Meta-analysis of interpersonal discrimination and health-related behaviors.

OBJECTIVE: This article comprehensively examines the relationship between interpersonal discrimination (IPD) and health-related behavior (HB), expanding upon Pascoe and Richman's (2009) meta-analysis and research synthesis. METHOD: One hundred and twenty one articles providing zero-order correlations (or information allowing their calculation) between perceptions of IPD and a variety of HB outcomes were coded and analyzed using a random-effects meta-analysis model. One hundred and fifty six articles examining this relationship using multivariate models were also coded and summarized within a research synthesis. Subanalyses were performed for articles examining smoking, alcohol use/abuse, substance use/abuse, sexual risk, and diet/eating behaviors. Potential mediators of the IPD-HB relationship were also tallied when available. RESULTS: Compared to the original analysis, results suggest an overall attenuated but stable relationship between IPD and HBs. CONCLUSIONS: The documented meta-analytic associations between perceptions of IPD and a variety of HB provide supportive evidence for one pathway through which IPD heightens risk for negative physical health outcomes among marginalized groups. (PsycInfo Database Record (c) 2022 APA, all rights reserved).

Stress of Conscience Questionnaire (SCQ): exploring dimensionality and psychometric properties at a tertiary hospital in Australia.

BACKGROUND: This study explored the psychometric properties and dimensionality of the Stress of Conscience Questionnaire (SCQ) in a sample of health professionals from a tertiary-level Australian hospital. The SCQ, a measure of stress of conscience, is a recently developed nine-item instrument for assessing frequently encountered stressful situations in health care, and the degree to which they trouble the conscience of health professionals. This is relevant because stress of conscience has been associated with negative experiences such as job strain and/or burnout. The validity of SCQ has not been explored beyond Scandinavian contexts. METHODS: A cross-sectional study of 253 health professionals was undertaken in 2015. The analysis involved estimates of reliability, variability and dimensionality. Exploratory factor analysis (EFA) and confirmatory factor analysis (CFA) were used to explore dimensionality and theoretical model fit respectively. RESULTS: Cronbach's alpha of 0.84 showed internal consistency reliability. All individual items of the SCQ (N = 9) met the cut-off criteria for item-total correlations (> 0.3) indicating acceptable homogeneity. Adequate variability was confirmed for most of the items, with some items indicating floor or ceiling effects. EFA retained a single latent factor with adequate factor loadings for a unidimensional structure. When the two-factor model was compared to the one-factor model, the latter achieved better goodness of fit supporting a one-factor model for the SCQ. CONCLUSION: The SCQ, as a unidimensional measure of stress of conscience, achieved adequate reliability and variability in this study. Due to unidimensionality of the tool, summation of a total score can be a meaningful way forward to summarise and communicate results from future studies, enabling international comparisons. However, further exploration of the questionnaire in other cultures and clinical settings is recommended to explore the stability of the latent one-factor structure.

Validation of the Food-Linked Virtual Response task.

This research validates a computerized dietary selection task (Food-Linked Virtual Response or FLVR) for use in studies of food consumption. In two studies, FLVR task responses were compared with measures of health consciousness, mood, body mass index, personality, cognitive restraint toward food, and actual food selections from a buffet table. The FLVR task was associated with variables which typically predict healthy decision-making and was unrelated to mood or body mass index. Furthermore, the FLVR task predicted participants' unhealthy selections from the buffet, but not overall amount of food. The FLVR task is an inexpensive, valid, and easily administered option for assessing momentary dietary decisions.

Which coping strategies can predict beneficial feelings associated with prostate cancer?

