Health-related hardiness with different ethnic populations.

There has been successive strong support for the validity of the Health-Related Hardiness Scale (HRHS) in chronic illness and health-related research over time. The article summarizes health-related hardiness research completed with adults that has relevance for ethnic populations, describes progress with translation of the HRHS, and discusses recommendations for future work, such as international programs using hardiness interventions, continued progress on the translation of the HRHS, and improved retrieval and dissemination of results from HRHS research internationally. The HRHS has been used in more than 250 studies that focused on either health promotion or adaptation to health problems. The instrument has been translated into seven languages, with the most extensive work being reported with the Spanish version.

The Health-Related Hardiness Scale: Spanish language equivalence and translation.

The article describes the development and initial evaluation of a Spanish language version of the Health-Related Hardiness Scale (HRHS) and reports on the Spanish language HRHS (SHRHS). The second study back-translated the SHRHS, which demonstrated a strong correlation with the first translation obtained by Boytell, Velasco-Whetsell, and Coffin, further supporting the accuracy and reliability of the SHRHS.

Adaptation to suffering. Meaning and implications for nursing.

Nurses daily encounter persons who are suffering, but few have studied the suffering experience. Although the phenomena has been observed in the clinical setting, scientific inquiry has been limited. The meaning of suffering was explored through semistructured interviews with 20 subjects who had multiple sclerosis. The adaptation to suffering model provided the conceptual framework for this qualitative study. Stressors (e.g., problems associated with multiple sclerosis) and strategies perceived as helpful were identified. Subjects' responses about their suffering experiences followed an hierarchical progression from shock and denial through acceptance and understanding to finding meaning in their suffering. Rank ordering of responses illustrated the components of adaptation and how they changed with duration of illness. Findings provided support for the theoretical model and the importance of assisting clients to find meaning in their suffering experiences.

A special pathway for registered nurses with baccalaureate degrees in fields other than nursing.

In response to the need for nurses with advanced degrees, Lehman College of The City University of New York instituted a special pathway to graduate education for registered nurses with baccalaureate degrees in other disciplines. More commonly referred to as the non-BSN program, this alternative pathway has provided the opportunity for approximately 65 registered nurses to obtain the masters degree in nursing during the past six years. The purpose of this study is to evaluate the effectiveness of the bridge course in preparing registered nurses with baccalaureate degrees in fields other than nursing for graduate nursing education.

Improving self-efficacy in nursing research.

THE PURPOSE OF this project was to increase research activities of practicing nurses at one large healthcare facility. The members of the nursing research committee at this institution planned a participatory learning experience with the goal of increasing the nurses' self-efficacy toward conducting research. Increased self-efficacy was the impetus for stimulating increased research activities by the nurses. Measurable outcomes of this project included a significant increase in the participants' self-efficacy and implementation of a number of research projects. The Delphi technique proved useful in identifying nursing research priorities as well as in stimulating nurses to initiate and conduct clinical research. Project implementation and evaluation are described to help practicing nurses and their employers in pursuit of the same goal.

Contributions to nursing science: synthesis of findings from adaptation model research.

Researchers who had used the Roy Adaptation Model (RAM) to guide their individual investigations collaborated to enhance knowledge development about adaptation of adults to actual and potential health problems. The purpose of this article is to present the synthesis of findings across selected studies that used the RAM. From this synthesis, middle-range theories were identified that in turn provided the scientific rationale for development and testing of clinical interventions. Contributions to the advancement of nursing science include a method to strengthen the relationships between research, theory, and practice; and increased understanding of the process of adaptation in adults; support for the efficacy of the RAM for nursing practice; and the benefit of collaboration between nursing researchers using the same model to guide their work.

Adaptation to chronic illness: a program of research for testing nursing theory.

The adaptation to chronic illness framework, an elaboration of the Roy adaptation model for chronic illness, provided direction for a program of nursing research. The purposes of investigations within the program were (a) to identify predictors of adaptation to chronic illnesses and (b) to determine whether the relationships between the variables differed by diagnostic group. A total of 597 adults, representing various chronic illness groups, participated in longitudinal studies during a seven-year period. Health-related hardiness and engagement in health promotion activities consistently predicted both physiological and psychosocial adaptation in all chronic illness groups. In addition, the individual's perception of the degree of disability caused by the illness was related to psychosocial functioning. Comparison of adaptive responses between the groups revealed significant differences in physiological adaptation but no significant differences in psychosocial adaptation. Results clarify relationships posited using the theoretical framework and support the value of using nursing models to guide nursing research.

Responses to chronic illness: analysis of psychological and physiological adaptation.

