U.S. Nurse Practitioner Beliefs About Routine HIV Screening: Predicting Behaviors.

HIV is a preventable infection. Effective HIV prevention interventions, which include routine HIV screening, have reduced HIV transmission. As health care providers, nurse practitioners (NPs) have a role in screening for HIV. In this study, we explored NP attitudinal, social normative (expectation and priority), and behavioral control (perceived barriers and facilitators) beliefs that predicted their self-reported HIV screening behaviors. The Theory of Planned Behavior guided the study. Data from 141 NPs were collected through a cross-sectional, paper and pencil survey. Findings revealed that the belief that "my office staff supports routine HIV screening with my patients" predicted HIV screening, whereas the belief that "consent from a parent/guardian should be obtained before screening for HIV in a person younger than 18 years" predicted less HIV screening. Nurse practitioners identified social normative expectations to be most influential in predicting their routine HIV screening behaviors.

HIV screening intentions, behaviors, and practices among nurse practitioners.

BACKGROUND AND PURPOSE: HIV/AIDS is a significant public health issue for individuals living in the United States. Federal agencies and key stakeholders recommend routine HIV/AIDS screening among individuals aged 13-64 of age, yet few studies focus on the nurse practitioner's (NP) perspective. The purpose of this study was to examine routine HIV screening intentions, behaviors, and practices using a national sample of NPs. METHODS: Cross-sectional study utilizing a random sample of 600 NPs from the American Association of Nurse Practitioners™ organization. A total of 141 NPs returned complete responses to the paper and pencil questionnaire and were included in the study. CONCLUSIONS: One-quarter (25%, n = 35) of the NPs reported routine HIV screening behavior. Half (48%, n = 67) reported intentions to increase routine HIV screening in the next year. HIV screening practices were reported as risk-based and patient-initiated among this sample of NPs. IMPLICATIONS FOR PRACTICE: In the U.S. healthcare system, NPs serve as leaders in primary and secondary prevention, screening and identifying individuals who are unaware of their HIV infection. Greater coordinated efforts and new system approaches are needed to help NPs adapt HIV screening recommendations and practice guidelines.

Barriers to Asthma Management as Identified by School Nurses.

Asthma rates are increasing in children. School nurses have opportunities to care for children with asthma but need to overcome barriers impacting their ability to manage asthma in the school setting. This study (a) assessed barriers present in the school setting, (b) determined the impact of barriers on performance of asthma management behaviors, and (c) determined the impact of barriers on importance ratings of asthma management behaviors, asthma self-efficacy, and asthma attitudes (N = 537). Results revealed 72% of the nurses reported at least one barrier. As numbers of barriers increased, performance of asthma management behaviors decreased. Significant relationships were found between specific asthma management behaviors and specific barriers. No significant relationships were found between barriers and asthma self-efficacy, asthma attitude, or importance ratings of asthma management behaviors. Removing barriers may allow the nurse to perform at greatest effectiveness, enhancing the positive outcomes that result from appropriate asthma management.

Using the Health Belief Model to Understand School Nurse Asthma Management.

Ten million children in the United States have asthma. Since children are in school about 6 hr a day, school nurses are positioned to intervene and influence asthma outcomes. A descriptive correlational study was designed to investigate performance of school nurses' asthma management behaviors in relationship to asthma knowledge, asthma attitude, asthma self-efficacy, and rating of importance of asthma management behaviors. Results indicated that asthma attitude, asthma self-efficacy, and rating of importance of asthma management behaviors were associated with performance of asthma management behaviors. The higher the rating of importance of asthma management behaviors, the more likely school nurses were to perform the behaviors (p < .05). Higher levels of asthma self-efficacy were associated with performance of asthma management behaviors, indicating the importance of strengthening school nurses' asthma self-efficacy in asthma management. By understanding factors influencing performance of asthma management behaviors by school nurses, interventions can be implemented to increase asthma management behaviors, leading to improved outcomes for students with asthma.

Functional health status among rural and urban older adults in Taiwan: the effect of personal control and social control.

AIM: To assess the relationship between perceived social control/personal control and functional health status among older adults in rural and urban Taiwan. BACKGROUND: The ageing of the population is poised to emerge as a preeminent worldwide phenomenon. It is assumed that even though older adults experience many decades of autonomy and independence, the potential for illness or bodily decline will induce a serious reduction in the level of perceived control in older adult populations. METHOD: This is a descriptive correlational study using a secondary data base, Social Environment and Biomarkers of Aging Study. Social Environment and Biomarkers of Aging Study is a nationally representative study of health outcomes in the Taiwanese population. RESULTS: Both perceived levels of social control and personal control had a statistically significant relationship with functional health status. Functional health status was significantly higher for urban older adults than their rural counterparts. CONCLUSIONS: Personal control and social control were both found to be predictors of functional health status. Major findings are supported by previous studies. RELEVANCE TO CLINICAL PRACTICE: Nurses should create programs and plan activities to assist older adults to enhance their perceptions of social control or personal control in order to improve the health status of older adults and minimize associated health care costs.

Domestic violence: what do nurse practitioners think?

PURPOSE: To examine factors that influence nurse practitioners' (NPs) ability to incorporate universal domestic violence screening practices (e.g., asking, identifying, referring and reporting) into their practices. DATA SOURCES: A stratified random survey of certified NPs in New York state was conducted in 1999. There were 118 family, women's health, OB/GYN, and adult NPs in the survey. Chi-square and ANOVA were used to analyze the data. CONCLUSIONS: There were significant differences in the domestic violence screening practices among women's health, OB/GYN, adult, and family NPs. Women's health and OB/GYN NPs were more likely to ask screening questions and identify victims of domestic violence than their other NP counterparts. IMPLICATIONS FOR PRACTICE: There is a need to identify strategies that encourage all NPs to incorporate universal domestic violence screening behaviors into their practices.

Health risk behaviors among adolescents attending rural, suburban, and urban schools: a comparative study.

This study describes differences in health risk behaviors among 2,017 adolescents attending rural, suburban, and urban school districts in upstate New York. Differences in risk behaviors regarding use of tobacco, alcohol, and illegal substances; sexual activity; and carrying weapons were analyzed. A consistent pattern emerged from the analysis of the data, with rural students at most risk. The findings reinforce the need to focus on the relationship between residence and health risk behaviors, so that intervention programs specific to the needs of rural, suburban, and urban adolescents can be developed.