AIMS AND OBJECTIVES: This study aimed to identify the extent to which different coping strategies can predict benefit finding in prostate cancer experiences. BACKGROUND: Although beginning evidence suggests that the capacity to find positives in adversity and find some benefit from cancer-associated experiences may be influenced by coping, little is known about which coping strategies can predict benefit finding in prostate cancer. DESIGN: Cross-sectional. METHOD: Data from men (n = 209) diagnosed with prostate cancer receiving hormone suppression therapy were analysed using descriptive statistics, bivariate correlations and backward stepwise multiple linear regression. Sociodemographic and clinical data, and self-report scales (17-item Benefit Finding Scale and Brief COPE) were used. RESULTS: Bivariate analyses showed significant correlations between 14 coping strategies and benefit finding in prostate cancer. Multiple linear regression modelling showed that the predictor variables 'acceptance', 'positive reframing' and 'turning to religion' explained 35% of the variance in dependant variable benefit finding when the other variables were controlled for. Of the three predictor variables, acceptance and positive reinterpretation were most strongly related to benefit finding. CONCLUSION: The self-reported coping strategies 'acceptance' and 'positive reframing' emerged as being most significantly predictive of benefit finding in this sample. 'Turning to religion' was also significant, but to a somewhat lesser extent in predicting benefit finding in the disruptive experience of prostate cancer. RELEVANCE TO CLINICAL PRACTICE: The use of positively oriented emotional coping strategies of 'acceptance', 'positive reframing' and 'turning to religion' are influential to benefit finding in prostate cancer. An understanding of the coping strategies that are predictive to benefit finding can assist clinicians to discern and target men who are more or less likely to find benefit, and to develop person-centred support strategies and interventions with an aim to optimising positive emotional states throughout the cancer journey.

An evaluation of a structured learning program as a component of the clinical practicum in undergraduate nurse education: A repeated measures analysis.

BACKGROUND: There is evidence that nursing students experience stress and anxiety and a reduction in self-efficacy when undertaking clinical placements. Previous reports have identified that a structured three-day program within the Bachelor of Nursing (BN) clinical practicum reduces the students self-report of anxiety and increases self-efficacy. However, it is unreported whether these improved outcomes are sustained for the duration of the clinical placement. OBJECTIVE: The aim of this study was to evaluate the duration of the effect of a three-day structured learning program within the clinical placement on final year Bachelor of Nursing student's report of anxiety and self-efficacy pre- and post-program participation in this intervention and following completion of the clinical practicum. DESIGN: A repeated measures design. SETTING: University-based Clinical School of Nursing, acute care clinical practicum. PARTICIPANTS: Final year Bachelor of Nursing students. METHODS: The intervention comprised the three-day program on starting the clinical practicum. A questionnaire included the anxiety subscale of The Hospital Anxiety & Depression Scale (The HAD) and the General Self-Efficacy Scale (GSES-12). The questionnaire was completed on day one (time one), upon completion of the three-day program (time two) and upon completion of placement on day 18 (time three). RESULTS: The questionnaire response rate varied over time. There was a statistically significant effect in reducing anxiety over time: F(1.73,74.46)=25.20, p<0.001 and increasing self-efficacy over time F(1.32,41.04)=7.72, p<0.004. CONCLUSIONS: This is the first report that we are aware of that has measured final year Bachelor of Nursing student's report of both anxiety and self-efficacy over repeated measures of time. Students continue to benefit from a structured learning program and the benefit of the intervention is sustained for the clinical placement duration.

Psychological Characteristics and Traits for Finding Benefit From Prostate Cancer: Correlates and Predictors.

BACKGROUND: Although beginning evidence suggests that the capacity to derive benefit from cancer-associated experiences may be influenced by some individual psychological characteristics and traits, little is known about predictors for finding benefit from prostate cancer. OBJECTIVE: The aim of this study was to explore the correlates and predictors for finding benefit from prostate cancer among a sample of men undergoing androgen deprivation. METHODS: Pearson correlation and multiple linear regression modeling were performed on data collected in an acute tertiary hospital outpatient setting (N = 209) between July 2011 and December 2013 to determine correlates and predictors for finding benefit from prostate cancer. RESULTS: Multiple linear regression modeling showed that while the 6 predictors of self-reported coping, depression, anxiety, distress, resilience, and hope explained 38% of the variance in finding benefit, coping provided the strongest and statistically significant predictive contribution. CONCLUSIONS: Self-reported coping was strongly predictive of finding benefit from prostate cancer, but questions remain about if subtypes of coping strategies can be more or less predictive of finding benefit. Self-reported levels of depression, anxiety, distress, resilience, and hope had a less predictive and nonsignificant role in finding benefit from prostate cancer and raise questions about their function in this subpopulation. IMPLICATIONS FOR PRACTICE: The findings suggest that coping strategies can maximize finding benefit from prostate cancer. Knowledge of influential coping strategies for finding benefit from prostate cancer can be immensely valuable to support men in rebuilding positive meaning amid a changed illness reality. Developing practice initiatives that foster positive meaning-making coping strategies seems valuable.

An exploration of graduate nurses' perceptions of their preparedness for practice after undertaking the final year of their bachelor of nursing degree in a university-based clinical school of nursing.

