Nursing image as reflected in sex role preferences.

This study examined the relationships between sex role preference and image of nursing among 43 female freshman students of nursing. Student nurses who envisioned themselves as fulfilling a more traditional female role saw nursing differently from those who envisioned themselves as more liberal. The Dreyer Sex Role Preference Profile delineated two groups. A two-tailed test of proportions was used to analyze the data with significance determined at the .05 level. The groups differed significantly on nine of the 19 attributes of nursing, and differed in the importance to self on eight of the 19 items. Interestingly, however, none saw themselves as strongly traditional.

Pain location: validity and reliability of body outline markings by 4 to 7-year-old children who are hospitalized.

This descriptive study addressed the validity and reliability of a body outline for pain location assessment in 4 to 7-year-old children (n = 46) who are hospitalized. The findings support the use of a body outline for pain location in this age group.

Alpha-fetoprotein testing: opinions of parents of children with spina bifida.

One hundred parents of children with spina bifida were surveyed on the issue of alpha-fetoprotein testing and related parent choices, including abortion. A majority of parents responded that, if testing had been available, they would have availed themselves of it. A large majority would use the testing if they became pregnant again. Parents expressed powerful feelings in relation to whether they viewed abortion as an option.

Nurses' experience caring for anencephalic infants who are potential organ donors.

A descriptive study explored the experience, attitudes, and concerns of 75 nurses who gave direct care to anencephalic infants in a program of potential organ donors. One ethical issue for a majority of nurses was concern about whether the program allowed dignity for the life of the infant. Other concerns were whether the infants felt pain, and the infants' physiological responses.

Children with cancer: the pain experience away from the health care setting.

Relatively little is known about the nature of pain in children with cancer away from the health care setting. Accordingly, this pilot study focused on the pain experience in this group. A purposive sample of 20 children, ages 4 through 16 years, with any type of cancer, was obtained. A semistructured interview including the Poker Chip Tool and Preschool Body Outline (ages 4 to 7 years) or the Adolescent Pediatric Pain Tool (age 8 to 16 years) was administered to all the children once during a clinic appointment. Supplemental parental input was sought during the interview. Two of the children also were contacted every 2 weeks for 3 months. Content analysis indicated that the children experienced pain in a number of locations, most frequently the "stomach", joints, legs, and back. Pain intensity varied widely. The source of pain identified most often was chemotherapy. The most common pain management strategies mentioned were rest/sleep, analgesics, rubbing, distraction, social support, and heat. Clearly, children with cancer away from the health care setting do have pain. Assessment of pain in children with cancer regardless of setting is a necessity.

Pain responses of hospitalized infants and children to venipuncture and intravenous cannulation.

The purpose of this study was to describe the experience of pain in infants and children in response to venipuncture and intravenous cannulation. Data on physiological, behavioral, and subjective responses were collected from 90 infants and children, in subgroups of 1 to 12 months, 1 to 3 years, 4 to 6 years, and 7 to 12 years. Changes in behavior were significant in all four groups, although the toddler group was the only group that showed a significant physiological change. The subjective measures showed that the children were able to identify their pain sites and intensity.

Parenting competence, social support, and self-esteem in teen mothers case managed by public health nurses.

The purpose of this descriptive study was to determine whether self-esteem, parenting competence, and social support for teenage mothers changed over the first 18 months of parenting when case managed by a public health nurse (PHN). A sample of 56 first-time teen mothers from a health department parenting project agreed to participate in the study. PHN case managers collected data close to the birth of the infants and at 6, 12, and 18 months. Demographic findings of teen mothers showed that the majority were below expected grade level, over half lived with parents, and over half were children of teen mothers. Outcome findings related to the infants revealed no delays in development as measured on the Denver Development Screening Test, adequate follow-up for identified health problems, and a high percentage of the children with up-to-date with immunizations. The research question findings showed a statistically significant drop in self esteem for the teens between birth and 6 months, and in social support between 6 and 18 months. No other findings were significant, but some trends appeared when the sample was divided by ethnicity, suggesting a need for closer follow-up for certain groups. Implications for public health nursing and nursing education are included.

Barriers to well child care for homeless children under age 13.

Barriers perceived by homeless families to preventive health care for their children under age 13 have been underdocumented. This descriptive study was designed to identify perceived barriers to care and to determine if there was a relationship between perceived barriers and duration of the family's homelessness. Using an investigator-modified version of Melnyk's Barrier Scale and a demographic measure, a convenience sample of homeless families (n = 53) from three transitional shelters was surveyed via questionnaire. Four barriers were cited most frequently by the respondents as greatly affecting their children's care. These barriers involved provider-selection difficulties, waiting for well child appointments, waiting during well child appointments, and the high cost of transportation and/or parking. No relationship was found between duration of homelessness and perceived barriers. These findings confirm the reality of potential barriers to care suggested by earlier studies. Innovative forms of health care delivery that may reduce or eliminate these barriers include the use of shelter-site clinics, mobile units, and the use of a nurse liaison between family shelters and hospital-based clinics.

Pain responses of hospitalized neonates to venipuncture.

Neonates' response to pain after venipuncture was studied by observing, recording, and measuring physiological and behavioral responses. The measurement used was the National Individualized Developmental Care Assessment Program (NIDCAP). Data were recorded from a convenience sample of 30 neonates required to have a venipuncture as part of their routine treatment for 20 minutes before and 20 minutes following the procedure by a person certified as reliable in administering the NIDCAP. Both behavioral and physiologic changes were observed. Most of the infants (93 percent) moved abruptly into a hyperalert or crying state in response to venipuncture, skipping several states without transition and showing disorganized behavior. The heart rate, oxygen saturation, and skin color showed significant changes when data recorded just prior to venipuncture were compared to data recorded immediately following the procedure. Nursing implications, including the unit environmental elements, are discussed.

Children's and adolescents' pain language in Spanish: translation of a measure.

The decision to include a Spanish-speaking sample in a study of pain in children with leukemia necessitated translation of the data collection tools. Therefore, the Adolescent Pediatric Pain Tool (APPT) was translated by using the standard translation, back-translation procedure. The Spanish word list consists of 66 descriptors in the sensory, affective, evaluative, and temporal domains. After initial pilot work with the translated APPT with well children in the Dominican Republic, additional pilot work was conducted in California. Two of these studies were completed with well children and adolescents, and one study that was part of a clinical research project focused on pain in children and adolescents with leukemia. Although content; construct, concurrent validity; and test-retest reliability were tested, further studies are necessary with larger populations of children and adolescents. This series of pilot studies supports the usefulness of the Spanish translation of the APPT word list, particularly for clinical or research situations in which multiple versions of a tool would counteract ease of use.