Determinants of physical activity in primary school students using the health belief model.

BACKGROUND: Thailand is a middle-income country in which two-thirds of children demonstrate an insufficient level of physical activity. Physical inactivity is a major risk factor for obesity and many other health-related consequences in children. Thus, it is important to understand how primary school children perceive things in their daily life as determinants of physical activity. The purpose of this study was to investigate the impact of cues, perceived benefits, and perceived barriers on the level of physical activity among primary school students. METHODS: A cross-sectional study was conducted in Phitsanulok Province, Thailand, in 2011. Multistage sampling selected a total of 123 primary school students. The Physical Activity Questionnaire for Older Children and the Cues, Perceived Benefits, and Barriers to Physical Activity Questionnaire were used to assess the student levels of physical activity, as well as the perceived benefits, barriers, and cues to action. The association between these factors and the level of physical activity was determined by correlation statistics and confirmed by robust regression. Multivariate analysis of variance compared health belief model determinants: perceived benefits, perceived barriers, and cues to action on physical activity between male and female students. Self-administered questionnaires were validated and tested in a pilot study. RESULTS: The level of activity among primary school children was significantly influenced by perceived barriers, such as fear of strangers when playing outdoors, bad weather, and too much homework. However, activity was not influenced by cues to action or perceived benefits. Perceived benefits, barriers, and cues to physical activity did not differ by gender. CONCLUSION: A safe environment and fewer barriers, such as amount of homework, could enhance physical activity in primary school children.

Global health diplomacy: an integrative review of the literature and implications for nursing.

The increasing interconnectedness of the world and the factors that affect health lay the foundation for the evolving practice of global health diplomacy. There has been limited discussion in the nursing literature about the concept of global health diplomacy or the role of nurses in such initiatives. A discussion of this concept is presented here by the members of a Task Force on Global Health Diplomacy of the American Academy of Nursing Expert Panel on Global Nursing and Health (AAN EPGNH). The purpose of this article is to present an integrative review of literature on the concept of global health diplomacy and to identify implications of this emerging field for nursing education, practice, and research. The steps proposed by Whittemore and Knafl (2005) were adapted and applied to the integrative review of theoretical and descriptive articles about the concept of global health diplomacy. This review included an analysis of the historical background, definition, and challenges of global health diplomacy and suggestions about the preparation of global health diplomats. The article concludes with a discussion of implications for nursing practice, education, and research. The Task Force endorses the definition of global health diplomacy proposed by Adams, Novotny, and Leslie (2008) but recommends that further dialogue and research is necessary to identify opportunities and educational requirements for nurses to contribute to the emerging field of global health diplomacy.

Research in conflict zones: implications for nurse researchers.

Using the example of a doctoral research study conducted in the Palestinian West Bank during December 2008 to January 2009, the implications for nurse researchers conducting research within armed conflict zones are described and analyzed. The philosophical implications for nurse researchers who are members of a displaced population being studied under conditions of violence are discussed. Instrumental and affective methodological implications are explored, with the identification of potential barriers and solutions for conducting research in this context.

Gender differences in coping and anxiety in patients after coronary artery bypass graft surgery in Taiwan.

BACKGROUND: Greater use of coping strategies and lower anxiety levels may be related to positive outcomes after coronary artery bypass graft surgery; however, the relationship between them, including by gender, has not been examined in Taiwan. METHODS: Cross-sectional survey research design and purposive sampling were used in this study, for which 50 men and 50 women were recruited from a medical center in northern Taiwan. RESULTS: After coronary artery bypass graft surgery, both male and female patients used more problem-focused coping strategies than emotion-focused coping strategies. In comparison with men, women tended to use more blaming of self and had slightly higher scores on both state and trait anxiety. CONCLUSION: Clinicians need to be aware that the use of appropriate coping strategies can reduce patient anxiety, a finding that needs to be considered when designing effective interventions for these patients.

Factors affecting quality of life in Taiwanese survivors of childhood cancer.

AIM: This paper is a report of a pilot study to examine the significance, direction, and magnitude of the relationship of risk factors, protective factors, and resilience to quality of life in survivors of childhood cancer, and to explore what these variables meant to participants in order to better understand the quantitative findings and to assess the validity of the instruments with this population. BACKGROUND: Cancer survivors contend with physical, psychosocial and emotional consequences of the disease and its treatment. There has been little research in Taiwan assessing these outcomes and, as survivor numbers increase, appropriate interventions need to be implemented. Haase's Adolescent Resilience Model was used as the theoretical framework. METHODS: A mixed methods design was used to assess the relationship between the variables for survivors of leukaemia and brain cancers. Ninety-eight participants completed quantitative tools and interviews, and the data were collected in 2006. FINDINGS: Survivors of leukaemia had better quality of life than those with brain tumours. This is attributed to more positive protective factors, fewer illness-related and individual risk factors and more positive resilience scores. Findings were congruent with similar studies from other countries. Qualitatively, participants believed that better quality of life meant less loss of self, a more integrated self, less chronic fear, and an ability to rebound and achieve personal control over one's life. CONCLUSION: Interventions and assessment of their efficacy are necessary to help survivors capitalize on their strengths, to decrease their individual risks and to promote resilience promote self-control.