The nursing literature continues to give ongoing attention to university-educated nurses' preparedness for practice in the first year following graduation. This interpretive descriptive study explored the impact of a university-based clinical school of nursing experience on graduate nurses' perceptions of their preparedness for practice. Ten registered nurses who undertook their graduate year programme in the same hospital where they attended the university-based clinical school of nursing were interviewed. The interviews were audio-recorded, transcribed verbatim, and analysed to reveal themes and categories. Thematic data analysis revealed three themes: 'being situated in a clinical school within a hospital', 'the university away from the university' and 'engagement with practice'. The outcome of the experience of being situated in a university-based clinical school of nursing contributed to the participants' sense of being prepared for practice as a graduate nurse.

An evaluation of a structured learning programme as a component of the clinical practicum in final year bachelor of nursing programme: a pre-post-test analysis.

AIM AND OBJECTIVE: To evaluate the impact of a structured learning programme as a component of the clinical practicum in final year bachelor of nursing course on the student's report of their anxiety and self-efficacy pre-post programme participation. BACKGROUND: Student anxiety and low levels of self-efficacy are known to affect the quality of clinical learning. A three-day structured learning programme at the commencement of an acute care clinical placement was designed to reduce student anxiety and enhance self-efficacy. DESIGN: A pre-post test design. OUTCOME MEASURES: The hospital anxiety and depression scale (The HAD) and the general self-efficacy scale (GSES-12) were administered prior to the commencement of the structured learning programme (time one) and at the end of the programme (time two). RESULTS: One hundred and twenty final year students undertaking an acute care clinical placement participated in the programme in three cohorts and completed the questionnaires at time one and 118 at time two. FINDINGS: Students levels of anxiety >8 with The HAD pre-post programme 53 vs. 30% (p < 0·001). Levels of self-efficacy <40 with the GSES-12 pre-post programme were 7 vs. 4% (p < 0·001). CONCLUSIONS: Participation in the structured learning programme resulted in a statistically significant reduction in student anxiety and increase in self-efficacy across the three cohort groups. This effect can be achieved with the development of a relatively low cost/low technology structured learning programme that is part of an acute care clinical placement. RELEVANCE TO CLINICAL PRACTICE: Nurse educators should not assume that students are less anxious about their acute care clinical placements as the semester proceeds. There is a typical correlation between increased anxiety and decreased self-efficacy which is likely to impact on student learning in the clinical setting. Significant results can be achieved with a relatively low cost and a low technology enabling intervention.

The effects of perceived discrimination on ambulatory blood pressure and affective responses to interpersonal stress modeled over 24 hours.

OBJECTIVE: This research examined the impact of perceived discrimination on ambulatory blood pressure (ABP) and daily level affect during social interaction. DESIGN: For 24 hrs, adult Black and White participants wore an ABP monitor and completed palm pilot diary entries about their social interactions. MAIN OUTCOME MEASURES: Mean level and time-trend trajectories of blood pressure and heart rate were examined as well as mean level measures of positive and negative affect after stressful and nonstressful social interactions. RESULTS: Analyses showed that, after controlling for important covariates, perceived discrimination predicted the slopes of both wake and nocturnal ABP responses, with those who reported more discrimination having steeper daytime trajectories for systolic and diastolic blood pressure and less nighttime dipping in heart rate over time as compared to those who had reported relatively infrequent discrimination. High levels of perceived discrimination were also related to positive and negative affective responses after stressful encounters. CONCLUSIONS: These results suggest that, regardless of race, perceived discrimination is related to cardiovascular and affective responses that may increase vulnerability to pathogenic processes.

Perceived discrimination and health: a meta-analytic review.

Perceived discrimination has been studied with regard to its impact on several types of health effects. This meta-analysis provides a comprehensive account of the relationships between multiple forms of perceived discrimination and both mental and physical health outcomes. In addition, this meta-analysis examines potential mechanisms by which perceiving discrimination may affect health, including through psychological and physiological stress responses and health behaviors. Analysis of 134 samples suggests that when weighting each study's contribution by sample size, perceived discrimination has a significant negative effect on both mental and physical health. Perceived discrimination also produces significantly heightened stress responses and is related to participation in unhealthy and nonparticipation in healthy behaviors. These findings suggest potential pathways linking perceived discrimination to negative health outcomes.