examine the relationship of age and other sociodemographic characteristics to life style throughout adulthood, and to identify differing life-style patterns among older adults. Six dimensions of life style were measured by the Health-Promoting Lifestyle Profile in 452 adults aged 18 to 88. Older adults had higher scores in overall health-promoting life style and in the dimensions of health responsibility, nutrition, and stress management than both young and middle-aged adults. Sociodemographic variables accounted for only 13.4% of the variance in life style and for 5.2% to 18.6% in its six dimensions. Five major health-promoting life-style patterns were identified among older adults, depicting a heterogeneous group with varying needs for health promotion programming.

The nursing shortage in California: the public policy role of the California strategic Planning Committee For Nursing.

California is experiencing a nursing shortage resulting from multiple factors. The purpose of this article is to summarize nursing shortage issues in California and present the role of the California Strategic Planning Committee for Nursing (CSPCN) in addressing the issues from a public policy perspective. Reasons for the development of CSPCN as well as goals, objectives, and phases of work are presented. Selected findings from CSPCN's 1999 synthesis of data on the demand for and supply of nurses as well as resulting recommendations are summarized. The role of CSPCN in public policy initiatives is described.

Role of the clinical nurse specialist: an integrative review of the literature.

This review of the literature related to the role of the clinical nurse specialist was commissioned by the AACN in order to provide a comprehensive resource for advanced practice nurses. This review provides a historical overview of clinical nurse specialists and some of the gaps or barriers to practice that have been experienced. A summary of these gaps shows that many have repeated themselves over the years. Also provided are potential solutions to facilitate the progression of this role in the future.

Development and psychometric evaluation of the exercise benefits/barriers scale.

Initial psychometric evaluation of an instrument to measure perceived benefits of exercise and perceived barriers to exercise was based on the responses of 650 adults and included item analysis, factor analysis, and reliability measures. Factor analysis yielded nine factors, five benefits and four barriers, which explained 64.9% of the variance in the 43-item instrument. Second order factor analysis resulted in a two-factor solution, one a benefits factor and the other a barriers factor. The standardized Cronbach's alpha reliability coefficients were: .952 for the total scale, .953 for the benefits scale, and .886 for the barriers scale. Use of the instrument in research involving perceptions of the benefits of exercise and the barriers to exercise appears warranted.

The Health-Promoting Lifestyle Profile: development and psychometric characteristics.

This article describes the development and initial psychometric evaluation of an instrument to measure health-promoting life-style. Based on responses from 952 adults in midwestern communities, the Health-Promoting Lifestyle Profile was evaluated using item analysis, factor analysis, and reliability measures. Factor analysis isolated six dimensions: Self-Actualization, Health Responsibility, Exercise, Nutrition, Interpersonal Support, and Stress Management. These six factors accounted for 47.1% of the variance in the 48-item measure. Second-order factor analysis yielded a single factor, interpreted as Health-Promoting Lifestyle. The alpha reliability coefficient for the total scale is .922; alpha coefficients for the subscales range from .702 to .904. Further evaluation of the measure with different populations appears warranted. This instrument will enable researchers to investigate patterns and determinants of health-promoting life-style, as well as the effects of interventions to alter life-style.

A Spanish language version of the Health-Promoting Lifestyle Profile.

The development and initial psychometric evaluation of a Spanish language version of the Health-Promoting Lifestyle Profile (HPLP) is described. The 48-item instrument was translated into Spanish and found to be culturally relevant and reliable in a pilot study. The Spanish version was then administered to a diverse but predominantly Mexican-American group of 485 Hispanics residing in metropolitan and surrounding rural areas. In a principal components factor analysis, all but one item loaded significantly on six factors similar to those isolated previously during psychometric assessment of the English language version. Those six dimensions comprise the HPLP subscales of self-actualization, health responsibility, exercise, nutrition, interpersonal support, and stress management. The six factors explained 45.9% of the variance in the measure. Second-order factor analysis yielded a single factor, interpreted as health-promoting lifestyle. The alpha reliability coefficient for the total scale was .93 and 2-week test-retest reliability was .86; alpha coefficients for the subscales ranged from .70 to .87.

Predicting health-promoting lifestyles in the workplace.

A multivariate model proposed as explanatory and predictive of health-promoting lifestyles was evaluated in a sample of 589 employees enrolled in six employer-sponsored health-promotion programs. Perceived personal competence, definition of health, perceived health status, and perceived control of health accounted for 31% of the variance in health-promoting lifestyle patterns. Employees who reported more health-promoting lifestyles perceived themselves as competent in handling life situations, defined health as high-level wellness rather than merely the absence of illness, evaluated their health positively, and perceived their health as affected by significant others but not by chance or luck. Those who were female, older, and in the maintenance phase of the company fitness program also had healthier lifestyle patterns. These variables and the perception of health as internally controlled were predictive of health-promoting lifestyles three months later.