Coping, anxiety and quality of life after coronary artery bypass graft surgery.

AIM: This paper is a report of a study to explore the relationship between ways of coping, anxiety level and quality of life for patients after coronary artery bypass grafting. BACKGROUND: Coronary artery bypass grafting requires appropriate coping strategies to achieve successful adaptation. In Taiwan, the incidence of this surgery is increasing, but research on adaptation following surgery is limited, with no research examining outcomes for women, who often have poorer adaptation outcomes than men. METHODS: An integrated research design, based on Lazarus and Folkman's transaction coping theory, was used. The research employed convenience sampling with four instruments: the Revised Ways of Coping Checklist, State-Trait Anxiety Inventory, Short Form 36-Health Survey, and a demographic questionnaire, sent to 50 men and 50 women who were recruited from a medical centre in Taiwan. Additionally, qualitative data from interviews with three men and three women, who had completed the instruments, were analysed. FINDINGS: Better quality of life was associated with lower anxiety level, greater use of problem-focused coping strategies and those who had more gender role responsibility. Women scored lower on the physical dimensions of quality of life, used more self-blaming coping strategies and experienced slightly higher levels of anxiety compared to men. The qualitative analysis supported the conclusions of the quantitative analysis. CONCLUSION: The results will help nurses design specific interventions intended to lower anxiety levels, promote the use of problem-focused strategies and identify patients' values, necessary to achieve optimal quality of life.

Achieving quality and fiscal outcomes in patient care: the clinical mentor care delivery model.

Contemporary patient care requires sophisticated clinical judgment and reasoning in all nurses. However, the level of development regarding these abilities varies within a staff. Traditional care models lack the structure and process to close the expertise gap creating potential patient safety risks. In an innovative model, senior, experienced nurses were relieved of direct patient care assignments to oversee nursing care delivery. Evaluation of the model showed significant impact on quality and fiscal outcomes.

Cross-cultural reliability of the Health Perception Index and the Health Control and Competence Index.

PURPOSE: To test the reliability of two Spanish instruments to measure (a) health perceptions, and (b) health control and competence. DESIGN: Triangulated methodology used with two different Latino populations. METHODS: Preliminary qualitative data were collected in Mexico. Based on themes from Mexico, data were collected from 44 men (Dominican Republic, n=24 ; Peru, n=20) with two instruments, the Health Competence and Control Index and the Health Perception Index. Alpha reliability estimates were obtained. FINDINGS: Results of the study confirmed reliability of the instruments in one of the Latino populations, consistent with understanding of the constructs found in the Mexican study. Reliability was low in the second Latino population. CONCLUSIONS: Although results from this study are useful, further translation and research procedures are needed to address the many differences among ethnically similar groups and to further strengthen internal and external validity of instruments designed to assess Latino men's perceptions of health and their control over health.

Acculturation and adherence: issues for health care providers working with clients of Mexican origin.

Providing care to clients who come from different countries is a challenge for the American health care providers as they traverse the issues of cultural health beliefs and practices and language and knowledge deficits. It is just as difficult for the clients as they face new cultural customs, language barriers, and unfamiliar health care systems and medical management plans. Both parties face acculturation and adherence challenges. This article intends to address these issues as they pertain to clients of Mexican origin and to identify key points to be considered by providers when working with this population.

Fatalism toward breast cancer among the women of Ghana.

Personal beliefs about health and illness influence many people's decisions about seeking care. This research represents a study of beliefs about breast cancer held by African women in Ghana. In-person interviews based on the revised Powe fatalism inventory (rPFI) were held with 109 women. Correlational analysis and factor analysis were performed. There were negative, nonsignificant associations between fatalism and age (r = -.095, p = 0.33), and educational level (r = -.078, p = .422). Fatalism scores were relatively low, 3.78 on an 11 -point scale. Comparisons are made to responses by African American women in other studies.

Making meaning: the creative component in qualitative research.

Findings in qualitative research are often wondrous and exciting, expounding new knowledge and perceptions previously unknown. Qualitative research requires the researcher to ponder and reflect on the data collected so as to find the meaning within. Helping researchers learn how to perform this step is not well discussed in the qualitative literature, yet this is one of the more crucial components of this type of research. In this article, the incubation, the meaning-making phase of qualitative research, is discussed in relation to the experiences of five researchers who have used traditional processes, models, metaphors, plays, pastiche, poetry, and quilt making and design to help them make meaning.