Advocating for continuing nursing education in a pediatric hospital: the Prince Scholar and Sabbatical Programs.

As nurses gain more experience, they often question the basis of nursing practice and want to find the most current and accepted methods of providing nursing care. Attending seminars, conferences, and continuing education programs is often difficult because of financial and staffing constraints. The authors describe the design and implementation of two funded programs--the Prince Scholars and Sabbatical Programs--that support continuing nursing education in a pediatric tertiary hospital.

Culture of Helicobacter pylori from a gastric string may be an alternative to endoscopic biopsy.

Helicobacter pylori was isolated from a swallowed string from 32 of 33 adult subjects (97%) with selective culture media. With this method, antibiotic susceptibility testing and molecular epidemiology studies of H. pylori can be carried out without the need for the collection of specimens by endoscopic biopsy.

Changing conceptions of measurement validity.

This article presents an historical overview of the changes that have occurred during the past 50 years in the theory and estimation of measurement validity. Current views about the meaning of validity, centering on a unified definition of construct validity, are described. Also given are examples of types of validity evidence appropriate for various kinds of inferences to be drawn from scores on measures; included are inferences about the content of a measure, relationships with other variables, differences between groups, the factor structure of a measure, and consequences of its use. Finally, some of the new ways of thinking about the role of reliability are highlighted.

Focus on quantitative methods. Determining cut-off scores.

The major methods for determining cut-off scores for certification and licensing examinations, and other criterion-referenced tests that result in pass/fail decisions, are described. Two major categories of methods are available: examination-centered and examinee-centered. Particular emphasis is given to the widely used Angoff (1971) method, and its common modifications. Some of the outstanding procedural and statistical issues are briefly discussed, including the need for more attention given to determining cut-off scores for measures used in clinical and research settings.

Meeting the challenge of immunizing the nation's children.

Achieving fully immunized status in the nation's pediatric population remains an elusive goal. A new campaign is underway to improve immunization coverage, and the nation's schools are logical sites to implement these projects.

Focus on psychometrics. Estimating construct validity.

The meaning of construct validity and techniques for its estimation are discussed. Of particular interest is the appropriate role of factor analysis (and related techniques) in construct validation efforts. A comprehensive view of construct validity is encouraged, as well as a cautious interpretation of the construct validity evidence available for many existing instruments.

Whose needs are we meeting? Results of a consumer satisfaction survey of persons with developmental disabilities in Colorado.

Results of one state's attempt to survey consumers and/or their families regarding their level of satisfaction with existing services, their needs for alternative or additional services, and their perceptions of overall quality of life are presented. Two hundred forty-seven individuals with developmental disabilities ranging in age from 0-72 years were interviewed. Information on consumer satisfaction and levels of integration, productivity and independence were measured for the following services: case management, residential, education, vocational, health, individual support, transportation, and caregiver support.

The mental health needs of elementary schoolchildren.

More than 500 elementary school personnel from a large Colorado school district provided perceptions of the unmet mental health needs of their students, the likely causes of the needs, and suggestions about solutions or programs to meet the needs. The district's definition of "mental health"--positive self-image, healthy interrelationships with peers and adults, and acquisition of school skills and competencies--guided the questionnaire design. Respondents perceived numerous unmet mental health needs, most involving about 15% of the student population. The most frequently perceived problems were poor decision-making and problem-solving skills, poor self-image, low self-confidence, inability to resolve interpersonal conflicts, depression/unhappiness, low motivation, and various conduct disorders. Further, most respondents believed children's unmet mental health needs are increasing, and the causes for most problems are family-and home-related, but most suggested solutions were school-based. Recommendations include increasing the involvement of school nurses in programs aimed at improving children's mental health.

An alternative to interference indexes in neuropsychological time-sharing research.

Interference indexes are used as criterion measures in a significant proportion of time-sharing paradigms in order to control for the initial discrepancy between left- and right-handed tapping rates. Problems associated with these indexes include low reliability, low statistical power, and especially correlations with baseline tapping rates. An analysis of covariance procedure using raw-score concurrent tapping rates as criterion measures, and baseline tapping rates as covariates, can effectively address these problems as demonstrated through a reanalysis of data.

Are validity and reliability "relevant" in qualitative evaluation research?