The Adaptation Nursing Model provided the theoretical framework for the comparative analysis of psychological and physiologic adaptation of 211 adults representing three diagnostic groups (rheumatoid arthritis, hypertension, and multiple sclerosis). Data were collected through interviews and completion of the Mental Health Index, Health-Related Hardiness Scale, and Margin in Life. Psychological adaptation was found to be independent of diagnosis. Four predictor variables (health promotion activities, psychological distress, physiologic adaptation, and dependence on medications) significantly discriminated among the three groups and correctly classified 73.08% of the total sample. Presence of the hardiness characteristic was significantly related to psychological and physiologic adaptation, involvement in health promotion activities, and participation in patient education programs. It can be concluded that a diagnosis-specific view of psychological status is not tenable or clinically meaningful.

The Health-Related Hardiness Scale: development and psychometric analysis.

This article describes the development and psychometric evaluation of the Health-Related Hardiness Scale (HRHS). The HRHS was developed to measure the effects of hardiness in individuals with actual health problems. Items were generated that measured the presence, rather than absence, of the hardiness dimensions based on theoretical definitions of health-related control, commitment, and challenge. Two factors were isolated using principal components analysis (n = 389). These two factors, Challenge/Commitment and Control, accounted for 32.1% of variance. Factor loadings were strong, ranging from .41 to .68. Parsimony of the HRHS was achieved by reducing the original 51-item scale to 34 items. Alpha reliability coefficients were .91 for the total scale and .87 for each subscale. Test-retest, reliability coefficients ranged from .74 to .78. The final scale retained only two of the originally conceptualized three dimensions of the health-related hardiness construct.

The hardiness characteristic: a motivating factor in adaptation.

This article describes the conceptual development and measurement of hardiness as a motivating factor in adaptation. The health-related hardiness concept is further refined to include theoretical and operational indicators that can be used to investigate the effect of hardiness on adaptation to actual and potential health problems. Empirical support is presented for both the direct and indirect effects of hardiness. A valid and reliable instrument has been developed for health-related research with both well and ill populations. Implications for theory and research are discussed with emphasis on contributing to the knowledge base of nursing and developing interventions in practice.

Adaptation to chronic illness. Analysis of nursing research.

The review of reported nursing research on chronic illness has many implications for nursing practice. Results of these studies may be implemented in many of the interventions provided for chronically ill patients. There needs to be collaboration between the researcher and practitioner to share knowledge of interventions that promote adaptation to chronic illness, and to investigate new and innovative therapies. Another contribution to nursing practice is the psychosocial variables that affect adaptation of chronically ill patients. Depending on the health problem and practice setting, nurses need to identify which variable may increase the effectiveness of their interventions and how they can best promote adaptation. Particularly noticeable was the absence of studies on the prevention of chronic illness. Although there is documented evidence of the relationship between stress and illness, and predictions that future environments will be even more stressful, a needed area for nursing research is prevention of chronic health problems. Areas such as stress management, health promotion, relaxation training, and behavior modification are timely subjects for nurses to research for prevention of these problems. There are merits to studying a particular chronic health problem in depth and in studying the commonalities among several chronic illnesses. With knowledge of both the physical and psychosocial, nurses are in an ideal position to contribute to the knowledge base of human responses to chronic illnesses.

Top Ranked Schools of Nursing: the role of the dean.

The Top Ranked School of Nursing Study (TRSN) was a nationwide investigation for the purpose of delineating a composite of elements that constitute a top ranked school. The role of the dean was identified as the most frequent, if not the most significant, element of administration. The influence and scope of the administration in a TRSN were described as were the ways in which these endeavors are pursued and supported. The findings will be of benefit to anyone interested in promoting and improving nursing scholarship.

Human responses to chronic illness: physiologic and psychosocial adaptation.

To identify factors that promote adaptation, physiological and psychosocial responses to chronic illness were studied. The adaptation to chronic illness model (Pollock, 1984a) served as the theoretical framework for integrating the major variables of chronicity, stress, hardiness, and physiological and psychosocial adaptation. The sample (N = 60) consisted of three equal-sized groups of adults who had been diagnosed with diabetes mellitus, essential hypertension, or rheumatoid arthritis for at least one year. Data were collected from all subjects over a 9-month interval to determine their physiological and psychosocial adaptation and if they had the hardiness characteristic. The hypothesis, that presence of the hardiness characteristic was significantly correlated with physiological adaptation, was supported for the diabetic group but not for the hypertensive or rheumatoid arthritic groups. Physiological and psychosocial adaptation were found to be two independent domains in this study.