Interest in and use of qualitative methodological strategies in evaluating research have increased considerably in the last few years. Many of the recent evaluation frameworks or models are entirely or partly oriented toward use of qualitative methods. A number of methodological issues and concerns have been raised, including the appropriateness of validity and reliability estimation for the measurement strategies employed in qualitative evaluations becoming more common in health and other fields. In this article, the views of prominent qualitative methodologists on this topic are briefly summarized; a case is made for the relevance of validity and reliability estimation; definitions of validity and reliability for qualitative measurement are presented; and appropriate estimation techniques are suggested. It is hoped that discussions such as this will promote increased attention to validity and reliability concerns in qualitative evaluations and thus help improve the quality of those evaluations.

Evaluation of the School Nurse Achievement Program: a follow-up survey of school nurses.

The University of Colorado School Nurse Achievement Program (SNAP) is a national continuing education program for school nurses who want to increase and improve the services they provide to disabled students. In this article, the results of one of the evaluation studies conducted on SNAP--a six-month follow-up survey of graduates--are reported. Generally, the results indicated high perceived effectiveness of SNAP in terms of increasing school nurses' knowledge and skills related to working with disabled students. These findings should be of value to readers interested in SNAP, in particular, as well as to those interested in the role of the school nurse with disabled students.

Increasing efficiency and precision of data analysis: multivariate vs. univariate statistical techniques.

In deciding upon an appropriate analysis strategy during the planning phase of a research study, it is important to specify all of the independent and dependent variables to be included. From there, a technique should be chosen that will yield all of the information desired in the most efficient, precise, and powerful way. Frequently, the method of choice in nursing research will be a multivariate technique, since so many studies involve numerous variables whose effects on, or relationships with, other variables are of interest, as well as involving additional variables that should be taken into account for control or generalizability purposes. Not discussed in this paper, but worth mention, is the fact that all of these techniques involve various underlying assumptions (e.g., normality, homogeneity of variance, and independence in ANOVA) that must be met in order to use the techniques appropriately. If the assumptions are not met, the researcher might want to consider the use of nonparametric techniques--and there are both univariate and multivariate techniques available to choose from (Hollander & Wolfe, 1973; Siegel, 1956). The general advantages of a multivariate technique rather than separate univariate techniques would apply in terms of nonparametric statistics as well as parametric statistics. Increasing the accuracy, power, and efficiency of data analysis strategies should be a major concern to researchers.(ABSTRACT TRUNCATED AT 250 WORDS)

The use of power estimation in nursing research.

Power estimation is most useful when conducted a priori--when modifications in the intended design and/or analysis strategies can still be made. If not used a priori, however, it still can be helpful as a post hoc secondary analysis, both for consumers of research literature and for researchers themselves. In cases when the null hypothesis is not rejected at the predetermined alpha level, it may be very informative to conduct a power analysis. The researcher might discover that there was very little power to reject the null hypothesis if it were indeed false. Knowing that this is a reasonable possible explanation for the "no significant difference" conclusion could preclude abandonment of the project or premature publication of discouraging results. It also could help in the design of future, similar studies.

The views of school principals and teachers on the role of the school nurse with handicapped students.

As part of recent program evaluation activities for the University of Colorado School Nurse Achievement Program, a questionnaire was distributed to a sample of school principals and teachers to obtain their views on the role of the school nurse with handicapped students. Generally, the respondents perceived this aspect of the school nurse's role as encompassing a variety of valuable activities; they tended to feel that certain activities (eg, writing the health component of the IEPs) should be carried out by school nurses more than they actually are; and they reported a myriad of unsolved problems and needs of handicapped students, many that could be dealt with by school nursing services if resources were available. Although the data were obtained from only a small and select group of principals and teachers, they help reveal how other school personnel view this increasingly important component of the school nurse's role and may provide some direction for future continuing education programs for school nurses as well as information-dissemination efforts for other school personnel.

Part II. Evaluation component. School nurse achievement program.

The School Nurse Achievement Program is a national continuing education course for school nurses to increase and improve their services for disabled children. It is currently being developed under the auspices of the Department of Education, Office of Special Education in conjunction with the University of Colorado Health Sciences Center, School of Nursing. A description of a national needs survey of school nurses and resulting program goals, curriculum development, and course administration in twelve states appeared in last month's Journal. Formative and summative evaluation studies to aid in curriculum development and to examine changes in the school nurses' activities are described in Part II of this article.